NHS: Long-term Strategy

Debate between Marsha De Cordova and Wes Streeting

Wednesday 11th January 2023 Commons Chamber

[Wes Streeting]

I have to make progress. I know that Conservative MPs were not interested in speaking in this debate, but many Labour Members were.

We cannot continue pouring money into 20th-century healthcare that is not fit for the future. We do not focus nearly enough on prevention, early intervention and care in the community. Because people cannot see a GP, they end up in A&E, which is worse for them and more expensive for the taxpayer. Because people cannot get the mental health support they need, they reach a crisis point, which is worse for them and more expensive for the taxpayer. Because people cannot get the social care they need, they are left stuck in hospital, which is worse for them and more expensive for the taxpayer. That is why the next Labour Government will agree a 10-year plan with the NHS to shift the focus of healthcare out of the hospital, into the community and closer to patients, which is where it should be.

[Marsha De Cordova (Battersea) (Lab)]

My hon. Friend makes an excellent case, showing that Labour is the only party with a plan to deliver for the NHS. He will know that prevention and early intervention are key for people who are losing their sight. More than 650,000 people are currently on waiting lists. We know that 50% of all sight loss is avoidable, but many people are completely losing their sight because they are not getting early intervention and appointments. Does he agree that the Government need to get on with having a plan to tackle the eye health crisis in our NHS?

[Wes Streeting]

My hon. Friend has campaigned so determinedly on the issue, and she is absolutely right. When I spoke about self-referral in an interview with The Times, it was partly with ophthalmology in mind. In the vast majority of cases and for the vast majority of conditions, self-referral will not be appropriate and it is right that people see a GP before being referred to specialist services. But when people go and see someone who is trained and qualified to investigate their eyes, and that person makes a clinical judgment that they need to see a specialist, how can it be that, rather than being referred straight to the specialist, they are sent off to a GP first? That is absolutely crazy. It is wasting valuable doctors’ appointments and is lengthening waiting times for patients.

Labour is willing to look with an open mind at how we improve the patient journey. It is that fresh thinking that the NHS needs and is so badly missing from this Government. That touches on what I have been saying about the need to fix the front door to the NHS in primary care, with more care in the community. Our plan to recruit more doctors will deliver better access to GPs and ease pressure on accident and emergency departments.

We have to take a look at the GP partnership model, which under this Government is withering on the vine. By 2026, a majority of GPs will be salaried. There are three routes: let it wither on the vine, as the Conservatives are doing; accept that it is in decline and have something better to follow as it phases out over time, which is how we would approach it; or accept that GP partnership is valuable, in which case we should rebuild it. I am open-minded about whether we phase out GP partnerships or whether we rebuild general practice, but what we cannot do is what the Conservatives are doing, which is allowing general practice to wither on the vine. That is exactly what they have done.

Do you know what I found most remarkable today, Mr Deputy Speaker? In advance of this debate, I received a letter from the Minister, no less—the hon. Member for Harborough (Neil O’Brien), who is unfortunately not in his place—telling me that the current system of general practice is working. Bad news for you guys sat opposite, who are facing the patients and the voters at the next general election: your Ministers think that general practice is working. Your Ministers are therefore not looking at plans to fix it. Your Ministers are leaving you hanging out to dry at the next general election, because patients can see that only Labour is thinking about how to fix the front door to the NHS and rebuild general practice.

Our plan to recruit 8,500 mental health workers and provide community mental health clubs in every community—a plan championed by my hon. Friend the Member for Tooting (Dr Allin-Khan)—will deliver faster treatment, supporting schools and easing pressure on hospitals, as well as general practice.

Then there is the exit door of the hospitals to social care. Labour’s commitment to deliver better pay and better terms and conditions for care workers will reduce the 400,000 delayed discharges every month and provide a better quality of care for not just older people but working-age disabled people. There are so many people in hospital who would not need to be there if we could provide quality care in their homes, which is why our commitment to double the number of district nurses qualifying every year is central to our policy. We will also give every child a healthy start to life, with 5,000 more health visitors. [Interruption.]

The Under-Secretary of State for Health and Social Care, the hon. Member for Lewes (Maria Caulfield) has just said, from a sedentary position, “We need more GPs.” I know we need more GPs. Patients know we need more GPs. So why have the Government cut more than 5,000 GPs in the last decade?