Urgent and Emergency Care Recovery Plan

Lord Forsyth of Drumlean Excerpts

Thursday 2nd February 2023 Lords Chamber

[Lord Markham (Con)]

I thank the noble Baroness for her question and her recognition of the 12 hours. In all these spaces, data is always the way that you give a backdrop to better services, and 12 hours is part of that. As regards capacity, I totally agree that we need more of it. I was surprised by what she said—I will find out some more about it. However, the absolute direction is a recognition that, with Covid and flu, what might have been the right number of beds a couple of years ago is not today. That is why we are committed to the 5,000 extra beds and, just as importantly—potentially more so—the 50,000 in virtual wards, because that is using technology to look at how we can expand supply, and absolutely critical to that is having the workforce.

[Lord Forsyth of Drumlean (Con)]

My Lords, my noble friend quite rightly pointed out that there are more doctors than ever in the NHS, but many of them are in training. As my noble friend Lady McIntosh pointed out, we are losing very senior and experienced doctors because of the rules that apply on pensions. My noble friend said that this was being addressed. I remember raising this several years ago—it is a continuing problem. What is worse is that doctors leave the NHS because of the tax implications for their pensions and then come back and cost it even more money. My noble friend says that this is being addressed, but in the autumn I heard the Chancellor say that he was going to freeze the level of the maximum amount that counts towards the pension before you pay tax for the next three years—so how is that addressing the problem? Is it not an urgent problem? We may be putting more people into the service who are in training, but we are losing people out the bottom at a greater rate.

[Lord Markham (Con)]

I thank my noble friend. As I mentioned just now, retaining doctors is critical, and pensions are a key issue. We had an excellent debate on this a couple of weeks ago. Again, we are working on all of that with the Treasury. However, as I said then, the simplest thing is that, while I understand the Treasury’s concern about making special rules for special groups and the potential knock-on from that, we can very quickly make sure that, if people are hitting that pension ceiling, they can get the equivalent pay in their pay package very quickly. As a health department we have the ability to do that, to make sure that no one is financially losing out from that. If it does not make sense for them to get it through their pension, they can get it through their salary instead. I am not saying that that is perfect, and more work needs to be done across the Treasury, but we can do that quickly.