Urgent and Emergency Care Recovery Plan

Wes Streeting Excerpts

Monday 30th January 2023 Commons Chamber

[Wes Streeting (Ilford North) (Lab)]

I thank the Secretary of State for advance sight of his statement.

After 13 years of Conservative mismanagement, patients are waiting longer than ever before. Heart attack and stroke victims are waiting more than an hour and a half for an ambulance. Mr Speaker, “24 Hours in A&E” is not just a TV programme; it is the grim reality for far too many patients. Some 7.2 million people are waiting for NHS treatment. Why? The front door is broken—people are finding it impossible to get a GP appointment—so they end up in A&E. At the same time, the exit door is broken because care in the community is not available. Patients are trapped in hospitals, sometimes for months. Between the two is a workforce who are overstretched, burnt out, ignored by Government Ministers and forced out on strike.

Does this plan even attempt to get patients a GP appointment sooner? No. Does this plan restore district nursing so that patients can be cared for in the comfort of their own home? No. Does this plan see Ministers swallowing their pride and entering negotiations with nurses and paramedics? No. And does this plan expand the number of doctors and nurses needed to treat patients on time again? No.

The Health Secretary said a lot of things, but he did not say when patients can expect to see a return to safe waiting times. His colleague the Minister for Social Care, the hon. Member for Faversham and Mid Kent (Helen Whately), rather let the cat out of the bag this morning. She was asked, “Is there any plan at all for when we will get back to 95% of patients in A&E being seen within four hours?” Her answer—and I am not joking—was, “I can’t tell you that.” How can the Secretary of State claim that his plan is ambitious and credible? What kind of emergency care plan does not even attempt to return waiting times to safe levels? It is a plan that is setting the NHS up to fail right from the start—a plan for managed decline.

These targets are not plucked out of thin air; patients waiting more than five hours in A&E are more likely to lose their lives, and so are heart attack and stroke victims waiting more than 18 minutes for an ambulance. Sadly, that is exactly what has happened this winter, it is what happened this summer and it has been going on since before the pandemic began. The four-hour A&E waiting time target has not been met since 2015. The only time the Conservatives have met the 18-minute target for ambulance response times was during lockdown. What is the Secretary of State’s ambition now? It is 30 minutes —30 minutes waiting for a heart attack or stroke victim to receive an ambulance, when every second counts. Is not the truth that the Government missed the targets, so they are moving the goalposts? They are fiddling the figures, rather than fixing the crisis.

The Secretary of State boasts that he is pouring more money in—£14 billion, which is almost as much as his Department has wasted on dodgy, unusable personal protective equipment—yet standards are being watered down. So can he explain why patients are paying more in tax but waiting longer for care? Why is it that under the Conservatives we are always paying more but getting less? So what is their answer? It is:

“There are so many people in hospital who wouldn’t need to be there if we could provide quality care at home… medical science and technology…offers a world of possibility for the NHS to transform patient care… Virtual wards allow people to receive hospital care at home.”

Those are not his words—that is my party conference speech! He did not have a plan for the NHS so he is nicking Labour’s.

I am happy for the Secretary of State to adopt Labour’s plans, but here is what he missed: you cannot provide good care in the community, in people’s homes or in hospital without the staff to care for people. That is the supermassive blackhole in his plan published today: people. Virtual wards without any staff is not hospital at home; it is home alone. So where is his plan to restore care in the community? Labour will double the number of district nurses qualifying every year, so can he hurry up and nick that plan too?

Of course, good care in the community is not a substitute for good care in hospital—we need both, now. So why, in the middle of the biggest crisis in the history of the NHS, with hospitals so obviously short of staff, is the universities Minister writing to medical schools to tell them not to train any more doctors? This is ludicrous. Labour will double the number of medical school places and create 10,000 new nursing and midwifery clinical placements, all paid for by abolishing the non-dom tax status. I know that the Prime Minister might not like that last bit—[Interruption.] Government Members are all complaining, but they did not complain when they put up income tax. The Prime Minister does not like it, but perhaps this would be a good time for the Conservatives to act tough on tax dodgers. So when is the Secretary of State going to nick that plan?

And when is the Secretary of State finally going to get his act together and end the strikes in the NHS? Perhaps I am speaking to the monkey when the Chancellor is the organ grinder. If that is the case, when will we get a chance to question the real Health Secretary on the strikes that this one is causing in the NHS? Labour will create more front doors to the NHS and we will tackle the crisis in social care. The Secretary of State offers sticking plasters and by now it is very clear: only Labour can offer patients the fresh start the NHS needs.

[Steve Barclay]

The hon. Gentleman started by thanking me for advance sight of the statement, and then he made a series of remarks that simply ignored what was in it. Even his last point shows how riddled with contradictions the Opposition’s approach is. He says in interviews that he supports the pay review body process—that is the official position, or at least it was—but then he says, “No, we should be negotiating individually with the trade unions and disregarding the pay review process.” There is no consistency on that at all.

The shadow Secretary of State talks about operational performance—[Interruption.] He has just had his go; he should listen to the answers. He says that it is about operational performance, but in my remarks I tried to be fair and said that these are challenges that are shared across the United Kingdom and globally. He seems to think that they are unique to England alone. We need only look at Wales to see that more than 50,000 people—notwithstanding the fact that Wales has a smaller population—are waiting more than two years for their operations, when we cleared that figure in the summer in England, leaving fewer than 2,000 in that cohort.

The shadow Secretary of State talks about the workforce. Obviously, he did not bother to read or listen to what was said in the statement. We are on track to deliver our manifesto commitment of more than 50,000 nurses. We have more than 30,000 so far. We have 10,500 more nurses in the NHS this year compared with last year. The grown-up position is to recognise—[Interruption.] Well, in the first five years we were dealing with what that letter said, which was that there was no money left. [Interruption.] Labour Members just do not like the response, but the facts speak for themselves. We have 10,500 more nurses this year than last year. The grown-up position, as I was saying, is to recognise that we have an older population with more complex needs, and that the consequences of the pandemic are severe—they are severe not only in England, but across the United Kingdom, in Wales and Scotland, and indeed in countries around the globe.

The shadow Secretary of State says that the statement did not cover the plan for GPs. Well, again, I was clear that this was one of three plans. We had the elective plan in the summer, which hit its first milestone. We have the second component today on urgent and emergency care, and we will set out in the coming weeks our approach to primary care. That is the approach that we are taking. [Interruption.] The shadow Secretary of State keeps chuntering. We did not have the pandemic 13 years ago. [Interruption.] I can only surmise that he did not get his remarks quite right the first time, which is why he feels the need to keep chuntering now and having a second, third and fourth go—perhaps next time.

On ambition, the shadow Secretary of State ignores the fact that we need to balance being ambitious with being realistic. These metrics, in the view of NHS England, show the fastest sustained improvement in NHS history. Clearly, his remarks are at odds with NHS England.

On funding, we are putting an extra £14.1 billion of funding into health and social care over the next two years, which reflects the fact that the Chancellor, notwithstanding the many competing pressures he faced at the autumn statement, put health and social care, alongside education, as the key areas to be prioritised.

On virtual wards, I had not quite realised that the shadow Secretary of State was the clinician who had invented virtual wards. I think that the credit for virtual wards actually goes to the staff, such as those I met at Watford, who are driving forward that innovation. It is slightly strange that he sometimes wants to claim ownership of something that has been clinically led by those working on the frontline. We have recognised the value of virtual wards, which is why, at North Tees this morning, at Watford last month, or on various other visits, I have been discussing how to scale up those plans.