Strikes (Minimum Service Levels) Bill

Debate between Justin Madders and Rachael Maskell

Consideration of Lords message
Monday 17th July 2023 Commons Chamber

[Justin Madders]

That is a very good question. My understanding—no doubt the Minister can correct me if I am wrong—is that it is still up to the employer to determine what work notices it issues, which makes the Bill a little ludicrous.

All these consultation papers, all these impact assessments, and we are still legislating in the dark.

[Rachael Maskell]

My hon. Friend has just made a valid point, because when NHS Employers and the NHS Confederation came before the Select Committee on Health and Social Care, they said that they did not want any of this legislation. Presumably, following that logic, they will not have to issue minimum service level terms for a strike.

[Justin Madders]

I thank my hon. Friend for her intervention. That is why it would have been so interesting to see what the consultation responses were to the draft regulations, because those might have told us whether employers were saying, “Don’t do this; we don’t think it is going to work.” We know that a long list of employers’ organisations are opposed to this Bill, and I will come on to that in a moment. They understand that, ultimately, it is not going to help industrial relations but will sour them.

In summary, the Bill’s impact assessment turns up late and is inadequate; no pre-legislative scrutiny or evidence sessions for the Bill took place; the Committee stage is rushed through in one day; and subsequent consultations are incomplete and leave many questions unanswered. Yet the Government still say that this Lords amendment is not necessary. The evidence to date and the opinion of the ILO say otherwise. I referred to the fact that the ILO is not alone in expressing concerns about the Bill. Many organisations have expressed alarm, including the Equality and Human Rights Commission, the Joint Committee on Human Rights, NHS Providers, the rail industry, the Chartered Institute of Personnel and Development, the TUC, and the Welsh and Scottish Governments. The Transport Secretary and the Education Secretary have also done so, and I could give more names, but I have only an hour for this debate and so I will leave it there.

When we have the shameful spectacle of the ILO calling this Bill out, Members need to think again. By rejecting this Lords amendment, the Government are, in effect, saying one of two things: either they do not know whether they break international law; or they do know but they just do not care. We ought to care, we ought not to be trailing behind in workplace protections, and we ought not to be mentioned in the same breath as Turkmenistan. We ought to be leading from the front, as an exemplar for other countries to follow and a leader on the international stage that says, “Yes, good workplace rights and strong trade unions are a key component in any prospering modem economy, and the right to withdraw your labour is a fundamental one.” However, this Bill is the hallmark of a weak Government who have run out of steam, have nothing left to offer but division and want to silence the very people who keep this country going—shame on them.

Strikes (Minimum Service Levels) Bill

Debate between Justin Madders and Rachael Maskell

Consideration of Lords message
Wednesday 21st June 2023 Commons Chamber

[Rachael Maskell]

I should refer to my entry in the Register of Members’ Financial Interests.

My hon. Friend makes a very good point about the jurisdiction of trade unions. I have said this in the House before, but Government Members just do not seem to understand it. It is the members of the trade union who determine what happens within a trade union—it is not a general secretary or even an executive, but the members—so how are they, as individual members, going to instruct workers to attend work?

[Justin Madders]

That is really a question for the Minister, and one that I think the Government have failed to answer adequately. I think the point my hon. Friend makes is a good one. When Conservative Members traduce the union barons, they actually traduce every single member of the trade union who has voted in support of industrial action, and I am afraid that that is no way for any Government to operate.

I would ask Conservative Members, not that there are many here, to consider what the Bill actually means. Representatives of trade unions will be required to encourage, cajole, advise, pressurise or even demand that their members cross a picket line. They will be asking trade unions to actively go against the very thing they were set up to do. I would say that it is a bit like asking a Conservative MP to vote in support of higher taxes, but I guess that, with the highest tax burden in over half a century, we may have to drop that particular analogy.

Health and Care Bill

Debate between Justin Madders and Rachael Maskell

Report stage
Tuesday 23rd November 2021 Commons Chamber

[Justin Madders]

New clause 29 and amendment 10 are the starting point, not the whole answer. They are a framework for getting this right in the future and offering the workforce, which, as the Minister said, has given so much in recent times, some hope that there will be better times along the way. I will refer later to the report by the Health and Social Care Committee on workforce burnout, which brought home just how demoralised the workforce have become and why they need to be given some positive news today.

[Rachael Maskell]

Anyone who on Sunday was on the March with Midwives will understand the real crisis now facing that profession—a particularly acute once since it is also about women’s health. Is there not a need to ensure that plans are not just on paper, but expedited, so that we are sure of seeing real delivery of those much-needed staff?

[Justin Madders]

Like just about every profession and sector in the NHS, midwives are under tremendous pressure and are understaffed. We need a clear plan, and a plan that is delivered. Of course, having a plan is not the whole answer, which is why it is important that we hear regular reports back from the Secretary of State on progress. That is why we hope amendment 10 will be supported.

--- Later in debate ---

[Justin Madders]

I accept what the right hon. Member has said. There has been a gap in investment in IT and other things that make people’s jobs easier and more efficient, and that has been a characteristic of NHS spending over the last decade.

With your permission, Madam Deputy Speaker, I will try to make some progress, but it is important, as we have talked about the staff, that we pay tribute to all those who make the NHS what it is today. On Nursing Support Worker Day, I pay tribute to all those who work in wards, clinics and community settings to support our nurses and provide that essential hands-on care to patients.

