(1 week, 2 days ago)
Commons ChamberIs there a better metaphor for the state of this country than the state of dentistry? Fourteen years of neglect left us with a decayed system of NHS provision, with those able to pay the only ones protected. I see it myself with wards full of children with dental abscesses at the weekend.
Residents have told me stories of searching for NHS dental provision that simply does not exist. In my constituency, the number of urgent appointments has increased by 35%, with practices providing urgent dental care services seven days a week and into the evenings, and there are more coming soon, so the Government are making a serious attempt to deal with the decades of decay and drift, but we must go further.
We do not have enough dentists and we do not have enough dental service providers, so let us sort out the dental contract, which we have heard about. The right hon. Member for South West Wiltshire (Dr Murrison), who is no longer in his place, is quite right that NHS dentists are in fact heroes.
The point has been made repeatedly that dentists can earn a lot more money in private practice than in NHS dentistry, and that is unlikely to change no matter what happens in the renegotiation. Does the hon. Member agree with the last Government’s review, which suggested that the roughly £300,000 cost of training a dentist should come with a requirement to work for the NHS for a number of years afterwards?
That is certainly a suggestion that should be investigated.
We must increase the number of dentists, as we have only 24 dentists for every 100,000 people in the east of England. We also need to increase the number of training providers and training places, but even with the opening of a dental school it will take ages for there to be new dentists.
One suggestion is that we sort out the dental accreditation system. Hon. Members may not know that there are only 600 opportunities to take the accreditation exam each year, but there are 6,000 people planning to take the exam—that will take 10 years. We must get the General Dental Council to increase the number of exam opportunities.
We have begun to address this political emergency, but we must go further with a clear and fair offer focusing on what the Minister described as the triangle of patients, practitioners and the public purse, providing a service that ensures that we give excellent, affordable care for all, including prevention, especially for the most vulnerable, and in a way that means we can pay for it. NHS dentistry can be saved. Let us have a sign on the door saying, “Urgent NHS dental appointments available here.” Would that not that be great?
I call the Liberal Democrat spokesperson.
(1 week, 5 days ago)
Commons ChamberI wish I could correct my hon. Friend and say that I have already read in detail the feedback from the Joint Committee on Human Rights, but he is right: I have not yet had a chance to do that. However, I can assure him that I and my hon. Friend the Minister for Care will look at the Committee’s report. We would be very happy to meet members of the Committee to discuss in further detail their findings and recommendations.
We want to ensure that the Bill is as strong as it can be, given the length of time that has passed since the Mental Health Act was reformed. Indeed, the Mental Health Act is as old as I am. [Interruption.] Thank you for those interventions. I assure Members heaping compliments across the Chamber that it will not affect investment decisions in their constituencies, but I am none the less very grateful.
There is a serious point here: whereas attitudes to mental health have come on in leaps and bounds in the past four decades, the law has been frozen in time. As a result, the current legislation fails to give patients adequate dignity, voice and agency in their care, despite the fact that patients have consistently told us that being treated humanely, and making decisions about their own care, plays a vital role in their recovery.
When patients are detained and treated without any say over what is happening to them, it can have serious consequences for their ongoing health. To quote one of the many patients who bravely shared their experiences with Sir Simon Wessely’s independent review:
“Being sectioned was one of the most traumatic experiences of my life. Sadly, as a result of being sectioned I developed PTSD”—
post-traumatic stress disorder—
“as the direct result of the way I was treated”.
Sir Simon’s review was published seven years ago. It shone a light on a group of people who had been hidden, ignored and forgotten. In the time that has passed since, the case for change has only snowballed. The Bill now takes forward Sir Simon’s recommendations.
The review stressed that legislation alone would not fix the system; culture and resources matter too. This was echoed in Lord Darzi’s investigation into the NHS, which uncovered some hard truths: a dramatic rise in the use of restrictive interventions on children; and 345,000 patients waiting more than a year for their first appointment with mental health services—more than the entire population of Leicester—of whom 109,000 were under the age of 18. This Bill does not solve every problem in our mental health services, but it marks a vital step in our plans to improve the quality of care, combat long-standing inequalities, and bring about a stronger focus on prevention and early intervention in mental health.
Does my right hon. Friend agree that while we are seeing record levels of mental health problems in our young people, investment in community services for people with mental health problems must be a priority?
