(10 months, 4 weeks ago)
Commons ChamberMy hon. Friend is right. I know how much work he did when he had oversight of urgent and emergency care services, which included his contribution to our urgent and emergency care recovery plan that was published almost a year ago. That plan included a host of steps to improve the flow through hospitals, including investment in bed management systems, as he described. The plan is working, which is why we are improving the flow through hospitals and seeing reductions in delayed discharges.
NHS data shows that we have delivered early on our manifesto commitment to have an extra 50,000 NHS nurses, with the number of nurses working in our NHS increasing from around 301,000 in 2019 to 357,000 today. That has been achieved through boosting training and education routes, ethically recruiting internationally and taking actions to improve retention. Measures such as the health and care visa introduced in 2020 support international recruitment.
I thank the Minister for his answer. As he knows, the national health service would completely collapse without the input and expertise of clinical staff from around the world. One barrier to those people coming to help us are the high fees for applying for permanent residency. Some nurses from countries such as India and the Philippines are having to take out expensive loans just to feel like they are welcome and able to stay in our country. I have presented a private Member’s Bill to exempt NHS clinical staff from paying those high fees to become residents. Will the Minister support the Bill and work with his Home Office colleagues to find a way to make that a reality for those people who work so hard in our health service?
I join my hon. Friend in paying tribute to the enormous contribution made by internationally recruited staff to our NHS. As he will know, immigration policy and fees are a matter for my right hon. Friend the Home Secretary. However, our long-term workforce plan supports international recruitment. In addition to the new visa route, we are exempting health and care staff from the immigration health surcharge.
(1 year, 9 months ago)
Commons ChamberI most certainly agree that that is a shocking figure. We need to make sure that we are really addressing all those issues very urgently. Those cancer waits are really important for what happens when undertaking treatment and the possibility of cure, so we really need to get on top of that.
When we look at accident and emergency, which has been much in the news, we see that 11,000 patients died after waiting more than 11 hours in A&E in 2021-22. The Government have just changed the target to 76% of patients waiting less than four hours in A&E by March next year, but we really need to return to the original target. Just changing the figures does not mean that people get better or that fewer people die; it means that the figures have been changed, and people understand that. My constituents know that.
More than 1.5 million people are waiting for key diagnostic tests such as MRIs, which is an increase of 95,500 from this time last year, whereas in May 2010 just 536,262—actually, that still sounds like a big figure—were waiting for key diagnostic tests. We need to get better, not worse, at doing these things.
One in seven people cannot get a GP appointment when they try to do so. All of us know, as constituency MPs, that one of the issues people consistently raise with us is that they are unable to get appointments in a timely fashion, so something that needs seeing to now is perhaps only seen to in a few weeks’ time. That is despite the really heroic efforts by a lot of our GP practices and surgeries, and the staff working in them, to try to make sure that people can get the advice they need when they need it. We know there is a shortage of GPs. Just in my constituency, people talk to me about that regularly. I regularly discuss with the NHS and with the new integrated care boards what is happening in that area, and things are really difficult for us at the moment.
At the same time, there are huge numbers of nursing vacancies in the NHS, with 47,000 posts unfilled, according to the latest figures. Some 40,000 nurses and 20,000 doctors left the NHS in the past year, and only 7,000 of those people retired. Surely, we must agree that patients need care and the NHS needs staff, and that it must be a priority to resolve this situation. That is why I am so pleased to see that Labour has a plan to address those workforce issues, because those workforce issues are at the heart of the difficulties within our NHS. It is not problems with NHS staff or that people are not working hard; they are working hard and, if anything, really becoming burnt out.
I am delighted to hear that Labour has a plan. Would the hon. Lady please share it with the Health Minister in Wales? If Labour has a plan, it would be really good to have it in Wales, where Labour does not seem to have one at all.
Well, I thank the hon. Member for that comment, but I will stick to my constituency in the north-east, if he does not mind.
As I was saying, this is not an issue with the staff themselves. The staff are working really hard and really down to the bone, and that is leading to the situation being made worse with people leaving or taking retirement. All of us will have friends and family who work in the NHS—certainly in the north-east, we have a huge number of people working in the NHS—and we see the strain on them, and on their faces, as they try to cope and deal with the issues they see day in and day out, so it is really important to address that.
It is a pleasure to follow the hon. Member for Bolton South East (Yasmin Qureshi), and I congratulate the hon. Member for Jarrow (Kate Osborne) on securing a vital debate on a topic on which I believe we could spend hundreds of hours, rather than the few short ones available to us this afternoon. But we take what we’ve got and we make a start.
I had hoped that this would be a serious debate about solutions, but sadly it seems to have descended into the same finger-pointing blame game that we always get. We will come back to that later.
I declare an interest: my fiancé is a research nurse who until recently worked in the NHS but has now gone into private sector research. I told him to watch this afternoon’s debate. He said, as a senior research nurse and someone who worked on the AstraZeneca covid team, “Why? It’ll just be a load of politicians blaming each other and not actually addressing anything.”
How right he turned out to be. However, he is watching it, and my phone has not stopped receiving messages such as, “Don’t agree with that intervention from the Opposition”, and, interestingly, “Hancock is making sense!” in respect of my right hon. Friend the Member for West Suffolk (Matt Hancock). My fiancé is not by any stretch of the imagination a traditional Conservative voter, but he gets it—he understands.
On 5 July 1948, the NHS was founded under Labour Health Minister Aneurin Bevan, who built on the initial idea in the 1944 White Paper, “A National Health Service”, introduced by Conservative Health Secretary Henry Willink, which set out the need for a free and comprehensive healthcare service. Aneurin Bevan is rightly hailed as the father of the NHS, but it is the Conservative Minister years earlier who can arguably be called its grandfather. And as we are all aware, grandparents always treat the grandchildren a lot better than their parents do.
There are 40 MPs in this place from Wales, the home of Bevan, and 26 of them represent various Opposition parties, but there are zero here today to talk about health services and to defend the record not of the UK Government over the past 13 years—right hon. and hon. Members have taken aim at them this afternoon—but of Labour’s control in Wales over the past 25 years.
In 1948, average life expectancy was about 68 years old; today it is almost 85. That is a 25% increase in lifespan. In 1948, hospitals had a couple of X-ray machines. CT scanners did not come into use until the 1970s, while MRI scanners appeared in 1984. Ultrasound, which was previously an instrument used to detect the flaws in the hulls of industrial ships, was first used for clinical purposes in Glasgow in 1956 due to a collaboration between an obstetrician and an engineer.
A new CT scanner sets us back £1 million to £2 million. An MRI takes up to £3 million, and ultrasounds a few hundred thousand each. Each hospital has multiple numbers of those machines. Drugs and treatment developments cost literally hundreds of billions globally every year. We are keeping people alive longer, diagnosing them with ever more expensive machinery and treating them with ever more expensive medication and devices. In 1948, the population of the UK was just under 50 million. Today it is almost 68 million—an increase of 36%.
