Oral Answers to Questions
Jamie Stone Excerpts(5 years, 2 months ago)
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Matt Hancock
I am very happy to look into that idea, while making sure, of course, that we also have the availability of staff, which is critical. We have just had two questions from Stoke-on-Trent. Let me say how much I appreciate the work of everybody at the Royal Stoke, who I know are doing so much. There are difficult circumstances there because of the second wave, which is quite significant in Stoke. I thank everybody at the Royal Stoke for all the work they are doing.
Jamie Stone (Caithness, Sutherland and Easter Ross) (LD) [V]
Matt Hancock
Yes, I would be happy to do that. We are proposing roving teams who can get out into rural communities across England. I know that there are ongoing discussions between those in the NHS in England and in Scotland who are responsible for the deployment of the vaccine. However, it is a critical principle that it should be deployed according to clinical need, not according to where people live across the United Kingdom.
Covid-19 Update
Jamie Stone Excerpts(5 years, 3 months ago)
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Matt Hancock
Yes. I know Stoke-on-Trent’s hospital and I think that the people who work there do a brilliant job. They are a great team that works so closely and well for the people of Stoke-on-Trent and, indeed, Newcastle-under-Lyme. Stoke has got an outbreak under control a couple of times in this virus. In fact, it had a second peak in the summer, which it got under control, so this is really the third peak in Stoke. Stoke-on-Trent City Council worked closely with us on the early roll-out of mass testing in a pilot even before Liverpool. I thank everybody at the Royal Stoke for all their hard work and I urge everyone in Stoke and across the country to respect social distancing and follow the rules, because that is the best way to support our NHS.
Jamie Stone (Caithness, Sutherland and Easter Ross) (LD) [V]
Clearly, I represent a vast and extremely remote constituency in which there are groups of elderly people who are potentially vulnerable to covid-19. When the Secretary of State talks to the Scottish Government, will he make sure that such people are reached out to with the vaccine? It would be too bad if one part of Scotland were to lose out against another as it was rolled out.
Matt Hancock
Yes. Our principle is to roll out the vaccine across the whole of the UK according to clinical need, and that is what we should do.
Oral Answers to Questions
Jamie Stone Excerpts(5 years, 4 months ago)
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Matt Hancock
The covid-19 app has now been successfully downloaded by around 15 million people, including my hon. Friend’s father. Every extra person who downloads it helps to keep themselves safe and keep others safe. I urge everybody in this House to download it—I hope you have, Mr Speaker. It is one of the tools in the armoury, and everybody can play their part in keeping this virus under control by downloading the app.
Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)
Matt Hancock
Yes, absolutely. The testing facilities are one example of that. Testing facilities across the UK work very closely with the Scottish NHS, to ensure that people can get a test as close to them as possible. I think we have reduced the problem of people being sent to Inverness, but we continue to work to increase the capacity in Inverness and right across the country.
Health and Social Care Workers: Recognition and Reward
Jamie Stone Excerpts(5 years, 7 months ago)
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Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)
May I say how delighted I am to be back in this place? For the last period of time, I have been working, rather like Harry Potter, under the stairs of my home in the highlands. Whether that has affected me as an hon. Member is up to others, from all parts of the Chamber, to decide.
By definition, health is devolved in Scotland, so my remarks will be pertinent to Scotland, but they may have a wider application to England. Of course, my colleague the hon. Member for Twickenham (Munira Wilson) will be enlarging on our party’s position in the rest of the UK. As my colleagues on the Back Benches have said, the notion of an award—a gong, a medal or a ribbon with something on the end of it—without a whole-scale review of pay and conditions is just not on.
I want to make several comments about conditions, and to quote two people. On occasion during the pandemic, from under my staircase in my home, I have telephoned Dr Alison Brooks of the Princes Street practice in Thurso, in the very far north of Scotland, and she gave me sage advice at all times. Today she said this to me about the nurses with whom she works. She knows of a nurse—a friend of hers in Glasgow—who has worked 10 night shifts on the trot just to cover the job, because colleagues were sick. Dr Brooks said to me, “Remember, NHS staff don’t just walk away; they go above and beyond. They feel a moral obligation.”
Dr Brooks encouraged me to think about the toll that it takes on NHS staff when they know that they have been in a risk situation, albeit with the best of equipment, but they go back to their families, loved ones and young ones with the niggling fear at the back of their minds that they might bring the virus back with them. When we reflect on pay and conditions, we must think about how we cover sickness absence.
My second example is from a nurse from Wick in Caithness who worked in the high-dependency covid ward in Raigmore for the duration of the pandemic. This is what she wrote to me:
“My suggestion would be that there could be skills based tiers within bandings. For example: one for those who have little clinical responsibility and/or skills; one for those who have advanced clinical skills and responsibility.”
She says that the doctors cover the advanced stuff, but very often the doctor will have to cover the entire hospital, so they have to make clinical decisions. Perhaps remuneration for such people should be fine-tuned within the banding.
I conclude with this. When I was a councillor, a long time ago, my colleagues gave me the area chairmanship of social work because they thought that nobody else would want it. Remember that social work may be seen as a Cinderella service, and we must sort that out in the review.
