Health and Care Bill

Debate between Peter Aldous and Margaret Greenwood

Consideration of Lords amendments
Monday 25th April 2022 Commons Chamber

[Peter Aldous (Waveney) (Con)]

I am grateful to have a few minutes to say a few words on the cap on care costs and on workforce planning.

With regard to the care cap, it is important to congratulate the Government on tackling a problem—or attempting to defuse a ticking time bomb—that all their predecessors shied away from. However, there is concern that the proposals are a rushed tag-on to a Bill that was designed for a different purpose: the integration of health and social care and the setting up of integrated care systems. I accept that there is a clear correlation, but the legislation that addresses the problem of people being forced to sell their homes to pay for their care should have been considered and scrutinised separately and carefully, with the objective of putting in place a system that has political consensus and will stand the test of time. That is what the Dilnot proposals and the Care Act 2014 achieved, and they should be the foundation stone on which we build this new system.

My concerns are twofold. First, clause 140 is extremely unfair to those with limited assets and modest incomes. The changes may save the Government hundreds of millions of pounds, but they do so at the expense of those on low incomes and those who live in parts of the country where house values are lower, such as Lowestoft in my constituency. Secondly, there is a worry that working-age adults with disabilities will be unfairly penalised, hence the introduction by the other place of a provision to address it. I acknowledge the Government’s worries about the cost implication of that additional provision, but that iniquity needs to be addressed.

On workforce planning, there is a staffing crisis both in the NHS, where there are 110,000 full-time equivalent vacancies, and in social care, where there are another 100,000 vacancies, high staff turnover and very limited respite for unpaid and family carers. Those deficiencies cascade through the health and care system, creating bed-blocking in hospitals and impeding the efforts made to reduce waiting lists. There is an urgent need for strategic planning to address this crisis. There is concern that framework 15 is not working because of inadequacies in the collection of data, lack of assessment of workforce numbers, and unresponsiveness to societal shifts.

Since we last considered the issue last month, the other place has sought to address the Government’s concerns and, as we have heard, has made reasonable concessions. There is a crisis that must be addressed, and I hope that at this very late stage the Government will accept this reasonable amendment, so that we can get on with this much-needed work.

[Margaret Greenwood (Wirral West) (Lab)]

Amendment 29B goes much further than the Bill’s current provisions on workforce reporting, which are extremely weak. It would require the Government, at least once every three years, to lay a report before Parliament describing the system in place for assessing and meeting the workforce needs of health, social care, and public health services in England. What could be more reasonable? One has to wonder why the Government do not support amendment 29B. Surely any Government who were committed to running the NHS as a public service would see these provisions as crucial.

The Royal College of Physicians has pointed out that clause 35

“will not set out how many health and social care staff are needed to meet demand”

and has stated that, without long-term projections, which amendment 29B would provide, there is no way to assess how changes in workforce trends, such as retirements or working part time, will impact the delivery of healthcare. The Royal College of General Practitioners has spoken of unsustainable pressures driving GPs out of the workforce and threatening to destabilise general practice.

Just a few weeks ago, the Royal College of Nursing said that nursing staff are exhausted and that staff shortages are undermining their efforts to give safe and effective care—a sentiment reflected by a nurse I met on bank holiday Monday. That is hugely concerning. As the RCN has said, there is a clear evidence base showing that staffing levels have a direct impact on the safety and quality of patient care. When I met members of the RCN last year, they made clear to me the increased stress levels that nurses are experiencing as a result of staff shortages and the impact that is having on the care they so desperately want to deliver.

According to the Health Foundation:

“In the next 25 years, the number of people older than 85 will double to 2.6 million”

in England, so demand for social care is increasing and we need to know that there will be enough doctors, nurses and social care workers to meet people’s needs. The “Strength in Numbers” campaign, a coalition of more than 100 health and care organisations, says that we must put

“measures to adopt a sustainable long-term approach to workforce planning on a statutory footing.”

Without credible, up-to-date numbers, the system cannot plan.

I support Lords amendment 29B. I urge the Government to think about those NHS staff who are working so hard and are so stretched by the amount of stress they are under because they do not have enough colleagues around them, and to listen to the clinicians who are calling on the Government in this regard.

Skills and Post-16 Education Bill [Lords]

Debate between Peter Aldous and Margaret Greenwood

Report stage
Monday 21st February 2022 Commons Chamber

[Margaret Greenwood (Wirral West) (Lab)]

According to the National Literacy Trust, more than 7 million adults in England have very poor literacy skills. That is 16.4% of the adult population. Someone who struggles to read and write, or who cannot read or write at all, experiences disadvantage daily. It is a form of deprivation that can lead to isolation and poverty and cause deep personal frustration, as was clear in Jay Blades’s programme “Learning to Read at 51”, which I highly recommend to hon. Members and Ministers.

My new clause 16

“would require the Secretary of State to, every two years, review levels of adult literacy in England, publish the findings of that review and set out a strategy to improve levels of adult literacy in England.”

We cannot afford to leave people to fend for themselves, barely able to read and write. Of course, it makes no economic sense either.

I also believe that it is important that there is a rich and varied educational offer in all parts of the country, as well as strong skills provision. Education is not just about finding a job, hugely important though that is, but about personal development, engaging with the world, pursuing interests and developing critical thinking. I am concerned that the Bill may lead to a reduced educational offer and a narrowing of educational opportunity because of its focus on employer representative bodies leading the development of local skills improvement plans.