My right hon. Friend the Member for West Suffolk talked about data earlier. I am no healthcare specialist or expert data scientist, and I do not in any way have all the answers, but I like to think that I have a reasonable amount of common sense, and my common sense tells me that, when 36% more people are living 25% longer and are being diagnosed by expensive machines and treated by a pharmaceutical industry that costs hundreds of billions, we cannot keep running things based on principles devised 75 years ago.
The main point I want to get across in my short contribution is one of openness and debate. I have sat and listened to right hon. and hon. Members in this debate and others over the years talking about various elements of the NHS in England. It is all a Conservative problem, they say. Tories are destroying the NHS, they say.
They are saying it now—they cannot help themselves. It is endemic in their thinking, but it does not help. Where is shouting at me getting them? Nowhere at all.
I invite them to come to Wales and view the conditions in the north Wales health board, where only 62% of buildings are operationally safe and where the hard-working staff, including friends and family of mine, are working in impossible conditions. In England, one in 20 people—5% of them—have been waiting more than a year on waiting lists. In Wales, the number is one in four—25%. The NHS in Wales performs worse in virtually every measurable area than the English equivalent. Labour Members are not shouting any more—how interesting. Currently, only 51% of red call patients are responded to within the target eight minutes. These are the second longest ambulance wait times ever. Only 23% of amber calls, which include strokes, were reached within 30 minutes.
The hon. Member for York Central (Rachael Maskell) mentioned dentistry in an intervention. Only 7% of dental practices in Wales are accepting new patients. Where is the outrage? Where are the demands for better? For every one pound spent on healthcare in England, there is almost £1.20 available in Wales—it is not a money problem—but for markedly worse outcomes in all areas. Where is the outrage? Instead, the Leader of the Opposition, in a speech last year in Wales, described the Welsh Government as providing
“a blueprint for what Labour can do across the UK”.
Well, good luck to the rest of the UK if it chooses to install the right hon. and learned Gentleman into Downing Street next year on that basis.
I am not helping the discussion with these statistics at all. I am guilty of the very thing I always tell others not to do—to stop blaming people, stop trying to score silly political points, and stop wasting everybody’s time by saying that different Administrations are to blame. There is no prospect of an open debate on the actual issues—the real, fundamental problems—if all we focus on is finding blame. It is easy, it is lazy and it gets us nowhere.
The NHS across the United Kingdom is in difficulty. It is in difficulty in England, Scotland, Wales and Northern Ireland. It is not in difficulty for political reasons; it cannot be, because there are three very different Administrations running health services in all those parts of the UK, and the same problems occur in all of them. We need to ask why there is so much waste in the NHS and why there are nurses graduating from universities with degrees who—as the RCN agreed with me recently—cannot draw blood or insert a cannula into a vein. It is not their fault; as with everything, it is the systems that let them down—systems that mean that health boards across the UK spend hundreds of millions of pounds sending graduates on courses to learn the clinical skills that they were not taught on their degrees.
I commend the shadow Health Secretary for something he said recently. He said that he would be prepared to use private sector resources to bring down waiting lists faster. He asked the question: “How can I look someone in the eye as a prospective Health Secretary and tell them that I have a way to provide them with a better outcome, but my ideology is standing in the way of their recovery?” He was lambasted for that view from his side of the aisle but, while he and I will disagree about almost everything else, I have to say that my respect for him went up significantly with that intervention.
The NHS health boards across Wales are sending people to private facilities, which is costing hundreds of millions of pounds. I commend them, because it is all about outcomes. We get so caught up on process and procedure—on who does what, when—that we lose sight of the outcomes for people. One of my most hated phrases in politics is “political football”. It is used almost exclusively in discussions about the NHS, but the bottom line is that things such as the health service have to be run by political decisions; otherwise, who could be held accountable to the public? If we take decisions out of the hands of politicians, who should make them and how can they be held to account?
I thank the hon. Member for making—a speech. He says that this is a political issue. Does he agree, then, that his Government have failed politically by not getting around the table sooner to avert some of the strikes that we have seen up and down the country?
I thank the hon. Lady for her intervention. How easy would it have been to go out into the media and say, “We’re asking for a 20% pay increase, by the way” —which is what happened—and then to blame the Government for not coming to the table? When the Government are called to the table on such ludicrous terms—from my point of view; everyone will have their own opinion—why should they engage? Timing is everything; they are now getting around the table and are now doing it. To answer the hon. Lady, she has condemned the Government for not doing it sooner, so I am sure she will now praise the Government for taking the time to do it.
The same strikes have been announced in Wales, but what happened there? Would the hon. Lady also condemn the Welsh Government for not getting around the table and not negotiating in the right way? [Interruption.] It never happens, or it is very rare. It is easy for the Opposition to play the blame game. Where has it got them?
I fail to see how the hon. Member does not understand that these points are political. For 13 years, a Conservative Government have underfunded the NHS, which has led to over 7 million people on waiting lists and tens of thousands of vacancies. As for the trade unions, yes, the Government are now talking to the RCN, but when are they going talk to Unite, GMB and the other trade unions that represent NHS workers?
I thank the hon. Lady for her intervention, but I am so exasperated by this. We hear from the Opposition all the time that the NHS was properly funded by Labour in 2010, but as the King’s Fund and many others will tell us, NHS funding has increased in real terms since 2010.
It has—although if Opposition Members want to argue with the King’s Fund, that is fine. But if NHS funding was okay under Labour and has increased in real terms since then, how is it not okay now? I agree that it is not okay now, but that is because of all the reasons I have already mentioned: we are keeping people alive longer, and sicker, there are more of them, and it is more expensive to diagnose and treat them. They are not political issues.
To draw my remarks to a conclusion, I am not familiar with the machinations of how to go about these things, but it seems perfectly reasonable to have, finally, some kind of royal commission—some kind of massive public engagement exercise—on the future of health services in the United Kingdom. We must tackle it head-on. We must not be afraid to go wherever that debate takes us in search of better outcomes for people. I just wish we would keep in mind that we are here for people. We are here to serve them and give them the best outcomes we possibly can, not to get caught up in form and process, or dogma and ideology. We are trying to make people better. We have to do whatever we can to get to the root causes of the issue, because as my former NHS and now private sector nurse partner tells me all the time—I quote—“You could fix so much if you’d just stop politics getting in the bloody way.”
Order. I call Paulette Hamilton.
I, too, congratulate my hon. Friend the Member for Jarrow (Kate Osborne) on securing this debate.
I worked in the NHS as a nurse for 25 years. I know at first hand how soul destroying it can be to work long hours with inadequate staffing and funding. I am also a mom, a sister, a wife and a grandmother. I know how worrying it can be when someone is ill and how helpless long waiting times can make families feel. I have also experienced that at first hand with the NHS in the last year. That worry is felt right at the heart of our communities, time and again. My constituents tell me they cannot get a GP appointment. In Erdington, Kingstanding and Castle Vale, and across the country, every morning at 8 am, thousands of people call their local GP surgery to get an appointment. One of my constituents rang up her local practice to get an appointment and was fifth in the queue. By the time she got to the front, there were no appointments left. She told me, “If you ring at one minute past eight, you’ll be on the phone for at least 40 minutes. You won’t get an appointment, because they’ve already gone.”
