Building an NHS Fit for the Future

Liz Kendall Excerpts

Monday 13th November 2023 Commons Chamber

[Liz Kendall (Leicester West) (Lab)]

It is a real pleasure to close this important debate and to follow my hon. Friends the Members for North Tyneside (Mary Glindon) and for City of Durham (Mary Kelly Foy) who spoke powerfully about the need to take more action to help people quit smoking and not take up smoking in the first place. As a former smoker myself, I wish to goodness that I had never ever taken it up, and I can reassure Members that a Labour Government would do everything within our power to take further action in this area.

My right hon. Friends the Members for North Durham (Mr Jones) and for Walsall South (Valerie Vaz), and my hon. Friends the Members for Tooting (Dr Allin-Khan) and for Putney (Fleur Anderson) rightly held the Government to account for once again failing to bring forward legislation to reform the Mental Health Act 2007, despite all the serious problems that need addressing, all the promises that have already been made and the cross-party agreement that there is on the need to act.

My hon. Friends the Members for Blaydon (Liz Twist) and for Liverpool, Wavertree (Paula Barker) talked about the importance of reforming social care—another area where promises have repeatedly been made and repeatedly been broken—and the real importance of giving older and disabled people more support in the community, rather than their ending up in hospital, which is worse for them and worse for taxpayers.

My hon. Friends the Members for Ellesmere Port and Neston (Justin Madders) and for Ealing North (James Murray) rightly talked about the desperate need to build more affordable housing, including social housing, to tackle problems in the private rented sector, and to reform leasehold. Those are huge issues in my constituency. My hon. Friend the Member for Nottingham South (Lilian Greenwood) talked about the terrible problems of people waiting in huge pain and distress in ambulances or on trolleys in A&E, and many hon. Members talked about the need to improve GP access and dentistry care.

Last but by no means least was my hon. Friend the Member for Luton South (Rachel Hopkins), who talked about the fantastic work her council is doing to tackle health inequalities, and the need to understand that a good job is part of a healthy life, and good health is vital to getting a job.

The point that I wish to make today is that the health of our nation is critical to the health of our economy and that, after 13 years of the Conservatives, both are in a perilous state. There was nothing in the King’s Speech to address these problems or meet the scale of the challenge we face. But Labour has a plan: to improve the health of the nation; to get Britain working again; and to give our country its future back.

Ministers repeatedly attempt to claim that everything in the garden is rosy when it comes to the state of our economy and to employment, but the truth is that we are the only country in the G7 with an employment rate that still has not returned to pre-pandemic levels. The underlying reason for that is the increasing number of people out of work due to long-term sickness. Some 2.6 million people are now shut out of the labour market due to ill health, which is the highest number ever. Frankly, that is a scandal in what is still, despite all our problems, one of the richest countries in the world. Around half of this group are more than 50 years old—that is more than double that of any other age group—and musculoskeletal problems, such as bad hips, knees, backs and other joints, are the most common problem.

Many of the over-50s are also caring for elderly, sick or disabled loved ones, for which there is precious little help and support. Women are consistently more likely to be workless due to long-term sickness than men. Indeed, women account for more than two thirds of the increase that we have seen over the past decade. But the rise in worklessness due to long-term sickness is not just an issue for older people; there has been a sharp and hugely worrying increase in the number of young people not working due to ill health, predominantly driven by mental health problems—an issue that many of my colleagues have raised. The number of 18 to 24-year-olds who are workless due to ill health has doubled in the last decade, while the number of 24 to 35-year-olds has almost trebled. Those problems are even more likely for young people who lack basic qualifications and who live in parts of the country that are struggling economically, often outside our big cities in towns and rural and coastal areas.

The fact that such problems are more likely to affect certain parts of the country in the midlands and the north comes as no surprise to Opposition Members. In Conservative Britain, people are twice as likely to be out of work due to ill health if they live in one of the most deprived areas in England than if they live in the least deprived areas, with rates of economic inactivity due to long-term sickness in the north-east and midlands almost double that of London and the south-east.

