Future of the NHS

Part of the debate – in the House of Commons at 2:38 pm on 23 February 2023.

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Photo of Jeremy Corbyn Jeremy Corbyn Independent, Islington North 2:38, 23 February 2023

I agree that the issue of recruitment is crucial, which means that the issue of training is crucial. However, we have relied for a very long time, and we still do, on many medical professionals coming from other countries, making their homes here and making an incredible contribution to all of our lives. We should thank them, thank the Windrush generation and thank that generation of Irish nurses and others who came to this country to work in and run our NHS. My hon. Friend is right: when there is a shortage or a crisis, we need to reach out to somebody else—perhaps a private contractor—to help deal with it. I can see that happening in an emergency situation, but it has now become part and parcel of the NHS.

Most Members of this House grew up with the idea that the GP was the local person in a local practice. That GP might or might not have been in an NHS-owned building, but they were part of the NHS. We now have major American companies owning a large number of GP practices and providing that service. When I warned, during the 2019 election campaign, that the Government were in secret negotiations with the USA to allow American healthcare companies to enter our health market—as they deftly termed it—I was told that this was some kind of Russian plot that I was regurgitating. It was nothing of the kind. It was a dodgy deal done by this Government to bring in those private healthcare contractors who are making a great deal of money out of our NHS. What we need is public ownership of our NHS. I absolutely agree with the intervention of my hon. Friend Ms Rimmer.

I think everybody would accept that the NHS performed brilliantly during covid. However, what the former Secretary of State did not say was that he managed to make a lot of monumentally ineffective contracts with Serco and others that made a huge amount of money out of track and trace—out of our NHS budget. Those places that used local public health services for track and trace had a much better outcome. We should recognise that the need to invest in local public health services for preventive measures such as track and trace, as well as for many other preventive health measures, is very important, because, as others I am sure will agree, that ends up reducing the overall costs.

A central part of my contribution today is about the care services in this country. Everybody knows that quite a large number of people in NHS beds cannot leave hospital because the care service is simply not sufficient and cannot accommodate them. That means that they are stuck in the worst possible situation. They are in a very expensive NHS hospital bed, where they do not want to be, and are in danger of picking up or passing on an infection while they are there. They want to be in a care facility, but there is not one available for them. That is a monumental waste of money and resources, and it is also very cruel on the individuals concerned. We have all met such patients in hospital.

There was a 15% reduction in care beds between 2012 and 2020. Now, 84% of our care services are owned and run by the private sector. There have been debates in this House for as long as I can remember about the inadequacy of social care, the need to invest more money in social care, and the need to provide for real social care.

Social care is a fear that stalks many families. It is the fear that an older relative—a parent, or whoever—will develop dementia or any other condition, and need social care as a result. The amount of money that they would have to pay into the private care system terrifies people. To avoid that cost, who pays? Usually it is women in families who give up jobs, careers, and their life to care for somebody. It is not that they do not love their relative—they do love them—but their whole lives are turned around by the needs of care. We must grasp this nettle.

If in 1948, with all the post-war problems of investment, public austerity and so on, we were bold enough to develop a national health service, surely to goodness by 2021 we can be bold enough to develop a national care service, which takes away the fear for so many people of the enormous costs of healthcare—healthcare that at the moment is largely provided by the private sector on low wages and in sometimes not very adequate conditions. I think we need to revisit that. An interesting report produced by Unison on social care makes five recommendations, and I will quote the first:

“Remove the profit motive from the care sector. This would involve transitioning to either a national care service or a mix of not-for-profit provider types. If coupled with sufficient Government funding that meets the true cost of care provisions (something which is currently not in place), it would offer a number of benefits including greater financial accountability, value for public money, and likely greater attention to achieving quality care rather than generating a return for investors.”

People are making a great deal of money out of those with social care needs. I think we need to turn that around and ensure it is a public investment.

Our NHS was founded and put forward by very brave people, and it is something we should value and preserve. I think of the people who campaigned for many years on the national health service, but it has problems within it. It has the care problem that I have mentioned, and the inadequacy of mental health provision has been mentioned by a number of colleagues. Some years ago we mounted a huge campaign in my constituency to prevent Whittington Hospital from closing its A&E department. We were successful. The local papers, the community—everybody—got behind the campaign, and the A&E department is open and treats more than 90,000 patients a year. At the end of the campaign we held a celebration rally, and the main organiser of the campaign, Shirley Franklin, said, “Would you all have been here if it had been a mental health unit to be closed, or would you have stayed away?” I think we all know the answer to that. Mental health is seen as something separate and different that we simply do not want to talk about. We must invest in it fully.

This debate is about investing and extending, and thanking those who have gone before us. Some weeks ago I learned with great sadness that the late Alice Mahon died on Christmas day. I will be attending her funeral the week after next. She was a fantastic worker in the NHS, an auxiliary nurse, and I remember her like it was yesterday, standing up in this Chamber and challenging Ministers, be they Tory or Labour: “What are you doing to defend the principle of an NHS that is free at the point of need?” We can learn from the inspiration of wonderful people like the late, great Alice Mahon.