NHS Pay

Jamie Stone Excerpts

Wednesday 24th March 2021 Westminster Hall

[Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)]

In the time-honoured words, it is a pleasure to serve under your chairmanship, Mr Hosie, and to see you in rude good health. To follow that, if I can—almost everything has been said—I heartily congratulate the hon. Member for Liverpool, Wavertree (Paula Barker) for securing this debate.

Let us take this down to brass tacks. First, one of my best friends very, very nearly died of covid, and it was NHS staff who hauled him back from the edge. He is a pal of mine and, in a personal way, I am deeply grateful. All of us will have had similar experiences.

Secondly, it is a sad, true fact that another pandemic will come one day, because that is the nature of human life and the world—these viruses mutate and will come at us again. Therefore, we want to be even better prepared next time, so we have to have our NHS staff at tip-top levels of performance—they have to be absolutely ready. There is no doubt that if people do not get the pay they think they deserve, or the public, in this case, think they deserve, that demoralises NHS staff. When they are demoralised, some people will leave the profession; they will retire early and pack it in, and that is not what we want. As others have said, the general public expect better than 1%. In the Scottish Parliament, Liberal Democrat colleagues will work in a positive way with the Scottish Government to secure a better deal—pay is of course devolved north of the border.

I have one lesson, which relates to when I came to this place nearly four years ago. I said to myself then, “What was austerity all about?” I say that because, now that we have gone into the pandemic, money seems to just appear. So my final point is that the Government can give a better pay rise than 1%—it can be done. Strategically, for the health of the nation, and for the defence of the nation against a killer virus and another pandemic, that should be put in place as soon as possible.

--- Later in debate ---

[Justin Madders (Ellesmere Port and Neston) (Lab)]

It is a pleasure to see you in the Chair, Mr Hosie. I thank my hon. Friend the Member for Liverpool, Wavertree (Paula Barker) for securing this important and heavily subscribed debate today. She gave an excellent, impassioned introduction. She summed the issue up very well when she said that NHS staff are being asked to do more for less. That really does sum up the Government’s approach to a lot of things: more for less.

I thank all other hon. Members for their contributions today. There are too many to mention individually, but I will pick out one or two during my speech. I particularly thank my hon. Friends the Members for Luton South (Rachel Hopkins) and for Birkenhead (Mick Whitley) for co-sponsoring the debate.

Every Member spoke with great passion, sincerity and knowledge about why the Government’s approach to the NHS pay deal is flawed. It is disrespectful and ultimately self-defeating. Members who spoke showed clear support for and appreciation of the NHS workforce. Every single Member had that in common. They also have in common that they are all from Opposition parties. Not one Back-Bench Tory MP has come today to defend their party’s policy—not one. Worse still, not one has come to defend the NHS workforce. That says it all, doesn’t it?

I am sure we all agree, certainly among Opposition Members, that our amazing NHS staff have been the ones who have kept this country going during the pandemic, who have kept us safe and who have looked after our loved ones. They have been on the frontline looking after not just the 450,000-plus people who have been hospitalised with coronavirus, but everyone else who has needed medical attention, while at the same time putting their own lives on the line. Our NHS staff are feeling the strain. Do not forget that we entered the pandemic with a record 100,000 vacancies in the NHS, and with a health workforce smaller than many other countries, meaning that our NHS staff have worked longer and harder than others during the covid crisis.

For many people, the added pressure has had a profound impact on their psychological wellbeing. Almost half of NHS staff in England have reported feeling unwell from work-related stress—the highest rate recorded in the past five years—and NHS staff took 3.5 million sick days off between March and October last year due to mental health issues. The latest figures from the NHS staff survey, published this month, show that 300,000 staff have worked unpaid hours, and that almost 13,000 more staff reported working unpaid overtime compared with 2019, suggesting that over 1 million hours of unpaid overtime have been worked during this pandemic. It is little wonder that NHS staff are exhausted and that they are leaving.

My hon. Friend the Member for Liverpool, Wavertree made a strong case that pay increases can have a positive effect on retention levels, which is something that urgently needs addressing. The Minister will know all about the shocking number of healthcare staff who have left their NHS roles for better pay conditions and work-life balance in recent years, because she has seen the data—it is the Government’s own data that say this. She will be well aware that over the last year, 31,000 nurses and health visitors left the NHS—an increase of 50% since 2010-11.

[Jamie Stone]

Will the hon. Gentleman give way?

[Justin Madders]

I am sorry, but I will not have time to take any interventions.

The Minister will know that since 2010-11, there has been a 181% increase in nurses and health visitors resigning due to their work-life balance, and an 82% increase in the number leaving for health reasons. She will be aware that there has been a 57% increase in resignations since that time because people found a better reward package elsewhere.

Years of pay freezes, record vacancies and relentless pressure have had a devastating effect on our NHS workforce. Not surprisingly, as a last resort, hard-pressed staff are voting with their feet. That should ring alarm bells loud and clear that Ministers are not getting things right, that they need to change course and that they need to start listening to the NHS workforce. It is simply unacceptable that instead of giving our NHS staff the pay rise that they were promised, the Government are recommending that they should receive just 1% this year, an amount that the Government are fully aware is actually a real-terms pay cut. NHS staff are not being properly rewarded, as the Secretary of State said they would be. That is not what is set out in the legislation passed by this House, which the Government voted for in the NHS long-term plan.

As the Minister knows, the plan set out a 2.1% pay increase for all NHS staff. The head of NHS England, Sir Simon Stevens, has confirmed that the NHS did indeed budget for that 2.1% pay rise, so the Government have broken their promise. The Office for Budget Responsibility forecasts that inflation will rise by 1.5% this year, so instead of a pay rise that was budgeted for and indeed voted for, NHS staff will see a real-term pay cut of hundreds of pounds. Experienced nurses will see a paltry £3.50 per week extra in their pay packet, which is just 50p a day. My hon. Friend the Member for Worsley and Eccles South (Barbara Keeley) told of a healthcare worker who will get 9p an hour extra.

