Income Tax (Charge)
Richard Burgon Excerpts(1 month, 1 week ago)
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Richard Burgon (Leeds East) (Ind)
The Budget is a welcome break from more than a decade of austerity, and especially from the Tories’ slash-and-burn plans announced at their last Budget, which would have meant even more deep cuts. It is good to see public investment being emphasised, as that is key not only to rebuilding our public services but to driving growth and better living standards. Likewise, the boost in day-to-day spending for public services over the next couple of years is welcome—for example, we are funding 40,000 extra NHS appointments a week and recruiting 6,500 new teachers. Having campaigned against poverty pay for many years, I welcome the boosts in the minimum wage, although there is more to be done.
The Budget included positive measures for those like me who want the wealthiest and tax dodgers to be made to pay their fair share. That is why we have heard so much squealing from the Tories and the right-wing press in recent days. It seems that defending the super-rich is the main reason why they get out of bed in the morning. Progressive taxes, achieved by ending the non-dom scheme—why on earth would they have a problem with that?—having higher capital gains taxes, and extending the windfall tax on oil and gas profits, are what we need to fund our services. We need more of that, because public services need more funding. The increases announced in the Budget, after the initial boost over the next couple of years, will not be enough to repair the damage done by a decade of Tory cuts. The Government should grasp the nettle and introduce a series of wealth taxes, starting with a 2% tax on wealth above £10 million, which would raise billions more for our public services.
I would have liked the Budget to do more on tackling poverty. I am concerned that real-term cuts to benefits next year appear to be planned. That must not happen, and disabled people must not be subjected to more cuts and attacks. The two-child limit needs to go, fast. A Labour Government should eradicate child poverty, not allow more children to fall into poverty. The last Labour Government lifted many children out of poverty, and that is what we want to see again. The winter fuel allowance cut should be reversed. That cut makes no sense morally, politically or even economically, and it is not too late to think again and scrap it.
The Budget is a welcome break from a decade of austerity. It contains progressive tax measures, but more needs to be done now and going forward on poverty reduction. It was put together following the toxic inheritance from the Conservatives. It would be good to see more than a handful of Members on the Opposition Benches. Who knows? They might be able to learn something.
Children’s Hospices: Funding
Richard Burgon Excerpts(1 month, 2 weeks ago)
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Ian Byrne
I thank my hon. Friend for her excellent intervention; I wholeheartedly agree.
We had to raise £5 million in 30 days to give Zoe’s Place a future, so I asked the trustees to let us give it a shot, harnessing the spirit of the city, which has been galvanised since people heard the news, and the love for this wonderful institution. We put the call out in Liverpool, and I have never seen a response like it in my life. It has been my great city at its very best, for the world to see. We have had kids going door-knocking with fundraising buckets, raising money because one of their friends is being supported by the hospice; parents who turned to Zoe’s Place in times of need organising fundraising walks and sponsored motorbike rides; and support from MPs, such as my right hon. Friend the Member for Hayes and Harlington (John McDonnell) promising to carry on playing his unique take on “You’ll Never Walk Alone” on his trombone if we did not raise the funds—the city has spoken, John, and I’m saying no more. Cafés have pledged their takings to the campaign, running raffles to raise money, and local businesses have got involved, donating tens of thousands of pounds, and their time and expertise, which will never be forgotten.
Richard Burgon (Leeds East) (Ind)
Will my hon. Friend accept from me the congratulations of the people of Leeds, who value Martin House Children’s Hospice in Wetherby so highly? Many people in Leeds will look to Liverpool with great admiration at the incredible fundraising efforts, which have impressed and inspired so many. They have also led people to conclude that we cannot allow places such as Zoe’s Place to go to the wall, and that guaranteed full funding for palliative care and children’s hospices is a must.
Ian Byrne
I thank my hon. Friend for that excellent intervention, with which I wholeheartedly agree. Former football stars from Liverpool joined the efforts, donating more than £150,000. The local paper, the Liverpool Echo, and its staff led by Liam Thorp, have thrown their weight behind the campaign, doing everything they could to save the hospice. On Monday, we had the incredible news that Liverpool-based company Home Bargains was pledging £2.5 million to the campaign, bringing us within touching distance of the total.
