My Lords, the noble Baroness has asked some searching questions. I too want to focus on health. I have had the privilege of being married to a medical practitioner for some 60 years, during most—in fact all—of her working life. She started her medical practice in Biggleswade and grew that into one of the largest practices in Bedfordshire, so I have been immersed in the medical world.
Additionally, it is right to point out to the House that I had the privilege of managing, as chairman, two public companies listed on the Stock Exchange. I mention that because, to me, one of the key issues that the health service faces is management. I am ashamed, quite frankly—and this is not party political—that our NHS, on the most common outcomes, and in contrast to Europe, comes 17th out of 18 countries. I am ashamed of that. But there is some good news, I think and hope, in the appointment of Sir Gordon Messenger to review the whole leadership of the NHS. My goodness, it needs it. It brings back immediately to me the 1984 Griffiths report. Noble friends will remember that that was the report that, in essence, removed clinicians from senior management and installed non-medical management. I suggest to your Lordships that that ought now to be reversed.
Issue number two has to be patients. Look at the original basis of the National Health Service: that it should be free at the point of need and the patient was to come first. Our objective, I suggest, must be the patient and not the system. That brings me back to GPs. Up to the point when Prime Minister Blair brought in his changes, your average GP worked for four full days—morning, afternoon, evening and a share of night calls—and every other Saturday. They worked pretty hard. Today, almost all that has gone. Today, many practices have perhaps one or two full-time GPs and perhaps five or six part-time GPs, and every day, we read in the papers about the challenges the patient finds in getting to their GP. Something is not working.
The third issue is medical school intakes; I have banged on about this a number of times. Ten years ago, there were 42,000 medical students—18,800 men and 23,365 ladies. Today, there are nearly 55,000 medical students, of which 21,000 are men and 33,500 are females. In my judgment, the policy should be roughly 50:50. While the vast majority of the men work full time, over half the women work part time. It is no good when you multiply it; there are not enough full-time equivalent GPs in the NHS. I suggest to Her Majesty’s Government something I have already raised several times: we should look long and hard at the Singapore scheme, whereby every medical student has to sign up for five years and promise to work in its national health service—in whatever discipline within in—and, if they do not, they pay back to society the cost of their medical education. I have given the details of that to the current Secretary of State.
The fourth issue is why the NHS has got itself into the situation of having the lowest numbers of diagnostic equipment. I suspect that the final issue is as crucial for others as it is for me: care homes and their improvement. On
“what has been the COVID-19 testing policy for hospital patients that have been discharged to nursing and care homes over the last four weeks”.
I received quite a long Answer from the then Minister, the noble Lord, Lord Bethell, who basically said that all patients who moved from the National Health Service to social care would be discharged in line with current policy—et cetera—and that they would be tested before being discharged from hospital to a care home. We have seen the seismic judgment from the High Court that those 25,000 patients who were discharged from hospitals to care homes in March and April 2020 were not tested. The answer to that question is: if you set a policy, you should check the results of that policy.