Draft National Health Service (NHS Payment Scheme - Consultation) (No. 2) Regulations 2022

Debate between Will Quince and Karin Smyth

Monday 9th January 2023 General Committees

[Will Quince]

I thank the hon. Member for Enfield North for her constructive comments and broad support. Several of the issues raised did not actually relate specifically to this debate. We are of course here to discuss the objection percentages. I am conscious that she would like to push further on items including payment by results, but I will just say—not wanting to test your patience, Sir Graham, given the strict parameters of this statutory instrument—that I would be very happy to write to her. Alternatively, there are health oral questions coming up. I stress that if there are proposals that relevant commissioners disagree with, I encourage them to make representations as part of the consultation, which is open until 27 January.

Let me turn specifically to why I believe the 66% is proportionate—I covered that in my opening speech. The 66% is made up of either integrated care boards or providers, and I will happily write to the hon. Member for Bristol South on that. I think the point that she was making was whether there is weighting towards an ICB versus a provider. Is that right?

[Karin Smyth]

To be clear, the two or three trusts in my patch could all object, but the ICB could support this. Do the trusts have to come within the totality, or will the trusts be counted separately, without getting too mathematical about it? Every trust in the country could oppose this, but the 44 ICBs could support it, for example, in extremis.

[Will Quince]

I thank the hon. Lady for clearing that up. I think the answer to the question is that if an integrated care board or a provider hits the 66%, that threshold is triggered.

Perhaps it would be helpful if I set out what would happen if the threshold is triggered. Unlike the previous scheme, where the Competition and Markets Authority would be involved, under the new proposals, if the objection threshold is reached, NHS England must discuss the objections with representatives of all organisations that objected. It is in the interests of both them and NHS England to reach a conclusion that is workable for both.

Following the discussion, NHS England must decide whether to amend the proposed payment scheme and reconsult on the amended payment scheme, or to proceed with the scheme, as published, that was consulted on. If it decides to proceed with publication, it must also publish a notice explaining its reasons for doing so and send a copy explaining with the notice to all organisations that objected and therefore met the threshold.

I thank Committee members for their contributions to today’s debate, and I would be very happy to write to or meet any hon. Member who has further questions. I genuinely believe that the objection percentages that we have discussed strike the right balance in allowing real collaboration between NHS England and those that it is consulting on. I commend the regulations to the Committee.

Question put and agreed to. 

NHS Industrial Action: Government Preparations

Debate between Will Quince and Karin Smyth

Monday 12th December 2022 Commons Chamber

[Will Quince]

We are currently having those derogation discussions with the unions, and they will also happen at an individual trust level. As my hon. Friend will know, having been out with her trust, 999 calls are triaged and categorised from category 1 to category 4, and on days of ambulance strike action it is likely that category 1 and category 2 calls, where there is an immediate threat to life, will be responded to. We are looking at ways in which we can provide additional support for category 3 and category 4, including things such as block-booking taxis and support through community healthcare, local authority fall services and community support.

[Karin Smyth (Bristol South) (Lab)]

What we have got is a Government who refuse to govern. Retention and sickness rates were reported to the Health and Social Care Committee in June 2019 as higher than average by Health Education England, and if retention rates were kept at 2012 levels we would have 16,000 more nurses in the system. The Minister has talked about safe levels of cover during the strike, but the unions have told us that when they look at staffing levels, in some places, they are currently below what is safe. The issue for us as Members of Parliament and for our constituents is that none of us knows whether our local systems are safe or not. Can he tell us which hospitals across the country are currently operating at safe staffing levels, and which are below those levels, before the strike even starts?

[Will Quince]

The hon. Lady talks about NHS staffing levels; we have 1.2 million staff within our NHS, and compared with last year, we have 3,700 more doctors and 9,100 more nurses, and compared with 2019, we have 29,000 more nurses and 2,200 more GPs, but we do have high vacancies. That is why it will not have escaped her notice that we have commissioned NHS England to publish a long-term workforce plan, and that will be independently verified as set out by the Chancellor in the autumn statement.