The tireless and wonderful work of so many has been invaluable over the past few weeks. There are so many to thank, if I had the time, but I must pay tribute to the wonderful comic, Adam Rowe and fellow funnyman, Willie Miller, who have done so much to raise this issue both publicly and behind the scenes, and John Gibbons from “The Anfield Wrap” for his tireless efforts over the past few weeks.
There are still 10 days to go, and we are not over the line yet, but we are proving that if any city can do it, Liverpool can. The community, the solidarity, the togetherness—I have never been prouder to be a Scouser. Today, the plans for the future are coming together. Last week, we announced what the new Zoe’s Place Liverpool would be like, operated and run in Liverpool, putting it on a footing to care for kids from across Liverpool and beyond for generations to come. I am really optimistic that we will do it.
But the truth is this: talk to the families who rely on Zoe’s Place and Claire House, see the support that those hospices give to seriously ill children, babies and families, and you will know that that support is not a luxury—it is essential in a modern, functioning society. They provide a vital service that should not require charity to keep it going. Everyone who needs it should have access to high-quality palliative and end of life care, but that is not happening at the moment. Not just Zoe’s Place, but children’s hospices across the country are in crisis, with many more fearing for their future.
That is why today’s debate is important to families up and down Britain. Despite children’s hospices providing an essential service, they are overwhelmingly funded by charity. Less than a third of their income—around 30% —is public money, with the remaining 70% coming from charitable donations. That is a broken model. Let me be clear that I have the utmost respect for people who give up their time and money to support our hospices, but as one constituent said to me recently:
“We shouldn’t have to sell charity cupcakes to make sure kids are cared for”.
But that is what is happening at the moment.
The public funding element of children’s hospices is both inadequate and messy. Most of it comes from the children’s hospice grant. Introduced by the previous Labour Government, it was designed to provide direct funding to children’s hospices. Today, it stands as a £25 million grant, but it has an uncertain future. It was renewed by the previous Government for 2024-25, but the new Government have not yet said whether the funding will continue. According to the charity Together for Short Lives, if the grant is not renewed, there will be a profoundly negative impact on lifeline care and support. Eighty-two per cent of children’s hospices told the charity that they would have to cut or stop providing respite care or short breaks; 70% said they would have to cut or stop providing emotional and psychological support; and 45% said they would have to cut end of life care.
Will the Government commit to maintaining the £25 million children’s hospice grant as a ringfenced fund in 2025-26 and for the long term? Will they commit to making it centrally distributed once again? Many care homes have said to me that they are opposed to the integrated care board model that NHS England is using, as it has led to delays in children’s hospices receiving money.
The next biggest pot of public money for children’s hospices comes from integrated care boards, which have a legal duty to commission palliative care, but the funding is patchy and falling. Research shows that the funding per child with a life-limiting or life-threatening condition varies wildly across the country. It is just £30 per child in Northamptonshire but £397 in Bristol, north Somerset and south Gloucestershire. In my area, Cheshire and Merseyside, it is slightly above average at £206, but there should be no postcode lottery in funding care for kids. And the funding is falling—last financial year, children’s hospices on average received almost 10% less funding than the year before, and almost a third less than the year before that. What are the Government doing to make sure that every seriously ill child and their family, regardless of where they live, have fair and equal access to palliative care?
Local authorities have a duty
“to provide services designed to assist”
family carers of
“disabled children to continue to”
provide care
“or to do so more effectively, by giving them breaks from caring.”
Local authorities, which are under immense pressure, account for just a small fraction of children’s hospice public funding—about 2.5% of the total. The funding fell by 26% from last year to this year, and more than half of children’s hospices received no funding at all from their local authorities. What conversations is the Minister having with colleagues in the Ministry of Housing, Communities and Local Government to ensure that local authorities meet their legal duty to provide short breaks for disabled children who have life-limiting or life-threatening conditions?