That is not a unique example. If one of my constituents cannot wait to see a GP and calls an ambulance because they think a loved one has had a heart attack or stroke, they can expect to wait 27 agonising minutes. In December, many waited for over an hour. In November, my husband had a stroke. The ambulance never came. In January, across the UK, more than 40,000 people waited over 12 hours for treatment once they had managed to get to an A&E department.
With healthcare staff reporting stress, poor mental health and that they are still living with the effects of the covid-19 pandemic, it is no wonder that 40,000 nurses and 20,000 doctors left their jobs last year. Only 7,000 actually retired from their profession, so where did the other 53,000 go?
Let us be very clear: the NHS is on its knees. People in my community and across the UK are tired of empty promises from the Government when they know things are not improving. They know as well as I do that the NHS deserves better. People want to be heard. They want to feel like the people responsible for the services are listening to what they are saying and not just leaving the room. From GP practices in Erdington to hospitals and social care settings across the country, one thing is clear: only a Labour Government can fix this mess.
On a point of order, Madam Deputy Speaker. I apologise to the House for interrupting the debate. At the end of my speech, I may have used a little bit of intemperate language, which was not necessarily in best keeping with the traditions of the House. I apologise to you, Madam Deputy Speaker, and to the House.
I thank the hon. Gentleman for his apology. As he said, it is important that we use moderation in our language.
In fairness to the Government, they say that they are now looking at it—a bit late in the day, I think; a review should have been instituted much earlier—but the hon. Gentleman is right. It is ridiculous to have a structure in NHS dentistry in which the rewards are linked to the number of specific procedures that have been carried out. Each procedure is given a different rating, and then they are all added up to establish whether the total exceeds the permitted 110% capacity. That is another case of there being plenty of scope for reform and fresh thinking, but it seems to be almost a culture in the NHS not to be receptive to such ideas.
May I take up my hon. Friend’s point about dentists not taking on more work? The same applies to NHS doctors, who are subject to punitive measures involving their pension schemes. If they take on extra work or responsibilities, they receive huge pension bills—tens of thousands of pounds a year. Does my hon. Friend agree that a simple way of fixing a very simple problem would be to get rid of the annual allowance tax charge on the NHS defined-benefit scheme so that doctors could take on more work and reduce the waiting lists?
I do agree with that. I have raised this subject in parliamentary questions, and what have I had in return? Complacency and inactivity, and generalisations such as, “We realise that there is a problem and we must try to do something about it.” As a matter of fact, I do not think that this problem is confined to doctors; I think there is a much bigger problem relating to pensions, but that is a subject for another day.
Then there is the issue of productivity—or rather the lack of productivity—in the NHS. As we have heard, although the number of staff is increasing, output is not going up; in fact, it is falling. The Government again seem to be refusing to face up to these problems. Last April, NHS England carried out an internal review of productivity issues, which was referred to by the National Audit Office in its report on the subject in November. I submitted a parliamentary question asking for the NHS England report to be published, and I had to wait weeks for an answer. On 22 December, I was informed by the Minister for Health and Secondary Care, the hon. Member for Colchester (Will Quince), that the publication of information about NHS England productivity available to the National Audit Office
“could prejudice the conduct of public affairs.”
I was amazed to receive such an answer, because surely we are the public. We are speaking on behalf of the public. Why and how could withholding from us an internal review carried out by NHS England be prejudicial to the conduct of public affairs, and how could it be prejudicial if it had already been seen by the National Audit Office?
I tabled another parliamentary question on 9 January, asking in what way the publication would prejudice the conduct of public affairs. One might have assumed that there would be a quick answer to that, because the Department must have thought about it when the first answer was approved by a Minister, but I had to wait until 20 February. In other words, I had to wait for about six weeks, until more than a month after the question should have been answered. The Minister replied:
“This report”—
the internal NHS England report—
“is currently being used by National Audit office and NHS England to inform internal policy for public services. To share this information would inhibit the open, free and frank discussions that are being had on these internal policies.”
I think that those “internal policies” should now be discussed openly in this Chamber. My message to the Government is that they need to get their act together in a way that they have not done hitherto, and address these serious issues.
I want to get back to some statistics; I am sorry if I am going to bore the House, but I want to get back to some of the harsh reality. I know that subjective judgments have been made, but we cannot get away from some of the stats. I congratulate my hon. Friend the Member for Jarrow (Kate Osborne) on securing the debate and on an excellent speech, particularly in light of the fact that it was the Durham miners’ gala fundraising dinner last night.
I come back to the some of the harsh stats because I want to deal with why we need to address the funding crisis more effectively than we are at the moment. Some of these stats have been used already but I am still shocked by this: we have 7.1 million patients on waiting lists, which is almost double the level in 2010; and the average ambulance response time for patients in category 2 is now 48 minutes, which is half an hour more than it was a short while back, with the target of 18 minutes. I have met our local ambulance drivers and paramedics, and I know that category 2 is the heart attacks and strokes. I had a heart attack about 10 years ago and I do not want to be waiting for 45 minutes, as we are talking about the difference between life and death for some of us.
On A&E waiting times, the NHS target is 95% of people being seen within four hours, but the current level is 40%. Most Members will have visited the A&E departments in their local hospitals. One of our local people described them as being like a warzone at times, given the number of injuries and scale of suffering. Members have mentioned the public satisfaction issue, but on the GP front—again, this comes just from working with local doctors—1 million people are waiting for more than a month. There are currently 4,500 fewer GPs than there were a decade ago. I understand what the Government and ex-Ministers are saying about the recruitment of more GPs, and I understand what my hon. Friends have said about a lot of that investment being from some time when the Conservative party was not in government.
I have been trying to look at the repairs backlog as well, because we have been promised a new hospital at Hillingdon. I am really pleased about that because I have been campaigning for one for years. We will be getting a new hospital, eventually, but that is largely because our existing one is in such a dangerous state; we are worried about the main structure collapsing at any stage and we have had to do temporary repairs. The repairs backlog has grown by 11%, to £10.2 billion-worth of backlog.
There is another figure that I have been worried about. Let me make it clear that I have been on the picket lines with nurses and in the campaigns. When talking to them on the picket lines, we get the true reality of what people are having to deal with, but I wanted to get behind the anecdotes and get to the stats. They show that one in five NHS trusts and health boards is providing food banks for staff, with a further third looking to provide them in the future. It must surely be shocking to everyone that NHS staff are having to rely on food banks —these are professionals.
If we look at the underlying causes of that, we see that this is about pay. I looked at the pay of the paramedics I was talking to and I found that it has gone down by £2,400 in real terms in the past year—that comes from some TUC analysis. There are now 3,000 ambulance staff vacancies in England. I went on to look at issues associated with nurses’ pay. The average nurse’s take-home pay is more than £5,000 less in real terms than it was in 2010—again, that comes from number crunching by the TUC, but all of this is verified elsewhere as well. There are nurse shortages, with 47,000 vacancies. The most worrying thing, which has been touched on to a certain extent by others, is that one in nine nurses left the profession in the past year, which is the highest level in a year in the recorded history of the NHS. That says something about morale. We have heard that the talks are scheduled for 1 and 3 March, and I am hoping that they will resolve the current dispute. However, it is difficult to see how it can be resolved unless all the unions are engaged in those discussions.