Justin Madders (Ellesmere Port and Neston) (Lab)
I congratulate my hon. Friend the Member for Newcastle upon Tyne North (Catherine McKinnell), the Chair of the Petitions Committee, on introducing the debate and brilliantly articulating the many issues relating to the recognition and reward of health and social care workers. I thank all those who have signed the four petitions, which have so far amassed some 290,000 signatures between them. By doing so, they have brought this very important debate to Parliament today.
This debate comes at a particularly poignant time, when health and social care workers have been at the heart of the fight against coronavirus, working day and night to protect the NHS and save lives. They, and all the key workers who keep this country going, are the very best of us. I want to take this opportunity to once again pay tribute to the hundreds of NHS and social care staff who have lost their lives to the virus. I hope that when this is over, we can find an appropriate way to remember the frontline staff who gave their lives in the line of duty.
This was a heavily subscribed debate, and it was clear from every Member who spoke that the gratitude the whole country feels for our health and social care workers is replicated in this place. We had some superb speeches from Opposition Members, with good representation from Wales. My hon. Friend the Member for Merthyr Tydfil and Rhymney (Gerald Jones) spoke with typical eloquence and highlighted the wise decision of the Welsh Government to recognise the contribution of care workers. I hope that the Minister will be able to respond positively to my hon. Friend’s request, or at the very least confirm that she is making strong representations to the Treasury about the tax treatment of that payment. We heard a similar point from my hon. Friend the Member for Pontypridd (Alex Davies-Jones), who also reminded us of NHS Direct, which was a great innovation from the last Labour Government.
My hon. Friend the Member for Bethnal Green and Bow (Rushanara Ali) rightly said that staff need to be rewarded with more than just applause, and she drew attention through her strong speech to the sorry record we have seen over the last 10 years on the NHS. My hon. Friend the Member for Coventry South (Zarah Sultana) spoke with great passion and listed a whole series of ways in which the health workforce is hit with extra burdens in the course of their duties.
My hon. Friend the Member for Erith and Thamesmead (Abena Oppong-Asare) drew attention to the scandal of nurses being forced to use food banks. That should shame us all. We also heard from my hon. Friend the Member for Hackney South and Shoreditch (Meg Hillier), who made the powerful point that medals do not put food on the table. She brilliantly highlighted how insecure work is a blight on the NHS and a systemic problem that needs addressing once and for all.
As we heard, even before the pandemic our frontline health and social care staff were working in overstretched and under-resourced settings. We must acknowledge that many of our frontline careworkers have been in extremely stressful and sometimes traumatic situations as a result of covid-19—situations that those of us who have not been on the frontline cannot even begin to imagine. Working in these uncertain times, dealing with a new and emerging disease, often without adequate protection, while coping with losing patients and worrying about getting ill themselves or taking the virus home to their loved ones are all contributing factors to staff burn-out and poor mental health. It is vital that we keep them all safe in the event of a second wave.
Yesterday, following the Prime Minister’s announcement of the relaxation of the 2-metre rule and sweeping changes to the lockdown in England, health leaders called for a rapid and forward-looking assessment of how prepared the UK is for a new outbreak of the virus. Those health leaders from the Royal Colleges of Surgeons, of Nursing, of Physicians and of GPs say:
“the available evidence indicates that local flare-ups are increasingly likely and a second wave a real risk.”
They also point out:
“Many elements of the infrastructure needed to contain the virus are beginning to be put in place, but substantial challenges remain”,
and they call on the Government to focus on
“areas of weakness where action is needed urgently to prevent further loss of life”.
We cannot have any failures in preparation this time.
We may no longer be gathering outside our homes on a Thursday night to clap for our carers, but our admiration remains. It has been incredible to see the effort from staff in the last three months—staff who, too often, get very little in return. We hope that they are recognised for their true worth now.
Justin Madders
I am sorry, I will not have time to give way.
Many of our NHS and care staff are exhausted and fearing burn-out. They need our support now, which means safe staffing ratios, adequate PPE and decent fair pay, because for them the hard work is not over—it is only just beginning. They will continue to give their all as they begin to tackle the backlog in non-covid care. The millions of routine operations, screening tests, treatments and therapies that were suspended or cancelled during the pandemic will now have to restart. Those challenges cannot be met without the staff.
As we know, there are well over 100,000 vacancies in the social care sector, and systemic insecure work and low pay are not the answer to resolving that issue. We know that prior to the covid-19 outbreak there were also 106,000 vacancies across the NHS, including 44,000 nurse vacancies. Those vacancies matter. They mean that NHS services were already under extreme pressure due to the ongoing staff shortages, before being further stretched by more shortages due to sickness or caring responsibilities during the pandemic. That, in turn, has put all healthcare staff under intolerable and unsustainable levels of pressure.
On top of those staff shortages, healthcare staff have had to work in unfamiliar circumstances or in clinical areas outside their usual practice, and of course they have had to work in very difficult circumstances. A survey by the Royal College of Nursing found that half of nursing staff felt under pressure to work without the levels of protective equipment set out in official guidance, and a survey by the British Medical Association of 7,000 doctors found that 45% were experiencing stress, exhaustion and burn-out. We need to listen to what the staff are telling us.
Just last week, we learned that student nurses who joined the frontline six months ago as part of the coronavirus effort are seeing their paid placement schemes terminated early, leaving them with no income and no guarantee that they will not face extra costs for completing their studies. That is no way to treat student nursing staff who have put their studies on hold to join the fight against coronavirus, and who are at the start of what we hope will be a long career in the NHS. They deserve better.