The funding streams are insufficient for children’s hospices at the best of times, but we really are at crisis point. That is why we are all here today. With public funding falling, charitable donations squeezed as the cost of living crisis bites—the cost of living crisis, again, is affecting us all— and increased energy prices, children’s hospices have seen their income fall. That is having grave consequences. More than half of children’s hospices in England ended the last financial year with a net deficit, and it gets worse: next year, more than two thirds of children’s hospices forecast a deficit. Unless more public money is found, more and more children’s hospices will have to cut back, more services will be reduced, more kids will miss out, more families will have nowhere to turn and more children’s hospices will be put at risk, just like Zoe’s Place in Liverpool. Extra funding is needed just to stay still, let alone to build the world-class care system that our constituents deserve.
According to research from Together for Short Lives, the NHS needs almost £300 million extra to meet the standards for children’s palliative care set by the National Institute for Health and Care Excellence. That is the inheritance of 14 years of Conservative chaos, with deeply damaging NHS reforms and chronic underfunding of our public services. Our new Labour Government promised change, and that must be delivered. Will they use the opportunity of the NHS 10-year plan to fill the almost £300 million gap in funding for children’s palliative care?
Let me remind everyone that there is money in this country to fund children’s palliative care. Our problem is not a lack of wealth, but its extremely unequal distribution. In the run-up to today’s Budget, I was one of the MPs who called on the Chancellor to raise taxes on the richest, with policies such as a 2% wealth tax on assets over £10 million, which would raise £24 billion a year—enough to meet the palliative care funding gap 80 times over. That is why I introduced a private Member’s Bill yesterday that would launch a review of the funding for children’s hospices and guarantee high-quality care for all seriously ill children and their families. I really hope that the Minister will take up that call.
In Liverpool, the people have risen to the challenge, and we are on the cusp of saving Zoe’s Place. Now this place has to rise to the challenge as well, and we have to give children’s hospices the funding they need to survive. The children and families who rely on these incredible institutions do not have time to waste.
Oral Answers to Questions
Richard Burgon Excerpts(7 months, 3 weeks ago)
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Richard Burgon (Leeds East) (Lab)
The Minister for Health and Secondary Care (Andrew Stephenson)
Happy St George’s day, Mr Speaker.
Cutting waiting lists is one of the Prime Minister’s top priorities. We are spending more than £8 billion on additional elective activity and investing in additional capacity including community diagnostics centres, one such centre being in the hon. Gentleman’s constituency. Since September 2023 overall waiting lists have fallen by almost 200,000—the biggest five-month fall in over 10 years, outside of the pandemic.
Richard Burgon
NHS waiting lists have risen threefold since the Tories came to power, and the Prime Minister’s pledge to cut waiting lists is in tatters. Rather than taking responsibility, the Tories first blamed NHS staff who were trying to get better pay, and now they have opened up a new round of media attacks on the sick and the disabled. Why do not the Government instead go after the tax dodgers, as Labour plans to do, to raise funds and help resolve the crisis in our NHS?
Andrew Stephenson
Once again the hon. Gentleman does not condemn the strikes. I would gently say that while we are getting waiting lists down in England, Welsh Labour has the longest hospital waits in Great Britain, putting patients at risk because it does not have a plan to clear the backlog. In December 2023 the Welsh Labour Government had the highest number of patients in Great Britain waiting over two years for treatments. It is an outrage; yet that is the blueprint for what the Labour party says it will implement here in England.
Andrew Stephenson
My hon. Friend makes an important point. I know the huge value of Parkinson’s nurses to local patients in my constituency. Under the NHS long-term workforce plan, backed by more than £2.4 billion over the next five years, the NHS will focus on expanding the number of clinicians training for enhanced and advanced roles working as part of multidisciplinary teams with the right skills to meet the changing needs of patients.
Richard Burgon (Leeds East) (Lab)
Victoria Atkins
We switched on our fully funded dental recovery plan, in case the hon. Gentleman was not listening carefully earlier, on 1 March. Nearly 500 more practices in England are accepting new adult patients than at the end of January, and even more will do so under the dental recovery plan. We have plans to bring in new dental vans to help our most isolated communities. We are also bringing in the Smile4Life programme for children, because prevention must be a critical part of our dental recovery plan.
