Health and Social Care

Part of the debate – in the House of Commons at 12:06 pm on 16th January 2020.

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Photo of Jon Ashworth Jon Ashworth Shadow Secretary of State for Health and Social Care 12:06 pm, 16th January 2020

As the hon. Lady knows from her work on the frontline in the NHS, the problem is that bank and agency staffing have contributed to many of the deficits that our trusts are dealing with. That is one of the problems with the way in which the workforce have been managed by the Government.

The Secretary of State says that his figures include 19,000 existing nurses. I have some sympathy for him, because we have been raising the issue of retention in the NHS for some time. That is why we were so vigorous in opposing the public sector pay cap, of which he was a great champion for many years as a Tory Minister, and it is why we were pleased that the Government got rid of it, following pressure from those on the Labour Front Bench. It is a laudable aim to improve retention in the NHS, but it is not the same as recruiting new nurses.

The Secretary of State expects to recruit 12,500 nurses internationally, while at the same time imposing a tax on those nurses through the immigration health surcharge, increasing it to more than £600 per family member per year of a nurse’s working visa. Does he really expect to recruit 12,500 nurses internationally while imposing this nurses’ tax on them?

The Secretary of State will also know that we are desperately short of nurses in the field of mental health services. We welcome the commitment to reform the Mental Health Act 1983, and we will work constructively with him on that, but we have had enough warm words and rhetoric on mental health services. It is now time to deliver the parity of esteem that patients deserve. We have a shortage of mental health beds, which means that too many people are sent hundreds of miles across the country to receive care, away from their family and friends, often in poor-quality private providers.

The Secretary of State likes to boast of hospital upgrades, but anyone who has been in a mental health trust, works in one or has visited one, as I have, knows that the mental health estate is, frankly, some of the worst estate in the NHS. It is unsafe. Mental health patients deserve so much better, yet there is still no credible plan in anything he has said to modernise and replace the 1,000 beds in old-style dormitory wards in mental health trusts across the country. Children are being particularly let down, with increasing rationing of mental health services and more than 130,000 referrals to specialist services turned down despite children showing signs of eating disorders, self-harm and abuse. Matters have become so desperate that there are even reports of GPs advising children to exaggerate problems, because otherwise they will not get any help. This is the chaos of the underfunded system, and it leads to an increasing number of children and young people presenting at A&E in mental health crisis. A&E is no place for someone in mental health crisis. This is a disgrace, and our mental health services now need investment.

That brings me to A&E more generally. The Secretary of State will say that there is increased demand on our A&E, and that is true. There is increased demand on our A&E because mental health services have been pushed to the brink; because years of cuts to social care are pushing more and more people to A&E; because public health prevention budgets have been hammered by years of cuts under this Conservative Government; because GP numbers in our communities have been cut and people cannot get appointments; because walk-in centres have closed under the Tories; and because pharmacies were cut back. More broadly, it is because decisions by this Government—whether it is their decisions on housing and universal credit or their cuts to children’s services, with Sure Start centres closing—and rising levels of poverty mean that health inequalities are widening. It all adds up to more people presenting at A&E because of 10 years of Tory austerity.

What is the Tories’ answer to the worst A&E performance figures on record? It is to scrap the four-hour A&E target. Abolishing the target will not magic away the problems in A&E. It will not suddenly fix a system that saw 100,000 people waiting on trolleys last December. That is why the president of the Royal College of Emergency Medicine said yesterday:

“Rather than focus on ways around the target, we need to get back to the business of delivering on it”.

But Ministers cannot get back to the business of delivering the target, because they will soon ask the House to approve legislation that will legally bake in the underfunding of our NHS. The NHS underfunding Bill effectively caps NHS spending way below the level that experts say our NHS will need. The last Labour Government did not need legislation to signal their support of and commitment to the NHS. The last Labour Government got on and delivered record investment in our NHS. They delivered a 6% increase in investment into the NHS, and they delivered the lowest waiting lists and the highest satisfaction ratings on record—and we did not need the gimmick of a Bill to do it. We got on and delivered it.

The Secretary of State is proposing a Bill that fails to reverse the £850 million of cuts to public health prevention services. This is at a time of rising drug deaths, rising presentations at A&E for alcohol abuse, rising STI infections and rising obesity among children. He is asking us to approve a Bill that does not reverse the raids on capital budgets or deal with the £6.5 billion backlog of repairs facing our hospitals, which has left hospitals with sewage pipes bursting, ceilings falling in and lifts not working. He is proposing a Bill that does not give the NHS the 4% uplift annually that many experts say it needs. That is why Labour has tabled an amendment today to give the NHS a 4% uplift, and every Tory MP who believes in the NHS should support it. The Secretary of State is enshrining in law four more years of underfunding of our national health service and four more years of capped expenditure in our national health service, but it does not have to be that way.

I congratulate the Government on securing election. I congratulate the Secretary of State and all the Ministers who have been reappointed to the Front Bench, and I pay tribute to my former shadow Ministers who lost their seat, Paula Sherriff and Julie Cooper. We will hold the Secretary of State to account. We will test him on whether he delivers 40 new hospitals, 50,000 new nurses and 6,000 new GPs. We will test him on whether he drives waiting lists down, as the Prime Minister promised yesterday. Where the Secretary of State is right, we will work constructively with him. Where he is wrong, we will argue our case forcefully.

The Secretary of State was elected on a promise to fix the NHS. With 4.5 million people on the waiting lists, 2.5 million people waiting beyond four hours in A&E and 34,000 people waiting beyond two months for cancer treatment, our constituents now expect him to fix the NHS. He could start by giving the NHS the level of investment it needs, which is a 4% uplift. He could start by voting for our amendment in the Division Lobby tonight.