NHS Staffing Levels

Debate between Rachael Maskell and Peter Dowd

Tuesday 22nd November 2022 Westminster Hall

[Peter Dowd (Bootle) (Lab)]

It is a pleasure to speak under your stewardship, Mr Hollobone. I thank my hon. Friend the Member for Wirral West (Margaret Greenwood) for initiating the debate.

Where do I begin on this subject? It is difficult to know because Members have brought forward a plethora of information, but I will start with the House of Commons Library briefing, which is always a good source of information, and its research is based on independent sources. It says that the Health and Social Care Committee has said:

“The National Health Service and the social care sector are facing the greatest workforce crisis in their history.”

The NHS, which is the best part of 80 years old, is facing the worst crisis in its history, with a vacancy rate of 9.7%, which is 132,139 members of staff.

There is significant shortfall in staff across the piece. The hon. Member for Westmorland and Lonsdale (Tim Farron) talked about vacancies in pharmacy, dentistry, radiology, podiatry, ambulance staff, back-office staff—as those people who are at the heart of the service and keep it going are disparagingly called—cleaners and porters. Everybody says the whole NHS is under huge stress.

[Rachael Maskell]

I want to highlight the neuroradiology profession and the reality that staff shortages have an impact on clinical outcomes. Hardly any of our NHS trusts have neuroradiologists, but they could save 9,000 lives lost to strokes by being able to advance new techniques. Does my hon. Friend agree that it is important to look at the clinical outcomes that health professionals could bring?

[Peter Dowd]

My hon. Friend is right: it is crucial that we do that. A whole range of issues are beginning to affect staffing. For example, there is a £9 billion maintenance backlog in the NHS. Patients are being treated in hospitals that are not, in certain situations, fit for purpose and, importantly, staff have to work in those environments. In many cases, radiology equipment is not up to date, so staff and patients are either working or being treated in an environment in which the conditions and the equipment are not good. That goes to the heart of the staffing crisis as well.

There are lots of suggestions about how the Government could get to grips with the situation. Community Pharmacy England has plans to “resolve the funding squeeze”, which seems pretty straightforward, to

“tackle regulatory and other burdens”

that are affecting staffing, to

“help pharmacies to expand their role in primary care”

and to

“commission a Pharmacy First service”.

All those things go to the heart of enabling staff to feel wanted and that they are working in an environment where they are treated properly.

Of course, we then get people leaving in droves because of pay. I looked at some of the figures in relation to the pay restraint that we have had for the past few years: since the Government came to power in 2010, for all intents and purposes there has been either no pay increase or an increase of 1% here and 2% there.

NHS Dentistry

Debate between Rachael Maskell and Peter Dowd

Thursday 20th October 2022 Commons Chamber

[Peter Dowd]

That is a point well made. Another factor is that there are deep inequalities in access to dentistry. In my constituency, it is difficult to get to see an NHS dentist for love or money. I am not blaming the dentists; they are doing a fantastic job in the circumstances. They are going over and above their duty. I put on the record my thanks—as I am sure we all would—to my dentist practice, which I have been with for over 45 years. Dentists are doing a fantastic job, but they have both their hands tied behind their back at the moment. That has to change.

Some 91% of people, including 80% of children, are not able to access a dentist, and 75% of dentists are reducing their NHS engagement. The new contract announced before the summer did not really do anything and there was no new money with it. There is a significant gap—potentially as much as £750 million—in the resources that dentists need.

Another aspect is dentists’ morale, with 87% having experienced stress, burnout or depression in the last 12 months. That is a dreadful situation to put a committed profession in. We have a scenario in our country in which dentists who trained for seven or eight years—possibly more—and practised for many years are now getting to the stage where the majority are stressed, burned out or depressed. That is dreadful. According to one study, half of them are considering changing career. Some of them are seeking early retirement or going fully private. They are getting stressed out because they just cannot move the dial. They are waiting for the Government to move it, but the Government are not moving it.

Children in my constituency are three times more likely to have their teeth extracted in a hospital because they do not have access to a dentist. My right hon. Friend the Member for Knowsley (Sir George Howarth) and the hon. Member for Bath referred to oral cancer. That is identified very early on—and who does the identification? Surprise: it is often the dentist. We need substantive support from the Government, not tinkering around with the contract. We need them to provide adequate funding.

Dentists must not be an afterthought. They are a vital component of the health of the nation. We must build on the historical commitment to prevention; that is key—as the saying goes, prevention is better than cure. Dentists have had enough; they are under pressure. My constituents have had enough; they are under pressure. The Government have to do something about it.

In the debate before the summer, I referred, in relation to the lack of substantive action by the Government, to a rejigging of what Ian Fleming said about crisis: if once is happenstance and twice is coincidence, three times is friendly fire and four times is enemy action. We are now in a situation where the Government are perceived as the enemy because of their lack of action.

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

I apologise that I was not able to be here for the whole debate; I have been in a Bill Committee. In York, people have to wait six years to see a dentist. Of course that is completely unacceptable, but my real concern is that, with the transition of dental services into integrated care systems, ICSs will not have the powers—the levers—to make the difference on training, funding and the contract and, ultimately, dentistry will be pushed into a tug of war between ICSs and the Government.