Hospice Funding
Richard Burgon Excerpts(7 months, 3 weeks ago)
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Richard Burgon (Leeds East) (Lab)
I congratulate the hon. Members for Hastings and Rye (Sally-Ann Hart), and for Darlington (Peter Gibson), on securing this important debate, with cross-party support. The debate is a time for us to thank all the people who work in hospices in our local communities.
Hospices have touched so many lives in all our constituencies. St Gemma’s hospice in Leeds serves my community and has a special place in my heart because my grandma, mum and auntie all received care there before passing away, and the staff did a fantastic job. It was 20 years ago last month that my mum passed away there. Looking at the St Gemma’s hospice Twitter feed this evening, I saw that a friend of mine, Liam Raftery, who was a fantastic musician in a Leeds band called The Latchicoes, passed away there at the age of just 30 in 2017. I did not realise that it would have been his 37th birthday yesterday until I saw the St Gemma’s hospice Twitter feed.
The work that hospices do touches all our lives, and they do a fantastic job under incredibly difficult circumstances. St Gemma’s cares for over 300 people every day, and around 2,000 patients each year, but as we have heard from various speakers tonight, funding is a huge issue. St Gemma’s funding from the NHS covers less than 30% of the total hospice needs, so we need core funding on a sustainable basis. St Gemma’s hospice is budgeting for a deficit of over £500,000 in this financial year, which is why it has had a fundraising drive online over the last 48 hours. If people donated to St Gemma’s hospice before 8 pm tonight, their donation would be matched—in other words, it would be doubled.
I was delighted to see that, due to the generosity of people in Leeds, the hospice more than exceeded its target of raising £200,000 in just 48 hours. That shows how valued the hospice is in our community, as well as the generosity of local people. When I last went to St Gemma’s hospice and met the chief executive Kerry Jackson and her team, one of the things they made clear, and are still making clear, was that fundraising drives in general are becoming harder and harder to do. That is because of the cost of living crisis. People want to give but they cannot necessarily give as much as they used to. The people who run and work at St Gemma’s hospice are clear that NHS funding is not sufficient. They say that it covers less than 30% of the total hospice needs, so we need to see a change.
People have mentioned the independence of hospices, and that is important. We cannot have a situation where the people working in and running hospices in some of the most stressful circumstances imaginable, at a crucial and painful time for those who are losing loved ones, are worrying not only about how to care for people in the last moments of their life but about funding.
Ian Byrne (Liverpool, West Derby) (Lab)
Would my hon. Friend agree that the Government should provide an increased level of funding that is long-term sustainable to all children’s hospices, including Claire House and Zoe’s Place in Liverpool, West Derby, which provide magnificent and crucial support for everybody in West Derby and beyond who needs it?
Richard Burgon
I thank my hon. Friend for that intervention. He has spoken to me before about the hospices in Liverpool and how they serve the people of West Derby, and he is correct to say that sustainable, reliable and sufficient funding is needed—especially as we are seeing increased demand—if the hospices that Members on both sides of the Chamber have celebrated tonight are to continue to provide the service that is needed by the people in our communities.
I want to end by saying thank you to each and every person who works at St Gemma’s hospice in Leeds, to the team who work there day in, day out, and also to the people in Leeds for their generosity. Even in tough times, they are donating and raising money for St Gemma’s hospice. Long may it continue the fantastic work that it does, but we need to ensure that sufficient core funding is provided so that it can do that work more easily in the decades to come.
NHS Dentistry: Recovery and Reform
Richard Burgon Excerpts(10 months, 1 week ago)
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Victoria Atkins
Indeed, and it was a pleasure to meet my hon. Friend to discuss the issues facing his constituents. I hope he recognises that we will have those aims very much in mind in the delivery of the recovery plan. We will begin to see the roll-out of those 2.5 million more appointments in the coming weeks as the new patient premium takes hold.
