NHS Funding Bill

Chris Bryant Excerpts

2nd reading & 2nd reading: House of Commons
Monday 27th January 2020 Commons Chamber

[Matt Hancock]

I can guarantee that the mental health funding will be ring-fenced; and I want us, from the House, to pay tribute to the hon. Lady’s mum.

We are going to have more nurses, and I am delighted that we already have a record number of registered nurses, a record number of midwives, a record number of nursing associates and a record number of nurses in training. If the current trends continue, 36,000 nurses will join the NHS each year from the domestic and overseas workforce, which means that we will have more than 140,000 new nurses by 2024. However, we need more nurses now, and we will have 50,000 more by the end of this Parliament. That is a critical manifesto commitment on which we intend to deliver.

We need the right number of nurses and we need them to have the right skills, with nursing increasingly becoming a highly skilled as well as a caring role. From September this year, we will give every student nurse a training grant worth at least £5,000 to support them in their studies and ensure recruitment and retention. We are also expanding the routes into nursing with more nursing associates and nursing apprenticeships, making it easier to climb the ladder to become a fully registered nurse, and prioritising the care of our nursing staff to encourage more of them to stay in the NHS.

Of course, that training grant will also apply to midwives, paramedics, dieticians and all allied health professionals. Too often, the media use “doctors and nurses” as shorthand, and sometimes, if I am honest, we do that in this House, too. We should instead recognise the essential contribution of our allied health professionals, without whom our NHS family is incomplete and on whom our increasing move to multidisciplinary teams depends. This £2 billion training package is in addition to the funding contained in this Bill.

Finally, as well as revenue and training, the NHS also needs more money for infrastructure. On that point, I will give way to the hon. Member for Rhondda (Chris Bryant).

[Chris Bryant (Rhondda) (Lab)]

My question is not about infrastructure. It is about the Secretary of State’s last paragraph, on the training element. He referred to the fact that we often refer just to “doctors and nurses”. Actually, radiologists are absolutely vital to ensuring, first, that you get a swift diagnosis of cancer and, secondly, that you get swift and proper treatment for it. The Royal College of Radiologists reckons that we will be 2,000 radiologists short by 2023. How are we going to fill that gap?

[Matt Hancock]

As in so many other areas, we are hiring. My response to hearing about problems of shortages is, of course, to use all the tools available to ensure that we help those who are currently working in the NHS—for instance, with new technology—but also to hire and train more.

--- Later in debate ---

[Chris Bryant (Rhondda) (Lab)]

I agree with many of the things that the hon. Member for Birmingham, Northfield (Gary Sambrook) just said, and I congratulate him on his speech. I slightly differ with him on the stewardship of the NHS under the present Prime Minister and the rest of the health team, but I am not going to stray too far into partisan politics because, to be honest, I have a profound worry about the future of the NHS. I think we politicians are sometimes too proud of the NHS. We puff out our chests and say, “What a wonderful nation we are. We have the best NHS in the world,” but too often we are not prepared to look at the nitty-gritty of whether we are really delivering for people around the country. I say that equally about Wales, England, Scotland or, for that matter, Northern Ireland.

Statistics never tell the whole story, but some of them show that we do not have the best NHS in the world. Cancer care has obviously already been referred to several times in the debate, and we have worse outcomes than nearly all the equivalent countries with a free health care system in the world. Australia, Canada, Denmark, Ireland, New Zealand and Norway produce markedly better survival rates for pancreatic cancer, lung cancer and rectal cancer. Even more markedly, the gap between us and those other countries, although we are improving, is not getting any smaller. Our complacency about the NHS is sometimes our biggest downfall.

There are all sorts of reasons why our cancer survival rates are not as good as they might be. Sometimes patients do not present early enough, for example. We in the UK, men in particular, are worse at presenting. In working-class areas, such as my constituency, men are much more reluctant to take things to their GP that others might immediately spot as being potential cancer symptoms. Likewise, GPs in many parts of the country are too reluctant to send people on for tests when they would have been sent for further examinations in other parts of the country or in other countries.

This country has half the number of MRI scanners per 100,000 people compared with all the comparators everywhere else in the world. It has already been mentioned that we need more radiologists, but we need more MRI scanners and other equipment, too. Wales has only one PET scanner, but if we were measuring ourselves against other countries, we would probably have seven or eight. We also have a shortage of radiologists. I said to the Secretary of State earlier that the Royal College of Radiologists reckons that we will need an extra 2,000 radiologists by 2023 just to cope with the demand that we currently know about. At this instant, there are more than 1,000 vacancies for consultant radiologists in England alone, meaning that people are being seen later than they need to be, scans are taking longer, people are getting their results later, and it is more difficult to provide treatment on time.

Three fifths—60%—of consultant radiologist vacancies in England have been vacant for more than a year. That also applies to histopathologists—the people who cut up the biopsy to check whether cancer is present—and only 3% of pathology labs in England reckon that they have enough staff at the moment, with 45% of them are relying on locums and agency staff. That, in the end, is neither good practice nor economically sustainable, because it is more expensive for the NHS. The figures can be replicated in so many other areas. There is a 10% shortage in consultant psychiatrists. One in six eating disorder posts are vacant across the UK—one in three in England—one in eight CAMHS consultant vacancies have existed for more than a year, and 25% of perinatal psychiatric posts in the west midlands are vacant as I speak.