The Government still have not quite resolved the issue of the immigration health surcharge, where NHS and social care staff coming from abroad and working on our frontline are required to pay a surcharge of hundreds and sometimes thousands of pounds just to use the NHS themselves. It was welcome that, after considerable pressure, the Government announced last month that the surcharge would be abolished, but, as we have heard, there are still reports of people being charged. I would like an update from the Minister about what is happening in respect of that.
In conclusion, no one hearing this debate would be in any doubt that our health and social care workers are appreciated, admired and respected, but warm words are not enough. A clap on Thursday night is not enough. It is time for action, and for the Government to finally recognise the monumental contribution that health and social care workers make. No more poverty pay. No more “work until you drop”. No more sending people into work inadequately protected from exposure to a deadly virus. That cannot happen again.
The Government were too slow to recognise the need for PPE, too slow to protect the social care sector, and now they are too slow to properly reward our brave health and social care workers, who have literally put their lives on the line for us all. It is time we put that right.
Covid-19
Jamie Stone Excerpts(5 years, 8 months ago)
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Jamie Stone (Caithness, Sutherland and Easter Ross) (LD) [V]
Greetings from the far north of Scotland. I want to talk about tourism in the highlands.
Visitors and tourists from the UK and overseas are always very welcome in this most beautiful part of the UK, and our hospitality and tourism industry is critical to the local economy. It is an industry that is sustainable in the long term, and which, most importantly, provides local jobs for local people. As long as we have a high-quality tourism product, by which I mean landscape, culture, top-quality food and drink—that sort of thing—we can attract tourists to come back again and again to a truly special part of the world. But we are in the midst of the current pandemic. People leaving home and moving about simply increases the risk of the disease being spread. Many in the highlands and many of my constituents are concerned that visitors will look at the map of where the virus is most common and think, “Oh well, the highlands looks pretty free. Let’s go there.” The trouble is that in the highlands, health services are at best limited. The NHS staff and care workers are doing a fantastic job, but they work with limited resources and that is why we have taken the lockdown rules so seriously in the highlands. That is why we have taken every precaution to look after one another and that is why we continue to “stay home, safe lives and save the NHS”.
The health and safety of my constituents is my greatest concern during this difficult period, so I say this to potential visitors. In normal times you would be really, really welcome, but right now please stay in your usual homes, wherever they may be. Please, please wait until the medical advice says that the risk of you spreading the virus to my constituents has gone. Surely those who truly care for the highlands and highland people will respect the need to prioritise our health and safety.
Despite our strong feelings about the need to keep safe, we in the highlands also know that the longer the pandemic goes on, the more the long-term damage our local businesses will suffer. The absence of visitors paying money to our tourism businesses possibly for weeks and months could actually cause many businesses to go under. It is a vicious circle. For every business that goes under during the pandemic, the highlands becomes all the poorer in what we can offer visitors when it is safe for them to return. It is worse than that, however, because unlike many other enterprises tourism businesses are seasonal. The money taken in during the tourism season has to be sufficient to see that businesses have enough in the bank to get through what we call the dark cold months in the highlands. That is why I suggest that the present pandemic is so particularly dangerous for those tourism businesses. Even if the pandemic were to end in a few months, much of the tourism season will have gone. That is why I support the proposal from my hon. Friend the Member for Westmorland and Lonsdale (Tim Farron) for the UK Government to introduce a 12-month financial support package to secure the survival of the tourism industry until summer 2021.
To conclude, my plea is to both the UK and the Scottish Governments. Those tourism businesses are doing all they can just now. For instance, selling vouchers that can be used at a later date when travel is absolutely safe is a seriously good idea, one which we should all wholeheartedly endorse and support. But I believe that both the Scottish Government and the UK Government owe it to those tourism businesses to go a specially tailored extra mile for them right now. Otherwise, they will go under and we will have a disaster on our hands. I believe that all of us really owe the tourism businesses that hand of help—nothing less than that.
Health Inequalities
Jamie Stone Excerpts(5 years, 11 months ago)
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Jo Churchill
The hon. Lady will appreciate that I cannot speak for all Departments, but it is my job to drive home the value of health in those Departments and to ensure that, as she says, we think about the broader consequences across the policy-making piece.
In answer to my right hon. Friend the Member for South West Wiltshire (Dr Murrison), smoking does remain one of the most significant public health challenges. It affects disadvantaged groups in particular and exacerbates inequalities. That is particularly apparent when looking at smoking rates in pregnancy. Three weeks ago, I visited Tameside Hospital in Greater Manchester to see its smoking cessation work. It started with a much higher than average smoking rate, and having a tailored public health budget in the locality has allowed it drive down into the inequality within the community. It has a specialist smoking cessation midwife to help these young women, their families and their partners give up smoking—for their own health, yes, but also for the health of their babies.
Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)
I packed in smoking 15 years ago. I cannot understand why the NHS does not use people like me to go out there and help other people pack it in.
Jo Churchill
I thank the hon. Member—he has just got himself a job as an ambassador. I congratulate him on quitting smoking, because it is hard.
The specialist centre showed me that with the right holistic support and encouragement, the health of both mum and baby can be improved. Such services will be crucial in achieving the ambition of becoming a smoke-free society by 2030.