Richard Burgon (Leeds East) (Lab)
Last month, Healthwatch Leeds submitted evidence to the Health and Social Care Committee—testimonies from people at the sharp end of the NHS crisis. One said:
“I am really struggling to find an NHS dentist that is accepting new patients at the moment. I am an apprentice and get paid minimum wage and cannot afford a private dentist.”
Others spoke of the way in which, according to Healthwatch Leeds,
“having no access to treatment is impacting on their general well-being and mental health.”
One of them said:
“ I just don’t know what to do, who to turn to, how to get help. I just want to be able to smile again”.
Is it not the case that this Government’s plan is too little too late, and that the queues snaking around dentists’ surgeries are testimony to the failure of 14 years of Conservative government and a deliberate undermining of our valuable public services?
Victoria Atkins
The hon. Gentleman has quoted Healthwatch. I presume that he will also be gracious enough to acknowledge that the move to introduce 15 dental vans has, in fact, been welcomed by Healthwatch.
NHS Strikes
Richard Burgon Excerpts(1 year, 8 months ago)
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Steve Barclay
My right hon. Friend is absolutely right to focus on patient safety and the duty that all involved have to safeguard it. Indeed, I have previously given the Royal College of Nursing’s leadership credit and praise for granting strike exemptions, known as derogations—notwithstanding our disputes, I was happy to recognise that on the record. Given that less than a third of the RCN’s total membership has voted against the deal, and that the RCN’s leadership recommended it, it is very odd that it has now hardened its position and removed those exemptions. I very much hope that it will reflect further on the matter in the coming days, because I think its previous stance of granting exemptions was right.
Richard Burgon (Leeds East) (Lab)
We need to be clear: junior doctors have had a 26% real-terms pay cut. Restoring their pay would cost around £1 billion a year. That is less than half the giveaway handed to the super-rich through the non-dom tax avoidance scheme. Is it not the case that a proper pay rise for junior doctors is affordable—it is just that the Government have the wrong priorities?
Steve Barclay
It perhaps will not surprise the House to hear that the hon. Gentleman disagrees with his party’s leader on that, because the Leader of the Opposition says:
“I don’t think 35% is affordable”.
The hon. Member for Leeds East (Richard Burgon) is also wrong on the quantum, because the cost would be £2 billion, not £1 billion as he says. [Interruption.] Well, that has never been how departmental budgets operate—not when his party was in power, and certainly not now. He is wrong on the amount and wrong on the policy.
Future of the NHS
Richard Burgon Excerpts(1 year, 9 months ago)
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Kate Osborne
Yes. We have all seen for ourselves and heard from our constituents how difficult it is to get an appointment, and the private profiteers are driving that.
Richard Burgon (Leeds East) (Lab)
I congratulate my hon. Friend on securing this important debate and making such a powerful case. On the subject of privatisation, does she share my concern that, as we have heard in recent speeches in the Chamber by Conservative Back-Bench MPs, this is entirely deliberate? They want to manufacture consent among the public for a move to an insurance-based, American-style system by more and more people feeling forced to take out health insurance or pay for healthcare, so that over a number of years, we see healthcare provision go down the same path as council houses, which went from mass provision to minority provision.
Kate Osborne
I agree that if things do not change, that is exactly the route we are going down.
Oral Answers to Questions
Richard Burgon Excerpts(1 year, 10 months ago)
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Will Quince
I am very happy to meet my hon. Friend to discuss that further.
Richard Burgon (Leeds East) (Lab)
Will the Secretary of State for Health—today, on the record—condemn the call from his predecessor to impose charges on visits to the GP or to A&E?
Steve Barclay
I am not sure how many times one needs to say the same point. The Government’s position on this is clear: we are committed to treatment free at the point of use. That is the Government’s position, and it has been throughout the NHS’s history, the majority of which has been under Conservative Governments.
