NHS Winter Readiness

Jim Shannon Excerpts

Wednesday 30th October 2024 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

I am just chewing a sweet, Sir Roger; my apologies. It is a pleasure to speak in this debate. I congratulate the hon. Member for North Shropshire (Helen Morgan) on setting the scene so well. Today, we had some good news in the Chamber: that £22 billion will be spent on the NHS. The good news for us is that, through the Barnett consequentials, some of that will come to Northern Ireland. We do not yet know how much, but we are sure that some of it will come.

As the DUP health spokesperson, I join colleagues in expressing concerns for my constituents and their access to good health care this winter. Everyone has spoken about that; we cannot ignore the issue. We hope what the Government have put forward today is a helpful financial solution that will go some way to addressing the issue. I am aware that health is a devolved matter, but funding is not devolved, nor is the obligation of Government to implement their promised NHS reform throughout the entire UK.

When I asked the Secretary of State for Health about that reform, he was very clear in his commitment that everyone in the United Kingdom of Great Britain and Northern Ireland would see the benefits. I hope today is a step in the right direction. The Department for Health has released the preparedness document for last year. I welcome some of the impetus, such as strengthening the urgent and emergency care system to provide alternatives to emergency departments, including urgent care centres, urgent streaming services, rapid access clinics and the local phone first services.

The hon. Member for North Shropshire, who set the scene, referred to ophthalmology. It is important to include that because there are some questions along those lines. We had an event yesterday called “The eyes have it”. As the party’s health spokesperson, I try to go to as many health events as I can in the House of Commons. Those attending outlined a number of things they wish to see. Perhaps the Minister can give us some ideas on how we can improve ophthalmology across the United Kingdom.

I welcome the £3.4 million funding provided to general medical and out of hours services, to support GP practices to increase their capacity in light of the anticipated increase in demand over the winter. A figure of £4.3 million has been provided to support GP practices across Northern Ireland to provide proactive support and care to those in nursing and residential care homes. That is again an example of what can be done. I will mention some of the other positive things. I am hopeful that some of the extra money allocated to the NHS today by the Chancellor will filter its way towards Northern Ireland.

The hon. Member for North Shropshire referred to the ambulance service. The Northern Ireland Ambulance Service is increasing its range, capacity and clinical expertise at the ambulance emergency control to help ensure that cases are appropriately managed, without time delays. The enhanced hospital capacity, with 45 beds opened for last winter in my local Ulster hospital, will continue to be funded. Those are some of the good stories and news.

Another is the rolling out of the Pharmacy First pilot service for uncomplicated urinary tract infections in women aged 16 to 64 years. That will expand the current pilot of 62 community pharmacies to the entire pharmacy network of some 500 pharmacies right across Northern Ireland through an investment of £410,000. Again, money is being allocated in the right places to do the right job, which will hopefully make lives better. Over the winter period, it is estimated that this will deliver 12,000 consultations, freeing up capacity in GP practices.

The whole idea of the Pharmacy First pilot service was to ease pressure on GPs, and I know the Minister has always been committed to that. There are good things that can happen, and hopefully after today even more good things will be able to happen. Some £265,000 has been allocated for a new Pharmacy First sore throat test and treat service, which is being piloted this winter. When winter comes, there are colds, flus, sore throats and days off, and everyone rushes to the GP. This will reduce the impact on GPs. These good schemes can be of overall benefit to the NHS. The sore throat service will be piloted in 40 pharmacies, and it is estimated that 8,000 consultations will be delivered this winter, which is good news.

All these measures were welcomed, but none brought the result of an NHS that was prepared last winter. Indeed, that has increased my conviction that we are in a more difficult situation this winter and that the pressure on the NHS cannot be relieved by these small measures. If the Minister can, will she say how the moneys announced by the Chancellor today will be allocated and how that will improve the NHS’s response to this winter?