Similarly, we must tackle the health harms caused by alcohol, and support those who are most vulnerable and at risk from alcohol misuse. Through the NHS plan, up to 50 hospitals with the highest rates of alcohol dependency-related admissions will have alcohol care teams. That could prevent more than 50,000 admissions every five years. Currently, eight of those teams are in operation, providing seven-day services focused on those areas with the highest levels of admissions related to alcohol dependency.
Alcohol addiction has a devastating impact on individuals and their families, and it is unfair that children bear the brunt of their children’s condition. I know that this topic is dear to the heart of the hon. Member for Leicester South (Jonathan Ashworth), who has spoken about it movingly. I pay tribute to the way he has influenced this agenda in this place. I am pleased so say that we are investing another £6 million over three years to help fund support for this vulnerable group.
As is often the case with addiction, there is a toxic mixture of several items. On substance misuse, last Thursday I attended the UK-wide drug summit in Glasgow, along with Home Office Ministers and Ministers from the devolved Administrations. We discussed the challenges associated with drug misuse and listened to Dame Carol Black present her findings from the first phase of her review. I am pleased that my Department will fund and commission the second phase of the review, which will make policy recommendations on treatment, prevention and recovery. Only through the combined efforts of different Departments working together can we hope holistically to improve the health and other outcomes of people with substance misuse problems. Many of us know from our constituency work that they often bounce between various parts of the system. Local authority leadership and action on public health prevention is vital as it will help to focus local measures to decrease health inequalities. As a condition of receiving long term plan funding, every local area across England must set out specific and measurable goals, and ways by which they will narrow health inequalities over the next five and 10 years. Local areas know their localities best.
Dr Whitford
I do. I respect the work that Labour did, and child poverty was falling. Interestingly, the upturn in child poverty we have seen did not happen with the crash in 2008; it happened after the 2012 welfare changes. That is striking. The impact of Government policy has been austerity in every way and in every approach to individuals, families and communities. We have seen slow income growth for the vast majority of people over the last decade. There has been absolute inequality. The majority of the growth that there has been, has been at the top. The national living wage simply is not a living wage. More people are in insecure work—zero-hours contracts, the gig economy—and do not have protections. As the shadow Health Secretary mentioned, in all the discussion about covid-19, we have been trying to highlight that people on low pay and insecure contracts do not get sick pay, yet we will be asking them to stay at home for two weeks and self-isolate. In the meantime, the wealthiest people have actually trebled their wealth. So categorically we have not all been in it together over the last 10 years.
In addition, we have seen a restriction on public expenditure. The regressive welfare cuts of 2012 and 2016 have reduced support for families by 40%: the benefit cap, the benefits freeze, the two-child limit, the five-week wait for universal credit, which puts people in rent arrears and debt, personal independence payments, the bedroom tax. Eighty per cent. or more of these cuts have affected women directly because they tend to be lower paid, to be carers and to rely more on services. In the main, they are responsible for children. The disabled have also been particularly hard hit. We have not seen a cumulative impact assessment of female lone parents who are disabled and have three or more children. Some of them have had their income slashed.
There have been cuts to local government and services. Interestingly, the least deprived areas face 16% of cuts, while the most deprived on average had 31% cut from their local government budget. I have heard Labour Members talk about between 40% and 60% cuts in their local government budgets. There are changes in the pipeline to move £300 million from local authorities in the north to the south. I wonder if that will be reversed now that the Conservative party has won some seats in the north.
Jamie Stone
Some years ago, when I was a councillor, I had a harrowing case involving a young female constituent who was clobbered by the bedroom tax. She has multiple sclerosis and she was going to lose a lot of cash. I want to put on the record my thanks to the Scottish Government for the action they took to ameliorate and offset that tax.
Dr Whitford
I thank the hon. Member for that recognition. The Scottish Government are spending more than £100 million every year in mitigating some of these cuts—they pay the bedroom tax and they have set up the Scottish welfare crisis fund—but that is money that should be going into devolved areas, not patching up austerity decisions here; it is not the role of the Scottish Parliament just to mitigate.
Public health in England has been cut by £850 million—again, the greatest cuts to the poorest areas—and it is exactly the same with future planned cuts. This has led to cuts in smoking cessation projects. There is no point standing up and talking about the importance of stopping smoking—we all know that. People who have smoked for decades need help to stop and those services are critical. We have also seen cuts to drugs and alcohol projects and to sexual health projects, and all those have an impact on the poorest people.
The Minister, who is no longer in her place, might have listened to Dame Carol at the drugs summit in Glasgow but, sadly, the Minister for Crime and Policing, the hon. Member for North West Hampshire (Kit Malthouse), did not. He came to Glasgow, made his speech and then left before all the expert evidence was given. We also hear of a social care gap across England of over £6 billion. Again, that affects women if they have to give up work to look after elderly relatives or disabled children. This rolling back of the state has affected the social determinants and increased health inequalities. Child poverty has increased, as we have heard, with 4 million children affected, and 1,000 Sure Start centres have been closed. Education funding is down. There is a housing crisis and therefore a rise in homelessness. People with insufficient funds to afford a healthy life are depending on food banks, and deprived communities are simply losing hope.