That really matters to families, to our economy and to wider society. Being shut out of work because of poor health is terrible for individuals, especially during a cost of living crisis. It is bad for businesses, which need to draw on the skills and talents of all our population if they are to grow, expand and thrive. It is also bad for taxpayers, who are now paying an extra £15.7 billion a year in lost tax revenues and higher benefits bills, compared with before the pandemic. The Office for Budget Responsibility says that the rise in health-related economic inactivity poses a significant risk to our fiscal sustainability, because it reduces our prospects for growth, reduces tax receipts and puts ever-increasing pressure on health and welfare spending.

Yet despite all that, we have not seen a plan from Conservative Members that is anywhere near serious enough to get Britain working again. No doubt, when he rises to speak, the Secretary of State for Work and Pensions will tell us about work coaches and health MOTs for the over-50s. I am not against those measures—I support them; I have met work coaches in my own jobcentre, and I know how hard they are working to try to support people back into work—but they are nowhere near big or fundamental enough to get to grips with the root causes of worklessness, or to reform the way the system runs.

Britain deserves so much better, and that is what Labour will deliver. Our top priority will be to ensure that everyone who can work does work. We believe that the benefits of work go beyond a payslip to the dignity and self-respect that good work bring. We will tear down the barriers to success, tackle the root causes of worklessness and get Britain working again.

Our long-term plan for the NHS will invest an extra £1.1 billion a year, paid for by abolishing the non-dom tax status to provide 2 million more appointments a year and clear the NHS backlog—[Interruption.] The hon. Member for North West Norfolk (James Wild) laughs, but I say to him: if you were a woman stuck on a waiting list, waiting for help and treatment for your hips, for your knees, for your back, you would not be laughing. We will recruit 8,500 more mental health staff, with support in every school and every community to tackle mental health problems in young people early on.

But that is not all. We will transform jobcentres so that they provide personalised help and support, work in genuine partnership with local employers and services, and help people not just to get work, but to get on in their work, with all the benefits that progression from low pay brings. That is an issue that the Government’s own review said they needed to tackle, but they have completely failed to act on it.

[Richard Fuller]

For a shadow spokesperson, the hon. Lady is making some good points, but she has just raised the interaction of the non-dom status and the health service. As she will be aware, the General Medical Council said today how important it was that we continue to attract doctors from overseas, but many would be impacted by a change in the non-dom status. How will Labour’s policy affect our ability to recruit people from overseas for our health service?

[Liz Kendall]

I have spoken to many doctors who come to work in the hospitals in my constituency—

[Mohammad Yasin]

And Bedford.

[Liz Kendall]

—and in many other parts of the country, and they want to come, work and support the work that we do. We have looked at all those issues and taken them into account, and made a small-c conservative estimate of the impact that it would have. We are confident that that will provide the resources we need to get the backlog down and get Britain working again.

We will overhaul skills with new technical excellence colleges and by reforming apprenticeships, so that no one is ever written off again, whatever their age. We will devolve employment support to local areas to better meet local needs, because the man—or even woman—in Whitehall can never know what is really needed in Leicester, Liverpool or Leeds. We will grow our economy in every part of the country by getting Britain building, through our plans to make Britain a clean energy superpower, and by ensuring that we are the best place to start up and grow a business.

Those are the long-term changes that our country needs. In contrast, the King’s Speech just tinkered at the edges or ignored those problems all together. And what have we seen today? The latest round of chaos, confusion and division in the Conservative party—a party so concerned about its own future that it cannot focus on the future of the country, proving once more than it can never be the change from 13 years of its own failure—and a weak Prime Minister, finally forced to sack his Home Secretary, and to bring back a former Prime Minister he accused only weeks ago of being part of a failed status quo, in a desperate attempt to save his own neck. The people of this country deserve better. They want change. It is time for an election so Labour can give Britain its future back.

