NHS: Doctors’ Strikes

Lord Bishop of Exeter Excerpts

Wednesday 5th July 2023 Lords Chamber

Asked by

[The Lord Bishop of Exeter]

To ask His Majesty’s Government what progress they have made towards resolving the strikes by doctors in the NHS.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Markham) (Con)]

My Lords, the Government have been clear that we want to resolve the strikes by doctors. We negotiated in good faith with the BMA’s junior doctors committee in May. The Government stand ready to meet junior doctors again if they move from their unreasonable ask of a 35% pay rise this year. We also want to open negotiations with consultants. We encourage unions to come to the negotiating table rather than proceeding with strike action.

[The Lord Bishop of Exeter]

I thank the Minister for his response. I am sure that today, on the 75th anniversary of the founding of the National Health Service, he will want to join me and all Members of this House in paying warm tribute to the hard-working nurses and clinicians in our NHS. All that underlines and underscores the urgency of settling this dispute. What consideration have His Majesty’s Government given to the request of the BMA to use ACAS to resolve this dispute?

[Lord Markham (Con)]

First, I absolutely echo the sentiment about the 75th anniversary and the hard work of all our doctors, nurses, dentists and medical staff. Clearly, we want to find a negotiated solution. I think we showed in the case of the nurses and Agenda for Change that we have a framework and the ability to find a solution between ourselves as parties. That is why we encourage them to please stop the strike action so that we can have a sensible conversation.

NHS Long-term Workforce Plan

Lord Bishop of Exeter Excerpts

Tuesday 4th July 2023 Lords Chamber

[Lord Markham (Con)]

It is absolutely a pipeline; some people might say, “Why are you not doing more earlier in this plan?”, but, as the noble Baroness says, there is no point training a lot of people at the university end if you do not have junior doctor places later in the system. That is why we are trying to get a sensible ramp-up so that we can build capacity into those places, recognising the point that the noble Baroness makes. On the numbers in the plan, we have set down £2.4 billion for the first five years of training and development, but the point about it being a live plan is that we will update it every two years. Given the data—this is an NHS document, not a Department of Health one—I would expect those numbers to change, as I would be amazed if we got it spot on first time. The whole point about making this an NHS living document that we can use and which updates is that we can all stick to the plan.

[The Lord Bishop of Exeter]

My Lords, we on these Benches very much welcome this workforce plan, in particular the expansion of places for training with a range of clinicians and the shift of gaze towards community care and prevention. Our anxiety very much mirrors that of the noble Baroness, Lady Merron, and the noble Lord, Lord Allan of Hallam. We notice that page 23 of the report says:

“This Plan is predicated on access to social care services remaining broadly in line with current levels or improving”.


That is a jolly big assumption given that the Care Quality Commission report tells us that there are vacancies of 10.7% in adult social care and of 13.2% in the home care services. Without an equivalent plan for social care, in our view this admirable workforce plan is unsustainable, so will His Majesty’s Government publish an equivalent plan for social care?

[Lord Markham (Con)]

As I mentioned previously, the NHS plan is something that we or the NHS can publish, being the employer. With there being hundreds, if not thousands, of employers in social care, it is clearly a different situation. What we can do is make sure that we put the investment into the sector, so that there is pull through in the number of places. Over the next few years, we are looking at an increase of up to £7 billion, which is about 20%. We know that, of that £7 billion, around 65% to 70% flows through to staffing and wages. We are seeing a massive investment on our side, which we are looking to lots of employers to fulfil. By increasing the number of medically trained people, we will be increasing the supply base to fulfil that demand.

Long Covid

Lord Bishop of Exeter Excerpts

Thursday 17th November 2022 Lords Chamber

[The Lord Bishop of Exeter]

My Lords, I too thank the noble Baroness, Lady Thornton, for securing this important and timely debate.

I will focus my remarks on the rural dimension of long Covid, which is having an impact on many people in Devon where I am privileged to serve. I am concerned about rural sustainability and the need to ensure that the Government’s levelling-up agenda is not focused exclusively on urban deprivation. Rural poverty may not show up on government statistics because it is dispersed in pockets, but it is just as real. Research suggests that structural inequalities, including poverty, are important in the development and course of Covid-19 and may form an important context for long Covid.

