NHS (Contracts and Conditions)

Helen Hayes Excerpts

Monday 14th September 2015 Westminster Hall

[Helen Whately]

The hon. Lady is correct to distinguish clearly between correlation and causation, but I did feel that the tone of her remarks seemed to question the evidence of increased mortality over weekends and out of hours. I will say that I agree with her on the need for increased investment in IT to enable the clinical workforce to spend more time on clinical work. I agree with her on that point.

I have observed over recent years that the Secretary of State has championed the NHS. He has fought for its budget to be protected at a time when many other budgets have been cut. He has secured the Chancellor’s commitment to an extra £8 billion of annual funding by 2020, and he has truly focused on patients and clinical quality over finances and structures. I wonder whether any other Secretary of State has spent as much time with his sleeves rolled up in hospitals, not just listening to the sound of bedpans but actually emptying them.

I am a supporter of the Care Quality Commission and observe that three years ago it was close to collapse, but it is now widely praised, particularly by the acute sector. I know that GPs are unhappy about the inspections, but 70% of providers say that the CQC’s inspections have given them information that has helped to improve their service. That has been supported by the Secretary of State.

Along with that focus on quality and transparency, the Secretary of State is to be applauded for trying to improve the culture of the NHS—to make it more open, supportive and connected and to ensure that NHS leaders are in touch with patients and staff.

[Helen Hayes (Dulwich and West Norwood) (Lab)]

If the Secretary of State is doing the marvellous job that the hon. Lady suggests, why did so many of the front-line staff in our NHS, who work so hard day in, day out, take to Twitter to express their lack of confidence in him?

[Helen Whately]

I believe that the Secretary of State has done a good job of driving the NHS in the right direction, and I know that a large proportion of the workforce have been very supportive of him.

We are all in this room because we value the NHS, but we must not be complacent. We have to recognise when it lets people down. It is intolerable that if someone has the misfortune to get ill and be admitted to hospital at the weekend, they may be more likely to die. I am not going to repeat the statistics on that, because my hon. Friend the Member for Totnes (Dr Wollaston) helpfully updated us, and I suspect that my figures are not as recent as hers. She made a strong case, as have others, for why the NHS needs to have proper seven-day care, which must include the support services mentioned by the hon. Member for Warrington North.

The Royal College of Surgeons strongly supports seven-day care. It has said that one reason why outcomes are worse at weekends is that patients are less likely to be seen by the right mix of junior and senior staff; that such patients experience reduced access to diagnostics; and that earlier senior consultant involvement is crucial. Research from the NHS National Health Research Institute shows that 3.6 more specialists attend acutely ill patients on Wednesdays than on Sundays. More senior doctors need to be available at weekends—not just on call, as many consultants are at the moment, but present in hospitals.

The changes should not be about getting doctors to work intolerable hours, and that is not what is being proposed. As has been mentioned, only a small proportion of consultants exercise their opt-out. One could argue that the changes to the workforce, and to the consultant contract in particular, are about bringing the contract into line with what is actually happening. Looking at the terms of the workforce gives us an opportunity to ensure that there is an appropriate package for doctors in A&E, where there are large numbers of vacancies. That is the case in hospitals in and around my constituency in Kent, which is an area with a high proportion of out-of-hours work. It also gives us an opportunity to ensure that clinicians are recognised and rewarded for taking on management and leadership responsibilities. We really need clinicians to step up and take on those responsibilities. It gives us an opportunity to make sure that consultants are treated as professionals who take responsibility for their patients, their team and the whole service that they provide.

The NHS faces an incredibly tough time over the next five years. It faces rising demand for its services and rising expectations, and even with an extra £8 billion on its way, things will have to change. Senior doctors, along with senior nurses and other health professionals, will have to lead those changes. When I worked in hospitals grappling with the challenges of transformation, ideas came from everyone: junior doctors, senior doctors and patients. When it comes down to it, consultants, matrons and senior staff have to lead from the front and make things happen. They often face opposition from colleagues, so they need to be courageous and put in extra hours.

To ensure that that happens, and to get the NHS from where it is now to where we want it to be in five years’ time, there has to be a sense that we are all in it together. We cannot have a situation in which doctors blame managers and politicians, while politicians and managers point fingers at doctors. We absolutely have to move on and focus on doing what is best for patients, and what will achieve the best clinical outcomes. We have to build trust among all who are involved in healthcare and work out how we can have, and how we can afford, excellent care seven days a week, day and night. We have to support the healthcare professionals—consultants, nurses, managers and everyone else who is going to make that happen.

--- Later in debate ---

[Paul Scully]

The hon. Gentleman will also find that the NHS improved over those years. We were second when the Labour Government were in power, so we have improved, and more data are still coming through. That is backed by public confidence, which has gone up by 5 percentage points to its second-highest level in the period covered by the report. The number of people in England who think that they are treated with dignity and respect increased from 63% in 2010 to 76% last year, according to Ipsos MORI. Record numbers say that their care is safe, and the number who think that the NHS is one of the best systems in the world has increased by 24 percentage points in the seven years since Mid Staffs. That is a great base from which to start, but we need to continue working with healthcare professionals to secure the seven-day NHS that we need and people want to see. Shouting and using the NHS as a political football will not get us very far.

[Helen Hayes]

The hon. Gentleman talks about the need to work with NHS staff. One of my constituents, who is a trainee anaesthetist, wrote to me in great detail with her concerns about the impact of the proposed contract change. At the end of her email, she said:

“As a final insult, Simon Stephens, Chief Executive of NHS England, has announced plans to pay for fitness classes for NHS workers, to improve our health and reduce absenteeism. NHS staff are screaming out to be cared for so we can care for others—by employing enough of us on fair contracts, with adequate resources to do our jobs well. Zumba will not achieve this.”

Although there is nothing wrong with employers investing in fitness classes for their employees, does the hon. Gentleman agree that, in a crisis situation, this is simply adding insult to injury?

[Paul Scully]

In his King’s Fund speech, the Secretary of State talked about working with professionals, including the British Medical Association and other organisations, throughout September. That example is why we need to keep the dialogue going. I have seen nothing substantive in speeches by Ministers to pitch them into conflict with the vast majority of NHS staff. It is about change management. Change is always difficult, but change we must do. We can achieve much more together.