Counting for inflation since the Conservative party took power in 2010, some NHS workers have seen their pay slashed by thousands of pounds a year. The starting salary for nurses, physiotherapists, radiographers and numerous other NHS roles has seen a real-terms pay cut of £841 per year, and average salaries have reduced in real terms by around £2,379. That is not being properly rewarded; it is not being rewarded at all. It is not good enough for those who have performed heroically over the last year to be rewarded in this way. For many, a real-terms pay cut will be the last straw. My hon. Friend the Member for Sheffield, Hallam (Olivia Blake) made the point that we are in an international market for healthcare staff and cannot afford to be complacent in such matters.

It could not be clearer that we need investment in our workforce. Waiting lists have spiralled out of control, and we will need the staff more than ever. The Government urgently need to reconsider their approach; otherwise, the exodus that we are seeing at the moment will become a flood. Hon. Members, the public, UNISON, other unions, the NHS Confederation and other bodies are all urging the Government to reconsider their 1% pay rise proposal, so what is stopping them? It cannot be a lack of money, because, as we have heard, £37 billion can be found for Test and Trace, millions can be spent on unusable PPE, and we have had £2.6 million for the Prime Minister’s new media centre. It is a political choice, and it is a choice that cannot be defended. Indeed, as we see today, it seems that no Conservative Back Benchers want to defend it.

I am sure that the Minister is well aware of the anger the proposals have generated, but let me read out a few quotes from bodies representing the workforce so that she can see the strength of feeling. The British Medical Association said it is a

“total dereliction of the Government’s moral duty”

and a kick in the teeth. The Royal College of Nursing said:

“This is pitiful and bitterly disappointing”

and “dangerously out of touch”. Unison said it is the “worst kind of insult” and “some kind of joke.” The TUC said it is

“a hammer blow to staff morale”

and Unite described it as “unyielding contempt”. So I do not think there is any mistaking how NHS workers feel.

That mood is matched by the public, who overwhelmingly oppose the Government’s position. A poll showed that 83% of the public and 78% of Conservative voters think the Government should increase their pay offer. For a Government who routinely pit people against one another when it comes to pay, that must surely tell them they are on the wrong side of the argument. If it does not, they must surely know they should think again when the former Health Secretary, the right hon. Member for South West Surrey (Jeremy Hunt), calls their offer a “miscalculation”. As understatements go, that is right up there. We do not know whether that view is widespread on the Tory Benches, because no Conservative Member is here to tell us what their view is. I am not surprised that the Prime Minister wants to avoid putting the proposals to a vote, because how could any Conservative Member look their constituents who work for the NHS in the eye if they vote for that? I do not know.

It should not have come to this. The Government really need to think again. The whole country is watching and waiting for them to do the right thing. It is not enough to say, “Wait for the pay review body” without giving a guarantee that, should the pay review body recommend a real-terms pay rise, that will be honoured by the Government. If the Minister confirms at least that today, that would be a start.

After the last year, we should not have to fight a battle to ask the Government to consider more than a 1% pay rise. It says everything about how little value those efforts over the last year have been appreciated. Our NHS staff deserve more than that. They deserve an agreed fair and sustainable pay settlement. Ministers should admit their mistakes and undertake to agree a multi-year pay deal with NHS staff. In starting talks, they should take the pay cut off the table and not set a ceiling. Time and again, the Prime Minister said that the NHS would not pay the price for the pandemic. The Chancellor promised that the NHS would get whatever it needed. It is time to put those words into action. It is time to ditch the empty promises and gestures. It is time to do the right thing.

We stayed at home to protect the NHS. We clapped for our carers during the pandemic, and we on the Opposition side meant it. As my hon. Friend the Member for Liverpool, Wavertree said, claps and smiles do not pay the bills. That is why the Opposition will not rest until our brave NHS staff get fair pay and the long-term settlement that they truly and honestly deserve.

Covid-19 Update

Jamie Stone Excerpts

Tuesday 2nd March 2021 Commons Chamber

[Matt Hancock]

Yes. The proposed work, as set out by the Prime Minister at the UN General Assembly, which we are working on with our presidency of the G7, aims precisely to build on and strengthen the existing work that is under way. However, clearly we need to ensure that all the future risks, whether they are from zoonotic diseases or are due to environmental changes that lead to risks to human health, are taken into account and we need to have an early warning system that is as effective as possible.

[Jamie Stone (Caithness, Sutherland and Easter Ross) (LD) [V]]

This very afternoon, I am going to get a jag—a “jag” is a Scottish term for a vaccination, not a posh car. Getting the maximum number of people in the highlands vaccinated as fast as possible is crucial to the reopening of businesses in my constituency, including those in hospitality and tourism. Will the Secretary of State give the maximum encouragement to the Scottish Government to make sure that that happens?

[Matt Hancock]

The vaccination programme is a successful UK-wide programme. We work very closely with the Scottish NHS and indeed the Scottish Government to make sure that right across all these islands we have the vaccination available fairly, according to clinical need, as fast as we possibly can. We can deliver this because we are one United Kingdom, with the buying power and scientific capability that comes from being one United Kingdom, all working together; this simply would not be possible if there were the separation that some propose. I will do everything I can to ensure that businesses and residents in Scotland get the protection from the jab that they deserve at an equal pace to everywhere else in this country. It is a crucial part of getting all of us on the road to recovery.

National Security and Investment Bill

Jamie Stone Excerpts

Report stage & 3rd reading & 3rd reading: House of Commons & Report stage: House of Commons
Wednesday 20th January 2021 Commons Chamber

[Stephen Kinnock]

With apologies, Madam Deputy Speaker, I am indeed finishing now.