--- Later in debate ---

[Mel Stride]

I have just set out for the right hon. Gentleman two very significant actions that this Government have taken: £2 billion of additional funding compared with just four years ago, and a staff increase of some 20% since 2010.

I have to pick up on the non-doms point, because we hear it so often from the Opposition. Those poor old non-doms are going to be paying for the entire British economy over and over again. They pay UK taxes on their UK income, and it is just not realistic to expect to be gaining more tax in the longer term as a result of taxing them.

We have heard much about waits for NHS services. We have been working very hard on that issue, and it has to be recognised that we have had a pandemic, as well as a considerable amount of industrial action. Frankly, if the Opposition had done more with their trade union paymasters to encourage them to go back to work, we would have had smaller backlogs than we do at the moment. We have already largely eradicated the 18-month waits; the two-year waits have already been abolished; and we are rolling out all sorts of approaches to make sure we have more provision going forward, including 140 new surgical hubs. When Labour tells us about their plans, we need only to look at Wales, where we can see the results of Labour’s stewardship of the health service: on average, waiting times in Wales are five weeks longer than in England.

The hon. Member for Leicester West spent some time discussing employment, an area in which we have a first-class record. Economic inactivity, which she raised, is almost 300,000 lower than it was at its peak during the pandemic: it is below the average level of the OECD and the average level across the European Union. Unemployment is at a near-historic low, the number of those in payroll employment is at a near-historic high, and youth unemployment is down 44% on 2010. What happened under the Labour party? As Opposition Members know, it went up by almost exactly the same amount—another 44%. Labour is the party of unemployment; it has never left office with unemployment anything other than higher than when it came in. Under Labour’s stewardship, 1.4 million people were languishing on long-term benefits for over a decade, and that is a disgrace.

[Liz Kendall]

The Office for Budget Responsibility has said that

“A sustained rise in health-related inactivity poses a significant risk to fiscal sustainability by reducing the UK’s medium-term economic growth prospects and tax receipts”.

Does the Secretary of State disagree with the OBR?

[Mel Stride]

I do not, inasmuch as I recognise that long-term sick and disability has been on a rising trend for at least five years now. The hon. Lady knows that, but that is not the point that I was making; neither was it the point that she was making when she referred to the figures on economic inactivity.

That brings me to what this Government are doing. In the previous Budget, the Chancellor set forth plans for £2 billion to go towards resolving issues around long-term sickness and disability. We have consulted on occupational health across businesses to get upstream of this issue. The hon. Lady will know of our White Paper and the structural reforms that will make sure that, for the 2.5 million people on long-term sickness and disability benefits, we always focus on what those people can do, not on what they cannot do. The universal support we are rolling out is there to place people into work and give them a whole year’s worth of support, so we can make sure that those people stay in work. She will be aware of the pilots that we are now rolling out under the Work Well banner, which are there to bring people together with work. We believe that is one of the answers to mental health issues alongside medical support. Of course, we have just concluded our work capability assessment consultation, in which we are looking at how we can further help those people who can and want to work to go into employment, because we believe that that, ultimately, is in the best interests not just of the economy and of society, but very much of those people themselves.

This Government are not afraid to take long-term decisions in the national interest. The next generation of welfare reforms that I am bringing forward are part of this Government’s mission to deliver a better future for everyone across the country. It is a future that brings together employment support and healthcare to help disabled people and those with health conditions to realise their full potential. It is a future in which, thanks to the decisions we are now taking, the NHS can deliver better care in a changing world. It is a future that sees the first smoke-free generation become a reality, a future in which the most vulnerable in society continue to be the Government’s priority and are protected, and a future where work grows our economy, but perhaps more importantly still, changes lives, with thousands more people enjoying all the financial, social and health benefits that employment brings.

Ordered, That the debate be now adjourned.—(Mr Mohindra.)

Debate to be resumed tomorrow.