A few years ago, there was a junior doctors pay dispute. My right hon. Friend the Member for Islington North (Jeremy Corbyn) and I were on the picket lines and at the demonstrations for that as well. So I was looking at what has happened with the junior doctors, who are represented by the BMA. As someone has said, 98% have voted for strike action, on a turnout of 77%. I do not think we have seen those levels of turnout in recent history in these ballots for industrial action. Again, I have been trying to get behind the reason for that. BMA analysis shows that the pay of junior doctors has been cut by more than a quarter since 2008. It looks as though we are going to have a walkout for 72 hours in March, which, obviously, will have an impact on the service. When I talk to junior doctors, they tell me that they do not know what else they can do. They are beginning to struggle to survive on the wages they are getting. In constituencies such as mine, a west London, working-class, multicultural community, most of them will never be able to get onto the housing ladder to buy a property; in fact, because of the level of rents, many will struggle even to fund the rents there. Trying to come at this question as objectively as possible, it must come back to underfunding. There is no other reason that I can see.
I appreciate the right hon. Gentleman giving way and the tone in which he approaches the debate. He talks about funding, but Labour left office in 2010 and there was no argument about the fact that funding was not sufficient at the time of the last Labour Government. The King’s Fund says that statistics show that funding has increased or at least kept pace in real terms since then, so how is it not sufficient now?
That is an extremely valid point that must be addressed. When some of us were doing health economics in the 1980s and onwards, we were always told that the level of funding required just to maintain a standstill operation for the growing ageing population was at least 4%. What happened under Labour was a 6% annual rate of funding.
I will be honest with the hon. Gentleman: when I was on the Government Benches and Labour was in government, I was asking for more. Gordon Brown, to give him his due, had a sense of humour; I always used to produce an alternative Budget, so he described me as the shadow Chancellor even when I was not. I did that on the basis that I thought 4% was not enough and, while 6% was right, we needed to go further, because it was about not just the ageing population but the increased levels of morbidity we were experiencing. In addition, as the hon. Gentleman mentions, new treatments come on board and are more expensive.
Even though I was looking for increased investment, beyond what Labour was doing then, Labour was not just keeping pace with the 4%, but was going beyond it at 6%. To be frank, although the hon. Gentleman swore in the Chamber earlier, he should have heard some of the language I used in 2010, because I was quite angry as well. Those of us who were there will remember that in 2010, investment dropped to 1%. We were saying to George Osborne, who was the Chancellor at the time, “You are going to reap the whirlwind here for dropping the level down to 1%, because it means an erosion of the services that are provided.”
In addition, that investment did not recognise our ageing population or the other emerging issues with morbidity. I understand that the covid inquiry will include analysis of the resilience of the health service to cope with the covid pandemic. I believe that a number of those representatives are seeking to have George Osborne appear before that inquiry, because he bears responsibility for that under-investment.
Other hon. Friends have mentioned mental health, and I agree that it has been the Cinderella service. When I looked at mental health funding, I found that it has increased at a faster rate than overall NHS funding—at times nearly 3% as against 1%. However, that follows years of small increases or real-terms funding cuts, and the number of NHS mental health beds is down by 25% since 2010.
Curiously enough, I was on a bus in my constituency yesterday with a former mental health nurse, who described to me the implications of that and the consequences for the individuals concerned. Community mental health nurse numbers were also impacted upon. Some of us will have dealt with the results of that in our constituencies; in my constituency, I have to say, it has meant dealing with suicides as well.
That’s right.
The social care figures are startling. Some 1.5 million people aged 65 and over have some form of unmet care need. There are 165,000 vacancies in the social care sector across England and Wales—a 52% increase in the last year. The Health Foundation estimates that an extra £6.1 billion to £14.4 billion will be required by 2030-31 to meet the demand. As others have said, that has meant delayed discharges from the NHS, and—as I mentioned on Tuesday—it places a huge burden on unpaid carers, who are living on the pittance of the £70-a-week carer’s allowance.
The Institute for Government published a report today in which it basically argues for social care overhaul. It describes how social care has been overwhelmed in recent years and states that 50,000 fewer posts are filled than a year ago—the highest vacancy rate ever in social care. Then, there are the stats on what has happened as a result of under-funding—and I am afraid that it is because of under-funding; we cannot get away from that fact. I would be saying the same thing on these statistics no matter which party was in power. We need to go further in the coming month’s Budget.
The right hon. Gentleman is being very generous with his time. He will know, having been shadow Chancellor, that in the devolved Administrations, there is £1.20 in Wales for every £1 in England, and slightly more in Scotland. The results—I could say they are worse, but I will not—are measurably the same. Is it a problem only of funding, or is it one of structure?
I am sure that the hon. Gentleman has made that point before. I looked at the Nuffield Foundation report on Wales a couple of years back. I do not think that Wales has had a good deal out of the Barnett formula over the years, and although the Government have addressed some of that over the past year, they have not done enough. The Nuffield Foundation said that Wales has not only an ageing population, but higher levels of morbidity, so the funding does not match the need. A whole debate needs to take place about moving forward. When I was shadow Chancellor, I talked about a review of the Barnett formula. That frightened a number of people, but it is needed. In fact, I think there is a need for a Barnett formula for the north of England as well. [Hon. Members: “ Hear, hear!”] I thought that might raise a response.
There is a long-term funding crisis that we have to address. I look forward to next month’s Budget for some resolution of this matter. Where can the money come from? I know that a lot of people say we should never make unfunded commitments. To be honest, I was the first shadow Chancellor who produced a Budget and a manifesto that was fully funded and costed, in the “Grey Book”, so I want to look at some ideas and just throw them out there.
On Tuesday, we heard that, as a result of the higher level of tax receipts received than the Office for Budget Responsibility predicted, the Chancellor now has £30 billion of headroom that he did not have previously. Some of that £30 billion needs to be invested in the NHS, and particularly social care. I would also like to see some of that money invested in relieving poverty, which is one of the major causes of ill health in this society.
We need to do something on capital gains tax. If we taxed capital gains at the same rate as earned income and charged national insurance on it, we would get £25 billion extra. Let me throw in a few others. If we lifted the higher national insurance rate, so that instead of 3.25% above £50,000, it was paid at what everyone else below that level pays—13%—that could raise us £15 billion. I cannot for the life of me see why dividends are not taxed at the same level as earned income. If we did that, we could raise £8 billion. Those on the Labour Front Bench have put forward the idea of scrapping non-dom status. Again, I claim copyright on that one. That would raise between £1 billion and £3 billion.
The Government have implemented a windfall tax on the excess profits of energy companies, and they should extend that, as those on the Labour Front Bench have advocated. Some Members may have read the recent reports on bank profits and the return of extremely excessive bank bonuses. There is an argument for a windfall tax on bank profits during this extremely difficult period. This is a time when we should all bear the burden of the challenges that we face. Taxing the bankers’ bonuses needs to come back on the agenda, and I deeply regret that the Government removed the cap on bankers’ bonuses, which we supported.