Protecting our national security is just one element of protecting, nurturing and developing the sectors that are vital for the future. Technology sovereignty will be the defining issue of the coming decade. The economic dislocation we have seen from covid means that the case for action is stronger and more urgent than ever.

[Jamie Stone (Caithness, Sutherland and Easter Ross) (LD) [V]]

I shall heed your remarks, Madam Deputy Speaker, and try to keep my contribution short. In truth, I have not been involved thus far in this Bill, but I am my party’s defence spokesman and I therefore take a view on it.

Given the constituency I represent at the very top of the British mainland—north coast, east coast and west coast—I intuit from what I see that the Russian navy is no stranger to those waters. Therefore, the defence of the realm is in my mind personally as well as in speaking in the Commons. As I have said many times before, we do, alas and alack, live in a world where there are states that are not about the best interests of the United Kingdom. As other speakers have said, we see the Chinese threat and we see the Russian threat. It is within that context that I say what I say.

I want to make three or four very general points; as I say, I will try to be fairly speedy. The first is about the amendment that seeks to place an annual security report before the Intelligence and Security Committee. Yes, we have heard that the Government are proposing to bring in something similar to this amendment in the upper House, but it would be no bad thing for us to agree on it at this stage, and then let us see what the Government come back with if they decide not to accept it. In recent days, we have seen on the other side of the Atlantic the whole notion of parliamentary democracy come under some challenge. Here in the mother of Parliaments, the idea of Parliament as supreme and of reports brought back to Parliament is very much a part of our democracy. It is a vital mechanism in securing the way we do things nationally and our freedoms.

On the Chinese point, the sale of DeepMind to Google, and Arm, which will go to NVIDIA in due course, is regrettable, to say the least. Let us make no mistake: this is a quite deliberate act by China and other Governments who are hostile to us. At the end of the day, there are front organisations that are trying to get a grip on cherry-picking those parts of the British economy that are fundamental to our workings. That is extremely dangerous, to say the least.

The scope of the public interest test is important to the Liberal Democrats, as we have been saying for a long time. First and foremost, this Bill, which I support entirely, is important to the safety of the realm—to protecting British interests—but at some stage I would like the public interest test to be broadened out. Mention has been made of China. We know how incredibly badly the Chinese are treating their Muslim minority in the west of the country. It amounts to something approaching genocide: let us not muck about with this. When companies buy up a British company or business, I would like the public interest test to be applied, for instance, on child labour and on modern slavery. The trade deals should be examined in that context as well. At the end of the day—we have said it many times in the House of Commons and the House of Lords—we disapprove entirely of the way in which the Chinese have treated the Uyghurs. We have to try to take action to try to influence that. If we can stymie a trade deal on that front, that might be a very good move for the future.

I have discovered—it is a curious factor during my three years in the Commons—that on defence matters there is often broad agreement across the House, which is very encouraging. The idea of constructive opposition is important, and what comes back from the upper House will be of extraordinary interest. I hope that the lesson has been learned, and that when the Bill is enacted there will be a sensible approach to stopping the repetition of DeepMind and the sale of Arm. I give huge credit to the Chairmen of the Foreign Affairs Committee and of the Intelligence and Security Committee, who have worked assiduously, as have their Committees, on a cross-party basis, to protect the best interests of our nation. There I shall conclude my remarks.

[Katherine Fletcher (South Ribble) (Con)]

I join the hon. Member for Newcastle upon Tyne Central (Chi Onwurah) in paying tribute to all the members of the Bill Committee. The room may have been cold but, to be fair, the debate was not. I extend my thanks not only to the Front-Bench spokespeople but to all the Clerks and everyone who made that happen.

What occurred to me as I shivered, with the Thames windows open in the Committee room, was that, as my hon. Friend the Member for Tonbridge and Malling (Tom Tugendhat) pointed out, this is flipping important, but there is a risk of it becoming dry and remote. I hope that the House will bear with me if I try to bring it to life for people who spend the day on their phone and are not aware of some of the business takeovers that have occurred or of the actions of foreign states that are hostile to us.

I want specifically to speak to new clause 5 and the attempt to seek clarification on the definition of national security. In the spirit of clarity, let me take a step back to take a step forward. What does the Bill do? It enables us to catch up with nations such as America, Australia and Canada, in protecting us from threats from people overseas who try to use business and ideas, candidly, to do us harm. It gives us a legislative framework to address that, and I echo the comments of many Members to put stickers on how important that is.

The Bill gives the Government powers to investigate properly business deals that look a bit fishy or are much worse than that. National security can sometimes end up sounding like that bit in “Men in Black” where, all of a sudden, the sunglasses go on and the pen comes out. What does it mean? To me, it is not a static thing or concept—it is a fast-changing world. In seeking to define it, as new clause 5 does, we risk flagging to our enemies what the “it” of national security is, thus making a big pointy arrow saying, “Go and over there and do this, because we are not thinking about that as a Government at the moment.” The Government need flexibility to be nimble as threats evolve.

To explain that, let me give a hypothetical example. A small firm is curating a TikTok feed and videos on its channel, gaining ad revenue. It is not a huge business—a couple of people—but it is doing quite well. Those videos are funny and political, and are often further left of centre than me. They imply that I, as a Conservative, have only awful motivations for the decisions that I make in this House. Well, such is life. This is the lot that I picked, though, as an aside to the youth of today, I would like to point out that if they are getting their messages from people who are only giving them one side of the story, they should think about it quite hard, because there are always two sides to the story.

