Future of the National Health Service

Rachael Maskell Excerpts

Wednesday 22nd September 2021 Westminster Hall

[Rachael Maskell (York Central) (Lab/Co-op)]

It is a pleasure to serve with you in the chair, Ms Bardell. I thank my hon. Friend the Member for Leeds East (Richard Burgon) for opening the debate with so many facts that we need to reflect on. From before our first breath, to our very last, since 5 July 1948, the NHS has worked day and night to give us hope.

The principle was that, no matter who we were—duke or dustman, as Bevan said—we knew that, when the hands of the NHS reached out to us, it neither judged nor differentiated. It simply did everything it could to invest in our health. That equality was the way out of health inequality, which is, sadly, so stark today in constituencies like mine, where the most affluent can expect to live for 10 years more than the poorest.

Reading Michael Marmot’s report, there is something fundamentally missing from the NHS. This reorganisation will not address it. We must sew that into housing, air pollution, jobs—the things that really will bring about a fundamental change.

[Hannah Bardell (in the Chair)]

Order. I am sorry to interrupt the hon. Lady mid-flow.

--- Later in debate ---

[Hannah Bardell (in the Chair)]

Before I call the hon. Member for York Central again, I advise Members that the new end time for the debate will be 4.15 pm, and that I would like to call Ministers by 3.45 pm.

[Rachael Maskell]

Unless and until public health is the Government’s first priority, the demands will be ever-growing, but now, unlike before, it is uncertain whether those demands will be met. Just look at covid-19: the countries that put public health first had the lowest sickness and mortality rates, yet over 135,000 lives have been lost here. Whether it is covid or cancer, poverty is the greatest enemy of health, yet as we speak, the surge in poverty that this Government are imposing on our constituents through the changes they are bringing about—whether through national insurance contributions, or by taking away the £20 universal credit uplift and other benefits—is resulting in poorer mental and physical health. After a decade of austerity, poor workforce planning and a continued drive to profit off the sick have taken their toll on our NHS. In 2019-20, according to the King’s Fund, £9.7 billion was spent on private provision, up by £500 million on the previous year. According to the data provider Tussell, £37.9 billion-worth of covid contracts have been let.

The economic and health shock of covid should prompt us to hit the pause button on the NHS. Last Friday, I spent half a day with York Medical Group, with clinicians, managers, GP partners and support staff; I was there to listen. This Friday, I will be at York Hospital, which is also struggling. The GP practice has received 41,000 calls from a population of 44,000 patients on their books in a month; add to that the 5.6 million, rising to a possible 13 million, waiting for treatment in secondary care. The system is imploding, the staff are imploding, and the NHS is imploding. We cannot just keep feeding money into the NHS, and we cannot keep selling it off.

When I read the subject of the debate—“the future of the NHS”—I did not consider the Health and Care Bill to be that, nor did the staff who I met with. In fact, they see the Bill as a massive distraction from dealing with the current crisis that they are having to grapple with, and another assault is just one step too many. Staff are saying that to save their own mental and physical health, they are now having to walk. We therefore have a workforce crisis on top of a health crisis, and the NHS is now in a clinically dangerous place. Government Ministers who completely misunderstand how the NHS works cannot just keep interfering in the system. They need to pause. They misunderstand the professionalism, care, dedication and love of the people who give all that they have—day in, day out—to care for us. As Ministers introduce more complex systems and more private companies into the health service, the NHS itself is falling apart. The Health and Care Bill is not the solution; it cannot be the way forward.

On the integration of the health service and social care, if we do not put the money together, we cannot put the systems together. However, the reforms will create more barriers and more division, rather than solving the challenges before us. The World Health Organisation describes health as

“a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.”

A future NHS must start here. Public health has been so underfunded over the last 10 years, and even under-utilised during the pandemic. It is absolutely vital that it is at the forefront of the future NHS. Regular population screening will start addressing severe health inequalities. Health counselling will ensure that people make the right choices about their future and will divert people who do not access the health service when they need it into early intervention and prevention. If we invest in clinicians in the community to undertake that dialogue and those discussions, and if we invest in social prescribing and other ways of improving people’s lifestyles, we have a real chance to turn this system around.

We cannot delay putting together an integrated public health agenda to drive forward our health service. If we continue as we are, our NHS will not be here. The pressures bearing down now are just indescribable. After listening to staff, all I can say is that the Health and Care Bill is just not the solution.