With regard to the City, I have been an advocate of the financial transaction tax for a number of years. All it does is close some of the loopholes in terms of stamp duty. If we look at the work on this recently by Advani and others, we see the potential. With limited changes, we could raise £8 billion to £10 billion.
It is time to start looking at how we tax wealth in this country more effectively. If we look at the proposals that have been produced by various think-tanks over the last year or so, a 1% tax on people who have assets over £10 million could raise an additional £10 billion. This is not revolutionary stuff. It is straightforward and pragmatic, making sure that we have a fair taxation system.
Those on the Labour Front Bench have argued strongly that we have to go for growth, as have the Government. I fully agree, but that needs a rapid programme of investment in the public sector, with matching private sector investment. If we can increase growth by just 1%, we usually match Governments receipts at the same time by 1%, which would mean about £7.7 billion, and for 2% it would mean £15.4 billion. In addition to the short-term taxation measures, redressing the imbalances in our taxation system at the moment, that would enable us to achieve the growth that will give us a stable form of income to meet the needs of our NHS and social care system.
We cannot continue with an NHS and a social care service that is paid for on the backs of people we are exploiting in long hours, undermining their morale by not paying them properly, and at the same time making them face challenges that are both heartrending and certainly not what many of them signed up for. The NHS workers I have met just want to provide a decent service in a caring environment that is fully funded, where their profession is respected by being properly paid. I hope that we can achieve that sooner, rather than later.
I congratulate my hon. Friend the Member for Jarrow (Kate Osborne) on securing this important debate. It really is a privilege to speak after so many powerful and passionate contributions.
I want to start by telling the House about my constituent Mo Peberdy and her father, who is 83 years old. He has stage 5 kidney failure, diabetes—which has already led to a serious foot infection and the loss of one toe—and early-onset dementia. He is on a raft of medications and he has carers coming in four times a day.
On the weekend of 10 and 11 December, Mo’s father started to go downhill. By the 15th, he was in crisis. He had hugely swollen testicles and terrible sores all over his groin and backside. He could not eat or drink, let alone sit down, and he had severe diarrhoea, which was green and contained blood.
Mo immediately called the GP. She was told that no one was available and that she needed to ring out of hours. She did. When they called back several hours later, she was told to call 111. Mo called 111. Again, she waited several hours for them to ring back. When someone eventually did, at 6 pm, they said her call had been transferred to 999, so Mo and her father were told they had to wait for an ambulance—and wait, and wait, and wait. It was not until 8 am the next day—14 hours later—that a paramedic finally arrived.
All that evening, night and morning, Mo tells me,
“my dad was screaming in agony, wanting, begging to die… to listen to him in such pain, I will never forget it in all my life… My dad is one case amongst many… Our NHS is broken… We have to change from the top.”
She is right.
Time and again in this debate, we have heard about the crisis in our health and care system after 13 long years of this Conservative Government. More than 7 million people are now waiting for hospital treatment, after Labour ended waiting in the NHS. In the last month alone, 42,700 people waited more than 12 hours in A&E, and people who needed category 2 ambulance responses for suspected heart attacks and strokes waited one hour and 33 minutes on average. The target is 18 minutes.
The Royal College of Emergency Medicine estimates that up to 500 more people are dying every week due to delays in emergency care. I hope that the Minister will say what the Government are doing to investigate that and put it right, because it is a national scandal. The target that patients with suspected cancer should not have to wait longer than two months from GP referral to treatment has not been met since 2015.
As many colleagues have said, the situation in social care is even worse, with 1.5 million older people who need help with the very basics of daily living—getting up, washed, dressed and fed—not getting any help at all. Even among those who are in the system, half a million are waiting to have their care needs assessed or reviewed, or for treatment to start. Some 2.5 million unpaid family carers have been forced to give up work because they cannot get the help they need to look after their loved ones. With staff shortages in so many parts of the economy, where on earth is the sense in that? That basic issue—staff shortages—is at the heart of so many of these problems. There are 133,000 vacancies in the NHS and 165,000 in social care; the combined total is the same as the population of Newcastle. What a damning indictment of this Government.
Nobody denies that the covid pandemic and its aftermath have posed huge challenges to the NHS and social care, and I pay tribute to the frontline workers who gave us their all and got us through those dark days, but the reality is that NHS waiting times were at record levels, staff shortages were soaring and social care was stretched to breaking point long before the pandemic struck—something the Government refuse to acknowledge.
This dire situation makes the Government’s refusal to deal properly with the current industrial action in the NHS even more unforgivable.
I am pleased that Ministers are finally talking to the Royal College of Nursing about pay, but why did they not do that before Christmas, when the RCN first told the Government that it would call off the strikes if Ministers just got round the table for meaningful talks on pay? Why are they not also meeting the other unions and the junior doctors? Since the RCN first made its offer, 140,000 operations or hospital appointments have been cancelled as a result of the strikes. Those cancellations could have been prevented if Ministers had done their job and got round the table.
My constituents, and people throughout the country, deserve a Government who get on with the job, and they need a proper plan to get our NHS and care system back on track. That is why I am proud that my right hon. Friend the Leader of the Opposition has announced today that building an NHS fit for the future is one of Labour’s five key missions for government.
If Labour Members have this plan, have they communicated it to the Welsh Health Minister? Why is this not happening in Wales? With the greatest respect, and I really do not want to score these political points—
It is not a political matter! These issues affect the entire United Kingdom. Does the hon. Lady agree that that is the case? Does she agree that these matters are just the same in Wales as they are here, and that we need much wider reform?
May I gently say to the hon. Gentleman that I know what is best for his constituents and the people of Wales, which is a Labour Government in Westminster as well as a Labour Government in Wales delivering the changes that we are seeing? If he looks at Labour’s record when we were in government in Westminster, he will see the improvements that were made. May I also gently suggest that he focus on the lack of a workforce plan and the lack of a proper social care plan from his own Government, rather than trying to make these petty points?
Our plan will reform health and care services to speed up treatment by harnessing life sciences and technology to reduce preventable illness, and by cutting health inequalities. As a first step, we will carry out the biggest expansion of the workforce in the history of the NHS, doubling the number of medical school places, creating 10,000 more nursing and midwifery training places, recruiting 5,000 more health visitors, and doubling the number of district nurses. We will pay for this by scrapping the non-dom tax status, because we believe that people who come to live in the UK should pay their fair share of tax here. We read today in The Times that the NHS itself backs Labour’s plan, so why do the Government not back it?
(2 years, 7 months ago)
Commons ChamberJordan Giddins, or Giddo to his friends, from Flint in my constituency was 18 years old when he died, and tomorrow marks the fifth anniversary of his passing. At age 11, he became unwell with a mystery virus, and little did he or his family know that it would be the start of a seven-year battle with a deadly illness. It was determined that Jordan had HLH, a very long name that I will not mispronounce, which is a very rare blood condition that usually impacts infants and young children. Jordan attended Alder Hey Children’s Hospital in Liverpool and had various courses of steroids and chemotherapy, which seemed to be working. He was eventually able to return to school, catching up on the time that he had missed, and starting his life once again.