Covid-19: Effect on People with Learning Disabilities

Jamie Stone Excerpts

Tuesday 15th December 2020 Westminster Hall

[Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)]

Thank you, Ms Ghani. In the time-honoured words, it is a pleasure to serve under your chairmanship. From the bottom of my heart, I thank the hon. Member for City of Chester (Christian Matheson) for bringing forward this debate. I know from my three and a half years’ experience in this place that he treats any subject that he chooses with sincerity and dedication. That is recognised across the House, and we are thankful for that.

I will make the slightly boring point, which many Members have heard me make before, that I represent the most remote and distance-challenged constituency in the UK—or one of the two most remote. Therefore, when it comes to connectivity and empowering people who have learning disabilities, there is a big challenge because we do not have 3G in many places and people just cannot go online. I think I am duty-bound to put that on the record. Hopefully, between the Scottish Government and Her Majesty’s Government in Westminster, we will eventually address the issue. In the meantime, I have that fundamental stumbling block that gets in the way of it all.

It is very easy in one’s family life to think that learning disabilities are for others. People do not think that it is going to come close to home, but in my case it did. My daughter—can you believe this, in this day and age?—went undiagnosed as dyslexic until she went to college. On her first or second day, she came back with that astounding news and said, “They say I’m dyslexic, and I am getting a free laptop.” That empowered her in a way that she had never been at school. She struggled with written answers, getting the letters in the right order and so on. That is not a very severe case, compared with what the hon. Gentleman has been talking about, but it brought it home to me that the idea that technology can tackle this issue is for real.

I give credit where it is due. It would be very churlish of me not to say that I welcomed the Chancellor of the Exchequer’s announcement in the spring that he would be scrapping VAT on electronic publications, which was a seriously good move. With that in place, the challenge remains how we get the electronic publications to work on a Kindle or whatever people use. I will not repeat myself on that, as I think enough has been said for the record.

I move on to a second personal anecdote. I have been within my family bubble during this wretched pandemic and have found myself in situations with relatives young and old—I make no apology for digressing into the issue of older people, because they are connected—who say, “I have my desktop computer,” or iPad, or iPhone, “and it’s been great, but I’ve been sending emails and they’re not going anywhere. I don’t understand.” I have had to say, “I’m afraid they have gone to the outbox.” I have to sit down and say, “This is what you do.” Just a few days ago, someone said, “I have a Zoom meeting with a loved one, but I don’t know how to work Zoom.” I would then sit down and say, “This is how you do Zoom. This is what happens.”

My point is that there are people with learning disabilities in remote parts of my constituency. If they have a connection, that is great, but to start it all off they need the tuition. They need somebody who can come in and say, “This is what is not working for you,” because the collapse in morale when the iPad or whatever does not work is almost counterproductive. It leads to people putting the device on a shelf and saying, “I’m not going to bother with that. I’ll just be lonely and miserable.”

There are two points that I want to make to our friend the Minister. The first is that, in a general sense, it would be good if we were sure that professional carers, either state or private, who go out to help people young or old had an element of IT training, so that as and when a person has been helped to dress, or whatever the need was, the carer can then say, “Ah, you’ve got a problem. Let’s see what I can do for you. This won’t take two minutes.” That would be good.

My second plea is about the provision of services for people with learning disabilities, regardless of whether they live in Strangford, the City of Chester or the highlands of Scotland. We have a great expression in Scotland, which the hon. Member for East Kilbride, Strathaven and Lesmahagow (Dr Cameron) will know: we are all Jock Tamson’s bairns—we are all John Thompson’s children. It means we are all the same; we are all egalitarian. That is something we hold dear to our hearts in Scotland. We are all Jock Tamson’s bairns, regardless of whether we live north or south of the border, or whether we live in Wales or Northern Ireland.

My plea is for a co-ordinated approach between Her Majesty’s Government and the devolved Administrations to tackling this issue, because learning disability is no respecter of borders. People with learning disabilities have a fundamental human right to a quality of life, which the technology can offer. As the vaccine is rolled out, and as we have discovered what we can do with virtual technology, the challenge for the Government is to ensure that the technology now sticks and remains in place to benefit people with learning disabilities. This debate is about offering such help to the youngest, but we should also extend it to older people—although I am chancing my arm on that one.

Oral Answers to Questions

Jamie Stone Excerpts

Tuesday 17th November 2020 Commons Chamber

[Matt Hancock]

I am very happy to look into that idea, while making sure, of course, that we also have the availability of staff, which is critical. We have just had two questions from Stoke-on-Trent. Let me say how much I appreciate the work of everybody at the Royal Stoke, who I know are doing so much. There are difficult circumstances there because of the second wave, which is quite significant in Stoke. I thank everybody at the Royal Stoke for all the work they are doing.

[Jamie Stone (Caithness, Sutherland and Easter Ross) (LD) [V]]

I was very pleased by the Secretary of State’s answer to me last week that the vaccine would be rolled out on a needs basis. As the House knows, I represent a vast and very remote constituency. What worries me is the thought of elderly and vulnerable constituents having to travel long distances to get the vaccine. Health is devolved in Scotland, of course, but what proposals does he have for England and Wales to take the vaccine to those people who are elderly and vulnerable, and will he share that methodology with the Scottish Government?

[Matt Hancock]

Yes, I would be happy to do that. We are proposing roving teams who can get out into rural communities across England. I know that there are ongoing discussions between those in the NHS in England and in Scotland who are responsible for the deployment of the vaccine. However, it is a critical principle that it should be deployed according to clinical need, not according to where people live across the United Kingdom.