We need GP practices to be able to refer their patients for an MRI and know that they will be seen in reasonable time, rather than making the referral and then telling the patient to go and spend the day in A&E to get the MRI. Such small but significant things would make a difference and improve the service overall. GPs also tell me that they do not trust the red flag system and that A&E is turning into that red flag system for tests. How can we blame GPs for trying to ensure that they do not miss anything and for using the system in this way?

We need more capacity for MRIs, CAT scans and mammograms, and we need more trained radiographers. One of the things announced today was a significant investment in radiography, but when it comes to allocating the funds we must consider the need to ensure that we recruit and retain radiographers. The Minister may not have the answers to these questions, but does she know what has been done to train more radiographers and improve our NHS?

As a result of there being too few radiographers, 188,881 people in Northern Ireland—nearly 10% of the population—are waiting for a diagnostic test. The wait means that treatment such as radiotherapy is delayed and cases become more complex. That is the nature of having a health problem; people should get seen early and respond early. For some patients, even a two-week delay can mean the difference between life and death.

This long-term issue needs a long-term vision. That is why I am asking the Minister to take seriously schemes that would encourage our intelligent and capable young people to train here and stay here. I have been a great advocate of this and have raised this issue on numerous occasions over the years. We want these young people to train here and stay here with their skills. University bursaries or forgiveness of student debt in return for a period of employment in the NHS would be a positive way forward. Could the Minister look at that too?

Young people go into debt very early on and find it hanging over their shoulders for years to come. If we offer them a job in the NHS and they commit to staying, we can improve things. We have incredibly capable, intelligent British students, and we need to invest in their long-term careers in the NHS and allow them to work alongside junior doctors. We must prepare them for the marathon of NHS life rather than give them sprints that they cannot sustain. We should get the system moving in that direction. I believe that there is work to do not simply for this winter but for every day of the winters yet to come.

--- Later in debate ---

[The Minister for Secondary Care (Karin Smyth)]

It is a pleasure to serve under your chairmanship, Sir Roger. I thank the hon. Member for North Shropshire (Helen Morgan) for securing the debate and hon. Members for taking part.

We have all just rushed from the main Chamber and I think I am the only person here who has come out enthused and excited after what we heard about the massive support offered—particularly for the NHS. It is the first Labour Budget delivered after the 14 years of the coalition and the Tory party’s time in power, and it lays the foundations for fixing our economy.

Just in case people did not clock all the figures, there will be £22.6 billion in day-to-day extra spending on the health budget, including a £3.1 billion increase in the capital budget, £1 billion of which helps address the backlogs of repairs that have been allowed to fester over the past 14 years. There is also an additional £1.5 billion for beds, new capacity for diagnostic tests, surgical hubs and diagnostic centres, to address the key point made by the hon. Member for Meriden and Solihull East (Saqib Bhatti). Let us take some of that funding and not just stop the decline but fix the foundations, setting the path for the next 10 years, as we have clearly articulated in the few weeks that we have been in government. When I speak to my constituents in Bristol South, they are most concerned about the NHS spending every penny of taxpayers’ money wisely, properly and where it needs to be focused. That is why we have concentrated on our three shifts and launched this national conversation—I hope everyone takes part.

We all know the problems, and that is what Lord Darzi helped us address. We also know that winter is a difficult time for our health and care system. Although we cannot predict the severity of the weather, we can predict much of the activity, we know what is likely to hit us most of the time, and we can certainly plan better. I remember working on the issue as a NHS manager back in the day, across primary, community, and secondary care, as well as with ambulance services and local authorities. A systems response is needed, and it is important that we are all involved in preparing and planning.

I also remember just how demoralising it was for staff in the early 2000s, coming into work every day to fight fires and sort out the awful trolley waits—not to mention how unacceptable that was for patients and families. The point about the impact on staff’s mental health and morale was well made by the hon. Member for Winchester (Dr Chambers). I also saw, and was proud to be part of, the changes we made under that Labour Government to end those trolley waits, and we will do that again. That is what Lord Darzi’s report shone a searing spotlight on, including the chronic lack of capital investment that has put many hospitals into a perpetual bed crisis, particularly during peak periods such as winter cold snaps.