I wholeheartedly agree with my hon. Friend. As he has heard many times from this Dispatch Box, we want to see a shift in the centre of gravity in the NHS out of hospitals and into the community as one of the three key shifts that will underpin our 10-year plan for health, which we will be publishing in the not-too-distant future.
The Mental Health Act is designed to keep patients and the public safe, but it is clear to anyone who has seen how patients are treated that it does so in an outdated and blunt way that is unfit for the modern age. It is too easy for someone under the Act to lose all sense of agency, rights and respect. It is sometimes necessary to detain and treat patients, but there is no reason why patients experiencing serious mental illness should be denied the choice and agency they would rightly expect in physical care. Not only should the health service treat all its patients with dignity and respect anyway, but giving people a say over their own care means that their treatment is more likely to be successful. In the foreword to his independent review, Sir Simon Wessely said:
“I often heard from those who told me, looking back, that they realise that compulsory treatment was necessary, even life-saving, but then went on to say ‘why did it need to be given in the way it was?’”
Another patient in the 2018 review said:
“I felt a lot of things were done to me rather than with me”.
We need to get this right. We need to give these patients a voice.
(3 weeks, 4 days ago)
Commons ChamberI think that the right hon. Gentleman is referring to the single point of access digital technology, which is game changing in terms of improving the interface between high street and secondary care. It is probably worth reminding him that the question is about eye care. We are absolutely committed to single point of access technology, which we believe can be game-changing technology and is a vital part of our shift from analogue to digital.
The president of the Royal College of Ophthalmologists has stated that the widespread outsourcing of NHS cataract surgery to private, for-profit providers risks the integrity of hospital eye surgery departments meaning that there will be few services to treat patients with preventable blindness. How can we reassure the public that such services will be maintained?
Although the independent sector clearly has an important role to play in tackling waiting lists and backlogs, we will not tolerate any overpriced or sub-par care, and we will not tolerate any distortion of patient choice. The recently published partnership agreement between NHS England and the Independent Healthcare Provider Network commits to ending incentives that can lead to that, and to supporting equal access and genuine choice for all patients. We are working together to deliver on that.
(3 months, 3 weeks ago)
Commons ChamberIt absolutely is, and I thank the hon. Lady for agreeing to co-chair the re-formed taskforce. I know that she cares passionately about this issue, and it was lovely to meet Charlotte some time before Christmas.
Cancer is terrible, and cancer affecting children even more so. As the hon. Lady knows, we paused the taskforce because the general election got in the way. We wanted to carry out a real-time stocktake to establish whether we needed all these different taskforces, but, along with Charlotte, she convinced me, and convinced the Secretary of State, that the work of this taskforce will be crucial to informing our national cancer plan, and I wish her all the best in securing the outcomes that both she and I want to see.
Does the Minister agree that the move from analogue to digital will be key to cancer research, especially in the field of rare cancers such as the brain tumours that we have been hearing about?
I absolutely do. That shift to analogue to digital, and the use of the latest advantages in technology, science and research, will push the boundaries of what is possible when it comes to diagnosing and treating some of the rarer cancers, on which we have made virtually zero progress in recent years. I think that, with the right direction, the right commitment and the right drive, we can really start to make inroads in this area.
(4 months, 1 week ago)
Westminster HallWestminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
I beg to move,
That this House has considered the welfare of doctors.
It is a pleasure to serve under your chairmanship, Sir John. Our NHS is described as “broken”. Gigantic waiting lists; ambulance delays; collapsed confidence that the NHS is there when we need it; poor access to general practice, dentistry and pharmacy; and, disgracefully, falling life expectancy in some places—these are all failures of the last Government, who could not look after the NHS despite record funding. Labour must mend the NHS; we have no choice. We invented the NHS. We fixed it before and we will fix it again.
In this debate, I speak about the people who work in the NHS. There are nearly 1.5 million of them, all contributing in their own way, but let me speak specifically about our doctors. Doctors in this country are in crisis. They are leaving the profession, retiring too soon and emigrating. Who is looking after our doctors? I come to this place as a surgeon. I am one of the very few surgeons ever elected to Parliament.
My dad was an RAF medic, who served in Aden in world war two before joining the newly invented NHS in 1948. He became a consultant physician in Teesside, where I grew up, and then a professor of geriatric medicine in Melbourne. He wrote an excellent account of his life called “New Ideas for Old Concerns”, which is full of fascinating accounts of his medical experiences during the war and later in the new NHS. It was a time of such hope and optimism, and I sincerely wish that we will be able to recreate that hope today.
