NHS Workforce

Alex Sobel Excerpts

Tuesday 6th December 2022 Commons Chamber

[Wes Streeting (Ilford North) (Lab)]

I beg to move,

That this House recognises that the National Health Service is facing the worst workforce crisis in its history with a shortage of 9,000 hospital doctors and 50,000 nurses; condemns the Government’s failure to train enough NHS staff to tackle this crisis; regrets that, as a result, patients are finding it impossible to get a GP appointment, ambulance or operation when they need one; calls on the Government to end the 200-year-old non-domiciled tax status regime which currently costs taxpayers £3.2 billion a year; and further calls on the Government to use part of the funds raised to invest in the NHS workforce by doubling the number of medical training places, delivering 10,000 more nursing and midwifery clinical placements, training twice the number of district nurses per year and delivering 5,000 more health visitors to guarantee that the NHS has the staff to ensure every patient can access the care they need.

The NHS is facing the worst crisis in its history. Seven million people are waiting for NHS treatment, and they are waiting longer than ever before; 400,000 patients have been waiting for more than a year. Heart attack and stroke patients are waiting an hour for an ambulance, on average, when every minute matters. “24 Hours in A&E” is not just a TV programme; it is the grim reality facing patients in an emergency. Behind those statistics are people being held back from living their lives: people forced to give up work because they cannot stand the pain; young people, still bearing the scars of lockdown, unable to get the mental health support they need to step into adulthood; families losing loved ones for no other reason than that the NHS was unable to treat them in time.

My friend and colleague the shadow Leader of the House shared with me an email from one of her constituents. A patient with suspected cancer was urgently referred by his GP, which ought to mean being seen by a specialist within a fortnight. Four weeks later he had heard nothing. He phoned the hospital and was told, “two weeks currently means six weeks” and that he would be contacted, not seen, within the next two weeks. He has now had his appointment, during which the doctor identified cancerous cells. He has been told that he will wait up to eight months to have that cancer removed. He said that until waiting lists are down,

“more people will die unnecessarily from cancer. I hope not to be one of them.”

That is not uncommon. That is where we are. That is why Labour is today putting forward our plan to solve this crisis, make the NHS fit for the future, and get patients treated on time again.

[Alex Sobel (Leeds North West) (Lab/Co-op)]

Yesterday I spoke to a paramedic who had been with a patient with sepsis, waiting for two and a half hours to be taken in. There were 98 calls at that same Yorkshire hospital waiting to go in. Are we now post-crisis and in complete breakdown, and do we need Labour’s plans to come in now, and not have to wait?

[Wes Streeting]

I strongly agree with my hon. Friend. As the Leader of the Opposition has said, the NHS is not on its knees; it is on the floor. How many times were we told during the pandemic that restrictions were needed to stop the NHS falling over? It has now fallen over, and for the first time in its history people no longer feel certain that, when they phone 999 or arrive at A&E, they will be seen in time. It is the first time in our country’s history that people have not felt confident that emergency medicine will be there for them when they need it.

The Conservatives blame the crisis in the NHS on everything from the weather to the pandemic, and even NHS staff. Of course there is no doubt that the pandemic has made things worse, but the Government—the Conservative party—sent the NHS into the pandemic with 100,000 staff shortages. They spent a decade disarming the NHS, before sending it into the biggest fight it has ever faced. They cannot pretend that the NHS was well prepared. The problem for the Conservative party is that people are not stupid. Their memories are not that short. They know that the NHS was struggling to treat them on time before the pandemic, and they know who is to blame.

Access to GP Services and NHS Dentistry

Alex Sobel Excerpts

Tuesday 21st June 2022 Commons Chamber

[Wes Streeting]

I wholeheartedly agree with my hon. Friend. This is the problem: they overpromise and underdeliver. If they will not hear it from me, Mr Speaker, let us remind ourselves of what some of the Secretary of State’s colleagues have said. The hon. Member for South West Bedfordshire (Andrew Selous), who is in the Chamber, said in Prime Minister’s questions only last week:

“At one of my surgeries, which has double the recommended number of patients per GP, the bowel cancer diagnosis of a 51-year-old father of four was missed and is now terminal.”—[Official Report, 15 June 2022; Vol. 716, c. 283-4.]