The same situation applies to A&E. We simply do not have enough A&E consultants, and we are short of 1,500 across the whole UK. The Royal College of Emergency Medicine reckons that hospitals need to double their number of emergency consultants in the next few years, which means increasing the number of training places to at least 425. The Government have no plan to get anywhere near there at the moment.

All this has an impact on constituencies such as mine, even though it is in Wales, because we do not have enough A&E consultants. We should have roughly one for every 4,000 admittances. England is getting along with something like one for every 10,000 admittances. Some 180,000 people go to the three A&Es that are close to my constituency in Wales, so that should mean 45 consultants, but we have 10 and a half. In my local hospital, the Royal Glamorgan, there is one consultant, and he is leaving at the end of March, which means that our local A&E will be completely unsustainable.

The plans that the South Wales programme came up with in 2014 are undeliverable. We are going to end up with the most-used A&E on my patch, which sees 65,000 admittances every year, closing simply because there are no staff to staff it. It is not because there is no money, but because there are no staff. My patch has some of the worst levels of deprivation across the whole UK and some of the worst levels of health need in the whole of Europe, with high levels of ischaemic heart disease, high levels of diabetes, and poor health in every regard—every single measure of the health need that one can imagine. On top of that, we have the lowest number of people who have cars and are able to transport themselves to an A&E and mountains that are impassable in the winter. All that is going to make for an impossible situation for my constituents if the A&E at the Royal Glamorgan closes.

I am not laying blame anywhere. All I am saying is that we have to believe more in our national health service so that more people want to work as radiologists, pathologists or receptionists—the receptionist is sometimes the most important person in the cancer clinic, because they make sure everyone calms down and gets to their appointment when they are needed so that no time is wasted, and all the rest of it. We need to believe far more in our NHS if we are really to transform it in the years to come.

--- Later in debate ---

[Andrew Bowie]

I thank the hon. Lady for her intervention, but my figures were from the Scottish Parliament Information Centre, and that is a Parliament oft quoted by SNP Members. Moving away from funding, the story of the SNP’s record on the NHS in Scotland is also one of failed waiting time targets. The 12-week treatment time guarantee unveiled by Nicola Sturgeon when she was Health Secretary in 2011 has never been met—not once. For the quarter ending September 2019, just shy of 30% of in-patient and day cases were not treated within 12 weeks. The situation is even worse for my constituents living under the NHS Grampian umbrella, where more than a quarter of patients—34.6%—were not seen within the mandated 18-week referral time in the month ending September 2019. That is not the fault of the amazing people at NHS Grampian; how can they hope to meet targets when they are being so chronically underfunded by the SNP? According to the Scottish Parliament Information Centre, the 2019-20 cash allocated to the NHS Grampian health board was £7.7 million short of the target set by the NHS Scotland Resource Allocation Committee. The total shortfall over the decade for NHS Grampian is estimated to be £239 million.

I am sorry to say that the cancer waiting times are little better, with a fifth of people with urgent cancer referrals waiting more than two months for treatment. The target is that 95% of patients with urgent referrals are seen within 62 days, but this was met for only 83.3% of patients in the quarter ending September 2019. We have a GP crisis in Scotland—a shortage. It is shameful that the Royal College of General Practitioners expects a shortfall of 856 doctors across Scotland by 2021. There are delays to the promised Inverness medical centre, and fears over the same happening at the Aberdeen cancer and maternity units. There is a completed children’s hospital in Edinburgh, but it is sitting empty due to “ongoing safety concerns”. We also face a shameful, tragic situation at Queen Elizabeth University Hospital in Glasgow, where children have died and it has emerged that Health Protection Scotland reports had identified contamination risks as far back as 2016, with dozens of individual cases.

[Chris Bryant]

The hon. Gentleman says that in Scotland the figure is 82% in respect of people meeting the cancer treatment target, yet the figure in England is only 75%. I am not sure that throwing party political stuff around is going to make the blindest bit of difference to delivering for those people.

[Andrew Bowie]

I thank the hon. Gentleman for his intervention, and I tend to agree with him, but I have deliberately avoided getting into, “England is better than Scotland.”

[Dr Whitford]

indicated dissent.

[Chris Bryant]

indicated dissent.

[Andrew Bowie]

I am agreeing with the hon. Lady and the hon. Gentleman; I am trying not to get into that debate. What I am saying is that it could be better in Scotland. The SNP has been responsible for more than 10 years for the NHS in Scotland and it is missing its own targets and the service is underfunded. When SNP Members come into this Chamber to harangue, castigate and berate this Government for the record investment they are giving the NHS south of the border, perhaps they should look closer to home and sort the problems in Scotland, where they are failing to meet their own targets.

I know that Members from all parties, and especially on the SNP Benches, care deeply for the health and wellbeing of the Scottish people, as do I, but I ask them to bear in mind the record of the Scottish Government when they attack this Government, who are investing record amounts in the health service. I ask them to join me in welcoming the record boost to the block grant and calling for the NHS in Scotland to be funded to a level equivalent to the funding we are putting in here in England.

I welcome the Bill and hope that when the Scottish Government receive the unprecedented boost to the block grant made possible by Conservative decisions, they spend it wisely and where it is needed, fix the health service where it is broken up north, and invest in our healthcare workers, so that throughout the United Kingdom—in England, Wales, Scotland and Northern Ireland—we can have an NHS that all the British people deserve.