The NHS

Lord Pendry Excerpts

Thursday 5th July 2018 Lords Chamber

[Lord Pendry (Lab)]

My Lords, I, too, congratulate my noble friend on initiating this important debate. It is true that the National Health Service has grown under successive Governments, but currently the growth is slower than at any time in its history. Even the latest cash injection, recently announced, will, in the view of many health service organisations and influential experts, including the Association of Directors of Adult Social Services, the MS Society and the local government society are saying that it is clearly disappointing, that funding is at a standstill and that it is a sticking plaster at best.

The statement from the Prime Minister that social care must wait until 2020 for extra funds—which will not be additional to the £20 billion injection—beggars belief. Where, however, does that leave the Secretary of State? During the debate of 25 January I congratulated him on standing up to the Prime Minister with his implied resignation threat. However, when he was appeased with another string to his bow—the addition of social care to his title—he backtracked. I, and no doubt he, along with others, believed that that would bring extra cash on top of what came with his previous title. Since then, the Prime Minister has made it absolutely clear—Green Paper or not—that no extra money will be forthcoming. Surely Mr Hunt expected more money—for mental health issues, obesity, carers and the vulnerable in our society—when he threatened resignation.

The honourable thing to do, surely, is to adhere to his earlier threat and resign. Ruling out any increase in social care until 2020 makes a nonsense of giving the Secretary of State the additional handle of social care. By definition, that means extra responsibilities and funding now. That is what I thought when we debated the National Health Service and social care in January and I said that the Secretary of State had a golden opportunity—when the Green Paper comes to light—to prove his critics wrong and produce a meaningful improvement in social care provision. Unhappily, however, the Prime Minister has done it again: another promise not kept.

As the noble Lord who introduced this debate said, in a debate of this kind it is important to remind the nation—especially on the 70th birthday of the NHS—that it was Clement Attlee’s Government, and no other, that brought to life the National Health Service, and hopefully to end for all time the lie espoused by Jeremy Hunt at the last Tory party conference, when he claimed that the Tories, and not the Labour Government, invented the National Health Service. History books, and Hansard, clearly show that it was Aneurin Bevan who introduced the first comprehensive national scheme in 1948, when Tory luminaries Winston Churchill, Anthony Eden and Harold Macmillan—all former Tory Prime Ministers—were among other Tories who voted against the implementation of this bold policy. The result of that vote was an enormous victory for the Labour Party and for the nation. I hope that this gigantic lie by the Secretary of State will be laid to rest for ever.

NHS and Social Care: Winter Service Delivery

Lord Pendry Excerpts

Thursday 25th January 2018 Lords Chamber

[Lord Pendry (Lab)]

My Lords, I begin by thanking my noble friend for initiating this important debate. She exactly the right person to do so, bearing in mind her trade union background—as an official of a union which happens to be mine, serving public employees including various union members in the health and social care sectors. I also thoroughly enjoyed hearing the contribution of my noble friend Lady Pitkeathley, a real champion for carers, as was reflected in her speech. I have another reason to be grateful to her: together with the late Lord Alf Morris, she ably steered through this House my Private Member’s Bill, enabling it to become the Carers and Disabled Persons Act 2000. The limit on the speeches in this important debate is so restrictive that I can make merely a few points, with apologies to Carers UK, Age UK and others who have taken the trouble to give me material for my contribution.

I have long since advocated the merger of health and social care within one department. After all, they are one of another. It is clearly a step in the right direction, and I must say that some credit must go to the Secretary of State for standing up to the Prime Minister, who wanted to sack him. He has shown some muscle by standing his ground. We now know that he has the opportunity to flex those muscles with his new title embracing social care. But he must now ensure that cash follows this important step forward. If not it will be seen as just a gesture—merely a change in name with little substance.

Now we all await the long-overdue Green Paper, which should be followed quite quickly by a White Paper and an Act of Parliament, reflecting the true purpose of the 1947 Act. In truth, there is no clear definition of social care for it is so diverse—from cradle to grave, and taking in the current plight of our children who rank in the lower leagues of Europe and beyond. While Scotland and Wales face similar funding strains, they are coping rather better than England, having introduced measures such as banning smoking in playgrounds in Wales and developing stronger mental health schemes for children in Scotland. Child poverty is at its highest level in the UK since 2010, and measures need to be taken to ensure that the health of our children is not being put at risk.

At the other end of Mr Hunt’s responsibilities is tackling the plight of the elderly in our society. The care system in the country is close to breaking point, and it is estimated by Age UK that there has been a real-terms public spending cut of some £160 million to older people’s social care in the last five years. It goes on to point out that 1.2 million people aged 65 and over are in need of care and support, which represents an 18% increase on last year alone. It means that one in nine are living below the poverty line, which is a disgrace in one of the richest countries in the world.