I spoke to the hon. Gentleman beforehand about bringing up an issue that I think is important. I commend him on securing this debate, as the welfare of doctors is so important. He will be aware that GPs in Northern Ireland pay the highest indemnity costs in the United Kingdom, and that adds to the primary workforce pressures. The Medical Defence Union is working with the Government in Northern Ireland to find a long-term solution. Does the hon. Gentleman agree that support would help the Northern Ireland Executive to address this issue and get our GPs and doctors in Northern Ireland on par with those here?
I will speak of general practice shortly. My son is an A&E doctor here in London, and I am therefore one of three generations of doctors who have served the NHS continuously since it began; the welfare of doctors is personal for me. This Government have already done much for doctors, who are on the frontline and not the picket line for the first time in several years, but burnout, fatigue and stress are still very real problems that threaten to undermine the efficacy of our NHS.
Today’s new doctors graduate into the profession with debts of nearly £100,000. They immediately enter a lottery to be appointed to their first jobs as pre-registration doctors, sometimes ending up miles away from family and friends in places they have never visited before. Now that reminds me of another job that I just started. Young doctors are left immediately responsible for life-and-death decisions, sometimes with insufficient support. They are left scrabbling at the very last minute for somewhere to live—the on-call accommodation that my generation remembers has disappeared—and I have known several of them to sleep in their cars.
It has not escaped my notice that the new name for junior doctors is “resident doctors”. Resident doctors? That is the very last thing they are. If they are lucky, there is a place for them to rest, but many a time I have arrived to find a young doctor fast asleep from exhaustion at an office desk.
Given the desperate need for more doctors in the NHS, does my hon. Friend agree that we need to be looking after doctors’ welfare to encourage more people to enter the medical profession?
I agree with my hon. Friend, as he will see.
There are odd shifts, night duties without hot food, and days and weeks that go by without an opportunity to meet supervising consultants. Short clinical attachments mean that the relationships previously created with senior mentors are rare. Just last week, I received an email from a surgeon who was my consultant in 1986. He had noticed in a surgical journal that I had become an MP, and I remembered him as the brilliant surgeon that he was. These are the relationships that make people feel as if they belong within a wider profession, but I doubt whether the young trainees of today would have the chance to make such lasting connections.
There is little security of employment, because doctors are obliged to apply every year or two for another post, probably in another place. The doctors’ mess used to be a place where young doctors could find a sort of surrogate family in an unfamiliar place, but that is now sadly a thing of the past. According to research from the British Medical Association, fewer than 10% of UK trusts or health boards offer hot food after 11 o’clock at night.
The demands of the job affect relationships. Many young doctors are in relationships with fellow doctors, but lucky indeed are the couple who can work and live in the same place, or even contemplate raising a young family together. Sadly, relationship difficulties and breakdowns are commonplace. Holidays must be taken at odd times, and rotas are inflexible. Doctors are left unable to take a day off to attend a wife’s graduation, a sister’s wedding or even their own wedding—all true.
Progression in a chosen career depends on a multitude of competitive interviews and hugely costly professional exams. There is no security of employment. In a survey called “Fight Fatigue” conducted by the Royal College of Anaesthetists, 50% of respondents said that they had had an accident or a near miss when driving home after a night shift—I recall fatalities like this in my own hospital; 84% were too tired to drive home after a night shift; and only 64% had access to any rest facilities. What would we say if the same were true of airline pilots, to whom anaesthetists are sometimes compared?
Last week I met with a GP in my constituency, and she described very much what the hon. Gentleman is talking about: at the end of the day, after blitzing through 25 patients, back to back, she sometimes found herself sitting in her car, simply too tired to drive home for half an hour. Does he agree that we are expecting too much of our medical staff in relying on their dedication to go beyond the call of duty?
I agree with exactly what the hon. Gentleman said.
In a recent survey, 29% of hospital doctors said they were unable to take any breaks at all during the working day; for GPs, the figure rose to 40%. That is simply not safe, for either doctors or patients. In a 2023 survey conducted by the Royal College of Surgeons, half of respondents cited poor working conditions as the main challenge in their job. It is no wonder that so many colleagues are retiring too soon. The average age for a radiologist to leave the NHS is now 56, yet we are desperately short of these vital specialists. This is happening across many specialties. Just in 2023, 23,000 English doctors left the profession prematurely.