Earlier this month, the hon. Member for Telford (Lucy Allan) read a letter from a constituent to the Health Secretary. It said:

“Trying to get basic healthcare is a joke in Telford. Maybe I would be better off in…a third-world country”.

If the Secretary of State is not going to listen to us, he should at least listen to his own side. Before Conservative Members leap to the defence of their Government’s record, they should probably go back and check the record to make sure that they had not agreed with us in the first place.

As for dentistry, 2,000 dentists quit the NHS last year, around 10% of all dentists employed in England. It is an exodus under the Government’s watch. Four million people cannot access NHS dental care and cannot afford to go private either.

[Alex Sobel (Leeds North West) (Lab/Co-op)]

My hon. Friend is making an excellent speech. My constituent, Ellie Cokeley, wrote to me. She works as a receptionist in a local dental practice and gets hundreds of calls a week from upset members of the public who are unable to find an NHS dentist. She said that it feels greatly unjust that the poorest in our society are being forced to pay huge amounts for vital dental care or, worse still, having to continue without any at all. Are the Government not failing people in this country when it comes to the care of their teeth? It is vital that we get more dentists in the system.

[Wes Streeting]

My hon. Friend is absolutely right. Some places, such as Somerset, are dentistry deserts because the remaining NHS dentists are not taking on new patients.

Covid-19 Update

Alex Sobel Excerpts

Wednesday 8th December 2021 Commons Chamber

[Sajid Javid]

First, I hope that my hon. Friend will agree with me that one of the reasons for these measures is precisely to avoid a lockdown. We all want to see a lockdown avoided for all the obvious reasons, and taking the right proportionate measures now will certainly help to do that. On the vaccine, I am not proposing reformulation. I think the most important thing right here and now, and more important than even before, is the booster programme—not a reformulation, but getting a third shot to boost everyone’s immunity. On the future, where I see vaccines going is multi-variant vaccines, a number of which are already being developed. Just as we see that with flu, I am sure we will see that with covid.

[Alex Sobel (Leeds North West) (Lab/Co-op)]

Mr Speaker, I am sure you, the Health Secretary and everybody in the House would like to thank the South African scientists for their early work and discovery of the omicron variant. If we are to avoid more variants in the future, it is really important that we have a high level of vaccination not just in the UK, but everywhere in the world. Is it not our duty, as a country that produces vaccines, to ensure that countries such as South Africa and others have high levels of vaccine, and that we end the Government policy of vaccine nationalism?

[Sajid Javid]

First, I join the hon. Gentleman in thanking the South Africans for their huge efforts with respect to this variant, recognising how they have worked with the world, including us, on it. I think the way they have reacted to this is nothing but exemplary. However, I would have to disagree with the hon. Gentleman on referring to the Government’s approach as vaccine nationalism. We have already given more than 20 million doses to COVAX and bilateral doses, and there are another 9 million or so ready to go.

Health and Care Bill

Alex Sobel Excerpts

Report stage
Tuesday 23rd November 2021 Commons Chamber

[Justin Madders]

Let us just say that the more I hear of the right hon. Gentleman, the more I like what he has to say—I will leave it there.

We all accept the urgent need to address the workforce crisis, but I cannot find anyone who thinks that what the Government have put forward in clause 34 is the solution.

[Alex Sobel (Leeds North West) (Lab/Co-op)]

A doctor in my constituency, Dr Tom James, told me that he and his colleagues in the hospital were demoralised, exhausted and at the end of their tether, particularly after the covid crisis, in a building that was falling apart around them. He said there was no more goodwill, and the Government needed to grab hold of this crisis and resolve it. Are new clause 29 and amendment 10 not a minimum, rather than a maximum, for what we should be looking to achieve?

[Justin Madders]

New clause 29 and amendment 10 are the starting point, not the whole answer. They are a framework for getting this right in the future and offering the workforce, which, as the Minister said, has given so much in recent times, some hope that there will be better times along the way. I will refer later to the report by the Health and Social Care Committee on workforce burnout, which brought home just how demoralised the workforce have become and why they need to be given some positive news today.

GP Appointment Availability

Alex Sobel Excerpts

Tuesday 26th October 2021 Westminster Hall

[Rachael Maskell (York Central) (Lab/Co-op)]

It is a pleasure to serve with you in the Chair, Mr Robertson. I thank the hon. Member for Beaconsfield (Joy Morrissey) for calling today’s important debate. Let me set out the challenge, and how Government can make a difference.

