Health and Care Bill

Jeremy Hunt Excerpts

2nd reading
Wednesday 14th July 2021 Commons Chamber

[Jeremy Hunt (South West Surrey) (Con)]

To reorganise the NHS as one of your first acts as Health Secretary is what Sir Humphrey would describe as brave. I support this Bill, because it contains changes that the NHS has asked for. I take the Secretary of State at his word that there is more to come on social care, and he has said that he will pursue the idea of independent safety and quality inspections of the new integrated care systems to make sure that they are outward facing and focused on the needs of patients.

When it comes to the biggest challenge facing the NHS today, which is workforce gaps, the Bill says little or nothing. Independent forecasts say today that we are currently short of 400 psychiatrists; 1,400 anaesthetists; 2,000 radiologists; 2,000 midwives; 2,000 to 2,500 emergency care consultants; and 2,500 GPs. We have more nurses but we are short of learning disability, mental health and community nurses.

[Steve Brine]

It is unquestionable that we have a challenge with the GP workforce. It is about numbers, yes, but does my right hon. Friend agree that constituents have a big challenge with access to general practice? We currently do not have the right balance between telemedicine and in-person medicine.

[Jeremy Hunt]

There is a big issue, and my hon. Friend is aware from his time at the Department of Health that its root cause is capacity in the system. These capacity issues taken together are why the Health Foundation says that, in just over a decade, we risk a workforce gap in the NHS of about half a million people. That is why this is such a big issue. I urge the Secretary of State to think about that during the Bill’s passage.

[Joy Morrissey (Beaconsfield) (Con)]

Does my right hon. Friend agree that that is also the case for the rehabilitation services used by stroke victims? There is a vital link between occupational therapists and physios, but we do not have the proper workforce in place for at-home care after a stroke.

[Jeremy Hunt]

My hon. Friend is absolutely right. These issues are about not just doctors but all associated health professionals, allied health professionals and indeed the social care workforce. It is important to note that they predate the pandemic. That is why, when I was doing the job of my right hon. Friend the Secretary of State, I set up five new medical schools and increased the number of doctor, nurse and midwife training places by a quarter, but we need to go further.

When the number of clinicians we train is decided by haggling between the Department of Health and the Treasury in a spending round, there is always the risk that it will be eclipsed by more short-term considerations. The truth is that we have a short-term emergency with workforce burnout, so I urge my right hon. Friend to look at the simple and sensible solution proposed by the Health Foundation and all the royal colleges in The Times today to legislate for Health Education England to have a statutory responsibility to publish annual independent workforce projections across the health and care system for the next five, 10, 15 and 20 years. That would show how many training places are needed, which would start to tackle this problem and the obscenity of spending £6 billion every year on locum doctors and agency workers. That cannot be the best use of funds.

Frontline health and care workers are exhausted. They know that there is not an instant solution, because they know it takes three years to train a nurse and seven years to train a doctor, but we can at least give them the reassurance that there is a long-term plan in place. That is not in the Bill, but it needs to be. Given the dedication that we have seen from health and care staff over the last year, it is the very least that we owe them.

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[Steve Brine]

The hon. Lady makes a sensible point. There is obviously a process in place whereby that can happen, but if she is asking whether I agree with a liberal immigration policy to help our health service, then absolutely, yes I do. Addressing the cancer workforce and the wider NHS staffing picture is not an omission from the Bill—we cannot legislate staff shortages out of existence—but if we do not address that issue and face up to our long-term structural gaps, many of the reforms around tackling the backlog and building back better will not amount to a row of beans.

[Jeremy Hunt]

I congratulate my hon. Friend on the extraordinary work he did when he was a Minister on early diagnosis of cancer. Is he aware that the Health and Social Care Committee has just opened an inquiry—we had our opening session yesterday—into that issue, and into how we can get the right workforce in place to deal with those important matters?

[Steve Brine]

I was aware of that, and I am pleased to hear it. The Select Committee will soon have Cally Palmer before it—she is the national cancer director and one of the best in the business—and I look forward to following what she says. In advance of the comprehensive spending review, the Bill should include a requirement on the Government to publish modelling of the future supply of the entire healthcare workforce.

On primary care, I welcome the formal creation of integrated care systems, but we need them to realise their potential, and to do so fast. If they are going to work, general practice needs to embrace the wider primary care family, which means finally to recognise the potential of community pharmacy, ophthalmology and dental services as vehicles of prevention as much as of treatment.

Finally, if we move upstream of the Bill, what we do must be about prevention. We hear talk this weekend of a waiting list touching 13 million people. Let us tackle that for sure, but let us also get behind the food and drink clauses in part 5, and think about the future and our children as much as about the present. Several years ago I was fortunate to write up the high fat, sugar and/or salt proposals as part of chapter 2 of the child obesity plan, and I am pleased that the 9 pm watershed is legislated for in the Bill. I pay tribute to Jamie Oliver and his Bite Back 2030 campaign, and the young people involved with that, as well as to Cancer Research UK for its support. I realise that not everyone on these Benches, or perhaps outside, supports that move, and I agree that it will have little impact if that is its grand sum. Ministers need to take the tackling obesity strategy that was published last year, implement it all, and then go again.

I welcome the clauses on the fluoridation of water supplies. Let us stop debating whether we do that and —to borrow a phrase—follow the science.

In conclusion, the Bill is worthy of support on Second Reading. There will be an awful lot of work to do in Committee and the other place, but I will certainly support it this evening.