Our care system does indeed face a crisis—over waiting times, over recovery—but as with all other crises, the root cause is inadequate funding. The most visible and significant symptom is an inadequate workforce, plus the scandal of social care provision. There is no plan at the moment; it is just a plan for a plan. When we talk about a workforce crisis, that cannot be in any way a reflection on the huge value and contribution of the workforce we have now.

There are particular positive aspects to amendment 10 to which I would like to draw attention. Explicit recognition of the need to consult with the workforce through trade unions is very welcome. The planning covers health and social care, which is also absolutely essential. Given the scope of the review, the timescale is about right—every two years is demanding, but not too onerous—but a regular update each year might be preferable. However, the main point, which I have made already, is to compel a regular report and review of demand. The central role is that the Secretary of State has a duty to get planning done, and we hope that will be a crucial lever for the change we need to see.

If the amendment has a weakness, it is probably the one we have touched on already, which is that it does not ensure that the plan is feasible or delivered. A plan that shows the gap is not a plan unless it has a credible funding solution alongside it. Even if that is not explicit in the amendment, we assume that funding would follow any such assessment and plan that is set out. Our suggestion would be that any such financial projections in a plan are subject to the same level of independent expert verification as we see with the Office for Budget Responsibility. Since all the various think-tanks are going to do an assessment anyway, we may as well have a built-in process for verification.

[Rachael Maskell]

Does my hon. Friend agree with me that many of the recruitment challenges often sit in outsourced services in the private sector, and as a result it is really difficult to find the complement of staff required because people want to work in the NHS? That needs to be taken into consideration in any workplace plan.

[Justin Madders]

I thank my hon. Friend for her intervention and I will later talk a little about outsourcing and the role it has to play. We believe that plans should be built from the bottom up, not from the top, and that implies the involvement of ICBs, NHS trusts and foundation trusts. ICBs and their strategic arms, integrated care providers, will not be functional for some time. That is a shame, but it does not mean we should not proceed with the amendment.

The scale of the workforce challenge is well established: high rates of vacancy, inadequate levels of retention, and much more. It goes far deeper than numbers and structures, to issues of workforce terms and conditions, particularly in social care. It must also cover cultural issues, as there is a clear indication that all is not well in the NHS in terms of diversity. There is also whistleblowing, and aspects of how staff are nurtured and supported. At its very best, the NHS is very good, but unfortunately that is not the story across the board. It should be good in every part.

On that theme, let me mention the continuing disgrace in the way that some members of the NHS workforce are treated. I find it unacceptable that cleaners, porters, catering and IT staff are still being outsourced by trusts that are trying to make tax savings or outsource services to the lowest bidder. Perhaps the Minister can look into the current dispute at South Warwickshire in that regard, as we do not think that is a template to follow. Workforce planning is not a problem that can be solved quickly, although increased funding in social care could help that. For the NHS, the long term is indeed a long time—for example, the time needed to develop and train GPs and consultants. More money is not the only answer; technology and reform of the way we work must all be part of the mix. However, the labour-intensive nature of care will not fundamentally change, so we must look at workforce numbers as the priority. It is often said that failing to plan is the same as planning to fail. Some colleagues believe that a failure to plan is exactly that—a route to ending the NHS as we know it by showing that it fails. However, the Bill suggests an acceptance that a plan is needed, and work is under way. Hopefully that work is not being handed out to more consultants, of whom we see enough already.

Labour will support the amendment tabled by the Chair of the Health and Social Care Committee, which we hope will be pushed to a vote. I hope I have not been too effusive in my comments about him—I have a reputation to maintain after all—but I will refer to the excellent report done by his Committee on workforce burnout, which in many ways is the cornerstone of what we are debating. In its conclusion, the Committee said:

“The emergency that workforce burnout has become will not be solved without a total overhaul of the way the NHS does workforce planning. After the pandemic, which revealed so many critical staff shortages, the least we can do for staff is to show there is a long term solution to those shortages, ultimately the biggest driver of burnout. We may not be able to solve the issues around burnout overnight but we can at least give staff confidence that a long term solution is in place.

The way that the NHS does workforce planning is at best opaque and at worst responsible for the unacceptable pressure on the current workforce which existed even before the pandemic.

It is clear that workforce planning has been led by the funding envelope available to health and social care rather than by demand and the capacity required to service that demand. Furthermore, there is no accurate, public projection of what health and social care require in the workforce for the next five to ten years in each specialism. Without that level of detail, the shortages in the health and care workforce will endure, to the detriment of both the service provision and the staff who currently work in the sector. Annual, independent workforce projections would provide the NHS, social care and Government with the clarity required for long-term workforce planning.”

That conclusion shows what we are trying to achieve today. That is the nub of it: if not now, when? When will the Government finally accept the obvious that has been staring them in the face for years?

New clause 29 would require the Secretary of State to lay before Parliament a fully funded health and care workforce strategy to ensure that the numbers, skill and mix of healthcare staff are sufficient for the safe and effective delivery of services. It builds on other amendments, and seeks further assurances by putting patient safety and safe staffing levels at the heart of workforce planning, by setting out how the Government will be required to act to assess and rectify shortages. It seeks to ensure that the workforce will be on a sustainable footing in future. Patient safety should be our primary concern. We have the evidence base: when there are not enough registered nurses, mortality rates change and health outcomes are worse. I accept that the level of detail in the new clause is significant, but we consider that necessary to underscore the importance of setting out how this will be delivered.