York Medical Group has 44,000 patients on its books. In a single calendar month, it received 41,000 calls from people who needed to see a clinician—unprecedented demand, with higher acuity, co-morbidity and complex needs. When patients get through to the call-handling system, they are triaged and, when urgent attention is needed, that is followed up by a clinical conversation. Appointments are allocated, tests are ordered, referrals are made, and prescriptions are issued.

Of course, people are also applying to see a practitioner through the internet or are turning up at the surgery. That is managed by exceptional staff, who are really pulling out all the stops to support their local community. However, this logistical agility to meet the serious demand is outstripped by the pressures placed on it. When spending time embedded in the system—as I did, spending time with call handlers and with GPs—I saw how relentless they were in trying to meet that demand, but that demand is continuing to put pressure on them.

[Alex Sobel (Leeds North West) (Lab/Co-op)]

My constituency is only 25 miles from my hon. Friend’s. A constituent came to see me last week; they could not get an appointment with their GP, but were told to go to the accident and emergency department in Leeds. It took two hours at the A&E to be triaged, and they were then told it would be a further six to seven hours to see a doctor. They ended up going home because it was too cold at the hospital to wait. Does this issue not impose pressure right across our health system, to the point that it is near collapse? Winter has not even properly started yet.

Social Care Reform

Alex Sobel Excerpts

Wednesday 23rd June 2021 Commons Chamber

[Helen Whately]

One thing I will say is that during the pandemic GPs and primary care in general have really stepped up to support those in care homes in particular, with every care home having a point of contact in primary care to ensure the support from GPs that those residents require. Yes, quality is at the centre of our proposals for social care reform.

[Alex Sobel (Leeds North West) (Lab/Co-op) [V]]

We all know that commissioning in social care is broken. The price paid for care is too low, the wages paid to carers are too small and there is a lack of training and professional development for carers. I would like the Minister to address the issue of home care being commissioned by the minute—it is the only publicly funded service commissioned or measured by time. Will the social care plans address that? She could do worse than look at the GMB’s ethical care commissioning charter to see a way forward.

[Helen Whately]

Some really interesting and important work has been done on commissioning, looking at the outcomes of care rather than being so focused on inputs, which sometimes leads to the situation described by the hon. Member. One of the opportunities of the oversight system that we propose through the health and care Bill is that it will shine a light on the different ways in which local authorities commission care and give more visibility to what works. Those ways of commissioning that do not lead to such good outcomes can therefore learn from others. We look forward to seeing an improvement in how care is commissioned and, therefore, the care that people receive.

NHS Pay

Alex Sobel Excerpts

Wednesday 24th March 2021 Westminster Hall

[Alex Sobel (Leeds North West) (Lab/Co-op)]

It has been a year now since hospital beds started filling up. Since then, there have been more than 126,000 deaths: our mothers, fathers, brothers and sisters, friends, neighbours and colleagues—in the NHS, more colleagues than most. Last night, like many others, I reflected on a heartbreaking year of loss, but while last year was tragic, what happened was not unavoidable. Implementing the first lockdown just one week earlier, as advised, could have halved the early mortality rate. Our hospitals and NHS staff weathered a storm of the Government’s making.

Let us cast our minds back to March 2020. It seems implausible now that the Prime Minister was boasting about shaking hands with every person he met on a visit to a hospital with covid-19 patients. Edwina Currie compared him with Princess Diana. Others were less favourable. It has been revealed by the BBC this week that the Prime Minister said that the best thing would be to ignore the virus and that overreaction would do more harm than good.

The NHS is facing immense challenges, and overcoming them will be fundamental to its survival. There is the pandemic, of course, and the small matter of rolling out the most ambitious vaccination programme in the nation’s history. Not only is our NHS asked to bear the brunt of the pandemic; it is forced to do it with one hand tied behind its back. In February, NHS hospitals, mental health services and community providers were reporting a shortage of nearly 84,000 staff; 38,000 of those vacancies were for nurses—the enduring backbone of our national health service. A decade of underfunding, lack of accessible training and failure to prioritise healthcare workers have hit the NHS hard, but the Minister knows that—it is a situation of Government design.