As far as Devon is concerned, the picture postcard view of my county beloved by holidaymakers is only half the story. The best information we have is that there are currently around 16,000 people living with long Covid in Devon and, as I am sure the noble Baroness, Lady Watkins of Tavistock, will corroborate, it is impacting on the economic life of our county.

As in other parts of the United Kingdom, we know that the groups most likely to be affected by long Covid are people between the ages of 35 and 69; women; people living in more deprived areas; those in care; those with a high body mass index; those working in close-contact professions; and those living with long-term health conditions. Of the 16,000 people in Devon living with long Covid, only around 70% have been referred to long Covid treatment services. Research has revealed that children, older people, men and those living in deprived areas are less likely to seek help and be referred.

The pandemic has impacted people’s health and self-confidence, well-being and the demand for services. It has had an adverse effect on mental health, with higher levels of mental health anxiety and loneliness. For those suffering from long Covid, unsurprisingly, research has revealed that they have lower levels of life satisfaction and happiness, and some have lost hope of change or improvement. Overall, the pandemic has had a greater impact on those groups already suffering from greater disadvantage and higher health inequities than average across the county. In Devon, service providers have reported increased demand for mental health, domestic violence, and drug and alcohol support services. There have also been increased concerns over the safety of children, young people, and vulnerable adults.

Sadly, young people in Devon reflect the national picture, with a significant rise in child obesity during or after the lockdowns, especially among boys and those living in the most deprived communities. The noble Lord, Lord Dubs, highlighted that in his Question this morning.

The picture is not all negative. I am immensely proud of my county and the resilience of many rural communities, much of it, I am proud to say, fostered and supported by local churches.

However, one particular concern in Devon is the impact of long Covid on the workforce. National research shows that before contracting Covid-19 and then developing long Covid, two-thirds of respondents had been working in front-line jobs such as hospitality, schools, care homes, childcare, emergency services, retail, transport and delivery. Most respondents believed that they had almost certainly, 41%, or very likely, 18%, caught Covid-19 at work, pointing to the lack of PPE and the direct contact with Covid-positive patients. As one researcher commented:

“Key Workers are overwhelmingly paying the price of workplace Covid-19 exposure with loss of health, loss of employment and loss of income.”


As we move into winter, this is really serious.

This national picture is exacerbated in rural counties such as Devon. One of the problems facing the countryside post Brexit has been the shortage of workers, both in the care sector and agriculture. Not only is there a smaller population in rural areas from which workers are drawn but, on average, they have to spend more time travelling to and from their jobs or, in some cases, between jobs. Because long Covid disproportionately impacts lower-paid women in front-line roles, this has made it more difficult to recruit suitable staff in the countryside. This shortage is now being seen in many rural businesses in Devon, especially in the hospitality sector, which are closing for the winter period due to lack of staff and higher energy bills.

In conclusion, therefore, I ask the Minister: what research is being undertaken to assist the medium and long-term effects of long Covid, specifically in rural communities?

NHS Dentistry

Lord Bishop of Exeter Excerpts

Monday 31st January 2022 Lords Chamber

[Lord Kamall (Con)]

My noble friend raises a very important point. We have asked NHS dental practices to meet as many prioritised cases as is safely possible. They are currently prioritising urgent care for vulnerable groups, including children. We hope that the £15 million of additional funding that was recently announced will be targeted at those most in need, including children. If they cannot get access to urgent dental treatment, they can call 111 for assistance and look at the NHS website to identify an NHS dentist.

[The Lord Bishop of Exeter]

My Lords, the report of Healthwatch England states that, of all the areas in the country with lack of access to NHS dentistry,

“the worst affected is Devon, as there are currently no practices showing as taking on adult or child patients.”

Can the Minister assure the House that, as part of the Government’s levelling-up policy, rural communities in Devon and elsewhere will not be further disadvantaged and will have access to NHS dental services?

[Lord Kamall (Con)]

I am sure the right reverend Prelate will acknowledge that one of the things we have learned from Covid, the lockdown and its subsequent impact has been about the health inequalities that exist across the country. Both my right honourable friend the Secretary of State for Health and I believe strongly in tackling inequalities; that is one of the reasons why we are keen that this comes to the forefront of the forthcoming Health and Care Bill. But we acknowledge the inequalities and are working with the NHS and the BDA to address them.