NHS (Contracts and Conditions)

Debate between Helen Jones and Helen Whately

Monday 14th September 2015 Westminster Hall

[Helen Jones]

In a moment. I want to make a little progress and finish this point.

That is a false economy. I make no criticism of the skills of the nurses we recruit from abroad, but it—

[Helen Whately (Faversham and Mid Kent) (Con)]

Will the hon. Lady give way?

[Helen Jones]

In a moment. The hon. Lady will have to curb her impatience for a little while.

I make no criticism at all of those nurses’ skills, but it is much better to be employing people here in this country. The only people benefiting from the current situation are the companies that supply agency staff. Indeed, one, Independent Clinical Services, saw its profits more than double, from £6.2 million in 2010 to £16.5 million in 2013. In other words, what the Government have done is a textbook example of a false economy.

[Helen Whately]

Does the hon. Lady acknowledge that between May 2010 and May 2015 the number of qualified nursing, midwifery and health visiting staff increased by 2.1%, at 6,622 additional staff?

[Helen Jones]

I am grateful to the hon. Lady for reading that out, but I referred to nurses in hospitals. The number of nurses working in hospitals has fallen under this Government, particularly in the top grades. The failure to train and recruit enough permanent staff is putting a great strain on those staff already in post, who are having to deal with agency staff all the time to make sure that they know how things work in a particular hospital or ward. That does not offer continuity of care for patients.

--- Later in debate ---

[Helen Jones]

I have just said the Government should publish their research and delve deeper into the figures. [Interruption.] Look, the hon. Lady knows that people admitted at weekend are, overwhelmingly, emergencies. That is the point. Their death rates cannot be compared with death rates on weekdays, when there is elective surgery—that is a basic point, which she needs to grasp.

If the Government really believe these things are happening, they need to find out why. As I understand it, death rates are taken over 30 days, so someone can be admitted on a Sunday and die 28 days later, on a Thursday. The Government need to prove cause and effect before they can make the link between admissions at the weekend and death rates. So far, however, we have not seen that from them.

[Helen Whately]

Will the hon. Lady give way?

[Helen Jones]

No, I need to make some progress.

What, exactly, is the Secretary of State trying to do? If he is trying to bring about a seven-day fully elective service, he needs to say so. As far as I am aware, no major health system in the world has managed to do that. If he is not trying to do that, he needs to tell us clearly—perhaps the Minister will do so when he winds up—which services he thinks should operate at the weekend.

The Secretary of State also needs to recognise that, to have the service he proposes, he needs not only more doctors, consultants and nurses on the wards, but back-up staff. Doctors operate by leading teams. If they do not have the ancillary staff—the people to do the MRI scans, the radiology and the lab tests—they cannot operate properly. We need to hear how the Secretary of State will implement his proposals. Will he recruit more staff, or will he worsen the terms and conditions of staff who are already not well paid, to introduce weekend working?

It might help to improve morale in the NHS if the Secretary of State refrained from attacking staff for not working at weekends, when they do, and actually negotiated with them sensibly. Staff know what is happening at the frontline, and they can best suggest the changes that need to be made.

--- Later in debate ---

[Helen Jones]

What I said, if the hon. Lady was listening, was that the Government have to dig behind those figures and find out the reason for them. Correlation is not causation. That is a very basic principle when we are looking at things such as that, and I would be grateful if she did not attribute to me words that I have not said.

[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.