I cannot conclude my remarks without stating something said by my former GP and vice-president of the BMA, Dr Kailash Chand. He points out that the Government’s health plans are based on the reverse of NHS principles; instead, the greater your care needs, the more you pay. In the case of social care, which is beset with multiple providers, there is less state provision and more privatisation. That is also my view. Mr Hunt now has a golden opportunity to prove his critics wrong, and I hope he can do that. He has the perfect occasion to do so when eventually the Green Paper arrives. So, Secretary of State, this is your chance to shine.

NHS: Staff

Lord Pendry Excerpts

Thursday 30th November 2017 Lords Chamber

[Lord Pendry (Lab)]

My Lords, the Motion before the House, so ably moved by my noble friend Lord Clark of Windermere, is indeed timely. As the House knows, the National Health Service is probably going through its most difficult time since its inception, yet the Government’s attitude seems to be one of utter complacency.

When the Government—or, more specifically, Jeremy Hunt, the Secretary of State—hint that staffing in the health service is a priority and they are investing in what they call the “front line”, it hardly squares with the facts. At a time when more people than ever are using its services, it seems obvious to almost everyone except the Government that the fall in the numbers of nurses and health staff will result in a shortage of these essential workers, which is estimated to be in the region of 42,000 in the near future. Problems are especially acute in spheres of nursing such as district nursing practice and nursing in psychiatric care, where there has been a reduction of some 12% since 2010.

That these shortages cause pressure is borne out. For example, two-thirds of the respondents to UNISON’s annual survey reported that wards were so understaffed that nurses did not feel that they could guarantee safe, dignified and compassionate care. One must consider that those were among the main reasons why most nurses wanted to work in the National Health Service in the first place—it was certainly not for the pay they would receive. It is a fact that, on top of receiving inadequate salaries—we know that is the case—many in the health service find that the pressure can often produce physical dangers for both patients and staff. UNISON’s survey of mental health workers revealed an increasing risk of attacks on staff, driven in part by shortages.

We are now witnessing a vicious circle in which shortages of staff lead to them having to take on extra workloads. That leads in turn to fears for their own safety and that of their patients, which is having a damaging impact on their morale, and hence staff leave the service in great numbers. Therefore, pay by itself is not the reason for the staff shortages; low morale remains an enormous barrier to recruitment and retention, and it must be addressed by the Government.

The fiscal policies of this Government remain a major factor, about which my noble friend has already spoken. The recent attempt in the Budget to loosen the purse strings was but a half-hearted measure. Despite all the warm words from the Tory party before and during the general election, nothing of real substance has emerged since. In truth, most National Health Service workers have failed to receive a pay rise worth speaking of since 2010, due to the pay freeze and the pay cap of 1%. It is no wonder that the Royal College of Nursing has reported a “growing number” of nursing staff using food banks, taking on additional jobs and accruing personal debt.

Jeremy Hunt’s latest revelation in the Health Service Journal showed that staff could potentially lose extra amounts for working anti-social hours under his so-called “more professional” pay structure. That prompted the Royal College of Midwives to accuse him of being “ill-briefed”, and Sara Gorton, head of health at UNISON, went so far as to say that talks between the Government and her union would be,

“a very short set of talks indeed”.

It is not right that both Scotland and Wales can give their health workers a living wage, yet their counterparts in England cannot.

Of course, all the problems aired in today’s debate have been compounded by the uncertainty and possibly larger problems which could be awaiting the National Health Service with our possible exit from the EU. For instance, there was the revelation in January 2017 that there had been a drop of 92% in the number of EU nurses registering with the Nursing and Midwifery Council. Surely that alone should have been a wake-up call for the Government to recognise the serious consequences for recruitment that could lie ahead. The number of nurses from the EU leaving the NHS increased by 38% last year compared with the previous 12 months, and a mere 46 nurses registered with the Nursing and Midwifery Council in April this year.

It is a fact that in some areas the National Health Service is dependent on workers from the EU, especially in London and the south-east. It is obvious—is it not?—that reassurances should be given. It is not enough for the Government to say that they are confident that EU workers in the NHS will be able to stay, with the rights that they currently enjoy; instead, they should give a concrete assurance that those staff will definitely be able to continue to work in the NHS post Brexit. After all, did not that same reassurance come from the mouth of Jeremy Hunt in his speech at the Tory party conference?

