Future of the National Health Service

Chris Green Excerpts

Wednesday 22nd September 2021 Westminster Hall

[Chris Green (Bolton West) (Con)]

It is a pleasure to follow the hon. Member for Leeds East (Richard Burgon). He made a powerful speech, true to his beliefs and values, and he made some powerful points.

It reminded me of my more radical background when it comes to politics, especially in terms of health. I remember attending—not participating in—a demonstration and march in 2011 in Chorlton, shortly after the new Government came in. It was a reasonably left-leaning march and there were a few Soviet Union flags with the hammer and sickle. One of the most powerful contributions was from a trade union rep, who said, “We don’t need change. We don’t need innovation in the National Health Service. The only change you ever needed in the NHS was in 1948 when it was created. We don’t need any change from then.” That was the spirit, and it is the view that too many people have.

The NHS ought to be changing all the time, in different ways, to keep up with the way people work, and with technology and culture. There are so many ways in which the national health service ought to be changing all the time. We need legislation, led by my hon. Friend the Minister, to make sure that we keep up with changes in society. People would be outraged if we had not moved on culturally from 1948.

What does that lead to? Fundamentally, we ought to be focusing on the importance of patients’ values and needs, to make sure that they are at the centre of the national health service. It is not fundamentally about NHS structures, although those are incredibly important, or about maintaining structures as they are forever, but about ensuring that those structures reflect the needs of the national health service so that it is as effective as possible.

We hear discussions and talk about globalisation, which we know is a reality. Many parts of globalisation are a threat, as highlighted by the hon. Member for Leeds East, who talked about the threats and concerns. However, there are also significant opportunities. We want better access to drugs and medicines, especially innovative drugs and the latest drugs. If we look at figures from the European Medicines Agency about the adoption of drugs, we see that England is behind Germany, Denmark, Austria, Switzerland and Italy. We ought to be at the forefront of the adoption of new drugs and new ways to look after people’s lives.

What do we need to understand when we are thinking about this, especially when we consider treatments and support for people with rare conditions? The UK is often not big enough to provide the innovation for these new treatments, so we need international collaborations. The national health service and other UK bodies need to work with countries around the world, but there is a place for corporations, whether in America, Japan or other places.

We need to ensure that our research and development effort collaborates and works with countries around the world. That cannot be on a Government-to-Government or Government agency-to-Government agency basis only. It has to be right through the system. If we do not have that approach where we need clinical trials at scale to support people or to find new treatments for people with rare diseases, it will not happen. We need to participate in international trials as well.

I would expect these things and I hope my hon. Friend the Minister will articulate that they give more potential to the national health service, because we need more engagement. At the moment, the national health service does not function in the way that many people around the country believe it ought to function. It ought to be far more engaged in clinical trials. Talking to many people from the sector, my sense is that that is down to individual leadership in particular trusts.

Too many trusts do not lead and participate in innovation or the adoption of new drugs, once they have been approved. The system is too slow and it often takes far too long, so patients and patient groups know that their trust or clinical commissioning group does not have the life-enhancing or even life-saving treatment that is available. We need that reform of the system to ensure that it looks after the patients.

There is another aspect that needs changing, which is the way that the NHS is funded or operates. I have a strong sense that it is relatively straightforward for the NHS to adopt a new drug. However, it is far more challenging for the NHS to adopt a new medical device because of the up-front costs and the training needs at the beginning. It is more difficult to adopt a device than it is a drug, and we need to have parity in that. We need the NHS to have the ability to adopt these devices and adapt to them.

That naturally leads on to what devices do. A key part of devices is the generation of data. Data is important for understanding the performance and ability of new treatments to make a difference to people’s lives. The NHS does not operate, to any extent, as a system that works and engages properly and fully with data systems. We need reform of the NHS to do that.

[Hannah Bardell (in the Chair)]

Order. I hope the hon. Member will wind up his comments shortly.

[Chris Green]

I will. The integrated care systems ought to be part of this, with local leadership, and hopefully strong accountability, to ensure that leaders in those areas can drive that engagement with medical research technology charities, corporations, institutes and universities, to ensure that the NHS is innovative, adopts new technologies and ensures that patients have the best they can. That is a huge amount of reform, and it must start now.

--- Later in debate ---

[Edward Argar]

The hon. Lady has rightly highlighted the benefits of technology, while my hon. Friend the Member for Bolton West (Chris Green) highlighted the need for us to continue to move with the times and seize those initiatives. I fear that my noble friend Lord Bethell will not be visiting, as he left the Government at the end of last week. However, I have received a very kind invitation from the hon. Member for Central Ayrshire (Dr Whitford) to come and see how the NHS in Scotland is innovating and driving change. I look forward to taking her up on that invitation as soon as I can.

[Chris Green]

Just as medical devices and drugs innovate change over time, does the Minister agree that the place where the NHS operates and works must also change? Whether those are local surgeries or hospitals, they have to move with the times. In that context, would he also turn his mind to any needs that Bolton Royal Hospital may have in terms of new hospital infrastructure?

[Edward Argar]

My hon. Friend makes a fair point about the need for us to create the conditions—the physical spaces with the technology—in which the workforce, which is the heart of our NHS, can work. He makes a subtle—or not so subtle—plea for his own local hospital. He will not be surprised that I will not comment on the detail of that.

To finish my response to the hon. Member for Strangford, the Command Paper recognises the challenges posed by the current arrangements in the Northern Ireland protocol around the supply of medicines and other goods, for example. The approach that the hon. Member set out, of removing medicines and medical devices from the orbit of the protocol, is reasonable. I hope that discussions between the European Commission and Lord Frost are productive, and that a consensus can be reached on the way forward.

I have to take issue slightly with the hon. Members who raised the role of Sam Jones, one of the Prime Minister’s advisers. They focused on one particular aspect—that for a brief period she worked for an independent provider. What they did not do, which is extremely unfair to a dedicated public servant, is highlight that she worked for NHS England, running new care models; that she has been an NHS paediatric and general nurse; that she was the chief executive of Epsom and St Helier University Hospitals NHS Trust; that she was the chief executive of West Hertfordshire Hospitals NHS Trust; and that she was the Health Service Journal chief executive of the year for 2014 and was highly commended for her work in driving forward patient safety. I gently say that it ill behoves Members of the House to attack public servants, who cannot answer for themselves in this Chamber, with partial references to their careers rather than recognising that they have contributed a huge amount in the past.

The hon. Member for York Central was absolutely right to highlight health inequalities as one of the greatest challenges—not the only challenge—that we face as a society and as a health system. The measures on integration and change in the Bill will help us tackle those health inequalities. I suspect that on Report and Third Reading she may test and challenge me on those assertions and assumptions, but she is absolutely right to highlight the centrality of health inequalities.

The hon. Member for Liverpool, Wavertree (Paula Barker) spoke about residential care and the link to social care. While I am not the social care Minister, everything that I do in my role as Health Minister must have an eye to social care. I was a cabinet member for adult social care in the dim and distant past, when I had rather more hair, and I also sat on the primary care trust, as it then was, at that time. I recognise the need for those two parts of the system to work together to achieve the best outcomes for our constituents. She makes a valid and important point.

I found what the hon. Member for Wirral West (Margaret Greenwood) said about the US experience of great interest and instructive, but it is utterly divorced from what the Bill and the Government are doing in respect of our NHS. It was an interesting reflection on what is going on in America, but it certainly does not bear any resemblance to what is happening or will happen in this country.