Oral Answers to Questions
Richard Burgon Excerpts(3 days, 9 hours 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(4 days, 9 hours 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(2 months, 2 weeks 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 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, 2 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, 3 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, 3 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(1 year, 4 months 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.
Baby Loss and Safe Staffing in Maternity Care
Richard Burgon Excerpts(1 year, 6 months ago)
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Richard Burgon (Leeds East) (Lab)
It is a pleasure to serve under your chairmanship, Mr Davies. I congratulate the hon. Member for Hartlepool (Jill Mortimer) on securing the debate, and on the candour and bravery with which she spoke from personal experience. I will use the limited time available to me to share the experience of my constituents, Hayley Storrs and Reece Watson, who wrote to me as follows:
“My name is Hayley Storrs & my partners name is Reece Watson. I’m 33 years old & live in Leeds. I work for NHS England as a Care Manager & my partner as an Electrical Engineer.
In October 2021, after a low risk pregnancy our first baby Ollie James Watson, passed away following a placenta abruption at 40 weeks & 5 days gestation. After suffering a haemorrhage at home, we were kept waiting at Calderdale Hospital in an understaffed Maternity Assessment unit, with bleeding & in active labour for over 1 hour before being seen by a midwife.
My son had already passed away inside my tummy & I wasn’t aware. Following his death & traumatic labour where I suffered a post partum haemorrhage, we received no bereavement support from the trust aside from a postcard on his 1st birthday.
The labour ward was short staffed when Ollie was born & I was left alone on numerous occasions with internal bleeding & no pain relief due to staff shortages. We have since learned that had a simple doppler scan been undertaken at any time during my pregnancy Ollie could have been saved. As a result of our experience, I suffered from PTSD, Birth Trauma, depression & severe anxiety, which still impact my day to day life.
Sands were an incredible support to me during the darkest days of my grief, when I wasn’t sure I would survive without Ollie. They provided information, comfort, support & a listening ear when I needed it the most. I attended a local support group which helped me connect with other women in similar situations to ours & made me feel less alone.
What people fail to understand when someone loses a child, it is that you have lost a lifetime. First days at school, first steps, graduations, what their favourite story would have been, birthdays, Christmases. Instead we walk out of a hospital with empty arms & into a world of grief & loss we are not equipped to navigate. My son deserved better than a memory box of scan photos, he deserved to live.
Please listen to us when we say that enough is enough, ask yourselves the question what will it take for change to happen? How many more babies like ours will die before something is done? How many more bereaved parents will it take to campaign for better, safer maternity care for you to take notice? How many more government enquiries will it take for someone to stand up & say ‘we see you, we hear you & we stand with you’?
In loving memory of Ollie James Watson, and all of the babies who never made it home. You will never be forgotten.”
Those are the words of Hayley Storrs, Ollie’s mum, from the constituency of Leeds East. I share them because to put on record Hayley’s and Rhys’s experience. Although I have not experienced baby loss myself, I think it is important that hon. Members who have personal experience share their experiences, that other Members share our constituents’ experiences, as I have done, and that we all come together on a cross-party basis really to address the issue.
This incredibly important debate has shown what can be done when we come together. I congratulate every Member who has spoken bravely about their personal experience, particularly the hon. Member for Hartlepool, who secured the debate and opened it in such an illuminating, informative and brave way.
Oral Answers to Questions
Richard Burgon Excerpts(1 year, 10 months ago)
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Sajid Javid
My hon. Friend makes a very good point and some good suggestions. West Midlands ambulance service is my local ambulance service too, and I recently met its chief executive officer and chairwoman. As he knows, the NHS has published and is executing a 10-point plan for emergency service recovery, but I shall certainly take what he says into account.
Richard Burgon (Leeds East) (Lab)
Sajid Javid
I am pleased to say that we have more nurses working for the NHS than at any point in its history, and last year we recruited an additional 10,900.