Health and Social Care Leadership Review

Lord Young of Norwood Green Excerpts

Thursday 9th June 2022 Lords Chamber

[Lord Young of Norwood Green (Lab)]

My Lords, I echo the point made by my noble friend Lady Merron about the health service and the people who have done such sterling work within it. After all, they saved my life twice so I certainly recognise that.

However, I have to say that, like the report, the NHS is a bit of a curate’s egg, and we know it; it is good in parts. When it is good, it is very, very good, but when it is bad, it is dreadful—really dreadful. People die unnecessarily, as we saw in the gynaecology scandal at Telford. What worries me about that case is that I still do not see anyone being held to account for those appalling management failures. Even worse than that is the report yesterday from Birmingham of the consultant who was removing non-existent cancers from breasts and went on to practise for years without being uncovered, not only in the NHS but in private practice. We have to ask ourselves how on earth such appalling failures in accountability, management and checking are possible. I would welcome the Minister’s response on that.

I recommend that the Minister look at the Twitter account of a guy called Roy Lilley, because it is worth a look. I will give a flavour of it:

“There’s a problem with bullying and racism in the British Army. A BBC Three documentary shone a light on racism in the Army and there is still the shadow, cast by the events at Deepcut. It’s a hot topic for the Top-Brass. They’ve had reviews and all-sorts to try and stamp it out”—


and they failed. He continues:

“If they can’t fix racism and bullying in a small outfit like the Army, what chance does the NHS have … with around a million and a half people, a budget of about £3bn a week, a million customers a day and if it were a country it would be the thirtieth largest in the world. In the Army, the NHS, sport and wider society we’ll find good people, bad people, energetic, lazy, thieves, thugs, saints, angels, bullies and racists”—

[Baroness Penn (Con)]

My Lords, I encourage the noble Lord to reach his question.

[Lord Young of Norwood Green (Lab)]

I will, but hardly anyone has contributed to this debate. I have posed one question and I will pose a few more—I do not see why I should not take the opportunity. I would see why if the Chamber were full of people participating, but it is a bit rich that there is hardly anyone—

[Baroness Penn (Con)]

My Lords, attendance in the Chamber does not change the guidance in the Companion about questions on a Statement being brief and direct.

[Lord Young of Norwood Green (Lab)]

I have posed one question, and I will pose a couple more. I will move to further questions and my criticism of the report. First, I agree with a lot that the noble Lord, Lord Lilley, said. On diversity, we recently had a situation, on which I would welcome a comment from the Minister, where the NHS could not bring itself to define a woman in gynaecological circumstances—I find that somewhat unbelievable.

What are we doing about fixing the situation in A&Es where paramedics stand by trolleys for hours on end while people are dying of strokes outside? I have raised this question with the noble Lord a number of times. It can be fixed, but you have to be determined. If the noble Lord wants an example of best practice, I recommend that he look at Wolverhampton, where he will find an example. There is no mention of best practice in this report, which I find astonishing. I also note the importance of new technology being adopted in a coherent way. I look forward to the Minister’s answers to those questions.

[Lord Kamall (Con)]

I thank the noble Lord for his questions. I say up front that I am not a fan of Twitter, even though I am still on it. Frankly, I do not like social media and I try not to look at it too much—but I welcome that the noble Lord shared some of his concerns.

The noble Lord is absolutely right on bullying and harassment; they are not acceptable in any form and should not be tolerated—this is part of the NHS people plan. This goes to the heart of the review: it is about leadership and culture. We have to make sure that there is a culture where bullying and discrimination are not tolerated. Frankly, it is about not diversity officers but greater diversity, which are not always the same. As I said, we have a diverse workforce, but why do we not see more diversity in the upper echelons of our health service? It is important that bullying is tackled and that we have that culture—but this also comes from local leadership.

I am grateful to the noble Lord for the number of times that he has suggested thinking outside the box on A&E. We have looked at various pressures on it; sometimes people go to it because they cannot get a GP—how do we address that? Sometimes, people do not want to go to A&E and try other routes but end up there—so how do we make sure that those other routes are available? We are looking at how to triage better and how people can use 111 instead. There are a number of issues and, as the noble Lord rightly said, technology can play a role.