Future of the NHS

Debate between Ian Lavery and Margaret Greenwood

Tuesday 24th October 2023 Westminster Hall

[Margaret Greenwood]

First, in challenging the hon. Gentleman’s opening remark, I refer him to the point earlier in my speech when I spoke about the Government’s current spending commitment. I also ask him to listen to the rest of my speech, as I will come on to the economy.

It is not the fundamental model of the NHS that is broken; it is the fact that it has been underfunded that has led to us to where we are now. As is clear for all to see, we are at a point of crisis. Waiting lists for routine treatments recently hit a record high of 7.75 million, with more than 9,000 people waiting for more than 18 months. It is truly devastating that last year, more than 120,000 people in England died while on NHS waiting lists for hospital treatment. That is double the number who died in 2017-18. There are over 125,000 staffing vacancies, including more than 43,000 vacancies in nursing and more than 10,000 medical staff vacancies. Many of the staff who are in post are burned out, with not enough colleagues to work alongside them.

The “Fit for the Future” report published by the Royal College of General Practitioners last autumn revealed that the situation in primary care is dire. It found that 42% of GPs in England are either likely or very likely to leave the profession over the next five years. As of August 2023, there were 27,246 fully qualified full-time equivalent GPs in England, 3.1% less than in 2019 and 7.4% less than in 2015. That downward trend simply cannot go on.

Last week, the Care Quality Commission rated almost two thirds of maternity services in England either “inadequate” or “requires improvement” for the safety of care and said:

“The overarching picture is one of a service and staff under huge pressure.”

Cancer Research UK has pointed out that cancer waiting time targets continue to be missed in England, and recent months have seen some of the worst performances on record.

[Ian Lavery (Wansbeck) (Lab)]

With regard to cancer waiting lists, the Rutherford Cancer Centre, a specialist proton beam centre in my constituency, has been lying idle for almost two years, since Rutherford centres across the country went into liquidation. Does my hon. Friend agree that the NHS should take control of the Rutherford centres, and that that in itself would help to reduce waiting lists for cancer treatment?

[Margaret Greenwood]

I am not familiar with the centre that my hon. Friend speaks of, but I do believe that the NHS should control the assets and make sure that the service is there for people when they need it. I would like to hear more about the centre from him at another time.

By deliberately underfunding the NHS, the Conservatives have undermined it as a comprehensive, universal public service. Their desire to privatise the NHS has been evident for a very long time. It is a shocking agenda to essentially destroy our most cherished institution.

This determination to dismantle the NHS, which has been proven to be a world leader in terms of effectiveness, equity and efficiency, is not only immensely damaging to patients and the staff who work in the service, but damaging to the economy. Last year, an estimated 185.6 million working days were lost because of sickness or injury—a record high. Similarly, the Office for Budget Responsibility reported in July that the 15 to 64-year-old economic inactivity rate

“has increased in the UK by 0.5 percentage points”

since the covid pandemic.

Merseyside Fire and Rescue Service

Debate between Ian Lavery and Margaret Greenwood

Tuesday 26th January 2016 Westminster Hall

[Margaret Greenwood]

I thank my hon. Friend for making that really important point, which I will return to. She is absolutely right. A cut of 41% in any workforce would add stress, but in an environment such as firefighting the resulting stress would be an unacceptable one to place upon firefighters.

With these points in mind, I will set out the scale of the cuts that the service has suffered since 2011 and their impact. I will then turn to the further cuts that were announced in December last year by the Government, and their implications, and I will ask the Minister to consider what all this means for Merseyside fire and rescue service.

Looking at the cuts from 2011-12 to 2015-16, we see that Merseyside fire and rescue service had a total cut from central Government of 32%, which is a huge and damaging cut. Like other metropolitan authorities, Merseyside relies to a much greater degree on its central Government grant than do county combined authorities such as Buckinghamshire. In 2010-11, Merseyside received 63% of its funding from its Government grant. Clearly, when the Government grant is cut, Merseyside receives a disproportionate cut in overall funding.

From 2011-12 to 2015-16, the cuts resulted in Merseyside fire and rescue service having to make £26 million worth of savings. What that meant on the ground is that we have lost nearly 300 firefighters, which is a cut of 31%; we have lost nearly 150 support staff, fire prevention and protection staff, and management staff, which is a cut of 35%; and we have had a 21% cut in our control staff, whose numbers are down from 42 to 33.

Cuts from central Government have also led to cuts in the number of fire engines on Merseyside, and in this respect the numbers are staggering. Back in 2011, we had 42 fire engines; we now have just 28, which is a cut of 33%. That cut has also led to a cut in the number of fire stations. On Merseyside, we are losing four fire stations as we go down from 26 to 22, which is a cut of 15%.

In my constituency of Wirral West, we currently have two fire stations—one at Upton and the other at West Kirby. Both are due to close and my constituents will no longer have their own fire stations but instead will be reliant on fire engines arriving from a neighbouring constituency. That will lead to longer response times, particularly into West Kirby and Hoylake, which are important urban centres. I am extremely concerned about this situation. Merseyside’s chief fire officer, Dan Stephens, has described the closure of those two stations, to be replaced by one station at Saughall Massie, as “the least worst option”. Clearly, that is not a ringing endorsement. The situation is far from ideal.

The loss of firefighters, fire engines and fire stations has led to an increase in response times across Merseyside over the five-year period from 2011 to 2016. Most notably, the response times of the second fire engine to attend incidents have increased by up to three minutes. That is worrying, because the crew of the first fire engine to arrive at an incident have to assess whether to carry out a search for people or to tackle the blaze. The arrival of the second fire engine is crucial, because with two crews the service can both tackle the blaze and carry out search and rescue. The Minister knows that minutes cost lives in a fire and that any increase in response times increases the risk of loss of life.

[Ian Lavery (Wansbeck) (Lab)]

The number of fire deaths is often misrepresented, but the facts and figures with regard to Merseyside are that in 2011-12 there were five fire deaths; in the year 2014-15, there was a doubling of that number to 10; and the indications are that the number could even treble in the next year or so. Does my hon. Friend share my deep concerns about this situation?

[Margaret Greenwood]

I thank my hon. Friend for that really important point, because of course someone might say that five is a small number—of course, every life matters—but when we see a trend such as that one it is significant. We also have to consider the wider trauma that is suffered, because of course one person who dies in a fire may have many relatives and children, and so the trauma is not just restricted to that one person. This is a very serious situation.

In addition to the increased risks to the public that we are seeing, we must also bear in mind what these cuts mean to the fire crews themselves. When a firefighter is committed to an incident wearing breathing apparatus, the length of time that they spend dealing with that incident and the activity that they undertake will have a bearing on the length of time they will need to recover away from the area of danger before they can be recommitted. Each time a firefighter wears breathing apparatus at an incident, the potential risk that they face increases, because of the amount of time they are exposed to hazards and the physical efforts of repeated use of breathing apparatus.

The speed at which other fire appliances arrive to provide additional crew in breathing apparatus is crucial to reducing the risk to firefighters and to providing an effective firefighting response. Dan Stephens, the chief fire officer of Merseyside fire and rescue service, has given his view of the impacts of the cuts so far. He says, “The reduction of appliance numbers resulting from the cuts to the Merseyside fire and rescue authority budget have increased response times for the first and subsequent appliances to life-risk incidents. The reduction in appliances has also impacted on the number of crews that can be released for risk-critical training and exercises on any given shift. The organisational capacity to undertake community safety interventions such as home fire safety checks has also been significantly reduced.” It is important that we take notice of the chief fire officer’s analysis of the situation that the cuts have given rise to.