NHS: Long-term Strategy

Margaret Greenwood Excerpts

Wednesday 11th January 2023 Commons Chamber

[Steve Barclay]

My right hon. Friend raises an extremely important matter. I was in the Department when the current Chancellor was Secretary of State and when we made that commitment to a 25% expansion in medical undergraduate places. She is absolutely right in saying that it takes time for those cohorts to come through. She is also right that Chelmsford has been a huge success. I am sure that, in the context of the workforce strategy that NHS England colleagues are bringing forward, she will make the case for where any additional capacity should go, but we will, of course, look to that workforce strategy to map out what is needed.

Let me turn to elective care backlogs. A number of Members across the House have raised the issue of the 7.2 million people on the waiting list. I think that it is worth breaking that figure down between the 1 million who require surgery and the 6 million who are waiting for outpatient appointments—either for their first appointment or for their follow-up. The NHS is doing more than 94 million outpatient appointments a year, of which 30 million are for new patients and 64 million are follow-ups. The “did not attend” rate is about 6.5%. This relates to the question of my right hon. Friend the Member for Wokingham (John Redwood) about value for money and how we deliver the reform of which he spoke. If we halved the “did not attend” rate of about 6.5%, it would free up almost 4 million slots. I am very interested in looking at the data and at how we prioritise within that data the wider challenge around the elective care backlog. I hope that that provides him with some reassurance.

[Margaret Greenwood (Wirral West) (Lab)]

Will the Secretary of State give way?

[Steve Barclay]

Yes, I will.

[Mr Deputy Speaker (Mr Nigel Evans)]

Before the intervention is taken, I advise Members that there is a lot of interest in this debate, and each intervention is cutting into the contributions that can be made. We will be down to a three-minute limit very quickly, and some people still may not get in.

[Margaret Greenwood]

I wish to bring the Secretary of State back to the point raised by my hon. Friend the Member for Oldham East and Saddleworth (Debbie Abrahams), who pointed out that in the Health and Social Care Act 2012, the coalition Government legislated to allow NHS hospitals to make up to 49% of their money from private patients. She asked whether he regretted that, but we did not get a response, so I would like to hear the Secretary of State’s response. Will he also tell us what assessment he has made of the impact on waiting lists of non-NHS patients taking the place of NHS patients in our hospitals?

[Steve Barclay]

It is a good thing to be bringing more funding into healthcare rather than turning it away. However, conscious of your edict, Mr Deputy Speaker, I will truncate some of the areas that I was going to cover, because I am sure that right hon. and hon. Members will bring out some of those points in the wider debate.

Labour’s motion ignores the statement that I gave to the House on Monday. It ignores the extra funding that we provided in the autumn statement and the commitment reflected in the Downing Street summit on Saturday to publish recovery plans for urgent and emergency care and for primary care, which we will do in the weeks ahead. The motion ignores the very real health challenges being experienced across the United Kingdom in Wales, Scotland and Northern Ireland, which all face pressures. It ignores the fact that France, Germany and elsewhere in Europe also face significant pressure.

The Government recognise, as I set out to the House on Monday, that there are real challenges in the NHS and social care. That is why we set out a three-phase approach: first, taking immediate steps to reintroduce flow to relieve pressure in the emergency department and across the hospital estate; secondly, putting in more capacity to build greater resilience over the course of the year, mindful of the fact that summer is increasingly a busy period—more so than was traditionally the case; and thirdly, making investments in our life science industry, such as the deals with Moderna and BioNTech, to ensure that patients in the UK get the most innovative drugs at the earliest date. That shows the Government’s commitment to backing the NHS now and in the future, which is why I commend the amendment to the motion to the House.

--- Later in debate ---

[Margaret Greenwood (Wirral West) (Lab)]

Matthew Taylor, the chief executive of the NHS Confederation, has said:

“This crisis has been a decade or more in the making and we are now paying the high price for years of inaction and managed decline.”

He is right. The crisis has not emerged overnight. It was evident before covid, and it is a crisis of the Conservative Government’s own making.

That managed decline is a political choice. One needs to look only at the Health and Social Care Act 2012 to see the sheer ruthlessness of the Conservative party’s determination to run down the national health service. In that Act, the Conservatives and the Liberal Democrats legislated to allow NHS hospitals to generate up to 49% of their income from private patients. By 2015-16, nearly £600 million a year was being generated by the NHS treating private patients. How many operations for the general public have been delayed while private patients were treated? How much shorter would those waiting lists be had those resources not been siphoned off to private patients? Why did the Conservatives and Liberal Democrats think it was acceptable to hand over about half of our hospital resources to private patients? To argue that it is about making money for the NHS is a sleight of hand; it is taking resources and capacity away from the NHS and it is morally indefensible. The NHS belongs to all of us; it is not the Conservative party’s to give away.

I have met people who, in desperation and pain, have paid for treatment and been angry at being put in the position where they felt the need to do so, not just because it is expensive but because they believe in the NHS as a public service. It felt terrible to them to be put in that position. The Government have chosen to reduce capacity in the NHS by handing it over to private patients, and they have failed to provide the staffing and resources that the service needs.

We need to reinstate the NHS as a comprehensive and universal service, publicly run and free at the point of need. It has served us incredibly well for well over 70 years. The public will not forgive those who undermine it so ruthlessly and cause so much suffering for patients and staff.