We cannot afford to lose our most experienced doctors. Too often they are discouraged from continuing in practice by a bureaucratic and costly appraisal and revalidation process, and they simply throw in the towel. Their experience is a vital asset to the NHS, and we must think carefully about how we retain them or return them to the workforce. One solution will be to create simple routes for experienced doctors to practise flexibly.
The hon. Gentleman is making a powerful speech. Langport surgery, in my constituency, is in the all too common position of struggling to attract and retain staff because of stretched budgets that limit its ability to offer attractive terms and conditions to those working in these challenging roles. Does he agree that the recruitment and retention crisis—particularly facing rural GPs—is negatively impacting doctors’ welfare, and that urgent steps must be taken to address that?
I agree completely with the hon. Member, which will be no surprise.
The training of doctors is under threat. I spoke in the House about how cash-strapped universities are issuing redundancy notices to clinical professors, with no real plan on how to teach the increasing number of medical students or to continue the vital medical research for which our country has such a strong reputation. There was a 31% decline in the number of clinical academics in the country between 2004 and 2022. Something must be done about that.
Our GPs are under pressure as never before. Who is looking out for them? They face massive lists of patients and huge demands. We know that we must support them, for they are the front door of our NHS.
I thank the hon. Member for his articulate and persuasive statement. In my constituency, we have surgeries such as the Al-Shafa medical centre, which has more than 6,000 patients. Given the pressure on the NHS, more work, such as basic analysis and experiments relating to cardiovascular disease and so forth, now needs to be done in local surgeries. Does the hon. Member agree that when such GP practices have the additional burden of paying increased national insurance, there need to be more methods, or maybe redirection of income, so that they can sustain their great work in constituencies?
I agree that we must put resources into general practices to deal with the Government’s plan to move care from the hospital out into the community. I am sure that needs to be addressed.
The partnership model, which has served us so well, is now surely threatened as fewer young GPs are prepared to take on the responsibility or the financial risk of general practice.
I thank the hon. Member for securing this important debate, which I feel could have been easily extended beyond a mere 30 minutes. On the pressure and responsibility for GPs looking to become partners, I cite the example of Silverdale practice in Burgess Hill in my constituency. In December and January, it had a problem with the sewers being blocked up, which resulted in contaminated water coming up into the surgery and car park. The point is that it has taken weeks to get support from the NHS; the pressure on those GP partners and practice managers must be huge. Does the hon. Member agree that there needs to be more support for GPs who are prepared to take on the responsibilities of a partnership?
I do agree. I believe that the Government intend to do something about the somewhat terrible state of GP premises; the Health Secretary confirmed that only yesterday.
There are serious questions about the support that individual GPs receive, especially for mental health. At present, GPs rely on the NHS practitioner health service for addiction and mental health support.
We should not be looking to the old saying “Physician, heal thyself” within our national health service. It is critical that the practitioner health service should be available across all parts of the United Kingdom; the hon. Member may not be aware that it is not currently available in Northern Ireland. Would he encourage the Government to work with the Northern Ireland Executive to ensure that all our health professionals get the same standard of care that they want to give their patients?
I was not aware that the practitioner health service was not available in Northern Ireland; I certainly agree that it ought to be.
The practitioner health service was designed to be used by only 0.5% of GPs, but in fact it is accessed by 10 times that number. Ensuring that such services are fully funded will be important. There is alcohol and drug abuse, loneliness, depression, insomnia, anxiety and, sadly, suicide—including two of those who I graduated with from Sheffield, both in their very first year of medicine; and two doctors, a psychiatrist and a neurosurgeon, from my own road in Norwich. One of my own trainees was rescued at the last minute from a very serious attempt. All doctors know of this problem, but few speak of it.
Last week, I informed the House of my former student who described the terrible flashbacks and post-traumatic stress disorder of the young clinical intensive therapy unit staff who witnessed 40 or 50 covid admissions die at a hospital in Yorkshire, and the complete lack of support they received. Many are reluctant to seek help and do not know where to turn. Itinerant junior doctors not registered with GPs are known to self-medicate. We simply cannot leave them on their own.
