Building an NHS Fit for the Future

Rebecca Long Bailey Excerpts

Monday 13th November 2023 Commons Chamber

[Rebecca Long Bailey (Salford and Eccles) (Lab)]

It is a pleasure to follow the hon. Member for Worcester (Mr Walker).

The King’s Speech was more notable for what was not in it. On the day, critics called it the “all mouth and no trousers” speech. In fact, it had the fewest Bills in a monarch’s speech since 2014. People in my Salford constituency looked at it and wondered, “What is in it to make my life better? What is there to help with the cost of living? What is there to support public services, to improve our broken public transport system or to address the NHS crisis?” Sadly, the answer was nothing.

The mental health Bill was abandoned yet again, despite being a manifesto promise in 2017 and 2019, and despite there being a clear mental health crisis. There was no conversion therapy ban, despite it being promised repeatedly by the Government.

What was actually in the King’s Speech? Well, the big flagship policy seems to be the Offshore Petroleum Licensing Bill, which completely undermines the Government’s so-called commitment to net zero. Staggeringly, even the Government admit that the Bill will do nothing to bring down household bills.

The King’s Speech also talked about implementing minimum service levels. Of course, this was a reference to underpaid and, frankly, burned-out public sector workers striking for fair pay and adequate funding for their services, which are in a state of acute crisis. The irony is that the Government cannot deliver minimum service levels on a day-to-day basis in the NHS because of chronic underfunding and underpay, never mind on strike days. I wish to elaborate on the staffing crisis within the NHS.

More than 112,000 vacancies were recorded across NHS England in March. At the time, both the Royal College of Nursing and the British Medical Association warned that staffing levels were not meeting patient demand and that this was putting patient safety at risk. Further, the Royal College of Nursing stated that nursing staff were leaving the profession “in droves”, often because the stress and demands of the job do not match their current pay levels. It said that one nurse can be left looking after 10, 15 or even more patients. Those ratios are unsafe and require urgent action from the Government.

There is also a two-tier system for nursing staff, with different pay for the same job, as there is no parity of pay, terms and conditions across all the sectors in which nurses work. The position for midwives is equally dire, and midwifery now makes up a smaller slice of the NHS workforce than at any time on record. There is a big difference between the English regions, too. In the 12 months to July 2023, the number of midwives in the east of England rose by almost 9%, but in the north-west the number rose by just over 1%. The Nursing and Midwifery Council has said:

“There are clear warnings workforce pressures are driving people away.”

It found that 27,000 professionals had left the register in the UK in the year to the end of March 2023 and that although retirement was the most common reason for leaving, the next most common reason was health and exhaustion.

The real-world consequences of this crisis in midwifery are being felt in Salford. Ingleside birth and community centre is a freestanding midwife-led birth centre for antenatal and post-natal care, as well as low-risk birthing. It is situated in the middle of the beautiful Oakwood park in Salford. This state-of-the-art facility was opened a few years ago to address the absence of local maternity services after the closure of the maternity unit at Salford Royal Hospital in 2011.

Sadly, because of a midwife shortage, the facility has been closed since the pandemic, leaving Salford residents, families, new parents and their new-born babies without access to maternity services in the city. New parents and their new-born babies are forced to travel many miles across Greater Manchester to access these services. Even when they reach these services, which are miles away from their home, resource pressures and reduced staffing appear to be negatively impacting the remaining services at other locations. One mother explained the situation to me:

“I have recently given birth to my third child and the deterioration of services is shocking and has caused significant trauma to myself and my family... I experienced medical negligence, epistemic and testimonial injustice and disability discrimination throughout pregnancy, birth and in the postnatal period”.

Unfortunately, that mother’s story is not a one-off. Make Birth Better estimates that about 200,000 people a year find some aspect of giving birth traumatic, yet 30% of new parents suffering from mental and/or physical trauma after giving birth do not feel they are being supported. It is no surprise that we are hearing these stories, as the Government have chronically underfunded NHS maternity services—a commitment to only one third of the funding recommended by the Health and Social Care Committee was made recently.

Of course, the Government will say that they are responding to the staffing crisis and will cite their NHS workforce plan, but the Public Accounts Committee has criticised the plan heavily in a new report. In particular, it has criticised the lack of funding estimates and raised concerns about how the plan will be achieved. Although an additional £2.4 billion is to be provided to cover training costs for the first five years of the 15-year plan, no estimate has been put forward of total additional running costs beyond that for the hundreds of thousands of extra workers the plan says will be needed by 2036-37. The Government may refer to the education pipeline, but for every burned-out experienced nurse who leaves the profession, it takes at least three years to educate a new nurse. It has been estimated that one in three nurses leave their course citing financial challenges and poor support as reasons for leaving, and trainee doctors report feeling burned out.

Clearly, the Government need to take urgent action to increase the numbers of those training in NHS professions. They should listen to calls from the Royal College of Nursing to forgive tuition debt for all current nursing and midwifery students and to abolish self-funded tuition fees for all future nursing, midwifery and allied health students. That must be accompanied by a package for students, including a living costs grant that reflects the true cost of living and access to hardship payments. To keep those staff, the Government must listen to the alarm bells being rung by the NHS workforce, who do not want to take strike action but are simply desperate. Pay them properly and fund their services.