The NHS is sick. It is underfunded and understaffed. Just as a sick patient is not aided by removing their medicine, the NHS will not be healed by cutting the pay of its workers. The Government’s and their spin doctors’ praise for the NHS has been almost evangelical. We have seen the Prime Minister clapping on our TV screens. We have heard Tory Ministers refer to NHS workers as heroes and angels. We saw the hyperbolic outburst reach fever pitch when the Health Secretary cried on national breakfast television. Most of the NHS workers I know have no desire for constant praise and adoration. They do not want to be called angels. They are skilled professionals who have worked and are working through a deadly pandemic. Most would be happy for their hospitals to be properly funded, for their patients to be given the best chance of survival and, finally, for a pay packet reflecting their workload. To cry hero, and then cut pay, is as manipulative and cruel as it is unsurprising, from a party that has systematically sought to undermine the health service and its workers.

The NHS has done so much more than just jobs during the pandemic. Its staff risked their lives every single day for our most vulnerable. They held the hands of those in the their final moments whose loved ones could not. They have been a bright flame of hope in a year filled with anxiety and fear. NHS workers have given us more than we can ever give back. Their compassion, bravery and will is something we may not ever be able fully to repay. The recognition of their work can be fulfilled by a decent pay rise.

Covid-19 Vaccination Roll-out

Alex Sobel Excerpts

Monday 11th January 2021 Westminster Hall

[Alex Sobel (Leeds North West) (Lab/Co-op)]

It is an honour to participate in a debate under your chairing, Sir David. It is an extremely important and timely debate, and I thank all the people who signed the two petitions that brought it forward.

For almost a year, covid-19 has impacted all our lives in ways we could never have expected or imagined. Young people have missed vital time in the classroom, businesses have been forced to close, families have been kept apart and, shockingly, more than 80,000 lives have now been lost. The correspondence I receive every day from constituents represents their vast and varied concerns. The common thread is an overwhelming sense of fatigue and the desperate wish for the country to get back to normal.

The vaccine is our way out, our golden ticket to some sense of normality. I put on record my thanks to all those who have worked to make it possible. It should amaze us all that in less than 10 months humans have been able to learn about the virus, develop a vaccine to combat it, test it, conduct three phases of trials and get it approved. That could not have been done without enormous sacrifice, talent and a level of international collaboration that should inspire us all and be applied to a range of areas. Because of that hard work, we can now see light at the end of the tunnel.

The pandemic has demanded huge sacrifices from people all over the world in the name of beating the virus. Now that we have a vaccine, it is incumbent on the Government to hold to their end of the bargain and ensure that the roll-out is done correctly. The stakes are painfully clear. If we can get a vaccine for people most at risk, in the fastest amount of time, we will be able to save countless lives.

That is why, alongside the Daily Mirror and the TUC, my party has started the Let’s Vaccinate Britain campaign. We are working with trade unions to demand that employers give workers paid time off to get vaccinated. We are encouraging people to sign up to the NHS to volunteer and to speak to their friends, neighbours and relatives about the importance of getting vaccinated. I call on everyone listening to the debate to get involved in that campaign.

Many of my constituents and others in Leeds are already contributing to the national effort. Fittingly, Leeds’s first covid vaccine was given Sylvia Harris, an 80-year-old ward housekeeper who has worked for the NHS since she was 26, but has had to shield at home since March last year. Soon, she will finally be able to return to what she does best—caring for her patients. I thank Leeds United football club for offering its stadium, Elland Road, to be a vaccination centre, and all those across Leeds who are devoting time and energy to making the vaccine administration possible.

We need a huge national effort to get this country vaccinated, starting with key workers and those most vulnerable to the virus. That means conducting round-the-clock vaccinations, 24 hours a day, seven days a week. It makes perfect sense for key workers to be vaccinated overnight, allowing daytime vaccinations for the age priority groups.

Unfortunately, the Prime Minister has said that there is no public appetite for vaccinations 24 hours a day. I do not believe that is correct. Key workers, and people who want the vaccine in order to get back to normal, will take it on whatever day or night is offered to them. Older age groups might not be prepared to have the vaccine during the night, so maybe the strategy is to vaccinate the key workers in the nocturnal hours and the older age groups in the daytime hours. [Hon. Members: “Hear, hear.”] There is agreement about that across the House.

