All Joy Morrissey contributions to the Health and Care Bill 2021-22

Wed 14th July 2021
9 interactions (604 words)

Health and Care Bill

(2nd reading)
Joy Morrissey Excerpts
Wednesday 14th July 2021

(3 months, 1 week ago)

Commons Chamber

Read Full debate Read Hansard Text Bill Main Page
Department of Health and Social Care
Jeremy Hunt Portrait Jeremy Hunt
- Hansard - - - Excerpts

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 Portrait Joy Morrissey (Beaconsfield) (Con)
- Hansard - -

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 Portrait Jeremy Hunt
- Hansard - - - Excerpts

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.

--- Later in debate ---
Valerie Vaz Portrait Valerie Vaz (Walsall South) (Lab)
- Hansard - - - Excerpts

It is a pleasure to follow the hon. Member for Meriden (Saqib Bhatti) and to congratulate him on the birth of his child.

First, I am going to vote against giving this Bill a Second Reading. I cannot believe that the Government are going ahead with the Bill at this time. It is irresponsible and without any consideration to those who have worked to save our lives and continue to save our lives. The Secretary of State is going to have to assert himself, because he is only just in the job and he seems to have been bounced into this legislation.

Why is this happening now? We have been through this before. I was on the Health Committee from 2010 to 2015. The right hon. Stephen Dorrell was its Chair. On a cross-party basis, we heard evidence that the Bill introduced in 2012 was not the best solution for the NHS. We managed to pause the Bill but the Government continued to press ahead.

Integrated care is Labour party policy. We have seen it. We visited Torbay, where the fictitious Mrs Smith had a single point of entry and everyone was able to track her all the way through the system—through hospital and out—for all her needs. But the 2012 Act stopped that. It stopped the pooling of resources. Integrated care can work only if there are adequate resources for local authorities. Austerity measures since 2010 have starved local authorities and other public services of funding. That is what is making people angry. But the governance of the integrated care system has no clinicians and no patients. People who use it or work in it do not get a say. All sorts of other people can be added on.

My second point is that we do not trust the Government on contracts. Look what happened during the pandemic: £347 million to Randox, the Tory-linked private healthcare company whose testing kits had to be recalled over the summer because of concerns about contamination. We warned them about section 75 and opening this out to tender. The transaction costs associated with that drain the NHS of resources. There is fragmentation and destabilisation. Just ending section 75 is not sufficient; the NHS must become the first and the default option, and private providers cannot be involved in the ICS or in commissioning decisions. We cannot have a select group of fast-tracked friends.

My third point is about the workforce and it has already been raised. They have been magnificent. They have already had a slap in the face with a 1% pay rise and now they are facing further reorganisation. Workforce planning is key to a smart organisation. Clause 33 says who is responsible, but not what must be delivered. Instead of reporting once every five years, how about laying that before Parliament every year? The modelling will have to be done on the workforce assessment, so why can it not be made transparent and available? As the British Medical Association said, we need independently verified projections of future workforce supply so that local and regional decisions can be made on safe staffing levels. That phrase is not even in the Bill, post Francis.

The Secretary of State should think again, as this is the wrong time. The graphs are going up. The BMA and the royal colleges are against this Bill. The main point about healthcare—the right to healthcare—has not been enshrined in the Bill. It must be stopped now, and people and patients should be put first.

Joy Morrissey Portrait Joy Morrissey (Beaconsfield) (Con)
- Hansard - -

May I thank Neil from Buckinghamshire Healthcare NHS Trust, Buckinghamshire County Council, the local Bucks clinical commissioning group, local GP surgeries, REACH care homes and care workers across South Buckinghamshire, Thames Hospice and Jayne from the Care Campaign for the Vulnerable? They are all already modelling integrated care, which is promised and promoted through this Bill, and I just want to thank them for their tireless service.