At the risk of being accused of repetition—I know that the Minister believes that I bring party politics into this—the reason one cannot take the Secretary of State’s word as gospel is that, in the same speech, he made a colossal blunder by stating that the NHS was the child of the Tory party and a certain Minister in the coalition Government, a Mr Willink, who introduced what he called a consultative document in 1944. This was issued before Nye Bevan introduced a comprehensive National Health Service, which was approved by 187 votes in 1947. Tory luminaries such as Sir Winston Churchill, Sir Anthony Eden, Harold Macmillan, Rab Butler and other notable Tories were against it, including the man whom Mr Hunt named as the founder of the National Health Service, the hapless Mr Willink.

With those words, I merely ask whether the Secretary of State can expect nurses, the nursing world and the National Health Service to believe his words and his authority when he tells EU workers that they are safe in his hands and his assurances about their rights to stay after Brexit. I doubt it.

Queen’s Speech

Lord Pendry Excerpts

Thursday 29th June 2017 Lords Chamber

[Lord Pendry (Lab)]

My Lords, surely over the past six years we have witnessed the worst period in the history of the National Health Service. I make no apologies that from the outset I will refer in the main to the problems faced in the north-west of England. I am indebted to Dr Kailash Chand, the deputy chair of the British Medical Association, who used to be my general practitioner in Stalybridge. He points out that the problems in the Greater Manchester area are very acute, particularly in the accident and emergency section, which is under record strain, he says, with black alerts being regularly sounded and patients in need of care often being turned away.

In the community, general practice is on life support. GP practices in Greater Manchester are struggling, owing to the failure of this Government to provide the investment needed to match the increasing demand on services. Underfunding, increased red tape and GP shortages have left many patients struggling to get appointments, while 300 GP practices across the country are facing closure. Recent BMA surveys reveal that a third of GP partners in the north-west say that they have been unable to fill vacancies in the past year, and 86% said that their workload is affecting the delivery of patient care. Bed shortages, lack of mental health resources, underfunded social care and one of the worst winters on record have left services in the region struggling to cope. Reference in the gracious Speech to proposals to improve the basis of mental health provision is clearly welcome and awaited. Hopefully it will be rather better than the previous promises, which were woefully inadequate.

Mental health is in crisis, and we know that there is no health without mental health. A former medical health director of a mental health trust reports, “Mental health services are now more fragmented than ever, with a serious shortage in beds and community provision. There is parity of mental and physical care simply in name alone”. Moreover, the Care Quality Commission reports that only 14% of patients say that they received appropriate care in a crisis. That is hardly surprising, given that the number of psychiatric beds has dropped by 39% since 1998, 40% of mental health trusts experienced reductions in income in 2013-14 and 2014-15, and the shortage of beds has resulted in out-of-area placements, which are of course inconvenient to the families and friends of patients, and very costly. Meanwhile, detentions under the Mental Health Act have increased every year since 2009.

I have a particular interest in the problems that beset Alzheimer’s disease. On a personal level, a member of my family is currently in a care home, and the carers in those homes deserve better remuneration than currently exists. In 2000, I was fortunate to win a place in the ballot for Private Members’ Bills in the House of Commons, and I opted for a better deal for carers. As a result, my deal is on the statute book as the Carers and Disabled Children Act 2000, which in some degree has helped carers, although much more has to be done.

Last Saturday, I attended a charity function in my former constituency to help a former constituent of mine, Peter Flanagan, who has been diagnosed with dementia pugilistica, a particular form of the disease that affects former boxers and footballers. It is a neurodegenerative disease, which in itself is rare. However, we all know that there are many forms of dementia, which is the biggest killer in the UK. Peter, together with a colleague, is about to walk for six days on a route along the Great Wall of China to raise money for charity, and he will donate the proceeds to the Alzheimer’s Society. The biggest donor should of course be the Government. We should not have to rely on brave people like Peter to do what he is having to do to bring this to the attention of the Government.

Had there been more time, I would have liked to have referred to the excellent work done by the Teenage Cancer Trust, of which I am a patron. That will have to wait for another day, but I will say that it is critical that the Government make an explicit commitment to continue to implement and prioritise the need for the work that is done by the Teenage Cancer Trust. The next generation should be the first that is not afraid to talk about cancer, and the trust is committed to the idea that young persons so affected should be educated about this terrible disease.

Finally, due to the first-class service that it provides us with, the House of Lords Library has given me valuable information: the voting figures for Nye Bevan’s National Health Service Act 1946, which was passed by a majority of 187. Notable among those who voted against it were Sir Winston Churchill, Sir Anthony Eden, Harold Macmillan, Rab Butler, and many other notable Tories. Should there be any doubt which party is the party for the National Health Service?