(9 years, 5 months ago)
Commons ChamberI congratulate the right hon. Gentleman on his knighthood—it is remiss of me not to have done that. He will know that real-terms increases and cash increases are not the same. He will also know, because he voted for it, that the budget in Wales has been cut by this Government by more than £2 billion. Let us compare like with like.
The Royal College of Nursing has calculated that almost £1 billion—£980 million—was spent on agency staff in the last year alone. Those and other choices made by this Government have meant that, collectively, trusts in England reported a total deficit of £822 million in 2014-15. That is simply unsustainable. A recent survey by the King’s Fund found that 90% of trust financial directors and 85% of commissioners are concerned about the financial state of their local health economies, and that view will be shared by many Members on both sides of the House. An investigation by Pulse revealed that clinical commissioning groups were being forced to use their 2015-16 winter pressures allocations just to maintain regular services.
Questions must also be asked about this week’s revelations that thousands of foreign nurses working in our NHS could be forced to leave the country as a result of the Government’s immigration rules. The RCN points out that this would cause chaos for the NHS and waste tens of millions of pounds—the Secretary of State laughs as I mention that. It would make matters much worse for patients and for front-line clinicians. Will the Minister tell us how many nurses will be lost from A&E and how many will be lost in total as a result of this move? Where in the country will they be lost? How will the vacancies be filled? What will this cost? Has he or any Minister in his Department made representations to the Prime Minister about the effects of this policy? If so, will he share those with the House? When did Health Ministers know that this policy might cause so much damage?
When the Minister replies it will also be interesting to hear him say exactly how that cut and restriction on nurses will impact on the Royal Stoke university hospital, which had the great misfortune, for patients and the public more generally, of topping the list for the longest waits last winter of more than 12 hours on trolleys.
My hon. Friend is absolutely right. Stoke deserves better, and no one has worked harder than him to ensure that it gets something better. Let us ensure that the Minister answers those points.
The understaffing crisis represents a dire situation that will only get worse unless the Government demonstrate an understanding of these issues and give them the attention that they deserve. We know that, as well as deficits this year, the“Five Year Forward View” is based on assumptions that the NHS can save £22 million by 2020. Will the Minister assure us that this will not result in any fewer medical staff or cuts to hospital or community services? Will he also commit to placing the analysis and the assumptions behind the efficiency plans in the public domain so that we can have an informed and honest debate about NHS funding? We do not want a programme of services being set up to fail and then being cut by stealth.
I am grateful to the hon. Gentleman for his intervention. I absolutely agree that models such as that and local best practice can exist in pockets all over the country. It is just a shame that so many health economies are getting cut to the bone, because that stops them developing such care models. He is right that it is precisely that kind of integration that points the way to the future. Have the effects of these public health budget cuts on primary care and accident and emergency been modelled by the Department, and will the Minister share that work with the House? If that work has not been done, will he explain why? Has the Department consulted on these latest cuts, and what was the response?
I now wish to turn to the situation in general practice. In the previous Parliament, we saw a marked increase in the number of people waiting longer for a GP appointment. By 2013-14, almost 6 million people could not get a GP appointment. If the trend continues, that figure could be around 10 million by the end of this Parliament. Those people are often left with little option but to turn to accident and emergency. The GP patient survey suggests that almost 1 million patients went to A&E last year because they could not get a convenient GP appointment. It is clear that the GP workforce crisis is a major driver of the issues under discussion today.
My hon. Friend is making an extremely good speech and is being very generous in giving way. On that point, Stoke-on-Trent has traditionally had far more patients per GP than the national average, and the age of that population is rapidly approaching, and often way past, retirement age. What we are seeing is not that people cannot get an appointment when it is convenient, but that they cannot get an appointment for days on end.
My hon. Friend makes the case. What is happening in Stoke, I regret to say, appears to be something of a canary in a coal mine for the NHS around the country, and its issues will increasingly be seen in areas all over the country.
It is clear that the GP workforce crisis is a major driver of the problems. The number of full-time equivalent GPs per head has fallen over the past five years, even as demand has increased.
(10 years, 11 months ago)
Commons ChamberMy hon. Friend makes a telling point.
The circumstances in which people have to seek assistance to feed themselves and their families are not usually simple. They often involve a combination of issues, which manifest themselves in a great deal of pain and pressure for those involved. For example, I have constituents who are cancer patients who are forced to use food banks as a result of various combinations of Government policies. I wish I could say that those were isolated cases, but they are not. I wish I could say the situation was improving, but it is not. There are no signs of things getting better.
In the past year and a half, more than 100,000 kg of food has been distributed in the small city of Stoke-on-Trent alone. My hon. Friend talks about the people who go to food banks. Has he seen, as I have, people who are absolutely on their last legs because they are so desperate? Many people who go to food banks are also embarrassed that they need such help.
I have indeed seen that, and it suggests that we are seeing only the tip of the iceberg in terms of the numbers of people who need the services of the food banks. Compared with last year, about 600 more people in my constituency are now using food banks to ensure that they can eat. That brings the total to 1,778, including almost 700 children. That is truly shocking, and it is the policies of the parties opposite that have led to this huge growth in the number of people needing help.
It is no coincidence that the wards in my constituency with the highest rise in the number of children being fed through food banks correlate with the wards with the highest rates of child poverty. For example, 41% of the children in the ward of Sandwith are now living in child poverty, and 234 of them rely on the generosity of those who donate to food banks. In Mirehouse, a third of the children are in poverty and more than 200 of them rely on food banks. Child poverty and the use of food banks are inextricably linked, yet the Government have no credible plan to tackle either.
We have repeatedly warned the Government that the legacy of their policies would be felt most keenly by the most vulnerable in our society. The very poorest are bearing the brunt of the cost of living pressures that the Government’s various regressive policies have created, and the consequences are there for all to see. There is a hidden country that is unseen by the Government and dismissed by the Prime Minister, and it shames them both. The working poor are emerging as the Prime Minister’s legacy, as millions of people live in quiet crisis. The explosion in the number of food banks should haunt him, shame him and move him to act, but I doubt that it will.