Nine months later, sadly, he suffered a relapse which the doctors said could only be cured by a bone marrow transplant. At this point, he was just 13 years old. His sister Beth was 16 and she was a match. No greater gift could a sister give to her brother than a life-saving donation. But four years later, it was something as innocuous as having a slight pain in his shoulder that got worse that eventually led to a scan which uncovered a golf- ball-sized mass on his ribs. A further biopsy was carried out which confirmed that it was Ewing sarcoma, another very rare form of cancer which mostly affects children and young people. It all started again, even more intense than before. The regime for the treatment of Ewing sarcoma, as my hon. Friend the Member for Gosport (Dame Caroline Dinenage) said, is more than 50 years old. Mandy, Jordan’s mum, is a nurse practitioner. In her words:
“I’ve never seen anyone suffer like he suffered with this treatment”.
It is basically giving adult-level chemotherapy to children, and their bodies just cannot cope with it.
Jordan celebrated his 18th birthday hooked up to a drip in hospital. Still upbeat, as was his way, he was making so many plans for the upcoming year—a music festival and a lads’ holiday with his friends—but over the Christmas period in 2016, he became unwell again, and the relapse was confirmed in January. There was no relapse protocol and, after a couple of experimental treatments, he passed away on 27 April 2017.
Mandy talked about her anger that we are still using treatment protocols from 50 years ago on children. She paid tribute to staff in Glan Clwyd Hospital in north Wales, Alder Hey Children’s Hospital in Liverpool and the specialist cancer centre in Clatterbridge on the Wirral.
As my hon. Friend mentioned earlier, the problem is one of research. They say that childhood cancer is rare, and it is. Childhood cancer accounts for less than 1% of all cancers in the UK. It is easy to talk about in those terms—1% is nothing—but that 1% is 1,800 new cases diagnosed every year in children aged between 0 and 14: 1,800 sons and daughters who go through devastating and punishing treatments, and 1,800 families with constant anxiety about whether their son or daughter will become part of those statistics. It is one child in 500. Suddenly, it does not seem so rare at all.
Jordan’s passing did not end his story. Jordan—or Giddo, as he was known—had the gift of brightening up the lives of the people with whom he came into contact. The charity, Giddo’s Gift, has been set up in his name to provide gifts to make the lives of people suffering as he and his family did a bit more bearable. Since 2018, Giddo’s Gift has granted 176 financial wishes along with 23 bereavement grants. That is £112,000 in total, and I am proud to report that the local community in Flint has raised £263,000 and counting. My plea to the Minister, who I know is extremely big-hearted and cares deeply about this issue, is to sit with these families, hear their stories and make sure that no parent ever has to bury their child again.
(3 years, 1 month ago)
Commons ChamberThen I would like to see you wishing to press it to a vote and putting your vote—and your feet—where your mouth is. [Interruption.] I apologise, Madam Deputy Speaker; it is not your mouth. I was carried away by an overwhelming desire to get my point across, and I apologise most profoundly.
I turn to access to medicines. Most Members believe, do they not, that medicines that have been approved by the National Institute for Health and Care Excellence are available to all our constituents? The reality is that they are not. A medicine may have gone through the Medicines and Healthcare products Regulatory Agency and been proved to be safe, and through NICE and been said to be cost-effective, but each CCG—each ICB, as they will be—and hospital trust, and every other NHS body responsible for prescribing, sets its own formulary, and those formularies do not include all NICE drugs. If a medicine is not on the formulary, then no consultant or GP will be able to get reimbursement, so they will not be allowed to prescribe it.
In my constituency, a number of individuals have come to me because they cannot get access to a particular medicine, yet people in another constituency can. I do not believe that a postcode lottery is right. We all talk about the NHS, and health and care, being free at the point of delivery, and we all assume that we can get access, whether to GPs or to hospitals, but I do not think it occurs to most of us—it had not occurred to me—that we cannot necessarily get access to medicines.
My amendment 21 to clause 15 would effectively oblige every ICB, where any individual patient has the advice of their clinician that they should have a particular medicine and it has been approved by NICE, to make provision to ensure that that medicine is provided—perhaps from a neighbouring ICB, taking advantage of the duty to collaborate across ICBs. That would ensure that even if a medicine was not on the formulary in the area of an individual ICB, it could be obtained from another area. Bear in mind that there is no financial loss in doing that, because all NICE-approved drugs are subject to a voluntary pricing agreement between the pharmaceutical companies and NHS England. Under that agreement, x number of drugs will be provided at an agreed cost. Anything above that will be reimbursed by the drug company, so the Government and the NHS will not be out of pocket. Why would that not be a good clause? To provide belt and braces, under amendments 20 and 22, all NICE treatments would automatically be added to all formularies within 28 days of market authorisation and every ICB would be obligated to report.
My last area—I will be very brief, Madam Deputy Speaker—is research, which is so important, as we discovered during the pandemic. I would like to draw the attention of the House to some of the challenges. Some of the anti-viral solutions to coronavirus were late to market because we could not get the clinical trials. Why? Because we could not get access to the records of the patients who had had covid or been diagnosed with covid so that we then had the appropriate cohort to be able to test the anti-virals. It therefore seems very clear that research must be taken on board across every hospital trust and across every ICB. If every ICB and hospital trust had in place a system to ensure research was part of their DNA—that they had to report on what research they were undertaking and had an obligation, if they were asked and had the appropriate cohort, to recruit the patient base so that particular clinical trials could take place—we would get more medicines faster to market. I think most people would say that that was a win.
I declare an interest in that my partner is a clinical research nurse—working in cardiac research—so I completely appreciate and understand exactly where the hon. Lady is coming from. Does she agree that to find patients for studies, often tens of thousands of pounds is spent on radio and online adverts? If her amendment 17 is successful, it could be revolutionary for research in this country.
I thank the hon. Gentleman. He is absolutely right. If we could have this new system, so there was a research strategy and an obligation to consider clinical trial requests and then report, we would be in a very different place.
Madam Deputy Speaker, you have been incredibly indulgent and so have all hon. Members. On that note, having had my time for my four areas, I thank the House for its indulgence and I look forward to the Minister’s reply.
This part of the package was described in September, because it was made clear in September that the £86,000 cap was a cap on individual costs. It did not say then that that included the costs that local government may make on someone’s behalf. I think it is a strong Conservative principle that, when we say we are capping the costs that an individual pays, we do not include the costs that another part of the state should pay. I think that that was clear, and more details have now been set out. Most importantly, this is a package that takes things forward in a way that has not been achieved for decades.
I do not think anyone across the House would argue that the measures that have been put forward are a significant step forward from where we are. However, as my hon. Friend the Member for Thirsk and Malton (Kevin Hollinrake) and my right hon. Friend the Member for South West Surrey (Jeremy Hunt) mentioned earlier, they are not necessarily what we might have been led to expect. Would my right hon. Friend like to comment on that?