Poverty is simply the biggest driver of ill health and has the biggest individual impact on life expectancy. The increase in life expectancy in England has stalled for the first time in 120 years—the first time since 1900. The gap between the most and least deprived has widened: the gap is now almost 10 years for women and the life expectancy of some women in areas of the north-east of England has dropped by almost a year.
Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)
I really must praise the two excellent speeches by the hon. Members for City of Durham (Mary Kelly Foy) and for Coventry North West (Taiwo Owatemi). I rather fancy that those two Members will make their mark in this place in the years to come.
I want to tell the tale of Mr Billy Sutherland, who was a 63-year-old commercial traveller living in Wick. A good number of years ago, Billy set off from Wick on the A9, heading south. It was a winter’s day and the weather was not too bad when he left, but as he travelled further south towards the Ord of Caithness—the boundary between Caithness and Sutherland—it turned very nasty indeed. In the end, Billy drove into a snowdrift and could not get out of his car. The snow continued and eventually he was buried, in his car, 15 foot down. There was no trace of the car to be seen.
Billy was in that car for 80 hours. Eventually, the police found him by prodding the snow, and it clanged on the roof of the car. When they dug their way down to the car, they found that Billy was, astonishingly, alive and pretty well. He was not much the worse for his ordeal. Billy was a commercial traveller in ladies tights. As it got colder in his car over the 80 hours, he simply unwrapped more pairs of tights and put them on. It is an extraordinary tale. When he returned to Wick, he received a hero’s welcome.
I tell the tale because, until quite recently we enjoyed a consultant-led maternity service based at the Caithness General Hospital in Wick, but NHS Highland, in its infinite wisdom, decided to downgrade the service. As hon. Members know, because I have mentioned it before in this place, a great number of pregnant mothers now have to travel 104 miles from Wick to Inverness—a 208-mile return trip—to give birth to their babies. The vast majority of mothers have to do that.
What if it is winter? What if the ambulance gets stuck in a snowdrift? What if the mother’s contractions have started? What if the two emergency helicopters have been summoned to one road traffic accident in Lochaber and another in Morayshire? I have said it again and again: in my considered opinion, this is a tragedy waiting to happen. I make no apologies for raising it yet again in this place.
This debate is about equality of access to decent health services. I argue that my constituents in Caithness are losing out extremely badly indeed, and it annoys me intensely. In fairness, this is a matter that is devolved to the Scottish Government. I accept that and very much hope that the Scottish Government take the problem on board, because we cannot continue waiting for something dreadful to happen. When constituents come to me in Caithness, do I sit on my hands and say, “Well, it’s not a matter for Westminster,” or do I stand up and say something here? I make no apologies, because I think I owe it to the pregnant mothers.
Nursing Workforce Shortage: England
Jamie Stone Excerpts(5 years, 11 months ago)
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Mohammad Yasin (Bedford) (Lab)
I beg to move,
That this House has considered the nursing workforce shortage in England.
It is a genuine pleasure to serve under your chairmanship, Ms McDonagh. I start by recognising the skills and expertise that nurses bring. Nursing shortages impact on patient care and staff wellbeing. Wherever there are people, there are nursing staff. They work in public services, across the NHS, social care, public health and the independent sector. They are with us at every stage in life, from birth to death. I am grateful for all that health and care staff do in my constituency and across the country.
This debate was secured in response to petitions handed in by nurses from the Royal College of Nursing, calling on the Government to fix the workforce crisis. I am pleased to be their voice—and that of everyone who works in the health profession—in Westminster today, and call on the Government to do all they can to tackle nursing shortages, which have huge knock-on effects on our NHS and wider health and care system, as well as on patient safety and staff wellbeing.
There are about 40,000 nursing vacancies in health and care services in England. In my region, the east of England, the nurse vacancy rate is 10.7%, which amounts to more than 3,600 nurses. Worryingly, the vacancy rate for mental health nurses in my region is even higher, at 15.3%. Nurses are crucial in health promotion and improving population health, yet the numbers of health visitors, school nurses, community nurses and district nurses have dropped at a rapid rate and are in long-term decline. We need to see significant growth in the NHS cancer workforce as well.
I expect that the Minister will tell me that almost 8,000 more nurses work in the NHS since this time last year. Although that figure is correct, it must, as with all stats, be viewed in the relevant context. That is a growth rate of just 0.4%, which is nowhere near the scale needed to provide enough nurses now or in the future. The pace of growth is not sufficient to reassure patients that we have a workforce ready to meet their needs, and it is nowhere near the rate needed to cope with the increasing demands that are predicted to be placed on the NHS by our ageing population.
For every NHS nurse employed in hospitals last year, there was an equivalent of 214 admissions. Patient need is rising faster than the growth in our nursing workforce. Social care and public health are also without thousands more nurses. It is difficult to calculate the number of vacancies in those settings because the data is incomplete. We have no understanding of plans to support and fund social care, which I hope the new Minister will confirm are a priority.
Nursing shortages directly impact on patient safety. Even with the small increase in staff numbers, hospitals and other services are struggling more than ever. Last week, the RCN published findings from a survey of emergency care nurses, who are increasingly forced to provide care in corridors. Some 95% of survey respondents said that patient dignity is compromised, and 92% worry that patients may be receiving unsafe care. December saw the worst performances on record for A&E departments in England, with every single department failing to meet the four-hour waiting time target. Those stats should alarm us all. Chronic underfunding has led us to this point.