NHS Winter Pressures
Richard Burgon Excerpts(1 year, 11 months ago)
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Steve Barclay
My hon. Friend skilfully combines the importance of discharge at King’s Lynn with the importance of addressing RAAC—reinforced autoclaved aerated concrete—hospitals, on which he has campaigned assiduously. As he will know from my speech at the NHS Providers conference, it is an issue that I very much recognise. I have visited the hospital and seen the challenges at first hand; indeed, my son was born in that hospital, so I know it very well. We are discussing that issue with the Treasury and I hope to be in a position to update the House shortly.
Richard Burgon (Leeds East) (Lab)
We will not solve the NHS crisis without solving the NHS staffing crisis, which means sorting out pay. However, in talks with the unions today, the Government refused to make a new offer on pay. The unions say that the Secretary of State is ludicrously calling for—demanding—efficiency savings from nurses and other NHS staff. Many nurses and NHS staff are already working 18-hour shifts. When will the Government get real? When will the Government get serious? When will the Government make a proper offer to NHS staff to avoid strikes?
Steve Barclay
The hon. Gentleman seems to be quoting Onay Kasab, the lead national officer of Unite, who spoke to Sky News outside the Department of Health and Social Care just a few minutes after my discussions with the trade unions. The slightly odd thing was that Mr Kasab was not actually in the meeting on which he was commenting.
NHS Workforce
Richard Burgon Excerpts(2 years ago)
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Steve Brine (Winchester) (Con)
It has been interesting to hear the exchanges between the Front Bench speakers, although I am surprised that there are not more Members in the Chamber for what is a very important debate. [Interruption.] Actually, where are they on both sides of the House? Given that this is the No. 1 priority of the Opposition, where are they?
Steve Brine
Without the heckling from the back row of the Labour Benches, I can say that this has always been my No. 1 priority.
Back in July, the Health and Social Care Committee, which I now chair, published a crucial report entitled, “Workforce: recruitment, training and retention in health and social care”—I urge colleagues across the House to take a look at it, if they have not already done so. We looked at workforce issues right across the NHS, and the findings were stark. The report found that the NHS workforce is facing the biggest challenge in its history. It made the same point about the social care workforce. Although social care is not the focus of today’s debate, it is important to stress, as others have during today’s opening exchanges, that the two sectors are closely intertwined and the workforce problems in the NHS cannot be considered in isolation.
We had NHS Providers before the Select Committee this morning to discuss the industrial action. I asked them whether they support the independent pay review process. I would have intervened on the shadow Secretary of State with that question, but his speech had already gone on for an hour, so I thought he deserved to sit down. More than 1 million NHS workers under Agenda for Change have had, as the Secretary of State said, a £1,400 pay rise this year. That has come out of the independent pay review process. The question I asked NHS Providers this morning, to which the answer was yes, was: do they still believe in the independent pay review process?
Either we have that process, we believe in it and we respect it, or we do not. Are we saying that we have that process and it sticks until something else comes along? If Ministers then become directly involved in negotiating pay for NHS workers, that is a very different proposition. That is not the place we want to be, although the Select Committee is very happy to scrutinise that proposal if it is coming from the Treasury Bench. I would be interested to hear in the winding-up speeches what the Labour party’s position is on the independent pay review process, because it is independent for a reason.
The Committee’s report cited research by the Nuffield Trust suggesting that the NHS in England could be short of 12,000 hospital doctors and more than 50,000 nurses and midwives. The number of people on a waiting list for treatment rose to a record of just over 7 million in September, and the 18-week target for treatment has not been met, as is well known and is on the record, since 2016. Yet, as our report noted, the demand on the sector continues to grow relentlessly. There are estimates that an extra 475,000 jobs will be needed in health by the early part of the next decade.
One of the Committee’s most urgent recommendations was that the Government should do proper workforce planning. We noted that without workforce plans that are independently verified and publicly available, there would be little confidence among the public, the profession or NHS workers themselves that the Government have a grip on the problem.
I must say that the Select Committee has not yet had a Government response to our workforce report—it is a little overdue. The Secretary of State is on the Front Bench, and I know he is busy, but hopefully he will take that back to his officials. We look forward to receiving that response, because it is important that Select Committees get responses to reports in as timely a manner as possible, notwithstanding the fact that there has been a change of Administration.
