Building an NHS Fit for the Future

Ranil Jayawardena Excerpts

Monday 13th November 2023 Commons Chamber

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

Waiting lists are rightly one of the Government’s top priorities. To the best of my knowledge, Mr Deputy Speaker, you could not perform a knee replacement—one of the most waited-for operations—and if I were to give you £1 billion, I suspect that you would still be unable to do so. Too often, debates focus on money and how much has been put into the NHS—the Government have put record amounts into the NHS—but it is about more than money; it is about people.

On this, the 75th year since the NHS was founded, the workforce plan is a milestone in the NHS’s history, and one that I am very pleased to see. It is an essential step towards creating a more productive health service where we can expand training and recruitment while retaining the amazing pool of talent that we have in the NHS. My constituents will be particularly pleased to see the plans to increase the number of dentistry students by 40%, because many are struggling, as has been said, to see dentists. We will also double the number of GP training places by 2031, which is welcome.

These changes will take time, because doctors take a long time to train. One of the first things that the Conservative Government did was to put in place steps to open the new Lincoln medical school. It has opened and is training doctors, and it will not be long before the first new doctors will graduate, which is excellent news for my constituents. I am also pleased for my constituents that we have got a new diagnostics centre opening in Grantham, which will accelerate patients’ diagnoses and treatment.

I have been pleased to hear in the last few days about the streamlining of processes for clinical trials. That will help us to find the new treatments and diagnoses that will be the miracle cures. The Health and Social Care Committee recently visited Singapore, where we met a professor who had identified the benefits of chimeric antigen receptor T-cell therapy and treated Oscar, the little boy from Worcester whom many of us will remember from the news. Thankfully, he has recovered from his leukaemia. Such groundbreaking, world-beating discoveries will be made only if we make it easier to conduct safe clinical trials. However, we also need to look at how we incentivise people to do them.

The NHS has advertised roles for equality and diversity staff at more than £90,000, yet there is currently an advert for a professor of synthetic biology at Cambridge University—they will lead global clinical research—for a little over £67,000. We need to look at how the state values the people who will bring about world-leading discoveries and how it can support them in their quests so that our brightest children will want to do that not just through moral desire but, essentially, to turn their A-levels into cash.

The NHS has been crippled by strikes this year, and more than 1 million appointments have been cancelled. That is not helping with waiting lists, and patients are being left to suffer. Cancer diagnoses are being delayed, and patients’ conditions, when they are in pain, are being left unrelieved. As a paediatrician, I understand the desire for better working conditions and more money, but I cannot understand morally the desire to leave patients behind in order to achieve that. Morally, I do not agree with the strikes and I support the Government’s prioritising patients and their commitment to maintaining minimum service levels during industrial action.

[Mr Ranil Jayawardena (North East Hampshire) (Con)]

Does my hon. Friend agree that people often forget about the huge amount of pension rights quite understandably provided to people in public service? Junior doctors who are continuing their action do not take account of the huge benefits that they will accrue in later life.

[Dr Johnson]

I should mention that I have an NHS pension, but my right hon. Friend is right. The Government took a big step earlier this year to improve pensions, by changing the tax regime to make it easier for more senior doctors to remain at work and not feel they have to give it up because of punitive tax levels. Ultimately, doctors are paid well—they could be paid better, of course—but for me it is a moral question: morally, I do not think it is right to leave patients in order to advocate for more money.

I am pleased by the steps that the Government are taking to crack down on tobacco products. The proposal will not please everyone, but it shows the Government’s boldness and earnestness when addressing public health issues. Prevention is better—and usually far cheaper—than cure. A preventive approach to smoking will reduce the burden on our healthcare system and improve people’s quality of life. Colleagues will not be surprised to hear that I am especially pleased by the Government’s commitment to restrict the sale and marketing of vapes to children. I am glad that the Government have included some of my proposals in their upcoming consultation on vaping, including regulating their flavours, branding and visibility in shops, as well as giving local authorities the power to issue on-the-spot fines for those selling them to children.

I am glad that the Government are consulting on banning the sale of disposable e-cigarettes, which time and again have been the vape of choice for children. I was shocked by figures published last year that found that 1.3 million vapes are thrown away every week in the UK. Subsequent figures released in September show that, staggeringly, in the space of just one year that number has more than tripled to 5 million every week. Those disposable vapes would fill this Chamber from top to bottom twice over every single week—heaven forbid, Mr Deputy Speaker. That is the scale of the problem we are dealing with.