Trust papers from Bedford Hospital, a district general in my area, show just how intense the pressures are on our frontline workers. Staff are doing as much as they can to keep patients safe and to provide high-quality care, but the situation is outside their control. Staffing shortages are systemic, and addressing them requires political will and action.
Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)
The hon. Gentleman mentions staffing shortages. My vast and remote constituency, which has a large and ageing population and is the most remote mainland constituency in the UK, has problems not only with recruitment but particularly with retention. Health is devolved to the Scottish Parliament and Scottish Government, but as and when the UK Government develop an approach to keeping people in the most remote and rural areas, where they are needed most, I hope that that intelligence will be shared with the Scottish Government.
Mohammad Yasin
The hon. Gentleman is absolutely right. There are nursing shortages in every part of the country, and nurses are struggling to provide good care. I will come to that point in a moment.
Nursing shortages also impact on staff wellbeing. One testimony from an emergency nurse describes the realities of working in the profession:
“When I witnessed elderly patients being assisted onto bed pans while on ambulance trolleys, surrounded by paramedics, other patients on trolleys, and relatives all squashed in a freezing corridor…I realised that I can no longer preserve or protect my patient’s dignity, and that I am failing them as a nurse. Dignity is the first thing that the patients are stripped of when in a queue in a dark, cold corridor, closely followed by safety.”
Sharon, a community nurse who recently responded to a House of Commons digital debate on this Westminster Hall debate, said:
“I have worked in my locality for four and a half years. In that time, we have never been fully staffed. This puts enormous pressure on the whole team and many people have left because of it. Often, we are rushed, we forget things, and we cannot give the quality of care that we would like as we are just too thinly spread. Many of us end catching up on our notes or management at home, working way over our contracted hours. We are exhausted, frustrated and disappointed.”
This is an appalling situation for all concerned, and I know from these responses that this happens daily in hospitals up and down the country. Talk of a winter crisis is meaningless when staff and patients experience crisis every day, all year round. We must all focus on fixing this.
There is a long-term plan for the NHS, but its ambitions are dependent on having enough nurses. We have no funded workforce plan, even though it was promised by the Government when they announced the funding allocations back in the summer of 2018. Will the Minister tell us when the long-promised NHS people plan will be published, and whether it will include bold and funded policies to recruit, train and retain vital nursing staff to meet the needs of our population?
Nursing students in England can receive grants of up to £5,000 a year, and for some they can go up to £8,000. However, these do not reflect the true cost of living. Just as importantly, tuition fees are also a huge burden on nursing students, and it is important that this is addressed in the forthcoming Budget. As a father of four, I believe that financial barriers to education must be removed.
Jim Shannon (Strangford) (DUP)
I congratulate the hon. Member for Bedford (Mohammad Yasin) on securing this debate. Although this debate is about nursing shortages in England and health is a devolved matter in Northern Ireland, I believe we are experiencing the same problems in Northern Ireland that exist in Wales, Scotland—as mentioned by the hon. Member for Caithness, Sutherland and Easter Ross (Jamie Stone)—and the whole of the United Kingdom. The solution must be UK-wide.
The Minister has responsibility for England, but I want to refer to things that are happening in Northern Ireland, which I believe the UK Government can change to the benefit of the devolved Administrations. We are currently facing a crisis in nursing care. Although nurses in Northern Ireland have received a pay increase, which they deserve, that does not ease the conditions in which we are asking them to work. Those conditions are the same as in England, Scotland and Wales.
During the election, nursing was perhaps the largest issue I was confronted with on the doorstep, along with the dysfunction of the Northern Ireland Assembly, which, although we are not directly responsible for it, people still wanted to talk to us about. When we got past the misinformation that had been fed to people in a deliberate attempt to skew the vote, it was clear from speaking to nurses that, although the pay issue had been an insult to them, they had genuine concerns about staffing levels—the subject of this debate. The concerns I heard on the doorstep were clear to me, as I am sure they were to all hon. Members from across the United Kingdom of Great Britain and Northern Ireland. There was a genuine concern that the everyday nurse felt guilty about taking annual leave; they felt that they were letting people down by having their hard-earned time off. That should not be so.
The health service in Northern Ireland has a registered nurse vacancy rate of 11.6%, equating to precisely 2,103 empty posts, as well as a shortage of 421 nursing assistants. The cost of employing nurses via agencies has increased from £10 million in 2012-13 to £32 million in 2017-18. I know that the last few years, with a non-functioning Assembly, were an issue regarding the employment of agency staff.
I had a meeting with the Royal College of Nursing some six weeks ago in my office, and I welcome the fact that the Northern Ireland Assembly is up and running. I also welcome the fact that the Minister who has responsibility for the Health Department in Northern Ireland, Robin Swann, has committed to recruiting more nurses. I understand that 700 nurses will be recruited, which will go a long way to addressing some of the empty posts. However, that will still be only a third of the way to filling all the vacancies that exist; the other two thirds of vacancies also have to be filled.
Jamie Stone
The hon. Member makes an extremely interesting point. At the last election, constituents and voters said to me on the doors that they would prefer that nurses were employed by the public purse—by the Government—rather than via an agency, which, by definition, makes a profit on the salaries for those nurses. I suggest that the general public does not like that and, if I am reading him correctly, he does not like it either.