[Peter Dowd]

I am glad that my hon. Friend raised that matter because it is something that I was going to raise. The health service, because of the reorganisation, is in an element of flux. It is feeling under a bit of pressure. Potentially, people are having to reapply for jobs in the broader sense in the NHS because of the reorganisation. That is a fact. I am not sure whether we should be having a reorganisation of the NHS in the post-covid environment, but that is a different argument for a different day. The broader dissonance in the system now multiplies the problems that we are having in dental practices, because they are getting pushed further away, which is why practices need representation on these boards. I am glad that my hon. Friend highlighted that point.

As I said in the debate before the summer, we do not want any more excuses from the Government. We do not want any more prevarication, any more procrastination, any more pretext or any more self-exoneration. I hope the Government and the Minister, whom I welcome to his place, really get the sense of the frustration and, in certain situations, anger in the Chamber today. They really must pull their finger out—if not people’s teeth.

NHS Pay

Debate between Rachael Maskell and Peter Dowd

Wednesday 13th September 2017 Commons Chamber

[Peter Dowd]

No, I will not.

As the country suffered, those workers stepped forward. Will we step forward for them? Labour says, yes, it will. We know what those workers provide for our communities and for our country. What do we provide for them—or, rather, what do the Tories provide for them? First, they provide huge amounts of patronising claptrap—we have seen loads of that today—backslapping and warm words. Those workers do not need our tributes; they need our action. The Tories tell them how much they are valued and what a great job they do. The Prime Minister tells us virtually on a daily basis how wonderful our public services are—it usually happens after a national emergency in which people are murdered, maimed or, in the case of Grenfell, asphyxiated or burned to death. Yes, in the week of the Grenfell public inquiry, it is as stark as that, so let us not shilly-shally around this issue.

Those public sector workers are the people we turn to when no one else is available. They are the people who save lives, help to bring life into the world and are there when we leave the world. While they gave their all for us over these hard months, they knew that the Conservative Government remained committed to capping their pay and to continuing with the real-terms pay cut they have faced since 2010. Ever since the election, they have faced mixed messages about their pay from the Conservatives.

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

The problem is not just about pay, but about the funding of the NHS. York’s hospitals are in this capped expenditure process due to the debts they have accrued because of massive underfunding. Can we ensure that this money comes from the Treasury and not out of the coffers of the NHS?

[Peter Dowd]

I will come to that point in a minute.

In the election, Labour promised to end the public sector pay cap and to free the pay review bodies to do their work properly without the artificial encumbrance of a 1% cap. Meanwhile, the Tories have spent the period since the election putting the heads of public sector workers in a spin—will they or won’t they. Yesterday, No. 10 was briefing that the pay cap was over. The Chief Secretary to the Treasury was on the radio announcing derisory offers to police and prison staff, rather than coming to this House to explain what was going on. We had to have this debate today to get the Government here to explain their actions. Members on the Government Front Bench would do well to remember these words of wisdom:

“It is better that you should not vow than that you should vow and not pay.”

We will hold them to that. When the reality of this supposed U-turn emerged, there was nothing tangible. In the case of the police, it was just an unconsolidated 1% bonus on top of what they were due to get. Prison officers were offered just 1.7%. In effect, less than 4% of public sector workers were covered by the proposals announced yesterday. In the meantime, the other 96% can whistle. The nasty party simply cannot help itself. What is its tactic? It is the same old one, regurgitated time and again, of divide and rule. As ever, it tries to pit one group of workers against the other—the public sector against the private sector, doctor against manager, admin against manual workers, British workers against foreign workers, and the north against the south. Yes, it is the same old hackneyed tactic, but this time it has not worked. If the Government had focused on dealing with this matter and on sorting out the tax dodgers, we might not have been in this situation in the first place.

This is over. Even as the Government conceded the need for a thaw in the pay cap, Tory Front-Bench Members were briefing the media to raise the issue of wonderful contracts and pensions in the public sector. The Prime Minister attacked our public servants for having progression pay as they gain experience. The Government just could not accept that fairness required a change in direction. They still had to have that streak of resentment when they were announcing the policy change. As Anne Bronte said:

“There is always a ‘but’ in this imperfect world”.

With the Tories, it is always an industrial-sized ‘but’, visible from space.

The police and prison officers will have to pay for their pay rise themselves. There is no new money and no new resource. It is an announcement without substance. If and when the public sector pay cap is lifted across the rest of the public sector—namely the other 96% I referred to earlier and, in particular, the NHS—will the Minister be asking them to pay for their own pay rise by sacking more NHS staff? Will she provide new resources? Does she expect waiting times to get longer, and operations to be delayed or deferred? Who will be first on the sacking list—the porter, the radiographer, the medical secretary, the nurse, the doctor or an allied professional? Perhaps none of these redundancies will be needed because jobs in nursing, medicine and other allied health professions cannot be filled in large parts of the country.

This is a betrayal of public sector workers and it has to end. The Tories do have something in common with nurses and doctors, but for wholly different reasons. Nurses and doctors in the medical profession stitch people up for the benefit of the patient. The Tories stitch people up for their own benefit.