The National Health Service

Luciana Berger Excerpts

Wednesday 23rd October 2019 Commons Chamber

[Luciana Berger (Liverpool, Wavertree) (LD)]

It is a pleasure to follow the hon. Member for Hartlepool (Mike Hill) and I share a number of the assessments that he made in his contribution, because as the House pursues our debate on the Queen’s Speech, it is becoming ever more apparent that the casualty of a Tory Brexit will be Britain’s national health service.

The NHS is our greatest national asset; it is the product of the fusion of radical and enlightened minds in the last century that gave us healthcare for all based on need, not means. But now, in this century, the NHS is in great peril from a toxic combination of chronic underfunding and withdrawal from the EU, and responding to very different challenges from those when it was first created so long ago.

Notwithstanding the announcements in the Queen’s Speech, let us be very clear that the NHS is not in receipt of the resources that it needs to be effective. That was discussed only yesterday at the Health and Social Care Committee, when we had with us the Secretary of State and we talked about the backlog of £6 billion in NHS repairs alone, so an announcement of half that really is no cause for celebration. We heard from the Health Foundation, and its assessment of the Queen’s Speech funding announcement says that

“it falls well short of the scale of the challenge.”

We have a Prime Minister who announced 40 new hospitals, which then was downgraded to six within days, and we see demand for healthcare from our growing and ageing population outstripping the availability and quality of services, which means rationing and a diminution of quality of care; many right hon. and hon. Members from both sides of the House have referred to that in the debate this afternoon.

[Norman Lamb]

Does my hon. Friend agree that another sign of a system under unacceptable strain is the fact that teenagers around the country are often waiting a year or more for access to mental health treatment? I know of two teenagers who have recently had their first appointment after a year of waiting, which seems to me to be utterly intolerable.

[Luciana Berger]

I thank my right hon. Friend for making that really important contribution, and waiting times are a particular issue in our NHS, especially in the Cinderella of all Cinderella services, our CAMHS. Too many young people right across our country are struggling to get a referral and then, if they do get that referral, having to wait months on end. Frankly, it is unacceptable.

[Mike Gapes]

There is a further problem with teenagers when they reach the age of 18, because there is a gap between the CAMHS and adult services. Far too often, young people who have been given help when they are 16, 17 and 18 suddenly fall off the cliff and there is no support for them.

[Luciana Berger]

I thank my hon. Friend for making that important contribution. There is a cliff edge in our young people’s mental health services when they transition into adult mental health services. They have to start all over again and repeat themselves. There are a few places across the country that are creating mental health services for young people up to the age of 25, and that is welcome, but it is the exception rather than the rule. We need to do everything possible to ensure that young people have continuity of support in their mental health services at that fragile moment in their life, because not receiving that critical support can have a detrimental impact on their ability to access education, to maintain relationships with family and friends and to get into employment.

I am particularly concerned that we have seen a serious reduction in the state of our services in the past year. I refer to the Care Quality Commission’s “State of Care” report, which came out this month. It looked at acute wards for adults of working age, psychiatric intensive care units, child and adolescent mental health in-patient services and in-patient services for people with learning disabilities or autism, and it found a significant increase in the number of those services that are now rated inadequate. Those are services for some of the most vulnerable people in our country, and we should be improving them rather than seeing an increase in inadequate ratings from 2% to 8%, 9% or 10%. That is unacceptable, and I hope the Minister will address that serious point in his response. In particular, we know that this is as a result of too many of the people using mental health and learning disability services being looked after by staff who, according to the CQC,

“lack the skills, training, experience or support from clinical staff to care for people with complex needs.”

Again, I hope the Minister will respond to this important point.

This is not just about care for people with mental illness or disability. We are seeing that same story right across our NHS, with patients waiting far too long. We have heard significant figures, with millions of people across the country struggling to access services. They are also having to travel too far for the treatment they need, and too many areas still have too few staff and not enough resources. That is reflected in the 2019 British social attitudes survey, which shows overall satisfaction in our NHS falling by 3% in the last year to 53%. The main reasons given for that include long waiting times, staff shortages and a lack of funding.

Notwithstanding the announcements in the Queen’s Speech on patient safety and changes to mental health legislation, which I welcome, I want to reinforce the point I made to the Secretary of State that this is not just about changing the Mental Health Act and that we need to have the resources for the capital infrastructure to ensure that we raise the standard of mental health in-patient settings to the same standard as physical health in-patient settings, along the lines of the recommendations given by Sir Simon Wessely, who conducted that important review for the Government.

Let us be clear that the pressures on our NHS are urgent and that they demand action, before we even contemplate the existential threat to our NHS because of Brexit. I want to talk about Brexit, because we did not hear about it today from the Front Benches. We had a reference to it from the Secretary of State, but not an actual analysis of how Brexit will impact on the provision of our national health service. We know that the impact on our economy so far from Brexit has been between 1.5% and 2.5% of GDP since 2016, and by the Government’s own assessment, Brexit will impact on our GDP by up to 9.3% over the next 15 years. We are still waiting for those further economic impact assessments on the withdrawal Bill that we have seen in the past week.

We have already discussed the impact of Brexit on our NHS workforce. We know that 63,000 EU nationals work in our NHS and that 104,000 work in adult social care. We should be lining up to thank each and every one of them for the role they play and the contribution they make to our national health service, instead of making them feel like unwanted strangers. I am surely not the only MP who has received representations from people who are serving our NHS and social care service, who go above and beyond under incredible pressure to provide the best possible levels of care and who are feeling worried about what the future holds. They are particularly concerned about the Home Secretary’s proposed immigration rules and the damage that they will inflict on our ability to recruit doctors, nurses and social care workers from the EU and the rest of the world.

I could talk about the threat of access to medicines, the creation of a new medicines approval regime, which will lead to further delays, and the impact on medical research.

[Chris Ruane (Vale of Clwyd) (Lab)]

Will the hon. Lady give way?

[Luciana Berger]

Forgive me, but I only have 18 seconds, so I will not give way.

We should be addressing all that as a nation, and how we keep people well was missing from the Queen’s Speech. Other people have talked about prevention, and the lack of focus on public health in the Queen’s Speech is pitiful. We could be doing so much more, and I urge the Minister to refer to that in his response.