In conclusion, I will respectfully make some suggestions, which have little or no cost implications. In making them, I am thinking especially of our resident doctors. They include to provide identified mentors, not simply people called educational supervisors; simplified contracts, transferable across trusts and between hospitals; clear, early information for doctors about what they will be paid and their rotas, timetables and holidays; hot food at night, and places to rest and sleep; to cover exam fees and make examinations fair and achievable; and to provide parking at the hospital and, crucially, a GP for every doctor and simple access to mental health support.
Medicine is a brilliant career—satisfying, interesting and rewarding. Let us look after the doctors who look after us.
May I ask the Minister to finish a little before 4.30 pm so that I can put the Question?
(4 months, 1 week ago)
Commons ChamberA bariatric bed is a special big, strong bed used in hospitals for extremely obese people. When I was a medical student, there was no such thing as a bariatric bed—not invented, not needed. But then, hospitals did not have food banks for their staff either. So how have we got our relationship with food into such a mess?
The epidemic of obesity is a public health emergency costing billions. Millions of our citizens are dying early. The Government simply must act. This cannot be left to the market. We did it with smoking, and now we will do it with obesity. We have no choice. We know that at the heart of the matter is high-fat, high-sugar, high-salt, factory-produced food that is often ultra-processed, cheap, convenient, tasty and very profitable for a few very large food businesses. Nor must we forget that it is our poor citizens who are most affected—those who are cash-poor, time-poor and at high risk of a poor diet.
We cannot continue like this. The Government must act to change food habits. This is not the nanny state; this is simply good government. “Smoking kills,” it says on cigarette packets. Some food kills, too, so how about “The food in this packet will kill you if it is not part of a healthy, mixed diet”? Obesity is a massive issue for surgeons, increasing morbidity and mortality. Although we can staple stomachs or inject up to 3.5 million people with anti-obesity drugs, we all know that that is not the answer. Let us use the power of Government to legislate: warnings on food packets, breakfast clubs in schools, which we have already introduced, advertising bans, tax incentives, cooking education and an end to the dependence on the cheap, unhealthy food that blights the lives of so many of our citizens. We have no choice.
I thank my hon. Friend for giving way during a very interesting speech. Does he agree that the national curriculum review presents the Government with an opportunity to encourage and strengthen the healthy eating component of the relationships, sex and health education curriculum so that citizens and especially young people are empowered to make healthier decisions on eating?
My hon. Friend’s intervention was not really an intervention, because I had reached the end of what I wished to say. Nevertheless, I thank him sincerely.
(4 months, 1 week ago)
Commons ChamberThe Minister of State, my hon. Friend the Member for Bristol South (Karin Smyth), will be holding briefings tomorrow for Members from across the House and is happy to receive further questions. The hon. Member seems to be saying on the one hand to go faster, and on the other that he wants to challenge underlying assumptions in the scheme. He cannot have it both ways. As I said to some of his hon. Friends, if he is disappointed with this Government as we clean up the mess they left behind, goodness knows the self-loathing he felt when they were in government.
I feel doubly blessed this afternoon because the West Suffolk hospital in my constituency is to be rebuilt and the James Paget hospital where I have worked for 30 years is to be rebuilt. Does the Secretary of State agree that our primary care estate is in a terrible situation and that we must also invest in general practice facilities?
With that track record, my hon. Friend might want to tell us this week’s lottery numbers while he is here. In all seriousness, he makes a good point. Although today’s statement is about the new hospital programme, the challenges across the health and social care estate are enormous. That is why the Chancellor committed at Budget to the capital investment that will deliver not only this programme but a significant investment in the general practice estate. We have an enormous array of capital challenges in health and social care. I ask Members on both sides of the House to bear in mind that while I have to struggle to weigh up the competing priorities across the health and social care budget, the Chancellor and the Chief Secretary to the Treasury have to do so not only for health and social care, but for education, transport, defence, justice, the police estate—right across the board, we have inherited a country left in an enormous hole. We are taking the necessary decisions to get our country out of that hole and beat a path to a better future.
(4 months, 2 weeks ago)
Commons ChamberThroughout the winter, NHS providers have continued to flex bed capacity to meet demand. The important thing is that our approach to investment and reform delivers the system-wide improvements that help us to break out of the annual cycle of winter crises. There has been criticism of the Government’s focus on elective recovery—for example, people have asked if that is at the expense of urgent and emergency care—but I will not allow a status quo to settle in which the NHS is in effect reduced to a blue-light, emergency service. The Government will improve urgent and emergency care, elective recovery, primary care, community services and social care, because that is what we need to meet the health and care needs of people in this century, and that is what we will deliver.
