Tuesday 22nd October 2019

(4 years, 5 months ago)

Lords Chamber
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Lord Patel Portrait Lord Patel (CB)
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My Lords, it is a pleasure to follow the speech of the noble Baroness, Lady Doocey. I have of course been deprived of being able to congratulate the noble Baroness, Lady Emerton, on her valedictory speech, but nevertheless I would like to put on the record some points because I think that she might have been amused by what I have to say about her.

I never referred to the noble Baroness as “Baroness Emerton” or “Audrey”—I always called her matron. I think she enjoyed the idea that I, as a perhaps one-time senior doctor, was petrified of matron, as I always was. She is a formidable lady and was referred to as such by the noble Baroness, Lady Cumberlege, on the day she made her maiden speech. I say to the noble Baroness, Lady Watkins, that three nurses spoke that day: the noble Baronesses, Lady Emerton and Lady Cox, and Lady McFarlane of Llandaff—three formidable ladies, you might say. We all know that the noble Baroness, Lady Emerton, has contributed an enormous amount, quite forcefully, and has championed the causes she felt strongly about—particularly the health service and, within it, the important role that nurses play. I was interested to see that her motto is “Pro fide, pro utilitate hominum”—quite appropriate for a nurse, you might say. A more appropriate motto for her might have been “Cibum non est mecum”. I hope my Latin from a long time ago makes the point. For noble Lords who cannot translate: “Don’t mess with me”.

The Queen’s Speech said:

“Measures will be brought forward to support and strengthen the National Health Service”,


and its workforce. Furthermore, it said that legislation will be brought forward to establish,

“an independent body to investigate serious healthcare incidents”.

It also said:

“My Government will bring forward proposals to reform adult social care”.


It has been said enough already that there is, as yet, no Green Paper on reforming adult social care; we all await that.

Furthermore, the Speech said that:

“My Government is committed to establishing the United Kingdom as a world leader in scientific capability”,


and that there will be,

“a more open visa system”,

to encourage and recruit talented individuals from overseas to support our science. We have no workforce strategy as such. We have repeated comments that we are recruiting more nurses or doctors, or that we have more places for medical students or nurses. But the challenge of the NHS and social care workforce is far too great to be dealt with by those policies. I do not criticise the Government; I just say that more needs to be done.

The report following the House of Lords inquiry, The Long-term Sustainability of the NHS and Adult Social Care, made the point that the greatest challenge the NHS faces for its sustainability is its workforce. We need to do more about it. Let me give a small example. I thought the Government would bring in legislation to regulate health professionals following their July report, Promoting Professionalism, Reforming Regulation, but that did not happen. The legislation that governs the UK’s medical regulation is not fit for purpose. Noble Lords might be shocked to hear me to say that, but it is true. It is the regulation that followed the Medical Act 1983. It does not allow the flexibility to easily put on the registers GPs and specialists, particularly fully trained senior people. It has no flexibility and legislation is needed to change that. The General Medical Council is very open to this and wishes it would be done, but it is not in the Queen’s Speech.

Making specialist and GP registration more flexible could make it more accessible to doctors to join both registers and would go some way to dealing with the workforce required. We are trying to recruit more doctors because we are short of psychiatrists—as we heard yesterday—geriatricians, radiologists and many others. There is an enormous shortage of nurses, too. Change here would be helpful, and I hope the Government will bring in legislation through another Bill; otherwise, I will be minded to put forward an amendment at some stage to do this.

I now come to the science side. Two-fifths of the UK’s academic workforce in science and technology are from overseas, and 50% of postgraduate researchers are overseas staff, so we need to make sure our visa system is more flexible.

Finally, I will have a lot to say about the Health Service Safety Investigations Bill when it comes to Second Reading. All I will say at this stage is that I wish we had not started it in this place.