As the hon. Member for Montgomeryshire (Craig Williams) said, politicians across the House have been keen to emphasise the importance of getting children back into school. I declare an interest, as I have a 10-year-old and a 12-year-old, and it is sometimes difficult to motivate them for home learning. I am sure we all know that feeling. We cannot get them back in school until it is safe. Schools cannot operate in a socially distanced way, without access to proper personal protective equipment. Vaccination is the only way we can ensure staff are protected.

It is not just teachers who need to be added to the priority groups. I submitted a written question last week on hospices. The Minister who has just finished in the Chamber, the Under-Secretary of State for Health and Social Care, the hon. Member for Stratford-on-Avon (Nadhim Zahawi), can listen to this debate now and to what I have to say. He responded by saying that the JCVI based its advice on the data it reviewed from a number of sources, including the Office for National Statistics and Public Health England. For the purposes of covid-19 vaccine prioritisation, the definition of care homes is all care home premises licensed and registered with the Care Quality Commission. This definition does not include hospices. I want to ask the Minister on duty, the Under-Secretary of State for Health and Social Care, the hon. Member for Bury St Edmunds (Jo Churchill), and the Minister who is hopefully watching, why hospices should not be added, because they are just as important as other care settings.

I also want to make a plea for early years. Why is early years treated differently from teachers or other settings? They should not be. Early years settings are suffering at the moment because they are open, and the financial pressures are immense because of the different pressures on their time. Today the leaders of Leeds City Council wrote to the Minister for Children and Families and copied in the Minister for COVID Vaccine Deployment. Councillors Blake and Venner wrote, “We are requesting that early years staff, to include childminder staff working in group settings and wraparound care, are prioritised for the covid-19 vaccine. Early years providers support a large number of children, provide personal care and do not wear PPE. It is of course vital that the NHS and care home workers as well as other priority groups more vulnerable to the virus receive the vaccine first. But we are asking that early years staff form an additional priority group after this.” That is another group that can be vaccinated in the evening or at night, putting our youngest away from harm in those settings.

I will conclude by asking about transparency on data, which the hon. Member for Montgomeryshire gently touched upon. We have a lot of data around testing. We know how many tests are being conducted in each local authority area. We know where the roll-out is and where the centres are. If we can have that level of data for testing, why can we not have it for vaccinations? I am sure that other Members, like me, look on the Worldometer website, which has started recording vaccination data as well as testing data, cases, mortality and so on. Soon there will be global comparisons around vaccinations and we will be able to see where the UK stands. We can see that now, but we need to be able to dig right down to see how many vaccines have been supplied to each primary care network, how many centres there are, and how many first and second vaccines have been given. That will start to give the public confidence that there is not a postcode lottery, that roll-outs are happening and that centres are open. That will encourage more people to come forward, not just to receive the vaccine but to support the roll-out.

Data and public confidence are really important. I hope that the duty Minister, the hon. Member for Bury St Edmunds, will take that away and provide us with that data. I asked the hon. Member for Stratford-on-Avon about that in a private call just before Christmas. He said he would get back to me. Now that I have raised it in this Chamber, I hope that he will.

Family Visits in Health and Social Care Settings: Covid-19

Alex Sobel Excerpts

Wednesday 11th November 2020 Westminster Hall

[Alex Sobel (Leeds North West) (Lab/Co-op)]

I thank the hon. Member for Beaconsfield (Joy Morrissey) for securing the debate and I congratulate her on her moving speech on Jamie’s behalf. I lived in her constituency through my teens, and in fact I stood against her predecessor a long time ago. My mother is still one of her constituents. She is living very much independently, but maybe one day I will need to go to the hon. Member for help with my mother regarding the issue that we are debating today.

I will also place on the record my thanks to those working in the social care sector. Their courageous work during the pandemic, delivering quality care in horrendously difficult circumstances, has not gone unnoticed. The pandemic has been difficult for everyone, but for those residing in care homes, or for those with loved ones living in them, it has been nightmarish. Over 40% of covid-19 deaths have taken place in care homes—more than 26,000 deaths. The combination of fear and isolation, coupled with a dearth of familiar emotional support, is creating a mental health crisis in our care home settings.