Winter pressures have caused the cancellation of thousands of operations, including many of my own lists. Does the Secretary of State agree that the opening of the dedicated Clare Marx surgical centre in Colchester, serving patients in Essex and Suffolk, is an extremely welcome development?
I thank my hon. Friend for his question, and for the expertise and experience that he brings to the House. We absolutely need to ensure that we are innovating in our service provision, and are shifting the centre of gravity out of hospitals and towards care and treatment closer to home—indeed, in people’s homes. As we have set out in recent weeks, since the investment announced in the Budget and particularly in the elective reform plan, this Government will continue to innovate, in order to provide services that deliver not only great value for the taxpayer but, even more importantly, great outcomes for patients.
(4 months, 3 weeks ago)
Commons ChamberIt sounds like there is some interesting, dynamic and innovative work going on in the areas that the hon. Gentleman mentioned. I would be happy to meet him to discuss it further.
I have just been visited by my former medical student, a young doctor in Yorkshire working in an intensive therapy unit, who told me that 40 of the 50 patients who were admitted with covid died. Many healthcare workers are suffering from flashbacks and post-traumatic stress disorder. What measures will the Government take to look after the mental health of the healthcare workers who so bravely helped us during the covid pandemic?
My hon. Friend raises an important point, which provides an opportunity for us all to reflect on the incredible work of those working in our health service; they are, in many ways, heroes, and we should absolutely acknowledge that fact. We need to explore the point he has raised—we could meet to discuss it further, or I would be happy to write to him.
(4 months, 3 weeks ago)
Commons ChamberI had expected to tell the House that I had come straight to Parliament from my operating theatre in Norfolk, where I had been dealing with ear, nose and throat surgery backlogs this morning, but late last night I received a call telling me that my operating list was cancelled because there are no beds in the day unit that was purpose-built to avoid that issue, and which opened only a few years ago. Every surgeon in the country will be familiar with that situation, and in every hospital, surgical teams are sitting idle waiting for beds. It is like a fog-bound airport where nothing can take off.
There are enormous backlogs across almost all of surgery, especially in gynaecology and orthopaedics. We are short of theatres, short of anaesthetists and short of scanners. Our patients are suffering and deteriorating in front of our eyes. Some of them are dying. We are short of all manner of specialists, including crucial diagnostic radiologists and pathologists. Delays in diagnostic imaging and reporting are very problematic—there are more than 1.5 million people on the waiting list to receive a diagnosis—but the Labour Government will deal with the massive NHS backlogs because we did it before. Between’97 and 2010, we abolished the waiting list, but in the period from 2010 to 2023, waiting lists reached record levels. Now we see access to GPs, dentistry and all routine surgery as the political emergencies that they are.
We all hear terrible accounts of the consequences of such delays from our constituents. We know of them first hand from our own families. My son, who is an A&E doctor, describes trollies of elderly, incontinent patients two abreast in corridors, and in car parks. He is unable to admit his patients, and that is right here in London. We know that we must rebuild our hospitals, and we will start with those that are actually falling down. My constituents were so pleased to hear both the Prime Minister and the Chancellor promise here in Parliament to replace West Suffolk hospital in Bury St Edmunds.
May I carry on, as I have very little time?
I am glad that the Prime Minister has made general practice and care in the community a central part of his plan. General practice is the front door to the NHS. Patients who have a genuine connection with one or two GPs are less ill and live longer.
There is an illuminating article entitled “Closer to home” in this month’s Fabian Review by my Suffolk GP colleagues Drs Reed and Havard, who reimagine GP as a comprehensive community health service close to the patient, with multiprofessional teams of health workers and with mental health services and district nursing all in one place. Patients know who their doctors are and know that the community health centre is the place to go. Let us call them Bevan community health centres. We really can manage most clinical problems in the community, and investing in our brilliant GPs is truly the key to the crisis. Community hubs with diagnostic capabilities for larger populations would send to hospital only people who need to go to hospital.
We must do something about productivity. I started my career with four workers in the theatre operating on eight children, only to reach a situation today of operating on four children with eight workers. As we reform and rebuild our NHS, let us bring the 1.5 million staff members with us on this great journey, for it is on them that we and the NHS depend. The measures announced today will surely help, but only if we find enough staff and invest in training. Let us look after those who look after us, with fair pay, fair conditions and a great deal of respect. That must be our mission.