While we have inherited a broken NHS, it is not beaten. As we have just heard from the Chancellor, this Government have taken the first steps towards fixing the annual crisis with new capital investment. However, one Budget cannot undo the last 14 years of failure, so while we fix the foundations we are also mitigating the immediate risks. At the very least, going into this winter we will be better prepared than we were last winter. That is because the managers in the NHS will be preparing for winter rather than planning for strikes, which is what they had to do the last three years—already a significant improvement.

The health service does face challenges on all fronts, and the figures are sobering. We have heard some of them today. In September, provisional statistics showed that almost one in 10 A&E patients waited over 12 hours to be admitted, transferred or discharged. The mean category 2 response time in September stood at about 36 minutes—around double the NHS constitutional standard. I recently attended a meeting where officials highlighted the number of attendances requiring admissions are already up by 1.8% in September compared to 2023, which is continuing to place increased pressure of patient flow. Those are the results of deep structural issues in the NHS that will not be fixed overnight. But work is already under way to rebuild resilience and manage pressures across the health and care system this winter.

I will come on to the specific work being done, but I assure hon. Members that the Government are taking the issue extremely seriously. I am already meeting senior leaders in NHS England and the UK Health Security Agency every two weeks to ensure that the risks can be identified quickly and that pressures are managed effectively. Once the peak winter period hits, the meetings will move weekly and include the Secretary of State.

Local NHS systems are best placed to determine how to respond to issues in their local area. That is why NHS England has worked with local systems to ensure robust winter plans are in place at a local level. As someone who knows exactly what is involved in that planning, I pay tribute to the staff for their skill, motivation and commitment to protecting every patient this winter.

[Jim Shannon]

There is no better choice the Government can make than committing that money to the NHS—we all welcome that. Anybody who does not would be insane. I always try to be constructive in my contributions. I asked about staffing and made the suggestion to retain students wherever they do their training. Sometimes they come to the end of it and go somewhere like Australia or New Zealand to get a job. Instead of that, if Government were to consider a bursary-type system to retain the staff, I think we would be able to address some of the pressure that we have.

[Karin Smyth]

I will come on to staffing to address some of those points. The hon. Gentleman makes an excellent point about staff recruitment and retention, which is a key part of our future look at the system.

On winter planning, the Government should not be micromanaging people in local systems as they do their job. Rather, we need to focus our efforts on where they are needed the most. Notwithstanding the excellent work of individual staff, let me repeat: the NHS is broken. None of us should underestimate how difficult this winter could be, but we are taking immediate steps to cushion the blow. First, we have set out our national winter planning priorities to NHS systems, local authorities and social care providers to support operational resilience over the coming months. Secondly, we are standing up the winter operating function seven days a week to respond to pressures in real time.

Thirdly, we are expanding the operational pressures escalation levels framework to give us a clearer picture of what is happening on the ground in all our systems. The framework uses comprehensive data to keep track of hospital pressures, and this year we are expanding its scope to mental health, community care and 111. Fourthly, we are continuing to support systems that are struggling the most through the urgent and emergency care tiering programme. Those are direct interventions to help systems get back on their feet and make the necessary improvements in performance.

Fifthly, we are providing targeted, clinically-led support to 19 of the most pressured hospital sites across the country, to help long waits in A&E and avoidable admissions over winter. Those measures are in addition to the aforementioned meetings that I hold with NHS England and UKHSA every fortnight. I am chairing every one of those meetings to ensure that we identify risks as soon as they arise, while supporting NHS England to mitigate them.

The party of the hon. Member for North Shropshire has called on the Government to set up a winter taskforce to prepare for an NHS winter crisis. Some might describe what we are doing as a taskforce; I actually think that is my job and the Secretary of State’s job, which, as I have outlined, is why we meet regularly with NHSE. I know that the hon. Member and others are sincere in their efforts to be constructive. I am happy to take away any specific suggestions about what we are not doing to help the NHS, because we all want the system to work well.