NHS: Long-term Strategy

Steve Brine Excerpts

Wednesday 11th January 2023 Commons Chamber

[Steve Brine (Winchester) (Con)]

I only have a short time, so I will make a couple of points.

On strikes, since we have a major strike today, I understand that many of the trade unions are saying they will not engage with the independent pay review bodies for the 2023-24 settlement. That is a catastrophic mistake on their part. The shadow Secretary of State, the hon. Member for Ilford North (Wes Streeting), and I were on a well-known evening news programme together the other night. Far from trashing the pay review body, he said that although it may need reform, it is important. I am glad to hear him say that, because it is important, and the alternative is Ministers directly negotiating pay settlements with unions. They have tried to do that in Scotland in recent weeks, and the Royal College of Nursing rejected the offer out of hand. The pay review process may not be perfect and may need reform—our Select Committee hopes to talk to the NHS pay review body soon—but I think that madness lies in pay negotiations around beer and sandwiches in Ministers’ offices. The unions should engage with the pay review process for next year. That would be the smart thing to do on their part.

My second point is about demand. The GMB came before the Select Committee just before Christmas and told us that the number of calls coming into the ambulance service is about 10 times what it was pre-covid. There are 100 times the number of people with flu in the acute setting than at this time last year. Demand is significantly outstripping supply in the health service right now, and I think it is disingenuous not to face that.

[Aaron Bell (Newcastle-under-Lyme) (Con)]

I am grateful to my hon. Friend for his work in chairing the Select Committee, and for the joint session with the Science and Technology Committee, on which I sit, about the lessons learned from covid. We heard that there are lessons for the NHS to learn for the future. Does he not find it a bit strange that there is no mention whatever of covid in the Opposition’s motion? Clearly, covid—combined with flu and everything else that he talks about—is one of the reasons behind the acute pressures that we have experienced this winter.

[Steve Brine]

I said in the House on Monday that covid has put the health service on its knees—it has done so to health services in the UK and around the world. To repeat what I have just said, it is disingenuous to suggest that the problems faced by our health service right now are not caused by our covid experience. The number of people presenting with suspected cancers is through the roof. That is good—many of those cases will turn out not to be cancer, which is even better—but so many people are coming forward because we suppressed demand during that time, and it is adding to the demand outstripping the supply in the health service right now.

[Karin Smyth]

The hon. Gentleman chairs the Select Committee, so it is really important that he is clear about this. The Government ran the health service at 96% capacity well through the 2010s, well before the pandemic. They were consistently warned that 96% capacity is too much; we should be running at about 85% capacity for staffing and so on. Capacity in the system has been our problem for a long time. Demand is outstripping capacity—supply is about capacity—and he, as Chair of the Health and Social Care Committee, needs to be clear about that point.

[Steve Brine]

I will choose my words and the hon. Lady can choose hers. I will come to capacity in the conclusion of my remarks—I promise her that.

I will touch on patient flow. Any acute sector that I speak to or visit at the moment is saying clearly that patient flow is hampering everything happening at the front door and the back door. One of the reasons why those in the ambulance service are striking is that they are so heartbroken about not being able to deliver the service that they want to deliver and cannot get out on the road because they are waiting to dispatch their patients.

I said it on Monday and I will say it again now: I welcome the £250 million that the Government have put forward to buy beds. I repeat that two thirds of social care is domiciliary care—care in people’s homes—and we must not forget that, because it is important to getting people through the acute system. The modular work that the Secretary of State talked about—modular units in and around emergency departments—to add extra capacity and meet some of the extra demand coming through the front door, is also very welcome.

I said that we have to separate the now from the long term, so let me address the long term. The elective recovery taskforce is important; the 15 new elective hubs are important. At Prime Minister’s questions today, the Prime Minister talked about eliminating the two-year wait, and that is good—it is not, of course, the extent of his ambition, and to say so is facile. We do not yet have an elective hub in Winchester. The Secretary of State knows that I am on his case about it, but may I just land that point with him again? The Prime Minister’s primary emergency care plan, which we eagerly expect later this month, will be important. It is also part of a long-term strategy and plan, and I think many people in the ambulance service will be pleased with what they see there. I hope that it will be as ambitious as what we hear in some of the rumours.

Some of the things the Select Committee is looking at feed into what the Secretary of State and the Government are doing. Integrated care systems are a creation of this Government. They are about flattening services across the NHS and breaking down those barriers between health and social care. We are in the middle of a big inquiry into integrated care systems, and we are liaising with the Hewitt review, which is a good thing. We were talking to the Care Quality Commission this week, and the Government have not yet laid the regulations on how the CQC will look at ICSs. Will the Minister please look at that?

This morning we talked about the digital transformation of the NHS. There are huge dividends in digital for the NHS, including simple things, such as the amount of money that the NHS spends on sending letters to patients—not least given that they never get there due to Royal Mail strikes. There are clinical dangers to that. Let us pursue our digital transformation, and I know that the Secretary of State is up for that. In terms of the stuff we will be doing this year, we eagerly await the workforce plan.

[Maria Eagle (Garston and Halewood) (Lab)]

Will the hon. Member give way?

[Steve Brine]

I cannot give way, because I do not have any more time. We eagerly await the workforce plan. When the Minister sums up, will she update us on where we are with the workplace plan and its independent verification, which the Chancellor announced in the autumn statement?

The Select Committee will be looking significantly at prevention this year. I know that the Secretary of State is passionate about some of the upstream prevention measures we will be talking about, and I look forward to him coming before the Select Committee on 31 January to talk to us—many of my fellow Committee members are here—about the work we are doing. I am excited about our work on the future of cancer. We hear all this evidence about there being cancer plans around Europe that lead to better outcomes, so I want to see the new cancer plan.

Finally, we need to be very careful about the language we use and how we talk about the NHS. Are we honest about the reform we need? Do we believe in the independent pay process? Is primary care really fit for purpose as it is? Do the British people want to spend more than the £159 billion that we will spend this year, and how will we pay for it? I think we do need a bigger NHS, and we clearly need more people in the NHS—that is not a point of debate—but we need to be careful about the language we use around the NHS, because otherwise the long-term strategy is nothing more than a moot point of debate in this House.