However, I am encouraged that the Government are paying attention to what the Committee recommended, and I was delighted to hear my predecessor in this role, now Chancellor of the Exchequer, say in his autumn statement that he agreed with himself—his words—and that the Government would now be publishing an independently verified workforce plan for the NHS for the next five, 10 and 15 years, something the Committee has long called for. The Treasury outlined that the plan would
“include measures to make the best use of training to get doctors, nurses and allied health professionals into the workforce, increase workforce productivity and retention.”
Excellent—that is progress.
Questions remain, however—maybe the Minister can touch on this in her winding-up speech—about what the independent workforce planning will look like in practice. We need to know more about who will provide the independent verification once the work has been done. I understand the work has largely been done by the NHS, but we need to know who will be doing the independent verification, when it will be published and how regularly it will be reviewed. When we know that, we will look forward to talking to him or her in the Select Committee.
Our report contained a number of other important and detailed recommendations about how to tackle the NHS workforce crisis. I do not want to go into all of them today—as I have said, the report is on the record and published in the House—but among them I wanted to highlight the radical review of working conditions that was touched on by both the shadow Secretary of State and the Secretary of State.
Work conditions are critical. We talked about the need to reduce the intensity of work felt by so many people in the service—which I hear about both as a constituency MP and as Chair of the Select Committee—and the need to boost retention and of course recruitment of people who are looking at where they might work when they have done training. We recommended that the review should start with an overhaul of flexible working, which would mean that NHS workers were not driven to join agencies or become locums to gain control over their working lives. I often hear those words, “We just need control over our working lives.”
We also said it is a huge problem that senior doctors are being forced to reduce their working contribution to the NHS or to leave it entirely because of the long-standing problem around pension arrangements, which was a problem when I was a Minister in the Department. We accept that the Government have made some progress on pensions, with changes to the taper rate and the annual allowance, and credit to them for that, but we note that the problem persists and have called on the Government in our workforce report to address it.
In that context, to give credit where it is due, I was very pleased to see on Monday that the Government have announced plans to amend NHS pension rules to retain senior doctors and encourage staff to return from retirement. The Secretary of State was slightly mocked when he said that was subject to a consultation, but that is how government works. If the hon. Member for Ilford North (Wes Streeting) were to become Secretary of State—I like him very much, but I hope he does not—he would also publish consultations, because that is how proper government is done, and he knows that. We look forward to seeing the Government response to that consultation, which I know the Secretary of State is keeping a keen eye on
The Secretary of State is right to say that there are a record number of doctors in training, with five new medical schools, two of them focused on training GPs. That is true, but the Select Committee will return to our workforce work next year, and we will be taking evidence from anyone who wishes to contribute about the cap on training places. I have said to Ministers and to No. 10 that I think the Government are going to have to look again at that issue. I hear in my constituency from bright young boys and girls who wish to train as medics, whose parents have maybe worked in the profession and who have that ambition for themselves. The cap is a problem.
My other point is about demand. We had somebody from the British Medical Association’s GP committee before the Select Committee this morning, as part of our ongoing inquiry into integrated care systems, who was talking about the NHS being underfunded. That depends on which end of the lens we look at, does it not? We spend £150 billion or so of taxpayers’ money on the NHS. We could spend £300 million; that would be a choice. We would have to fund it, of course, because we know what happens when people make unfunded spending pledges from the Dispatch Box—the markets go into meltdown, and rightly so.
We need to have a serious and honest conversation with ourselves about how much of our national wealth we wish to spend on our health service and whether that would achieve the desired outcomes. We are the fifth-largest spender on health services in the OECD, but we do not get the fifth-best outcomes. I can give the House a bit of an exclusive here, because in the new year the Select Committee will be launching a big inquiry into prevention. Anyone who knew me when I stood at the Dispatch Box as a Minister will know that cancer and prevention are the two things that most get me out of bed in the morning, so we will do a big piece of work on prevention.