Recently, I received this letter from a constituent:

“Dear Alex, my letter is concerning my bedbound 81-year-old mother. who is currently resident at a care home in Leeds North West. My mother, Patricia, has been a resident for many years. Along with many families, we had no contact with mum over the course of the pandemic, apart from a very short video, which lasted around a minute, sent when requested at desperation in the early months of the pandemic.

We requested that should a window room become available, could mum be moved, so we could at least visit her from a safe distance without entering the premises. Six weeks ago, a room did become available and we have been visiting mum at a window since. Today, however, I was contacted by the care home manager to inform me that we can no longer visit mum.

We are devastated that our family is being so cruelly torn apart. I thought that, as a strong woman, I would be able to deal with the mental impact, but it is destructive. Surely, there are humane options which can keep families together.”

I am thankful to the Minister and to the Government that guidance has now been released that says visiting through screens or windows is allowed, which is welcome news for my constituent. However, for many residents with dementia or other cognitive impairments, the distress that would cause makes it untenable. Similarly, the British winter makes outdoor visits impractical for older and vulnerable visitors.

In addition, the cost of implementing measures that have been suggested to create environments that are safe from covid-19 are to be met by care providers. There is no commitment of additional money, excluding the infection control fund, to cover the costs associated with purchasing screens or visiting pods. Government shortcomings will doubtless result in convenient finger-pointing at individual care homes, which are unable to front the additional costs for safe visiting.

We also need to give family members the same rights as key workers, who are afforded regular access to testing and trained to wear personal protective equipment. The Government must know that that is the best way forward, as they promised a pilot scheme on those lines, but that was nearly a month ago and no date for the pilot has been forthcoming. I look forward to hearing the Minister say when we can expect to see that pilot begin.

The wellbeing of residents must be placed at the forefront of the Government’s plans. That should include a recognition of the important role that social workers play in facilitating providers’ and residents’ decision making about visits. Social workers must be recognised as professional visitors, to ensure that residents’ views and wishes are central to decision making about visits, and to support care providers to explore thoroughly rights and risks alongside all the other factors that must be considered in making bespoke visiting arrangements.

Practice is different across the care sector. Hospices such as the Sue Ryder Wheatfields Hospice in my constituency have given social workers access, unlike many care homes, which have denied them access. Social workers are mentioned briefly in the guidance issued for lockdown, which states:

“Social workers can assist with individual risk assessments, for visits, and can advise on decision-making where the person in question lacks capacity to make the decision themselves.”

But social workers do so much more, and are pivotal in promoting strengths-based human rights models of good practice. Social workers undertake a variety of statutory and non-statutory functions on behalf of public bodies. Recognition of the importance of safe access to care and health settings for social workers as professional visitors is essential. I look forward to hearing the Minister’s comments on this matter.

Residents, staff and the families of those in care homes have been failed by this Government since the beginning of the pandemic. From woefully inadequate PPE—I had to deliver PPE myself to care settings—to inadequate testing, I am afraid that the social care sector has been treated with contempt. On top of a decade of underfunding, that has created a crisis within a crisis that is entirely of the Government’s own making.

Beyond the pandemic, long-term reform of the social care system is urgently needed. But for now, at the very least families should be able to see their loved ones, so I urge the Minister for Care to press forward with the pilot, to ensure that it begins as quickly and safely as possible.

Local Contact Tracing

Alex Sobel Excerpts

Wednesday 14th October 2020 Commons Chamber

[Rachel Reeves]

Local councils are desperate to take on the responsibilities from Serco. They are begging the Government: “Hand over the resources and the responsibilities, because we can do it better than you.” I will come later to the issues relating to what the Government are doing with tier 3 compared with the other tiers.

[Alex Sobel (Leeds North West) (Lab/Co-op)]

My hon. Friend and parliamentary neighbour is making an excellent speech. If local authorities undertake similar procurement, they have to utilise best value and have a social value framework. If they conducted procurement as the Government have, the Government would bring in commissioners. This is an absolute scandal.

[Rachel Reeves]

I could not agree more. My hon. Friend will know that in Leeds, which we both have the privilege of representing, with the expertise we have on the ground, our local authority and director of public health could be doing a much better job than Serco is doing. Indeed, when we have had local outbreaks in Leeds, it has been the local authority going out and knocking on doors to ensure that people know what is going on—something that Serco cannot or does not do.