The UK risks falling behind if it does not seize the agenda quickly. I eagerly await the results of the Government’s consultation, as I know many colleagues do. Sometimes, it can be difficult to find issues on which figures from across the political spectrum are strongly aligned, but I am confident that the House will unite behind the Government’s recent proposals on vaping.

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[Sir Edward Leigh (Gainsborough) (Con)]

I congratulate my hon. Friend the Member for Uxbridge and South Ruislip (Steve Tuckwell) on a superb election victory and on a great speech from a real local champion. That result shows how important it is for the Government and the Mayor of London not to get ahead of public opinion on green energy. We all want more green energy but it must be economically driven and we must take the general public with us. I am afraid that the Mayor of London, certainly in outer London, has not taken the public with him. In Lincolnshire we have an aspect of green energy that affects my constituency, with 10,000 acres ringing Gainsborough to be put under solar panels. That will involve a huge loss of agricultural land, enough to feed the city of Lincoln every year. We all want solar panels as long as it is proportionate, but 10,000 acres ringing one small town in Lincolnshire is overdevelopment.

The advantage of the King’s Speech debate is that we can range quite widely, and in the few minutes I have, I shall raise a few general points. We have a new Foreign Secretary, a new Home Secretary and a new Health Secretary. The challenges facing the Foreign Secretary are enormous, both in the middle east and in Ukraine. On the earlier intervention, I am all in favour of a ceasefire, but it must be by both sides, and there is no intimation yet that if Israel were to announce a ceasefire, Hamas would follow suit. If Hamas are now prepared to commit themselves to a permanent ceasefire with Israel and respect the right of Israeli citizens to live in peace and tranquillity, I am sure we can have a negotiation on that basis, but I do not see that happening.

We also need to have a tone of compassion for the Palestinian people. The Palestinian people are not Hamas. I was quite impressed by what President Macron was saying on this. The Israeli Government have the right to defend themselves, but it must be in proportion, and I think we are all devastated and concerned about the plight of women, children and babies in Gaza. The Israeli Government have to deal with this issue in a proportionate way.

On Ukraine, I do not suggest a ceasefire, because that would simply benefit President Putin, but if there is a stalemate, I am not sure that we can go on thinking that we can solve the problem by pouring in more and more weaponry. Eventually there will have to be some sort of settlement.

This is a debate primarily about the NHS. We in Lincolnshire suffer from a poorly performing NHS. I have constituents—people of my age—who have paid taxes all their lives and who suddenly fall ill, go to A&E in Lincoln and have to stay there for 24 hours, often in pain and difficulty. More and more doctors are insisting that people who want an appointment have to go online, and fewer and fewer doctors are providing prompt face-to-face service. The NHS simply cannot continue as it is.

We have a new Health Secretary and, as I have said before, I think we need fundamental reform. Frankly, our counterparts on the continent, in France, Italy and Germany, get a much better service. We have to look at some sort of social insurance system by which people who pay taxes all their life are entitled to treatment within a certain period and, if they do not receive that treatment, the state will assist them to go private.

I have made the point many times that a previous Conservative Government gave tax relief for private health insurance. This Government have not progressed that idea, which I do not think would be a wildly popular one, but we have to do something. The NHS is consuming an ever-larger proportion of the national budget and delivering a worse and worse service.

Over the next 12 months up to the general election, I hope the new Health Secretary will think big ideas to try to give people, particularly those of pensionable age, some right to the healthcare that they have paid for all their life and that they do not get at present. Having more children brushing their teeth at school under a putative Labour Government will not solve the problem; it is far greater than that.

Of course, we also have a new Home Secretary, who has an enormous challenge. I have confidence that he will speak up for Conservative Britain and Conservative voters who are deeply unhappy about the very high levels of both legal and illegal migration. It is completely unsustainable to carry on with the current net migration rate of some 600,000 people a year, which is overwhelming our services, the NHS, housing and everything else. It is said that we need these people to work in the NHS or in care homes, but we need to provide proper wages so that people who already live in Britain want to work in the NHS or in care services.

We should not allow employers to think they can solve their problems by constantly importing labour from abroad. There is a simple solution to help solve this problem. The average wage in the UK is about £34,000 a year and, at the moment, a person can enter this country for a job paying £26,000 a year. If we said that migrants have to earn a minimum of, say, £34,000 a year, we would bring in high-quality staff and not undercut our own indigenous labour.

[Mr Jayawardena]

Does my right hon. Friend agree that we have a structural problem because of our country’s ageing population, and that we need to have more children in this country so that we meet our replacement rate for the first time since the 1970s?