Covid-19 Update

Jamie Stone Excerpts

Tuesday 10th November 2020 Commons Chamber

[Matt Hancock]

Yes. I know Stoke-on-Trent’s hospital and I think that the people who work there do a brilliant job. They are a great team that works so closely and well for the people of Stoke-on-Trent and, indeed, Newcastle-under-Lyme. Stoke has got an outbreak under control a couple of times in this virus. In fact, it had a second peak in the summer, which it got under control, so this is really the third peak in Stoke. Stoke-on-Trent City Council worked closely with us on the early roll-out of mass testing in a pilot even before Liverpool. I thank everybody at the Royal Stoke for all their hard work and I urge everyone in Stoke and across the country to respect social distancing and follow the rules, because that is the best way to support our NHS.

[Jamie Stone (Caithness, Sutherland and Easter Ross) (LD) [V]]

Clearly, I represent a vast and extremely remote constituency in which there are groups of elderly people who are potentially vulnerable to covid-19. When the Secretary of State talks to the Scottish Government, will he make sure that such people are reached out to with the vaccine? It would be too bad if one part of Scotland were to lose out against another as it was rolled out.

[Matt Hancock]

Yes. Our principle is to roll out the vaccine across the whole of the UK according to clinical need, and that is what we should do.

Oral Answers to Questions

Jamie Stone Excerpts

Tuesday 6th October 2020 Commons Chamber

[Matt Hancock]

The covid-19 app has now been successfully downloaded by around 15 million people, including my hon. Friend’s father. Every extra person who downloads it helps to keep themselves safe and keep others safe. I urge everybody in this House to download it—I hope you have, Mr Speaker. It is one of the tools in the armoury, and everybody can play their part in keeping this virus under control by downloading the app.

[Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)]

As you can imagine, Mr Speaker, I was astounded to be told that people living in Devon were being advised to go to Inverness for a covid test. Can the Secretary of State reassure me that a truly collaborative effort is being made by Her Majesty’s Government and the Scottish Government to beat this virus?

[Matt Hancock]

Yes, absolutely. The testing facilities are one example of that. Testing facilities across the UK work very closely with the Scottish NHS, to ensure that people can get a test as close to them as possible. I think we have reduced the problem of people being sent to Inverness, but we continue to work to increase the capacity in Inverness and right across the country.

Health and Social Care Workers: Recognition and Reward

Jamie Stone Excerpts

Thursday 25th June 2020 Commons Chamber

[Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)]

May I say how delighted I am to be back in this place? For the last period of time, I have been working, rather like Harry Potter, under the stairs of my home in the highlands. Whether that has affected me as an hon. Member is up to others, from all parts of the Chamber, to decide.

By definition, health is devolved in Scotland, so my remarks will be pertinent to Scotland, but they may have a wider application to England. Of course, my colleague the hon. Member for Twickenham (Munira Wilson) will be enlarging on our party’s position in the rest of the UK. As my colleagues on the Back Benches have said, the notion of an award—a gong, a medal or a ribbon with something on the end of it—without a whole-scale review of pay and conditions is just not on.

I want to make several comments about conditions, and to quote two people. On occasion during the pandemic, from under my staircase in my home, I have telephoned Dr Alison Brooks of the Princes Street practice in Thurso, in the very far north of Scotland, and she gave me sage advice at all times. Today she said this to me about the nurses with whom she works. She knows of a nurse—a friend of hers in Glasgow—who has worked 10 night shifts on the trot just to cover the job, because colleagues were sick. Dr Brooks said to me, “Remember, NHS staff don’t just walk away; they go above and beyond. They feel a moral obligation.”

Dr Brooks encouraged me to think about the toll that it takes on NHS staff when they know that they have been in a risk situation, albeit with the best of equipment, but they go back to their families, loved ones and young ones with the niggling fear at the back of their minds that they might bring the virus back with them. When we reflect on pay and conditions, we must think about how we cover sickness absence.

My second example is from a nurse from Wick in Caithness who worked in the high-dependency covid ward in Raigmore for the duration of the pandemic. This is what she wrote to me:

“My suggestion would be that there could be skills based tiers within bandings. For example: one for those who have little clinical responsibility and/or skills; one for those who have advanced clinical skills and responsibility.”

She says that the doctors cover the advanced stuff, but very often the doctor will have to cover the entire hospital, so they have to make clinical decisions. Perhaps remuneration for such people should be fine-tuned within the banding.

I conclude with this. When I was a councillor, a long time ago, my colleagues gave me the area chairmanship of social work because they thought that nobody else would want it. Remember that social work may be seen as a Cinderella service, and we must sort that out in the review.

--- Later in debate ---

[Justin Madders (Ellesmere Port and Neston) (Lab)]

I congratulate my hon. Friend the Member for Newcastle upon Tyne North (Catherine McKinnell), the Chair of the Petitions Committee, on introducing the debate and brilliantly articulating the many issues relating to the recognition and reward of health and social care workers. I thank all those who have signed the four petitions, which have so far amassed some 290,000 signatures between them. By doing so, they have brought this very important debate to Parliament today.

This debate comes at a particularly poignant time, when health and social care workers have been at the heart of the fight against coronavirus, working day and night to protect the NHS and save lives. They, and all the key workers who keep this country going, are the very best of us. I want to take this opportunity to once again pay tribute to the hundreds of NHS and social care staff who have lost their lives to the virus. I hope that when this is over, we can find an appropriate way to remember the frontline staff who gave their lives in the line of duty.

This was a heavily subscribed debate, and it was clear from every Member who spoke that the gratitude the whole country feels for our health and social care workers is replicated in this place. We had some superb speeches from Opposition Members, with good representation from Wales. My hon. Friend the Member for Merthyr Tydfil and Rhymney (Gerald Jones) spoke with typical eloquence and highlighted the wise decision of the Welsh Government to recognise the contribution of care workers. I hope that the Minister will be able to respond positively to my hon. Friend’s request, or at the very least confirm that she is making strong representations to the Treasury about the tax treatment of that payment. We heard a similar point from my hon. Friend the Member for Pontypridd (Alex Davies-Jones), who also reminded us of NHS Direct, which was a great innovation from the last Labour Government.

