NHS: Long-term Strategy

Maria Eagle Excerpts

Wednesday 11th January 2023 Commons Chamber

[Steve Brine]

I will choose my words and the hon. Lady can choose hers. I will come to capacity in the conclusion of my remarks—I promise her that.

I will touch on patient flow. Any acute sector that I speak to or visit at the moment is saying clearly that patient flow is hampering everything happening at the front door and the back door. One of the reasons why those in the ambulance service are striking is that they are so heartbroken about not being able to deliver the service that they want to deliver and cannot get out on the road because they are waiting to dispatch their patients.

I said it on Monday and I will say it again now: I welcome the £250 million that the Government have put forward to buy beds. I repeat that two thirds of social care is domiciliary care—care in people’s homes—and we must not forget that, because it is important to getting people through the acute system. The modular work that the Secretary of State talked about—modular units in and around emergency departments—to add extra capacity and meet some of the extra demand coming through the front door, is also very welcome.

I said that we have to separate the now from the long term, so let me address the long term. The elective recovery taskforce is important; the 15 new elective hubs are important. At Prime Minister’s questions today, the Prime Minister talked about eliminating the two-year wait, and that is good—it is not, of course, the extent of his ambition, and to say so is facile. We do not yet have an elective hub in Winchester. The Secretary of State knows that I am on his case about it, but may I just land that point with him again? The Prime Minister’s primary emergency care plan, which we eagerly expect later this month, will be important. It is also part of a long-term strategy and plan, and I think many people in the ambulance service will be pleased with what they see there. I hope that it will be as ambitious as what we hear in some of the rumours.

Some of the things the Select Committee is looking at feed into what the Secretary of State and the Government are doing. Integrated care systems are a creation of this Government. They are about flattening services across the NHS and breaking down those barriers between health and social care. We are in the middle of a big inquiry into integrated care systems, and we are liaising with the Hewitt review, which is a good thing. We were talking to the Care Quality Commission this week, and the Government have not yet laid the regulations on how the CQC will look at ICSs. Will the Minister please look at that?

This morning we talked about the digital transformation of the NHS. There are huge dividends in digital for the NHS, including simple things, such as the amount of money that the NHS spends on sending letters to patients—not least given that they never get there due to Royal Mail strikes. There are clinical dangers to that. Let us pursue our digital transformation, and I know that the Secretary of State is up for that. In terms of the stuff we will be doing this year, we eagerly await the workforce plan.

[Maria Eagle (Garston and Halewood) (Lab)]

Will the hon. Member give way?

[Steve Brine]

I cannot give way, because I do not have any more time. We eagerly await the workforce plan. When the Minister sums up, will she update us on where we are with the workplace plan and its independent verification, which the Chancellor announced in the autumn statement?

The Select Committee will be looking significantly at prevention this year. I know that the Secretary of State is passionate about some of the upstream prevention measures we will be talking about, and I look forward to him coming before the Select Committee on 31 January to talk to us—many of my fellow Committee members are here—about the work we are doing. I am excited about our work on the future of cancer. We hear all this evidence about there being cancer plans around Europe that lead to better outcomes, so I want to see the new cancer plan.

Finally, we need to be very careful about the language we use and how we talk about the NHS. Are we honest about the reform we need? Do we believe in the independent pay process? Is primary care really fit for purpose as it is? Do the British people want to spend more than the £159 billion that we will spend this year, and how will we pay for it? I think we do need a bigger NHS, and we clearly need more people in the NHS—that is not a point of debate—but we need to be careful about the language we use around the NHS, because otherwise the long-term strategy is nothing more than a moot point of debate in this House.

--- Later in debate ---

[Maria Eagle (Garston and Halewood) (Lab)]

My constituent Lynne O’Sullivan emailed me at 4.30 am last Sunday from the A&E department at Aintree University Hospital. She said:

“Good morning Maria. I email you in a last bid for help. I’ve been sat in Aintree hospital A&E since Friday…with my father who was sent here by his GP. We arrived at 10.30 on Friday with my father, who they think suffered a stroke. They admitted my dad…saying he needs an MRI scan and some other tests. We are still sat in A&E awaiting a bed on hard seats having slept here since Friday…It’s now our 42nd hour sat in A&E. I am at my wits’ end trying to get help. A doctor on Friday evening prescribed high blood pressure medication for my father. He has only received one dose.

I beg for your help. I don’t want to lose my dad due to poor hospital care”.

Well, who would?

Lynne’s father finally got a bed after 54 hours sat on a hard seat in A&E at Aintree hospital. He eventually got an MRI scan 78 hours after he attended the hospital—that was without him needing an ambulance. I am glad to say that Lynne’s father had not had a stroke and that he is in hospital now.

That is not one isolated example; there have been many other examples in Liverpool. On 27 December, the wait at Whiston Hospital A&E was 20 hours; by new year’s eve, it was 30 hours and people were being told not to go unless their condition was life-threatening. At the new Royal Liverpool, staff were having to go around with a big list telling people that there was a 30-hour wait for a bed. Somebody was reported as saying that a three-page list of people waiting for a bed had been touted around by one of the staff.

That is not only appalling for patients; it is terrible for staff. Right hon. and hon. Members may have seen the letter that top doctors at the new Royal Liverpool wrote to their management saying that they were “ashamed” of the “dreadful conditions” in the “chaotic” emergency department—that is in a brand-new hospital. They described the new Royal’s accident and emergency as “overcrowded, chaotic and unpleasant”, with an “unacceptable and unsafe” reliance on corridor care. The letter stated:

“The need to utilise the waiting room and X-ray waiting area chairs to house patients awaiting admission is completely unacceptable.”

They also said that they were

“embarrassed, ashamed and demoralised by the standard of care”

that they were able to provide. Yet what have we heard from the Government?

I am sorry that the Secretary of State is no longer in his place, but I am afraid that today he has come across as complacent, as he did on Monday when he gave a statement to the House. He disappeared over Christmas. There is no point in talking about winter pressures in January—it is too little and too late if one is having to talk about it in January. There needs to be planning well in advance. He has come across as simply seeking to blame anybody else but him and his Government. Everything else is to blame: the pandemic, flu and unexpected pressures.

I am afraid that the Government are complacent. They are in charge of the system. I am appalled by the Secretary of State’s indifference. I actually find it quite shocking, because one cannot fix a problem if one does not accept that it is serious, that it is one’s responsibility to do so and that hard, hard work is necessary to get these things right. I am afraid that what we have from the Government is complete indifference and complacency, and I am very sorry to say that it comes across as a lack of care.

[Several hon. Members rose—]