A person living in an area where most available work is in agriculture may want to pursue a completely different career path. How can their local employer representative body cater for them? The Minister will be aware that Billy Elliot lived in a mining community but did not want to go down the mine. His local employer representative body would doubtless have said, “There’s no call for ballet dancers round here,” so his talent and passion would have gone to waste. Surely it cannot be right that people’s ambitions should be constrained by the needs of local employers.

We ignore the value of our cultural sector at our peril. My new clause 17 would require the Secretary of State

“to review the availability of humanities, social sciences, arts and languages courses at Entry level to Level 4 in areas to which an LSIP applies. It would also require the Secretary of State to take steps to remedy inadequate availability of the courses.”

From my own experience as an adult education tutor, working in an area of deprivation, I know the importance of offering courses that people can enjoy. I know, too, how transformational adult education can be, and that one of the best ways to support people to access the labour market is to build confidence, expand horizons and offer educational opportunity.

My amendment 18

“would require the Secretary of State to draw on responses to a public consultation run by the relevant local authority, when publishing a local skills improvement plan for a given area.”

There is immense expertise and insight in every community, so it makes sense to draw on them. Such a consultation would be open to local providers, educationists and trade unions, as well as the general public. It could prove to be an important local conversation about the potential that is there to be developed.

If adult education is to expand and flourish, it is important that barriers to learning are removed. If someone is in receipt of universal credit, they should not be disincentivised from engaging in training or education, so I support new clause 5, which stands in the name of the hon. Member for Waveney (Peter Aldous). I also support amendment 12, in the name of my hon. Friend the Member for Chesterfield (Mr Perkins), which

“would require…a review of the operation of the apprenticeship levy, and…to pay particular regard to ensuring that sufficient apprenticeships at level 3 and below are available”,

and new clause 1, in the name of the right hon. Member for Harlow (Robert Halfon), which would enable prisoners to participate in apprenticeships.

I urge the Government to take action to address the very high levels of poor literacy among adults, to ensure the provision of a broad curriculum in adult education that includes the arts, social sciences and humanities as well as vocational training, and to give local people, providers and trade unions the opportunity to have a say in the post-16 education and training made available in their communities.

[Peter Aldous (Waveney) (Con)]

I welcome the Bill because it provides the means to address problems that have hung over the UK for far too long and to meet future challenges. It has been closely scrutinised, both in this Chamber and in the other place. Some amendments have been made that the Government have accepted, but there is still room for improvement.

I urge the Minister to take on board new clauses 2 and 3, which are in the name of my right hon. Friend the Member for Harlow (Robert Halfon), and new clause 4, which is in the name of my right hon. Friend the Member for Kingswood (Chris Skidmore). I would also be grateful if the Minister gave full consideration to new clause 5 and amendment 2, which are in my name. New clause 5 would enable people who are trapped in low-paid, insecure roles with limited progression opportunities to acquire the skills to progress into well-paid, secure and rewarding jobs, thereby delivering levelling up and eliminating the productivity gap that has been part of the UK economy for far too long.

GP Appointment Availability

Debate between Peter Aldous and Margaret Greenwood

Tuesday 26th October 2021 Westminster Hall

[Peter Aldous (Waveney) (Con)]

It is a pleasure to serve with you in the Chair, Mr Robertson. I congratulate my hon. Friend the Member for Beaconsfield (Joy Morrissey) on securing this debate and on her graphic and very personal assessment of the current position.

Over the past two to three months, I have received a great deal of correspondence on this issue, with constituents very upset that they have not been able to secure face-to-face appointments with their GPs. Late last month, I had a virtual meeting with GPs practising across the Waveney area, who themselves are very upset at the abuse that they have been receiving—something that they and their staff should not have to put up with.

There is clearly a major problem, and, at a time when the pressures on the NHS are growing at an exponential rate, there is a need to work together to find a solution. In the Norfolk and Waveney clinical commissioning group area, notwithstanding the enormous demand for GP services, the position with regard to appointments is positive, although it is recognised that more needs to be done. In August 2019, there were 478,160 GP appointments, and this August that figure increased to 482,993. The proportion of patients being seen face to face is increasing. This August it was 69%, compared to 67% in July and 66% in June. More patients are being seen face to face in Norfolk and Waveney than in other parts of the country: the August figure of 69% compares with a national average of 58%.

That said, it is recognised that a lot of people are very distressed, and in many cases very worried, that they have not been able to see their GP. The pandemic has meant that there is now an enormous increase in demand for GP services, with people on growing waiting lists needing support, and with those who were unable to see their GP during the pandemic wanting an appointment in order to highlight something that is causing them a lot of worry and distress.

The increase in demand for GP services has been happening for some time, but there are severe capacity constraints on the number of patients who can be seen face to face. The current infection, prevention and control measures that are needed to keep patients and staff safe mean that in-person appointments take much longer. Social distancing means that, at practices with smaller waiting rooms, people have to wait in their cars and staff have to go and get them when it is time for their appointment. Additional cleaning arrangements are also required between patients. There is a need to improve and standardise the way that remote appointments are operated and to adopt a whole-team approach, as there are many cases where a patient does not always need to see their GP and can often be cared for better by a physio or pharmacist.

[Margaret Greenwood]

The hon. Member is making some very interesting points. Does he agree that it is important that the Government review the outcomes of patients who have been consulted remotely? I have heard harrowing stories from my constituents. One woman thought she had a very minor ailment—she did not get seen by a GP, and she ended up with life-changing surgery. She will never be the same again. It is important that there is a national review of what has happened to such patients, rather than assuming that everything is all right because a patient does not come back.