[Sir Edward Leigh]

I have made a personal contribution by having six children. They are all now in their 20s and 30s, and they are finding it unbelievably difficult to get on the housing ladder. The Government really have to solve this problem. We cannot just fill this country with more and more people so that our young people cannot get on the housing ladder and cannot find a place to rent.

I am a bit dubious about reforming how landlords can evict tenants. I just want supply-side reforms to ensure there is more housing coming on to the market for young people to rent. I want the Government to be far more proactive on building houses, if necessary in grey areas on the green belt. That might not be universally popular with my colleagues, but we certainly have plenty of room in Lincolnshire. If people want to come up to Lincolnshire and build houses, they are very welcome. We will do our bit.

I am very dubious about the smoking ban and, as a libertarian, will vote against it. It will not solve the problem, and I believe it will result in a massive increase in criminality. Every time we ban something, we simply increase the criminal class. I am not sure a ban is even enforceable. In 50 years’ time, old boys will go into a tobacconist and say, “I am 64 years old and am entitled to buy cigarettes, but my friend here, who is 63, cannot buy cigarettes.” It is ridiculous, and it is not enforceable. I do not smoke, and smoking is decreasing all the time. The people who smoke are heavily taxed. I do not believe we can solve this or any other problem by banning things. Conservatives have to be primarily about freedom. They have to be about low taxation and deregulation. We have to give something for our own people to vote for, which is why I have talked about these issues and, in particular, curbing legal and illegal migration. I am a victim of that, as is the Home Secretary, because the previous Home Secretary was going to open a camp for asylum seekers in his constituency. I do not know whether the Home Secretary is still going to do that; if he decides to row back on that idea in his constituency, I hope he will not close that camp in Essex but keep open the putative camp at RAF Scampton in Lincolnshire, as that would be completely unfair. Being a fair-minded person, he will not do that, I am sure. I shall be knocking on his door soon to say that we need a compromise, as we cannot have 2,000 illegal migrants overwhelming local social services. After that brief run around the King’s Speech, I am sure you will be grateful if I now sit down and let others have a go, Mr Deputy Speaker.

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[Anna Firth (Southend West) (Con)]

On behalf of the people of the city of Southend and Leigh-on-Sea, I wish to express my gratitude and respect for His Majesty. Her Majesty the late Queen Elizabeth II is still much missed in Southend, but His Majesty has acceded the throne with all the dignity and gravitas that we came to expect from his mother. It was a true privilege to witness the first King’s Speech in 70 years.

I judge all new legislation against my three priorities to make the new city of Southend safer, healthier and wealthier. I am pleased to say that the King’s Speech hits all three of those priorities, although today we are, of course, talking about building an NHS fit for the future. That goes right to the heart of much of the work I have undertaken since being elected. As many Members have done, I welcome very much the commitment to creating a smokefree generation, cracking down on youth vaping, growing our NHS workforce and cutting waiting lists. However, I would like to talk a little about capital funding.

I welcome very much that core spending by the end of this Parliament will have increased from £140 billion to £193 billion in 2024-25. We have invested record sums in our NHS. That is an increase of £53 billion in cash terms, or a 37% increase. I welcome the fact that that includes capital spending of £83 million in the current spending review going into Southend Hospital, with another £19 million set to come on top of that, meaning a total of £102 million into my local hospital since the last election. I welcome that wholeheartedly, but we must do more to speed up the arrival of NHS capital funding.

The House is well aware of my campaign to get £118 million of capital investment that was promised to South Essex hospitals in 2017. The lion’s share of that, £52 million, was promised for Southend Hospital and it is much needed. I termed that money the missing millions and I have mentioned it 11 times in this House. Last year, I got £8 million to secure improvements to our emergency department, and two years ago I was absolutely delighted to hear that the rest, the £110 million, was finally confirmed and would be delivered in full. That will mean a modern endoscopy suite for Southend, an upgraded refurbished main theatre, more hospital beds and an upgraded emergency department: better and faster hospital care in better surroundings for all Southend’s residents and those around who come to our hospital. Better late than never, but we must do more to get that money through the bureaucracy faster than we have managed so far.

That investment will be moot if my constituents cannot get to the hospital. Ministers are aware that last year elderly residents were left stranded literally overnight when First Bus withdrew the No. 21 bus service, literally cutting them off from Southend Hospital. Working with First Bus I managed to reroute the No. 3 bus, but that is not good enough because it runs only once every two hours. I reiterate the need to restore that bus service. I am delighted that, working with the previous Roads Minister, bus funding of almost £1 million is now coming to Southend over two years, which should help to protect and enhance local bus services, including getting the No. 21 back. I am now looking forward very much to working with the new Roads Minister—as soon as I know who that is!