I will happily comment on that. In the debate over the past few days, many people have been comparing the package put forward by the Government with the proposals from Sir Andrew Dilnot in 2014-15, but there is a reason those proposals were never enacted and never came into force. It is because they had a huge price tag, and there was no successful debate on how to pay for them. It has been easy to ask for social care reform for the past three decades, but until this Government did it, nobody had come forward with a plan for how to pay for it. We simply cannot magic things out of thin air. If we are a grown-up Government, we have to come forward with a grown-up package, which includes saying how it will be paid for. That is what has happened, and that is why this package hangs together. We should support this new clause, because it is part of that overall funded package.
I want to turn briefly to the measures on integrated care systems. The purpose of the ICSs is to have a more preventive, more flexible and less siloed approach than we have under the current clinical commissioning groups, without removing the grit in the oyster that is the purchaser-provider split and without upsetting the 1948 settlement involving local authorities doing social care and having a national NHS. Amendment 76 in particular contains a lot of suggestions that might seem tempting. There are people who have an important voice in the debate. The problem, as we have seen with existing legislation, is that if we put too much into statute, it is far harder to deliver high-quality services that are integrated on the ground. That is why the Government are right to resist putting too much detail into legislation. However, I do support the change proposed by the Government, which makes it clear that the purpose of ICSs is not to have private providers on the board. I can confirm that, as the Minister said, it never was. Mischievous rumours were put about, some of which have been repeated today, that that was the intention, and I am glad that the Government’s amendment puts that matter beyond doubt.
I am attracted to amendments 89 and 90 and, in another group, amendments 91 to 98 and amendment 23, tabled by my hon. Friend the Member for Broxbourne (Sir Charles Walker). I was going to say this before I knew that I would be sitting next to him in the debate today, and I hope that the Government will look on these amendments kindly. The parity of esteem between mental and physical health is incredibly important, and I commend the amendments to the House.
(3 years, 1 month ago)
Westminster HallWestminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
Thank you, Mr Hollobone, for calling me to speak and it is a pleasure to serve under your chairmanship.
I congratulate the hon. Member for Strangford (Jim Shannon) on securing this debate on such an important matter; as he says, it is a matter of life and death. I have no doubt that this issue will draw agreement from all political parties, and such is the nature of the hon. Gentleman that he is one of the few Members who could rightly be called “my hon. Friend” by Members from all parties in the House.
It is vital that there is greater access to defibrillators in local communities across the whole of the UK. To save myself tripping over the word “defibrillators” for the next five minutes, I will shorten it to “defibs” from this point onwards.
Every year in Wales, around 6,000 people suffer from cardiac arrest. About half of those incidents occur outside hospitals, with just one in 20 of the people affected surviving. The National Institute for Health Research has found that survival outcomes for people experiencing out-of-hospital cardiac arrest are greatly improved when bystanders use a defib.
When we consider that, as the hon. Member for Rutherglen and Hamilton West (Margaret Ferrier) said in an intervention, someone’s chance of surviving cardiac arrest decreases by at least 10% to 15% with every passing minute, it is vital that everyone in the community not only knows where the nearest defib is located but—most crucially—has the knowledge and confidence to use it.
I understand how important it is to improve the teaching of these lifesaving skills having campaigned with the family and friends of Janene Maguire, a loving mother of three who unexpectedly passed away of a cardiac arrest in February 2000. Sadly, and almost amazingly, nearly two decades later one of Janene’s daughters also suffered from a sudden cardiac arrest. Fortunately, she was with her friend, who saved her life by performing CPR until a paramedic arrived.
The experience of that family in my constituency highlighted to me the importance of improving awareness and knowledge of both CPR and defibs. I am pleased to say that, as a result of our campaigning, the Welsh Government committed to including these lifesaving skills in the school curriculum in Wales, as they are in the curriculum in England. I hope that equipping young people with the knowledge to save lives will ensure that the survival rate for out-of-hospital cardiac arrests is greatly improved.
Despite the success of having added to the curriculum in Wales, the campaign to improve lifesaving skills and access to lifesaving equipment is far from over. Access to defibs and the knowledge of how to use them still needs to be greatly improved. As part of my commitment to improving these skills, I will continue to work with the Welsh charity Calon Hearts to organise a number of CPR events in my constituency in the new year. Participants will be able to learn the skills and gain the confidence to apply them, ensuring that people from all backgrounds have that knowledge, so that they too are able to save lives.
Although the Resuscitation Council has provided guidance for adult basic life support, which advises on how CPR and defibrillation should be administered during a sudden cardiac arrest, the vast majority of people still do not have that knowledge and are unable to use it when needed. Currently there are 5,423 public access defibs registered with the Welsh ambulance service, but the British Heart Foundation estimates that there are thousands more defibs that the trust has no record of. With that in mind, there is an obvious but important question to ask: what is the point of increasing the number of public access defibs if people do not know where they are or how to use them?
There seems to be a simple solution to the issue. Why not create a comprehensive, UK-wide database, on an app that can be downloaded to smartphones, including all defibs and their precise locations, and simple, easy-to-follow instructions on how to use them? It seems as though that would be a relatively simple database to establish and maintain. It should not be beyond the wit of man to put something in place along those lines. There are currently a number of different defib databases covering different areas of the UK, so it is certainly a feasible idea. Much of the data is already there, and just needs to be amalgamated in one comprehensive database. If all NHS systems in the UK worked together with organisations such as The Circuit, the national defibrillator network, it could easily be achieved, and would undoubtedly help to save many more lives.
The Welsh Government, to their credit, have recently committed £500,000 to improve community access to defibs. I encourage them to collaborate with the UK Government, and indeed the Scottish and Northern Irish devolved Administrations, to ensure that public access to defibs and the knowledge of how to use them is improved across the UK, and that it is mandatory for all defib providers to register every new device on the database.
When someone goes into cardiac arrest, every second counts. I want to ensure that as many tragic and unnecessary deaths can be avoided as possible, by equipping the general public with as much knowledge and as many skills as possible.
My hon. Friend is absolutely right. That gives people added reassurance that they can do no harm, because the machine is totally in control.
We are also using technology, and there are some exciting apps—the hon. Member for Delyn (Rob Roberts) talked about having apps. Some mobile technology works with the NHS to help people play a role in becoming first responders. If people know how to do CPR—the hon. Member for Gordon (Richard Thomson) seems to be trained up in that—I encourage them to use the GoodSAM app, which allows members of the public who can do CPR and feel confident about using a defibrillator to receive alerts. If someone collapses in the local area, they will get an alert on their phone, which will tell them where the nearest defibrillator and the person who needs help are. It integrates with ambulance dispatch systems and has a crowd-sourced map of defibrillators, including those in vehicles. The platform now has more than 19,000 volunteers and partnerships with 80 organisations, including the NHS and ambulance trusts.
We are also reassured that the British Heart Foundation is developing an app. It will link to The Circuit and show people where their nearest defibrillator is. Technology is being used to help communities to help themselves.
