(3 days, 3 hours ago)
Lords ChamberThe noble Baroness has just made a very good case as to why the offer which has been rejected would have been so helpful. On the issue of pay, our door has remained open to the BMA and to reasonable, realistic solutions to resolving the dispute, on which we have been repeatedly clear. I know the noble Baroness did not say this, but I say more broadly that there can be no suggestion that the BMA was not aware that we can go no further on pay this year. Resident doctors have already had a good deal on pay—an average 28.9% rise over the last three years—but pay expectations have to take account of the fiscal position and the impact across the whole of the NHS and beyond. I am glad to hear that noble Lords are in agreement with that approach.
My Lords, the BMA pay claim has been ridiculous right from the start, and I share my noble friend the Minister’s outrage at the decision to carry out these strikes at a moment when the health service is on its knees, certainly in Birmingham. We are in a critical situation: the service is working under huge pressure, and ambulances are finding it very difficult to discharge patients at A&E because we cannot get the flow of patients through the system.
Listening to the noble Lord, Lord Kamall, I wondered if my noble friend the Minister shares my view. I remember the 2014 junior hospital doctors’ dispute. Although that was ostensibly about pay, what came through was frustration at the way training and working lives were organised, with inflexible placements and utterly insensitive rota allocations. It made junior doctors’ working lives increasingly difficult. This was 2014. Does my noble friend the Minister think that part of the reason we are here now is that nothing was done to respond to the substantive issues juniors raised at the time, and that at some point, there will be a constructive way forward? I am convinced that tackling the way junior and resident doctors are treated in the health service will have to be at the heart of what we do.
I am grateful to my noble friend, and I share his view. I am sure he will be very familiar with this, but it is worth reminding ourselves that in the Statement we are debating, the Secretary of State said last week:
“On jobs, I have much more sympathy with the BMA’s demands. I have heard the very real fears that resident doctors across the country have about their futures; it is a legitimate grievance that I agree with”.
As the Secretary of State outlined and my noble friend referred to, we have inherited
“training bottlenecks that … leave huge numbers of resident doctors without a job … UK graduates”
used to compete
“among themselves for specialty roles; now, they are competing against”
the rest of the world.
“That is a direct result of the visa and immigration changes made by the previous … Government post-Brexit, and … compounded by the”
then Government’s
“decision to increase the number of medical students without also increasing the number of specialty training places”.—[Official Report, Commons, 10/12/25; col. 429.]
This has not just come about, and I am grateful to my noble friend for reminding us of the history of this.
(3 weeks, 3 days ago)
Lords ChamberTo ask His Majesty’s Government what assessment they have made of the provision of wheelchair services by the NHS and social care authorities.
My Lords, integrated care boards are responsible for the commissioning of local wheelchair services based on the needs of the local population. NHS England has developed policy guidance and legislation to support ICBs to commission effective, efficient and personalised services. This includes a Wheelchair Quality Framework, published in April, which is designed to assist ICBs and NHS wheelchair service providers in delivering high-quality provision that improves access, outcomes and experience.
My Lords, I am grateful to my noble friend, but does she recognise that the work by the Wheelchair Alliance and the All-Party Group for Wheelchairs Users would suggest that, if you leave this to local health bodies and local authorities, they simply will not improve the current inadequate and patchy service? The All-Party Group for Access to Disability Equipment has reported that
“63% of carers and 55% of equipment users said that services are getting worse”.
Given what my noble friend said about the quality framework, which I very much welcome, does she accept that nothing will change unless this is enforced from the centre, with strong performance management?
I accept the observations that my noble friend has made; I know he has been a voice on this for many years. I share with him the impatience for change and welcome the work of the APPG and the Wheelchair Alliance. The NHS Medium Term Planning Framework, which was published just in October, requires that, from 2026-27, all ICBs and community health services must actively manage and reduce the proportion of waits across all community health services over 18 weeks and develop a plan to eliminate all 52-week waits. I expect that wheelchair provision and services will improve through this as well as other means.
(3 months ago)
Lords ChamberThe noble Lord makes an important point. There is absolutely no intention that people will be disadvantaged in any way. This is about equalising access, which means keeping all forms of access open. That may be online, but it will also be possible to deal with things in person and on the phone. Obviously, if we can take pressure off phone access, or personal access, through the use of online, that will assist the group to which the noble Lord referred.
My Lords, my noble friend referred to Community Health Councils. I was one of the first CHC secretaries to be appointed in 1974.
Wait for it, my Lords—I was also the Minister who got its abolition through your Lordships’ House. Mea culpa; I was mistaken. We should bring it back.
My noble friend does himself credit with his honesty, which I too will take example from .