Money is not the be all and end all for the future of our NHS. We are investing record sums, but what we need to 100% focus on religiously is reform and prevention. Here, I want to talk about something called the fracture liaison service. I recently visited the fracture clinic at Southend Hospital, which is to launch a new fracture liaison service in spring next year, with the support of the Mid and South Essex integrated care board. This will be the first fracture liaison service in the UK to have a single FLS across an entire area, supporting consistent care across Mid and South Essex. In our region, there are an estimated 8,000 to 10,000 fragility fractures every year in adults aged 50 or over, often causing patients to spend extended periods in hospital, taking up hospital beds and staff time. Over five years, the new Southend FLS is expected to prevent 550 fractures, saving half a million pounds and 1,300 bed days every single year. If that is scaled up nationally, we will be saving 74,000 osteoporotic fractures and releasing 750,000 hospital bed days. Services like this are truly the future of the NHS. Their benefits are unquestionable. I look forward to seeing all regions following our lead in Southend to deliver savings and free up beds across the board.

On waiting lists, I was extremely disappointed to see The Times reporting erroneously that Southend is England’s NHS waiting list hotspot. The number quoted on waiting lists did not include the total catchment population for Mid and South Essex, where waiting lists today sit at approximately one in seven people, not one in five as was quoted. It is disappointing to see prestigious leading national newspapers irresponsibly pumping out the wrong information and not getting their facts straight.

Of course I am not happy for any of my constituents to wait longer than they should, but we must recognise that industrial action has played a part in the extension of waiting lists across the NHS. Mid and South Essex NHS Foundation Trust has a recovery plan, and provided that there is no further industrial action it will virtually eliminate 65-week waits—except in the case of some specialist services—by next March. However, we must have sustainable staffing in order to cut waiting lists, which is why I welcome the proposal to deliver the NHS long-term workforce plan. Like others, I also welcome the commitment to creating a new smoke-free generation. That will save thousands of lives, and it goes without saying that a healthier future for our children means a more sustainable NHS.

Community pharmacies are already saving 619,000 GP appointments every week—roughly 32 million a year—and removing the need for about 3.5 million people a year to visit A&E departments and walk-in centres. Given such staggering results, we must surely consider moving more health services out of hospitals and into the community.

[Mr Jayawardena]

Is it not also important for us to educate the public so that they know how much they can obtain from their local pharmacies rather than always relying on GP appointments or, indeed, associated professionals?

[Anna Firth]

I entirely agree with my hon. Friend, and he has brought me neatly to my next point. The brilliant Belfairs and French’s pharmacies in Leigh-on-Sea are run by an inspirational pharmacist, Mr Mohamed Fayyaz Haji, known as Fizz. The range of services that those pharmacies deliver is incredible, including cholesterol and blood pressure checks, health advice and prescribing, and they are now expanding into primary and community care, from ear syringing to community phlebotomy, earlier diagnosis measures such as measuring prostate-specific antigen levels to test for prostate cancer, electrocardiograms, ultrasound screening for sports injuries, and services for pregnant women. This is a model for community pharmacy care around the country that will keep people out of hospitals unless they really need to be there.

I am delighted that one of my key campaigns has made it into the King’s Speech. My campaign to ban all forms of zombie knives will be enacted through the criminal justice Bill, which will increase the maximum penalty for those who sell dangerous weapons to under-18s and create a criminal offence of possession of a bladed article with intent to cause harm. Being stabbed is the No. 1 fear for young people in Southend for the second year in a row, and I welcome the fact that the Bill will make our streets in Southend safer.

I see you looking at me, Madam Deputy Speaker, so I will summarise my next few points. Bleed kits must be rolled out, because the first person to reach a stab victim is often not an ambulance driver but someone from a pub, a club or a police car. If we support Julie Taylor’s award-winning campaign and roll out those bleed kits, we will save more lives.

No speech from me would be complete without my mentioning Southend United. I wholeheartedly welcome the football governance Bill, which will deliver a more sustainable future for football clubs such as Southend for generations to come.

I believe that this King’s Speech will deliver a healthier future, a stronger economy, and a safer future for all the residents of Southend and Leigh-on-Sea, especially children, and I look forward to voting for it later this week.