My hon. Friend the Member for Bethnal Green and Bow (Rushanara Ali) rightly said that staff need to be rewarded with more than just applause, and she drew attention through her strong speech to the sorry record we have seen over the last 10 years on the NHS. My hon. Friend the Member for Coventry South (Zarah Sultana) spoke with great passion and listed a whole series of ways in which the health workforce is hit with extra burdens in the course of their duties.

My hon. Friend the Member for Erith and Thamesmead (Abena Oppong-Asare) drew attention to the scandal of nurses being forced to use food banks. That should shame us all. We also heard from my hon. Friend the Member for Hackney South and Shoreditch (Meg Hillier), who made the powerful point that medals do not put food on the table. She brilliantly highlighted how insecure work is a blight on the NHS and a systemic problem that needs addressing once and for all.

As we heard, even before the pandemic our frontline health and social care staff were working in overstretched and under-resourced settings. We must acknowledge that many of our frontline careworkers have been in extremely stressful and sometimes traumatic situations as a result of covid-19—situations that those of us who have not been on the frontline cannot even begin to imagine. Working in these uncertain times, dealing with a new and emerging disease, often without adequate protection, while coping with losing patients and worrying about getting ill themselves or taking the virus home to their loved ones are all contributing factors to staff burn-out and poor mental health. It is vital that we keep them all safe in the event of a second wave.

Yesterday, following the Prime Minister’s announcement of the relaxation of the 2-metre rule and sweeping changes to the lockdown in England, health leaders called for a rapid and forward-looking assessment of how prepared the UK is for a new outbreak of the virus. Those health leaders from the Royal Colleges of Surgeons, of Nursing, of Physicians and of GPs say:

“the available evidence indicates that local flare-ups are increasingly likely and a second wave a real risk.”

They also point out:

“Many elements of the infrastructure needed to contain the virus are beginning to be put in place, but substantial challenges remain”,

and they call on the Government to focus on

“areas of weakness where action is needed urgently to prevent further loss of life”.

We cannot have any failures in preparation this time.

We may no longer be gathering outside our homes on a Thursday night to clap for our carers, but our admiration remains. It has been incredible to see the effort from staff in the last three months—staff who, too often, get very little in return. We hope that they are recognised for their true worth now.

[Jamie Stone]

Will the hon. Member give way?

[Justin Madders]

I am sorry, I will not have time to give way.

Many of our NHS and care staff are exhausted and fearing burn-out. They need our support now, which means safe staffing ratios, adequate PPE and decent fair pay, because for them the hard work is not over—it is only just beginning. They will continue to give their all as they begin to tackle the backlog in non-covid care. The millions of routine operations, screening tests, treatments and therapies that were suspended or cancelled during the pandemic will now have to restart. Those challenges cannot be met without the staff.

As we know, there are well over 100,000 vacancies in the social care sector, and systemic insecure work and low pay are not the answer to resolving that issue. We know that prior to the covid-19 outbreak there were also 106,000 vacancies across the NHS, including 44,000 nurse vacancies. Those vacancies matter. They mean that NHS services were already under extreme pressure due to the ongoing staff shortages, before being further stretched by more shortages due to sickness or caring responsibilities during the pandemic. That, in turn, has put all healthcare staff under intolerable and unsustainable levels of pressure.

On top of those staff shortages, healthcare staff have had to work in unfamiliar circumstances or in clinical areas outside their usual practice, and of course they have had to work in very difficult circumstances. A survey by the Royal College of Nursing found that half of nursing staff felt under pressure to work without the levels of protective equipment set out in official guidance, and a survey by the British Medical Association of 7,000 doctors found that 45% were experiencing stress, exhaustion and burn-out. We need to listen to what the staff are telling us.

Just last week, we learned that student nurses who joined the frontline six months ago as part of the coronavirus effort are seeing their paid placement schemes terminated early, leaving them with no income and no guarantee that they will not face extra costs for completing their studies. That is no way to treat student nursing staff who have put their studies on hold to join the fight against coronavirus, and who are at the start of what we hope will be a long career in the NHS. They deserve better.

The Government still have not quite resolved the issue of the immigration health surcharge, where NHS and social care staff coming from abroad and working on our frontline are required to pay a surcharge of hundreds and sometimes thousands of pounds just to use the NHS themselves. It was welcome that, after considerable pressure, the Government announced last month that the surcharge would be abolished, but, as we have heard, there are still reports of people being charged. I would like an update from the Minister about what is happening in respect of that.

In conclusion, no one hearing this debate would be in any doubt that our health and social care workers are appreciated, admired and respected, but warm words are not enough. A clap on Thursday night is not enough. It is time for action, and for the Government to finally recognise the monumental contribution that health and social care workers make. No more poverty pay. No more “work until you drop”. No more sending people into work inadequately protected from exposure to a deadly virus. That cannot happen again.

The Government were too slow to recognise the need for PPE, too slow to protect the social care sector, and now they are too slow to properly reward our brave health and social care workers, who have literally put their lives on the line for us all. It is time we put that right.

Covid-19

Jamie Stone Excerpts

Tuesday 12th May 2020 Commons Chamber

[Jamie Stone (Caithness, Sutherland and Easter Ross) (LD) [V]]

Greetings from the far north of Scotland. I want to talk about tourism in the highlands.