On a different but related subject, in this place and in the main Chamber, the Pensions Minister, our hon. Friend the Member for Hexham (Guy Opperman), has talked about how he is working with the BBC and other broadcasters to do some kind of nationwide campaign to raise awareness of pension credit. Is that something the Department of Health and Social Care could work on for this subject?
The hon. Gentleman makes an excellent point. Some of the developments have been over the past two years and, during covid, they have not necessarily had the publicity they deserve. We all have a role in promoting initiatives. There is work to be done so that people are aware of the apps and initiatives.
In our communities, defibrillators are available at airports, shopping centres, train stations and community centres. School-age children are at low risk, but it can still happen, as I said earlier. As a result, and thanks to the work of the Oliver King Foundation, huge pressure was placed on the Department for Education, so defibs are now available for schools and other education providers across the UK to purchase through the NHS supply chain. They can get those important pieces of equipment at reduced cost. As of January this year, more than 5,000 defibs had been purchased through the defibrillators for schools programme, so we are getting defibs out into our schools.
Since May 2019, the Government have required all new and refurbished schools in Department for Education school building programmes to have at least one defib in their buildings. We are pushing that out for new and refurbished schools, but that does not cover all schools in the network.
(3 years, 5 months ago)
Commons ChamberToday’s Bill will help our healthcare system to become more accountable and less bureaucratic, allowing our brilliant healthcare professionals to focus on their job of providing world-renowned care to patients, rather than filling in unnecessary paperwork. It allows our healthcare system to be flexible, adapting to meet future and local needs.
As my hon. Friend the Member for Meriden (Saqib Bhatti) said earlier, a one-size-fits-all approach is rarely the most effective, and today’s Bill will mean local areas can develop practices that best suit their needs.
No.
This is something we are acutely aware of in Delyn, as we have a much higher proportion of over-65s than the national average. Sadly, the Welsh Government’s funding to the north Wales health board is significantly lower per capita than that enjoyed by the health board in south-east Wales, but that is a debate for another time and place.
No.
Sadly, one of the major elements of today’s Bill that should be praised falls a little short for my constituents in Wales. The Bill will lead to greater collaboration and integration between the NHS, local authorities and care providers in England, and ultimately this will deliver more joined-up working and the best outcomes for patients, yet this move towards greater collaboration needs to go further. We need to see collaboration in healthcare across all the constituent parts of the United Kingdom.
The NHS is not limited to one part of our country; it is nationwide. When someone is treated in their local hospital, they are treated by the NHS—not NHS England, or NHS Wales but the national health service. People do not see that there should be a difference and, frankly, they do not care.
Just as we should be united in our response to covid-19, it is now time for our healthcare system to work together across borders for the good of all UK residents. Despite holidaying within the same country, as so many people are doing this year, if a constituent from Delyn holidays in Cornwall and needs NHS treatment, their medical records will not be on file and will be difficult to access. Without immediate access to those medical records, I cannot help but worry that it could affect the outcome and care they receive, demonstrating the need to share records between all four nations. This issue is one of many that could be resolved through greater collaboration between the UK Government and the devolved Administrations on healthcare, just as we saw with the fantastic vaccine roll-out.
I urge the Government to remember that they are the Government of the whole United Kingdom, which should come with an overarching responsibility to care for and look after all their UK citizens, regardless of the nation in which they reside. As this Bill progresses through the House, I hope the Government draw on the lessons they learned from working together on the covid-19 vaccine programme to consider how greater collaboration in healthcare can be achieved between all four constituent parts of the UK to tackle the public health issues that we collectively face.
(3 years, 10 months ago)
Commons ChamberAll countries that have attempted a zero-covid strategy have found that this virus transmits and gets round the boundaries that have been put in place. There were parts of this country that tried a strategy of zero, and in fact we were urged to do so in this House, but what matters is making sure that we get the tools that are going to be used permanently for us to get through this, and that we get them deployed as fast as possible. That means testing, with the hundreds of testing sites that are now available and, crucially, it means getting this vaccine rolled out. The hon. Member said the vaccine offers hope, and I think that is where we should all focus—on getting this vaccine rolled out as quickly as we possibly can.
The Betsi Cadwaladr University Health Board in north Wales has had some difficulties over a number of years, and it was not surprising that there was a collective sharp intake of breath, and mutterings of “here we go again”, when the vaccine got off to a bit of a faltering start in north Wales. My colleagues and I have been in constant contact with the health board, and are pleased to report that things are now back on track. It is making good progress, and is very confident of being able to hit the target of vaccinating the first four groups by the middle of February. Will my right hon. Friend join me in paying tribute to the staff of the health board, and to the legions of volunteers, the armed forces, and all those involved in that process who are doing such a fantastic job in north Wales?
That is close to my heart, Madam Deputy Speaker, and across the UK people have done extraordinary things and worked incredibly hard to deliver this vaccine roll-out. We have been working as hard as we possibly can as a United Kingdom to support the NHS in Wales, including north Wales, and in Scotland and Northern Ireland, to ensure that the vaccine is delivered as safely and rapidly as possible to all parts of these islands.
(4 years, 1 month ago)
Commons ChamberYesterday, the House will know that we secured 5 million doses of the Moderna vaccine, so we have now secured access to 355 million vaccine doses through agreements with seven separate vaccine developers. We have secured them for the whole UK.
We have done a huge amount of work. The deployment of the vaccine is, of course, being led by the NHS, which reaches into all parts of the UK. Our principled approach is that we will deploy the vaccine according to clinical need in every single part of the UK at the same time. That, of course, includes rural areas. A significant amount of work has gone into how best to deploy to rural areas, especially as some of the people who clinically will need to get the vaccine first are also those who might find it most difficult to travel. It is a very important question on which a huge amount of work is being done.
I thank my right hon. Friend and fellow one nation Conservative for his hard work and that of his Department in impossible circumstances this year. Kate Bingham and the vaccine taskforce have done an amazing job in securing so many doses of vaccines, as and when they become available, which will be centrally procured by the UK Government and equally available across all parts of our United Kingdom. Does my right hon. Friend agree that that shows the power of all parts of the UK speaking with one voice and working together for the good of our entire Union?
I feel very strongly about this, and I agree very strongly with my hon. Friend. We should take forward this vaccine and ensure it is available fairly and equally across all parts of our United Kingdom. Of course, it will be deployed in each of the devolved nations through the devolved NHS. I have been working closely with my counterparts, and the four NHS organisations have been working together. Ultimately, let us hope that should a vaccine become available—we still do not yet have one authorised—it will be a moment at which the whole country can come together in support of making sure that those who are clinically most vulnerable will get support first wherever they live.
(4 years, 9 months ago)
Commons ChamberI am absolutely delighted at the response of the private hospitals which are rising to that challenge, and we are working very closely with them.
Will my right hon. Friend outline what discussions he has had with the First Minister of Wales to ensure that the plan is consistent and that constituents do not get mixed messages? Furthermore, will he appeal to certain sections of the media to realise the power of their platform and encourage them not to undermine the official advice?
Yes, that is very important. I was in Cardiff on Friday to discuss that with my opposite number who attended the Cobra meeting today. We are working very closely with the Welsh authorities, which, of course, run the NHS in Wales.