Health and Care Bill

Sarah Olney Excerpts

Report stage
Tuesday 23rd November 2021 Commons Chamber

[Paul Bristow]

My hon. Friend speaks with much experience and makes a powerful point. I think he would agree that that core admin function is not what he went into medicine to do. He went into medicine to treat patients. I am grateful that the Minister laid out some of the plans that the Government have to deal with this issue. It is right that we should be looking to the long term, and the 15-year framework for future workforce is to be welcomed, but there also needs to be a much more regular reporting mechanism attached to that to ensure that we as Members are informed, but more importantly the NHS is informed, about how that challenge is going. The integration between NHS England and Health Education England—aligning the delivery arm and the workforce capacity arm—is probably also the right thing to do.

I end with this point: the challenges around workforce will be addressed not only by employing and training more NHS staff, although that is crucial—that is why I have some sympathy for amendment 10—but by ensuring that we work more productively by asking clinicians to operate at the top of their licence. It is also about ensuring that the NHS works smarter. We have created organisations such as Getting It Right First Time and NICE and asked them to go away and do the hard work of coming up with the most cost-effective and efficient ways of delivering care. If we ask those organisations to come up with the pathways and the ways of doing these things, surely it is only right that the NHS then adopts them instead of sitting there and saying, “These things will not necessarily work here.” We ask experts to come up with the right way of performing procedures; I suggest we go ahead and adopt them.

[Sarah Olney (Richmond Park) (LD)]

I rise to speak in support of amendment 10, tabled by the right hon. Member for South West Surrey (Jeremy Hunt), the Chair of the Health and Social Care Committee, because the amendment reflects the key issue facing the NHS and all our health and care services at this time: the workforce. Access to healthcare services is the No. 1 issue raised with me by constituents at the moment, and I know that concern is being echoed in other constituencies across the country.

People are experiencing the issue in many different ways. Some are struggling to get a GP appointment. I regularly speak to parents in great distress because of the lack of available help for their children’s mental health needs. The accident and emergency department at Kingston Hospital in my constituency has regularly had to ask patients to consider whether there are more appropriate sources of help for their needs. Patients waiting in the backlog of elective procedures are regularly having appointments rescheduled or cancelled. Ambulances do not always arrive when called.

The impacts are many and various, but when I speak to health service leaders in my local area, the answer is pretty much the same: there is a lack of available staff. Even in cases where lack of funds is not in itself a limiting factor, the lack of people with the relevant skills makes it impossible to fill all the vacancies they are able to pay for.

Many of these problems are covid-related. The current NHS waiting list is estimated to be over 6 million, and it is clear that much of that is because so many elective treatments were delayed during lockdown. Demand for mental health services has accelerated because of the impact of the lockdown, particularly on young people. Covid is still with us, of course, and workforces in every part of the economy are being impacted by the need for individuals to isolate when they have symptoms or test positive. Healthcare staff need to be more vigilant than the rest of us.

Many of these problems are also Brexit related. A lot of young Europeans decided to return to their home countries at the start of lockdown and have not since returned. Brexit has stymied our ability to recruit from the EU, shutting off an extremely important supply for all parts of the labour market, but the effect is being felt most markedly in health and social care, since it is having to manage the extraordinary demand of a global pandemic at the same time.

Many of these problems are also the result of a long-term failure to correctly predict or prepare for workforce demand. One of the huge advantages of a national health service is that it is possible to get clear data from right across the sector and to make appropriate plans and decisions. For some reason, that has not been done, and it is absolutely right that the Government should adopt amendment 10 to start to put that right.

I want to amplify a Backbench Business debate that I was able to bring to this Chamber a few weeks ago, in partnership with the right hon. Member for South Northamptonshire (Dame Andrea Leadsom) and the hon. Member for Newcastle upon Tyne North (Catherine McKinnell). It was on the subject of giving every baby the best start in life, and it was the firm view of all who attended that debate that the health visiting workforce needs to be substantially boosted to enable all new parents to receive a home visit from a trained healthcare professional. During the course of that debate, we heard of the many ways in which a health visiting workforce can support new families and the critical role they play in supporting babies and their families. One estimate is that the cost of poor parental mental health in the first year of life is more than £8 billion. It is clear that the cost of boosting our health visiting workforce would more than pay for itself in a very short time.

I also want to reflect briefly on a conversation I had with a constituent in the street in Richmond town centre on Saturday. Despite having two degrees, she was working in the care sector, and she was talking to me about her terms and conditions of work. She is employed by an agency and is not allowed to engage with any other agency. She is on a zero-hours contract, so she has to sit at home and wait to hear how many hours she might be required to work the following week. For various reasons that suits her, but I feel that it underpins the recruitment crisis we are experiencing in our social care sector, because that is no way to retain skilled and committed staff.

[Mr Kevan Jones]

Does the hon. Lady agree that it is not just about levels of pay and uncertainty for those individuals, but ensuring that we nationally accredit the qualifications of those individuals and address the career paths that do not exist in those sectors at the moment?

[Sarah Olney]

The right hon. Gentleman is absolutely right, and that is the point I want to make: we need to boost the status of our care home staff and improve their terms and conditions. We need to improve their pay. This lady who I spoke to on Saturday was telling me that she gets paid for the hours she spends in people’s homes, but not the time spent travelling in between. It is clear to me that the crisis of staffing we are experiencing in our care sector—I think every one of us as MPs is hearing about it regularly from our constituents, who are at the sharp end of that—is as much about workforce planning and improving terms and conditions. The Government needs to give that the most urgent attention, and amendment 10 would go some way to resolving that, although it will not resolve it entirely.

I know that Ministers will push back against the cost of boosting the workforce in all areas of the NHS, but they must surely realise the cost of failing to do so. The right hon. Member for South West Surrey. along with the hon. Member for Central Ayrshire (Dr Whitford), spoke about the cost of locum resource in the NHS. It is not just about the direct cost of locums or of worsening health outcomes as people wait longer for treatment; it is also about the lost productivity of days off sick, the cost of poor mental health as lives are put on hold and, as has been mentioned many times, the cost of exhausted and demoralised staff who are overwhelmed by the demands on the NHS. We cannot afford to continue to fail to effectively plan our healthcare workforce.

I am also very happy to support the amendments tabled by the hon. Member for North West Durham (Mr Holden) on virginity testing and hymenoplasty. I am delighted that the Government are adopting the provisions on virginity testing. We still have much to do to make this country a safe place for women and girls, but all progress is to be welcomed, and I am very glad that this opportunity to bring to an end the degrading practice of virginity testing has not been lost. I congratulate the hon. Member for North West Durham on all the work he has done and, although they may have left the Chamber, the representatives of the other charities referred to earlier. I hope in due course we will see the provisions for hymenoplasty as well, when the review has concluded.

[Mr Deputy Speaker (Mr Nigel Evans)]

I have three people indicating that they wish to speak. I ask people to make really short contributions, because I want to give the Minister six minutes to wind up and we will then go into the votes at half past.