Jim Shannon
I thank the hon. Gentleman for his intervention, and that is exactly what I am saying. I know that the Health Department in Westminster does not have responsibility for recruiting nurses in Northern Ireland. The Minister in Northern Ireland now has, and he has made the first step towards addressing that issue. It is hoped that over the next couple of years the number of vacancies—over 2,100 nursing posts, as well as 400-odd nursing assistant posts, making about 2,500 vacancies in total—will be addressed. We hope that the cost of agency staff and the extra financial burden created by the fact that agencies are profit-making organisations—this is how they make their money—will be addressed in a way that helps to reduce the shortcomings.
This situation means that nurses cannot simply work their 37.5-hour working week. They are called in on days off and asked, “Can you do the twilight shift? Can you give me a couple of hours?” That is not the fault of the ward sisters; they need the floors covered and are under pressure. It is simply that we do not have enough full-time working nurses in the NHS. That means that conscientious nurses, who do not want to leave the ward or the district short, are working additional hours themselves, and not in the short term to save money for a holiday or a renovation of their house. Instead, they are consistently working overtime to help on the wards, and so they are not getting their family time, their social time and—more importantly—their rest time
I have had glimpses of this situation. Some 6,500 nurses live in my constituency, so I have regular contact with them. I got a brief glimpse of the work of a nurse during my surgery and was in awe of how they stayed on their feet, and remained both sharp and compassionate —as they do. Doing all that with no rest is simply unsustainable. So, for a better system and a better caring system with better nurses, who are more able to work within that system, we need to address the shortage of nurses.
It used to be the case that bank nurses were only used in an emergency, but now they are used ever more frequently and their use is becoming the norm. They are no longer just used in the emergency. Using them is now just the fall-back position: “Let’s just do it”. That is not good either for morale or for finances—the current finances clearly indicate that it is not. It is more costly to have agency staff in than it is to have nurses on full-time pay.
I will give another example, of a nurse who approached me in my office and asked me to clear up rumours about nurses, their employment and so on. She is a young nurse in her early 20s who has been working at the Ulster Hospital in Dundonald—the main hospital in my constituency—but she has been left as a staff nurse in charge at night on numerous occasions. What she said to me was simple; she just said to me, “Jim, keep the pay rise and please give me an extra nurse per shift.” That was her initial reaction, because she can feel the pressures of delivering this system, and was saying, “I physically can’t do it all for much longer”.
This is a lovely young girl who is dedicated and good at her job, but who knows that when she has kids she will not be able to work 60 hours a week. She is asking me to do something about that, and today I am on the path towards doing something; I am highlighting this issue. I am very happy to do so.
NHS Funding Bill
Jamie Stone ExcerptsMonday 27th January 2020
(6 years ago)
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Craig Mackinlay
My hon. Friend makes a good point. How much do trusts spend on recruitment consultants? There is a whole panoply of expenditure on other things that the NHS, as a very big procurer, could get at competitive, keen prices.
My hon. Friend the Member for North Dorset (Simon Hoare) made a good point about the cost of medicines and repeat prescriptions. That has to be a major issue: across the country, £20 billion a year—nearly one sixth of the NHS budget—is spent on medicines, many of which are on free, repeat prescription. My wife, a pharmacist in the community, far too often sees bags full of expensive drugs come back to the pharmacy after the demise of a loved one. They have to be thrown away, and the money is completely wasted. We need to ask some difficult questions about the NHS. Let us not try to throw more money at it in the hope of a better outcome, because we need to be rather more clever. Great as it is—it has become a national institution, greatly loved—the NHS does not always do things perfectly.
Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)
I thank the hon. Gentleman for giving way, and I have been listening with great interest to the excellent contributions of new Members.
There is some evidence that NHS provision in Scotland is somewhat rackety. The hon. Gentleman has described the cost of bits of paper, and so on. Would it not be a good idea to apply the same tests to the delivery of NHS services in Scotland?
Craig Mackinlay
Obviously the hon. Gentleman takes a great interest in Scotland. This is a debate about England, but I think there should be a serious debate in every part of the country about whether the NHS is operating as we would operate if this were our own business, and I think that in many areas of procurement, whether the item in question is paper, telecommunications or power, the answer will be “Probably not.”
I have benefited from a couple of interventions adding to my time, but I will end by saying this. As I said earlier, the NHS does not always do things perfectly, and in that regard I reflect on the death of young Harry Richford at the Queen Elizabeth the Queen Mother Hospital maternity unit, and on what the coroner said last week. The coroner said that the death of young Harry—who died after a week, following a very difficult Caesarean—had been “wholly avoidable” and “contributed to by neglect”, and that “Harry was failed”.
We cannot just keep saying that we will learn from these things. We need to embed improvements so that our healthcare system in this country is much the best on the planet, and I am sure that the Government will deliver that.
The National Health Service
Jamie Stone Excerpts(6 years, 3 months ago)
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Matt Hancock
I am delighted to have been able to give that assurance and I thank my hon. Friend for the work he has done.
Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)
This is further to the point made by the hon. Member for Stirling (Stephen Kerr). As this Chamber has heard me say before, pregnant women have a 200-mile round trip to make from Caithness to Inverness to give birth. Some months ago, a mother gave birth to twins 52 miles apart on the A9 from Caithness. In the past two days, a pregnant woman came all the way down from Caithness only then to have hours of agony because there was no bed ready for her. I concede that this is a devolved matter, but would Her Majesty’s Government, for my sake and that of my constituents, share the best safety practice with the Scottish Government and with NHS Highland?