Visitors and tourists from the UK and overseas are always very welcome in this most beautiful part of the UK, and our hospitality and tourism industry is critical to the local economy. It is an industry that is sustainable in the long term, and which, most importantly, provides local jobs for local people. As long as we have a high-quality tourism product, by which I mean landscape, culture, top-quality food and drink—that sort of thing—we can attract tourists to come back again and again to a truly special part of the world. But we are in the midst of the current pandemic. People leaving home and moving about simply increases the risk of the disease being spread. Many in the highlands and many of my constituents are concerned that visitors will look at the map of where the virus is most common and think, “Oh well, the highlands looks pretty free. Let’s go there.” The trouble is that in the highlands, health services are at best limited. The NHS staff and care workers are doing a fantastic job, but they work with limited resources and that is why we have taken the lockdown rules so seriously in the highlands. That is why we have taken every precaution to look after one another and that is why we continue to “stay home, safe lives and save the NHS”.

The health and safety of my constituents is my greatest concern during this difficult period, so I say this to potential visitors. In normal times you would be really, really welcome, but right now please stay in your usual homes, wherever they may be. Please, please wait until the medical advice says that the risk of you spreading the virus to my constituents has gone. Surely those who truly care for the highlands and highland people will respect the need to prioritise our health and safety.

Despite our strong feelings about the need to keep safe, we in the highlands also know that the longer the pandemic goes on, the more the long-term damage our local businesses will suffer. The absence of visitors paying money to our tourism businesses possibly for weeks and months could actually cause many businesses to go under. It is a vicious circle. For every business that goes under during the pandemic, the highlands becomes all the poorer in what we can offer visitors when it is safe for them to return. It is worse than that, however, because unlike many other enterprises tourism businesses are seasonal. The money taken in during the tourism season has to be sufficient to see that businesses have enough in the bank to get through what we call the dark cold months in the highlands. That is why I suggest that the present pandemic is so particularly dangerous for those tourism businesses. Even if the pandemic were to end in a few months, much of the tourism season will have gone. That is why I support the proposal from my hon. Friend the Member for Westmorland and Lonsdale (Tim Farron) for the UK Government to introduce a 12-month financial support package to secure the survival of the tourism industry until summer 2021.

To conclude, my plea is to both the UK and the Scottish Governments. Those tourism businesses are doing all they can just now. For instance, selling vouchers that can be used at a later date when travel is absolutely safe is a seriously good idea, one which we should all wholeheartedly endorse and support. But I believe that both the Scottish Government and the UK Government owe it to those tourism businesses to go a specially tailored extra mile for them right now. Otherwise, they will go under and we will have a disaster on our hands. I believe that all of us really owe the tourism businesses that hand of help—nothing less than that.

Health Inequalities

Jamie Stone Excerpts

Wednesday 4th March 2020 Commons Chamber

[Jo Churchill]

The hon. Lady will appreciate that I cannot speak for all Departments, but it is my job to drive home the value of health in those Departments and to ensure that, as she says, we think about the broader consequences across the policy-making piece.

In answer to my right hon. Friend the Member for South West Wiltshire (Dr Murrison), smoking does remain one of the most significant public health challenges. It affects disadvantaged groups in particular and exacerbates inequalities. That is particularly apparent when looking at smoking rates in pregnancy. Three weeks ago, I visited Tameside Hospital in Greater Manchester to see its smoking cessation work. It started with a much higher than average smoking rate, and having a tailored public health budget in the locality has allowed it drive down into the inequality within the community. It has a specialist smoking cessation midwife to help these young women, their families and their partners give up smoking—for their own health, yes, but also for the health of their babies.

[Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)]

I packed in smoking 15 years ago. I cannot understand why the NHS does not use people like me to go out there and help other people pack it in.

[Jo Churchill]

I thank the hon. Member—he has just got himself a job as an ambassador. I congratulate him on quitting smoking, because it is hard.

The specialist centre showed me that with the right holistic support and encouragement, the health of both mum and baby can be improved. Such services will be crucial in achieving the ambition of becoming a smoke-free society by 2030.

Similarly, we must tackle the health harms caused by alcohol, and support those who are most vulnerable and at risk from alcohol misuse. Through the NHS plan, up to 50 hospitals with the highest rates of alcohol dependency-related admissions will have alcohol care teams. That could prevent more than 50,000 admissions every five years. Currently, eight of those teams are in operation, providing seven-day services focused on those areas with the highest levels of admissions related to alcohol dependency.

Alcohol addiction has a devastating impact on individuals and their families, and it is unfair that children bear the brunt of their children’s condition. I know that this topic is dear to the heart of the hon. Member for Leicester South (Jonathan Ashworth), who has spoken about it movingly. I pay tribute to the way he has influenced this agenda in this place. I am pleased so say that we are investing another £6 million over three years to help fund support for this vulnerable group.

As is often the case with addiction, there is a toxic mixture of several items. On substance misuse, last Thursday I attended the UK-wide drug summit in Glasgow, along with Home Office Ministers and Ministers from the devolved Administrations. We discussed the challenges associated with drug misuse and listened to Dame Carol Black present her findings from the first phase of her review. I am pleased that my Department will fund and commission the second phase of the review, which will make policy recommendations on treatment, prevention and recovery. Only through the combined efforts of different Departments working together can we hope holistically to improve the health and other outcomes of people with substance misuse problems. Many of us know from our constituency work that they often bounce between various parts of the system. Local authority leadership and action on public health prevention is vital as it will help to focus local measures to decrease health inequalities. As a condition of receiving long term plan funding, every local area across England must set out specific and measurable goals, and ways by which they will narrow health inequalities over the next five and 10 years. Local areas know their localities best.

--- Later in debate ---

[Dr Whitford]

I do. I respect the work that Labour did, and child poverty was falling. Interestingly, the upturn in child poverty we have seen did not happen with the crash in 2008; it happened after the 2012 welfare changes. That is striking. The impact of Government policy has been austerity in every way and in every approach to individuals, families and communities. We have seen slow income growth for the vast majority of people over the last decade. There has been absolute inequality. The majority of the growth that there has been, has been at the top. The national living wage simply is not a living wage. More people are in insecure work—zero-hours contracts, the gig economy—and do not have protections. As the shadow Health Secretary mentioned, in all the discussion about covid-19, we have been trying to highlight that people on low pay and insecure contracts do not get sick pay, yet we will be asking them to stay at home for two weeks and self-isolate. In the meantime, the wealthiest people have actually trebled their wealth. So categorically we have not all been in it together over the last 10 years.