I also need to declare an interest: I am now a carer for a very disabled relative, who became disabled through the pandemic and now requires 24-hour care. So I am fully aware of how broken the care pathways are. I want to speak on behalf of disabled adults and their access to care, and the carers who struggle with the demands of finding ways of advocating for their loved one in the current system. I welcome any changes to integrated care because of that. I want to share examples from my personal experience, not because it is important; it just chimes with what I keep hearing from patient advocacy groups, Age Concern, Mencap and other charities. The problem we see is: when a patient is discharged from hospital, who then takes up the duty of care? I have countless examples of my relative being discharged with open bleeding wounds or bed sores, of waiting four days for a nurse to come to attend to them, of being given the wrong medication, of being unable to access—

Jess Phillips Portrait Jess Phillips (Birmingham, Yardley) (Lab)
- Hansard - - - Excerpts

I just wanted to give the hon. Lady a bit more time. Does she agree that we would want to see more in this Bill on how social care is going to be accounted for? Currently, I feel that is lacking.

Joy Morrissey Portrait Joy Morrissey
- Hansard - -

I thank the hon. Lady for the point she has raised. I have had reassurances from the Minister that we are going to address the social care issues, but I agree that we need parity of esteem between health and adult social care. We need to see those who are delivering those care pathways—local authorities—given the parity of esteem that the NHS and other care providers now have. I hope that we will look at this further as the Bill progresses.

Parity of esteem is very important because there is a difficulty with collaboration and co-ordination of care, and it is the major driver of health inequality and avoidable deaths for people with learning disabilities. Many people with learning disabilities have very complex health needs that require healthcare professionals to collaborate and to co-ordinate interventions. On top of that, healthcare staff need to work together to deliver the healthcare that those vulnerable patients need, which requires effective communication and understanding, as well as resource. How those funding streams are co-ordinated and improved in future is something that should be looked at.

I have seen at first hand, particularly with stroke victims who leave hospital with varying levels of cognitive and physical impairment, the need for critical rehabilitation services to be co-ordinated and put in place the moment people leave hospital, but that is often difficult. Many Members have raised the issue of workforce capability—I echo that. We need to look at how we can work together collaboratively to put patients first and deliver the vital services that many disabled adults need. We have an ageing population, and we face a crisis in adult social care that will eclipse all other things in healthcare. If we work to deliver solutions now—I welcome what is in the Bill—to the hard problems that we face in integrated social care, we can find the solutions that we need for the future.

Clive Lewis Portrait Clive Lewis (Norwich South) (Lab) [V]
- Hansard - - - Excerpts

With the climate crisis and the reality of an ageing population, there has never been a better time for the Government to centre the wellbeing of people and planet and the way in which public services and the economy are run. Sadly but unsurprisingly, the Bill fails in this context, so I will vote against it, because it does not fundamentally deal with the very real issues facing our healthcare system. It does not address the desert of NHS England providing oral and dental healthcare, which has made it impossible for my constituents to get an appointment. It does not guarantee fair pay and conditions for the key workers who have seen us through the pandemic, and it does not deal with the scandalous state of mental health- care. Patients in my constituency are in crisis, are discharged too early, or not admitted at all, while for a decade, Norfolk and Suffolk NHS Foundation Trust has failed to end the practice of sending patients out of area.

What the Bill does do is transfer yet more centralised power to the Executive—rightly described as a power grab by my right hon. Friend the Member for Leicester South (Jonathan Ashworth)—and, of course, to the private sector. Clause 13, which provides for the establishment of integrated care boards, opens the door to private companies having a say in where funding is allocated and what services are delivered. Clause 3 gives greater political control to the Secretary of State over the NHS England mandate without creating a duty to provide universal, comprehensive and free healthcare to all. Clause 38 empowers the Secretary of State to intervene in the reconfiguration of services, opening the door for politicised interference and gridlocks on decision making.

Where is the democracy, accountability and transparency in the Bill? How will the right of my constituents to healthcare be guaranteed over and above the interests of private companies and the political whims of the Secretary of State? To see what happens when private companies have any role in delivering care, we need only look at the social care crisis. In England, 84% of care home beds are managed by private companies, and three of the five largest care home companies are owned by investment firms whose main priority is economic rent seeking, not the long-term care of our elderly. That model has, unbelievably, led to a cut in the number of care home beds, despite an ageing population, meaning that demand is only growing.

I therefore urge the House to vote against this legislation on what remains of NHS England. It extends the same failed ideology that puts profit before people and which has driven our planet and public services to breakdown.