Matt Hancock
We will absolutely do that. The hon. Gentleman rightly says that this provision is a devolved matter, and we have already had a debate about the relative funding increases, but this case clearly needs looking at seriously. I will make sure I get in contact with my colleagues in the Scottish Government who are responsible for the provision of this service to make sure that it is looked at properly.
Baby Loss Awareness Week
Jamie Stone Excerpts(6 years, 4 months ago)
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Caroline Dinenage
I thank the hon. Gentleman so much for that intervention. He is absolutely right. In this place, we have a unique opportunity to raise subjects that people find it difficult to talk about out there. In doing so, we shine a light on those subjects, and we are able to really begin to move the dial and to change practice.
With that in mind, I would like to pay tribute to the hon. Member for Eddisbury (Antoinette Sandbach) and my hon. Friend the Member for Colchester (Will Quince), who is desperate to speak, although, being a Minister, he is prevented from doing so, so we will have to restrain him. However, in a late-night Adjournment debate back in 2015, they began to raise awareness of the variation in care for families bereaved by baby loss. It was an incredibly moving debate—I remember listening to it at the time—and it really made such a magnificent difference. It was followed by the Baby Loss Awareness Week 2016 debate, which was about bringing the subject to light and challenging the idea that baby loss is an uncomfortable topic that we do not like to talk about. I am grateful to the Members from across this House who shared their personal experiences on that day back in 2016 and have done since.
International Baby Loss Awareness Week begins tomorrow and finishes next Tuesday. This year, the focus is on the need for specialist psychological support for bereaved parents who need it. The Baby Loss Awareness Alliance group of charities will be publishing a report highlighting that some parents need that kind of support as part of their bereavement care.
Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)
I wholeheartedly support the thrust of this debate and what the Minister is saying. I am not going to make a speech today—I did that last year—but when a child is lost, which as Members know has affected my family, counselling and gynaecological advice are hugely important. However, my constituents are over 100 miles from the nearest hospital where someone can give birth. I just want to put it on the record that a 200-mile round trip from Caithness to Inverness makes getting the counselling and gynaecological advice so difficult. My constituents are losing out on that front, and I wish that Caithness general hospital in Wick could be used for such purposes.
Caroline Dinenage
I am grateful to the hon. Gentleman for raising that. The situation is particularly difficult in rural communities where people live a very long way from services. As we set out in the NHS long-term plan, maternity outreach clinics are going to start to integrate maternity, reproductive health and psychological therapy for women experiencing mental health difficulties arising from or related to maternity experience, and we must keep in mind those living in very remote communities when we talk about those outreach facilities.
Caroline Dinenage
My hon. Friend is right to raise that matter. When a tragedy could have been avoided by something as simple as sharing patient records, there is no option but to embrace the technology we need to make that a reality. Both the previous and the current Secretary of State for Health and Social Care are in favour of that.
Every trust is now using the perinatal mortality review tool to review stillbirths and neonatal deaths to make sure lessons are learned so that other families do not have to suffer in the same way. The first annual PMRT report is due for publication later this week, and it will provide an analysis of the first 1,500 cases. Overall, a review has been completed on 96% of stillbirths and 86% of neonatal deaths since the tool was launched.
Jamie Stone
The Minister talks about safety advice and safety good practice, so may I ask her and the UK Government to share that advice with NHS Highland and indeed the Scottish Government, who have never in my two years or so here given me a straight answer on the safety of pregnant women? Some of those women, who might be in labour, are being transported more than 100 miles from Caithness to Raigmore Hospital in Inverness, in the middle of winter, when the A9 can be blocked. I think lives are in danger.
Caroline Dinenage
The hon. Gentleman has put his thoughts clearly on the record, and if there is anything we can ever do to share best practice with colleagues across the devolved nations and around the rest of the world, we are always happy to do that.
The Healthcare Safety Investigation Branch is another remarkable innovation. It commenced investigations in April 2018 and has been operational in the 130 trusts providing maternity services since the end of March 2019. By the end of August, the HSIB had completed 88 investigations, with 169 draft reports looking into maternity and neonatal deaths currently with trusts and families.
NHS Resolution recently published a report on the first year of its early notification scheme for potential birth brain injuries. The scheme requires all births at NHS trusts in England from 1 April 2017 meeting qualifying criteria to be reported to NHS Resolution within 30 days for investigation, so families with a baby affected by a severe brain injury attributable to substandard care can receive significantly earlier answers to their questions. This approach means that they do not have to resort to full court proceedings and can receive financial support with their care and other needs at a much earlier stage. In the first year, 746 incidents were eligible for the scheme. There have been early admissions of liability for 24 families, who have been provided with detailed explanations, admissions of liability and, very importantly, an apology. Families have been provided with financial support for early access to additional care, respite and, where needed, psychological support and counselling.
I am happy to report that this summer the Office for National Statistics reported that the stillbirth rate in England had decreased from 5.1 stillbirths per 1,000 births in 2010 to four stillbirths per 1,000 births in 2018. That represents a 21% reduction in stillbirths two years ahead of our ambitious plan.