Health and Social Care Update

Debate between Wes Streeting and Thérèse Coffey

Thursday 22nd September 2022 Commons Chamber

[Wes Streeting (Ilford North) (Lab)]

I welcome the Secretary of State and her team to their new posts. I thank her for advance sight of her statement, but if any evidence were needed of a Government and party out of ideas, out of time and without a clue about the scale of the challenge that our country faces, the statement would be it.

The NHS is facing the worst crisis it has ever seen, with patients waiting longer than ever before in A&E, stroke and heart attack victims waiting an hour for an ambulance, and 378,000 patients waiting more than a year for an operation—and that was in the summer. We have gone from an NHS that treated patients well and on time when Labour was in office 12 years ago to an annual winter crisis, and now a year-round crisis under the Conservatives. But don’t worry: the Health Secretary has a grip on the key issues. She does not have an answer on the workforce, but she has sorted out the Oxford comma. I am sure that the whole country is breathing a sigh of relief about that.

The Health Secretary promised a digital revolution in the NHS. Well, Conservative Health Secretaries have promised a digital revolution 17 times since 2010. [Interruption.] Oh, apparently she did not say that—she is not promising a digital revolution. That is good news, because I do not think that the staff who are slogging their guts out in the most difficult conditions in history will be particularly impressed by the introduction of that cutting-edge modern technology, the telephone. The NHS can finally axe the carrier pigeon and step into the 20th century. I am sure that staff are absolutely delighted.

Madam Deputy Speaker,

“these measures will not come close to ensuring patients who need to be seen can be seen within the timescales set out…they will have minimal impact on fixing the current problems that general practice is facing over the winter”.

Those are not my words; they are the NHS Confederation’s verdict on the Secretary of State’s plans. Are they not the truth? The Secretary of State says that patients will be able to get a GP appointment within two weeks, but her party scrapped the guarantee of an appointment within two days that Labour introduced when we were in government. She made it clear this morning that it is not a guarantee at all, but merely an expectation—and what is the consequence if GPs do not meet her expectation? As we heard on the radio this morning, her message to patients is “Get on your bike and find a new GP.” Are patients supposed to be grateful for that?

Who will deliver the appointments that the Secretary of State is promising: the 6,000 GPs her party promised at the last election but will not deliver, or the 4,700 GPs her party has cut over the past decade? Where will these GP appointments take place? Certainly not in the 330 practices that have closed since the last general election alone. The Conservatives promising to fix the crisis in the NHS is like the arsonists promising to put out the fire that they started.

As if that were not bad enough, the super-massive black hole at the heart of the Secretary of State’s plan is the lack of a workforce strategy. She has no plan to provide the doctors that our NHS so desperately needs. Despite her “Sesame Street” approach to politics, in her A, B, C, D plan—by the way, last time I checked, S was for social care—she has missed the N for nurses. I say to the Secretary of State that without a plan to tackle the staffing crisis, she does not have a plan for the NHS. What is she going to do about the staff shortage of 132,000 in the NHS today?

The Secretary of State talks about £500 million to speed up delayed discharges. Is that a new investment or a re-announcement? She is right to say that if patients cannot get out the back door of hospital because care is not there in the community, we get more patients at the front door and more ambulances queuing out at the front. That is exactly where we are under the Conservatives today. But she misses the crucial point: unless the Government act on care workers’ pay and conditions, employers will not be able to recruit and retain the staff they need. What is her plan to address that?

Patients will have been concerned to read reports that after the Conservatives failed to hit the four-hour A&E waiting time target for seven years, the Health Secretary is planning to scrap it altogether. I notice that she was not brave enough to say that today; I hope that she will not do so. Can she reassure the House and patients across the country that her response to the crisis in the NHS will be not to lower standards for patients, but to raise performance instead?

The Secretary of State is the third Health Secretary in less than three months. The faces change but the story remains the same. There is still no plan that comes close to meeting the scale of the challenge—no plan for staffing and no real plan for the NHS. It is clear that the longer the Conservatives are in power, the longer patients will wait. As Dr. Dre might say: time for the next episode.

[Dr Coffey]

I thank the hon. Gentleman for his warm welcome to my ministerial team and me. It has been just two weeks—[Hon. Members: “Twelve years!”] Forgive me. Well, in those12 years there have been more doctors and nurses working in the NHS than ever before. We have record funding going into the NHS. The money that the Government spend through the Department of Health and Social Care is about 40% of our day-to-day spending. That is the reality of the Conservative party investing in the long-term health of our nation.

The hon. Gentleman mentioned a variety of things. I can absolutely say that there will be no changes to the target of a four-hour wait in A&E. I believe that it matters. I will give the House a recent personal experience. In July, I went to A&E myself; I waited for nearly nine hours to see a doctor, and I still did not get any treatment. I was asked to go back the next day, so I went to a different hospital just three miles away and was seen and treated appropriately. That is the sort of variation we are seeing across the NHS, and it is the reason for my approach.

Only last week we started getting some data from NHS Digital about what is happening practice by practice, so we can start to understand it and start to use experts in the local NHS to prioritise helping those patients who are not getting the service that they should rightly expect, while giving freedom to those other GPs who are doing a fantastic job of supporting patients in their practice. That is why I do not intend to be prescriptive, but I am determined on behalf of patients to drive up the performance of those who need help to do things better.

On ambulances, I am very conscious of the issue. The hon. Gentleman is right to say that we have been in power for 12 years, and I am conscious that I have been working for a decade on improving things for my constituents as well. With a particular focus on ambulances, I think it would be helpful for the House to learn about our recent analysis showing that 45% of the handover delays are concentrated in a part of the country. Even so, I appreciate that that is not good enough.

I also understand that although similar numbers of ambulance calls are being made, there are many more category 1 and 2 calls and our fantastic paramedics are treating more people at home without needing to take them to hospital. Nevertheless, that brings me the challenge of how we can do more to help ambulances get back on the road so that they can treat patients. As with many other emergency services, we also need to consider the potential extension of volunteers through auxiliary services or community first responders. In London alone there are about 120 community first responders, but I think I have more than that in my constituency of Suffolk Coastal. It is about recognising that for the million people who volunteered to help, we can find a way for them to help us during these particularly challenging times, as well as working with the NHS to tackle the fundamental issues.

On access to GPs, I am conscious that Labour introduced the 48-hour target when it was in power. We were told by the NHS and by doctors that of course they met it—I expect that was part of their contracts—but that it did not necessarily mean better outcomes for patients at their practice; indeed, they got into a routine of not booking appointments more regularly. It is important that we address that.

I am very conscious that the plan for patients has only just been published. I deliberately tried to ensure that we held back important aspects of it, such as the £500 million adult discharge fund, for the House’s interest rather than speaking about them before coming here today.

I can assure the hon. Gentleman that I am very happy to continue to work in partnership with the NHS. Keeping the focus on patients is critical, as is building on the existing NHS winter plan, developing the workforce, and all the plans and strategies that need to be carefully considered as we set about the long-term improvements that I think he will enjoy and will want me to champion on behalf of patients.