NHS: Doctors’ Strikes

Lord Markham Excerpts

Wednesday 5th July 2023 Lords Chamber

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Markham) (Con)]

My Lords, the Government have been clear that we want to resolve the strikes by doctors. We negotiated in good faith with the BMA’s junior doctors committee in May. The Government stand ready to meet junior doctors again if they move from their unreasonable ask of a 35% pay rise this year. We also want to open negotiations with consultants. We encourage unions to come to the negotiating table rather than proceeding with strike action.

[The Lord Bishop of Exeter]

I thank the Minister for his response. I am sure that today, on the 75th anniversary of the founding of the National Health Service, he will want to join me and all Members of this House in paying warm tribute to the hard-working nurses and clinicians in our NHS. All that underlines and underscores the urgency of settling this dispute. What consideration have His Majesty’s Government given to the request of the BMA to use ACAS to resolve this dispute?

[Lord Markham (Con)]

First, I absolutely echo the sentiment about the 75th anniversary and the hard work of all our doctors, nurses, dentists and medical staff. Clearly, we want to find a negotiated solution. I think we showed in the case of the nurses and Agenda for Change that we have a framework and the ability to find a solution between ourselves as parties. That is why we encourage them to please stop the strike action so that we can have a sensible conversation.

[Lord Dubs (Lab)]

My Lords, I join in wishing the National Health Service a happy 75th birthday—especially as, 75 years ago today, I was a teenager in Stockport Infirmary. Despite my efforts at persuading the consultant, he would not throw a party to celebrate the occasion. This dispute is dragging on, and there are some suspicions voiced in the papers that the Government do not mind too much, because on the whole they want to cut back on the health service—their heart and soul is not with the health service. Could the Minister reject that by demonstrating a greater willingness to negotiate with the doctors?

[Lord Markham (Con)]

I can totally reject that by pointing to the record spend we are putting in this area and the fact that, just on Monday, we launched the long-term workforce plan, with a £2.4 billion investment in expanding the workforce to make sure we are set fair for the next 75 years. We absolutely want to resolve the strike by all means possible.

[Lord Sherbourne of Didsbury (Con)]

My Lords, is my noble friend aware that, apparently, in the consultants’ strike, consultants are not obliged to tell their hospital whether they will be striking; nor is it possible for the hospital to ask whether they are striking. Is not the result of this that the BMA is going to impose maximum dislocation on hospitals, damaging patients’ interests?

[Lord Markham (Con)]

Clearly, that is the last thing anyone wants. I trust all the medics who, first and foremost, care about patient safety to inform their local management so that they can make sure that the correct processes are in place to ensure that patient safety is looked after.

[Lord Allan of Hallam (LD)]

My Lords, yesterday, we discussed the Government’s plans to increase the number of doctors in training. But does the Minister accept that junior doctors are facing real challenges in dealing with the rising costs of living on their current pay rates, especially in their early years? Is this need to retain trainee doctors part of the Government’s submission to the independent review body, so that we do not end up bringing in more trainee doctors at year 1 only to lose them at years 6, 7 and 8?

[Lord Markham (Con)]

Yes, of course, the noble Lord is absolutely correct; retention is key in all this. That is looking at all aspects of the package and work conditions and everything around those. That is what the workforce plan addresses, I hope, because recruitment and retention are key.

[Lord Stirrup (CB)]

My Lords, pay is the headline issue in this dispute, but behind it lies a wholesale collapse of morale within the NHS workforce, and that is about much more than just remuneration. The NHS Long Term Workforce Plan addresses some important issues but by no means all of them. Does the Minister not think that the morale issue, which is so crucial to the future of the NHS, will be better attacked through the kind of radical approach suggested by Sajid Javid than the “evolution” proposed by the Health Secretary?

[Lord Markham (Con)]

I think the morale of doctors is best approached by a number of measures. As I said yesterday, there is not one silver bullet. There are a number of things: clearly, pay is important; pensions are very important, and we have addressed those, and so are working conditions. I was at Whipps Cross Hospital, one of the new hospitals, last week. The morale boost to staff there, knowing they are getting a new hospital, is massive. All those features are vital to improving morale.

[Baroness Merron (Lab)]

My Lords, in celebrating the 75th anniversary of the NHS, I too pay tribute to all NHS staff. It is therefore highly regrettable that the Government are currently presiding over the largest amount of industrial unrest in the history of the National Health Service, with doctors’ leaders warning that the strike action could last until 2025. With that in mind, what is the Government’s assessment of the impact of their failures to resolve NHS disputes?

[Lord Markham (Con)]

As we have seen, it is having an impact, regrettably. We saw that from 14 to 17 June: almost 100,000 appointments were lost during that strike. We are now looking to cover that up. That is why we are firm in our conviction that we want to resolve this situation. These sorts of things are not good for anyone. We have a formula that worked; we have managed to do this with nurses and the Agenda for Change unions, which make up the vast majority of the health service. Our hope is that we can sit down and have sensible conversations and do the same with doctors and consultants.

[Lord Naseby (Con)]

My Lords, I thank my noble friend for his ingenuity and the work he has put in since taking over this role. All we hear of pay rises is that they should be 12%, 19%, 39% or whatever. Has the time not come for a slightly different approach? We should calculate the capital cost of whatever sections of the health service claim they have lost, pay them that cost and then revert to the normal process of review bodies.

[Lord Markham (Con)]

I thank my noble friend for his kind words. We are willing to look at all solutions. We have to balance the salary wishes of doctors with making sure that we keep the money in front-line services. Everyone is aware that pay rises of 35% would eat heavily into what we can do and afford on the front line. We need to get that balance right.

[Lord Clark of Windermere (Lab)]

My Lords, one of the greatest concerns of individuals working in the NHS is lack of confidence about the future. The real problem is retention. I understand that there is a massive shortfall of staff. Will the Minister tell us how big that shortfall is and what the Government are doing to make it up?

[Lord Markham (Con)]

The noble Lord is absolutely correct; that is why I was delighted, as I think all sides of the House were, by the launch of the NHS Long Term Workforce Plan. As Amanda Pritchard, the CEO of the NHS, said, it was a “truly historic” moment for the NHS; it absolutely recognises that staff are the backbone of it all and that we need to do everything to recruit and retain them. Retention is all about professional development and all those things that make up staff morale.

[Lord Bethell (Con)]

I congratulate all noble Lords who joined me this morning on the five-kilometre fun run in celebration of the 75th anniversary of the NHS. It was a tremendous event and all those involved greatly enjoyed themselves. With that in mind, will my noble friend explain what the NHS is doing today to reduce the incredible pressures on doctors and nurses from the huge amount of sickness in the country and what it is doing to make Britain healthier in order to reduce those pressures?

[Lord Markham (Con)]

As my noble friend says, wellness is about a lot more than treatment in hospitals. That is why I was so pleased by the long-term workforce plan, which recognises the importance of primary care and, especially, prevention—the use of our whole wellness through social prescribing and keeping fit through things such as fun runs, which is important for keeping people and staff well. As part of that, we are working on the technology front, because a lot of the frustration of doctors is that they spend so much time not seeing patients but filling in paperwork and forms. Earlier this week, I saw all the changes Chelsea and Westminster Hospital is making so that doctors can be where they want to be—in front of patients and caring for them.