My view and the view of many others is that the NHS will have long-term sustainability challenges if we do not get serious about prevention. I do not just mean returning to the argument around obesity and all the things I wrote about in the child obesity plan when I was a Health Minister, although they are important and I urge the Government not to backtrack on any of those policies but to implement them, because weight is a major problem in our ill health. We need to get upstream of ill health.
I will say more about this in the debate in the House on Thursday, but when the Committee returns to cancer work, we must look at future cancer and at getting upstream of cancers. At the moment, we want to diagnose quickly, but people have to have symptoms in order to be diagnosed quickly and then we need to treat very quickly as well, within the 28-day standard. The Secretary of State and I have talked several times already about how we need to get far ahead of that.
We need to bring together predictive medicines, biomarkers and some of the life sciences work that is going on with the NHS’s genomic strategy, and get ahead of some of the illnesses that drive ill health in our country. Without that, in my humble opinion, the NHS has long-term sustainability problems.
Richard Burgon (Leeds East) (Lab)
Just two years ago, in the middle of the greatest public health crisis in decades, millions of people came out to clap for the nurses, doctors and other NHS workers who were putting their lives on the line to save the lives of others. As people will remember, Conservative Members were only too happy to be seen joining in the applause. How times have changed.
We now have Tory Ministers wheeled out on the media to attack those same NHS workers with sick claims that their planned action for fair pay is aiding Putin’s abhorrent war on Ukraine. Those disgraceful remarks appear to be the opening salvo in a Tory propaganda war that seeks to blame NHS workers for the deep crisis in our health service. The Tories will attack nurses, as they do every other worker forced to defend their pay and conditions. But nurses did not create the NHS staffing crisis. Nurses did not create record NHS waiting lists. Nurses did not underfund our NHS. Nurses did not hand tens of billions of pounds that should have gone to the NHS over to the private sector, including in corrupt contracts. Whoever the Tories try to blame, the simple truth is this: it is 12 years of Conservative party rule that has created the crisis in our NHS.
At its core is a crisis in the NHS workforce, with workforce shortages at an unprecedented level across the NHS. The statistics are eye-watering, with 133,000 NHS vacancies in England alone and a record high of 47,000 nursing vacancies. This Tory-created staffing crisis is why patients are struggling to get a GP appointment, why heart attack patients face ambulance waiting times of more than an hour and why many are not getting the life-changing operations they urgently need.
Today we will vote on an important policy to scrap the non-dom tax status that is exploited by the super-rich to avoid £3.2 billion in taxes every year. Scrapping that, as Labour advocates, could fund a long-term plan to train enough NHS staff. For example, it could double the number of medical training places and deliver 10,000 more nursing placements.
The Tories should back that plan to put the NHS before non-doms and invest in our NHS instead of lining the pockets of the super-rich. It is a plan that would help bring about a long-term solution to this crisis. For the next two years that they are in government—that is all it will be—they should take the action needed to address the workforce crisis in the immediate term, and we cannot solve that unless we resolve the NHS pay crisis.
A third of public sector workers are actively considering leaving their jobs, and pay is a key factor in that. Key workers in our NHS still earn thousands of pounds a year less in real terms than in 2010. For example, nurses’ real pay is down by £5,200 compared with 2010, while hospital porters’ real pay is down by £2,500. Now the Government expect it to fall even further.
Staff, however much they love their jobs, simply cannot afford to stay in them. Their pay is not covering their essentials. Hospitals are even having to open up food banks for staff. That falling pay is why, over the coming weeks, nursing staff and—it was announced today—ambulance staff will be taking industrial action. Nursing staff do not want to take action, but they feel they have been left with no choice because Government Ministers will not even meet them to discuss pay.
Nurses hope that the Government will listen and open up the pay talks so that they do not have to go out on strike, but if they do strike, they will have public support and I will go and support them. It is not too late for the Government to avoid strikes. They have chosen strikes over negotiations, but they can stop this at any point. The Government need to open up the talks and they need to pay NHS workers properly. They need to give NHS workers the pay rise they deserve.