In addition, we have seen a restriction on public expenditure. The regressive welfare cuts of 2012 and 2016 have reduced support for families by 40%: the benefit cap, the benefits freeze, the two-child limit, the five-week wait for universal credit, which puts people in rent arrears and debt, personal independence payments, the bedroom tax. Eighty per cent. or more of these cuts have affected women directly because they tend to be lower paid, to be carers and to rely more on services. In the main, they are responsible for children. The disabled have also been particularly hard hit. We have not seen a cumulative impact assessment of female lone parents who are disabled and have three or more children. Some of them have had their income slashed.

There have been cuts to local government and services. Interestingly, the least deprived areas face 16% of cuts, while the most deprived on average had 31% cut from their local government budget. I have heard Labour Members talk about between 40% and 60% cuts in their local government budgets. There are changes in the pipeline to move £300 million from local authorities in the north to the south. I wonder if that will be reversed now that the Conservative party has won some seats in the north.

[Jamie Stone]

Some years ago, when I was a councillor, I had a harrowing case involving a young female constituent who was clobbered by the bedroom tax. She has multiple sclerosis and she was going to lose a lot of cash. I want to put on the record my thanks to the Scottish Government for the action they took to ameliorate and offset that tax.

[Dr Whitford]

I thank the hon. Member for that recognition. The Scottish Government are spending more than £100 million every year in mitigating some of these cuts—they pay the bedroom tax and they have set up the Scottish welfare crisis fund—but that is money that should be going into devolved areas, not patching up austerity decisions here; it is not the role of the Scottish Parliament just to mitigate.

Public health in England has been cut by £850 million—again, the greatest cuts to the poorest areas—and it is exactly the same with future planned cuts. This has led to cuts in smoking cessation projects. There is no point standing up and talking about the importance of stopping smoking—we all know that. People who have smoked for decades need help to stop and those services are critical. We have also seen cuts to drugs and alcohol projects and to sexual health projects, and all those have an impact on the poorest people.

The Minister, who is no longer in her place, might have listened to Dame Carol at the drugs summit in Glasgow but, sadly, the Minister for Crime and Policing, the hon. Member for North West Hampshire (Kit Malthouse), did not. He came to Glasgow, made his speech and then left before all the expert evidence was given. We also hear of a social care gap across England of over £6 billion. Again, that affects women if they have to give up work to look after elderly relatives or disabled children. This rolling back of the state has affected the social determinants and increased health inequalities. Child poverty has increased, as we have heard, with 4 million children affected, and 1,000 Sure Start centres have been closed. Education funding is down. There is a housing crisis and therefore a rise in homelessness. People with insufficient funds to afford a healthy life are depending on food banks, and deprived communities are simply losing hope.

Poverty is simply the biggest driver of ill health and has the biggest individual impact on life expectancy. The increase in life expectancy in England has stalled for the first time in 120 years—the first time since 1900. The gap between the most and least deprived has widened: the gap is now almost 10 years for women and the life expectancy of some women in areas of the north-east of England has dropped by almost a year.

--- Later in debate ---

[Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)]

I really must praise the two excellent speeches by the hon. Members for City of Durham (Mary Kelly Foy) and for Coventry North West (Taiwo Owatemi). I rather fancy that those two Members will make their mark in this place in the years to come.

I want to tell the tale of Mr Billy Sutherland, who was a 63-year-old commercial traveller living in Wick. A good number of years ago, Billy set off from Wick on the A9, heading south. It was a winter’s day and the weather was not too bad when he left, but as he travelled further south towards the Ord of Caithness—the boundary between Caithness and Sutherland—it turned very nasty indeed. In the end, Billy drove into a snowdrift and could not get out of his car. The snow continued and eventually he was buried, in his car, 15 foot down. There was no trace of the car to be seen.

Billy was in that car for 80 hours. Eventually, the police found him by prodding the snow, and it clanged on the roof of the car. When they dug their way down to the car, they found that Billy was, astonishingly, alive and pretty well. He was not much the worse for his ordeal. Billy was a commercial traveller in ladies tights. As it got colder in his car over the 80 hours, he simply unwrapped more pairs of tights and put them on. It is an extraordinary tale. When he returned to Wick, he received a hero’s welcome.

I tell the tale because, until quite recently we enjoyed a consultant-led maternity service based at the Caithness General Hospital in Wick, but NHS Highland, in its infinite wisdom, decided to downgrade the service. As hon. Members know, because I have mentioned it before in this place, a great number of pregnant mothers now have to travel 104 miles from Wick to Inverness—a 208-mile return trip—to give birth to their babies. The vast majority of mothers have to do that.

What if it is winter? What if the ambulance gets stuck in a snowdrift? What if the mother’s contractions have started? What if the two emergency helicopters have been summoned to one road traffic accident in Lochaber and another in Morayshire? I have said it again and again: in my considered opinion, this is a tragedy waiting to happen. I make no apologies for raising it yet again in this place.

This debate is about equality of access to decent health services. I argue that my constituents in Caithness are losing out extremely badly indeed, and it annoys me intensely. In fairness, this is a matter that is devolved to the Scottish Government. I accept that and very much hope that the Scottish Government take the problem on board, because we cannot continue waiting for something dreadful to happen. When constituents come to me in Caithness, do I sit on my hands and say, “Well, it’s not a matter for Westminster,” or do I stand up and say something here? I make no apologies, because I think I owe it to the pregnant mothers.