Future of the NHS

Rebecca Long Bailey Excerpts

Monday 31st January 2022 Westminster Hall

[Rebecca Long Bailey (Salford and Eccles) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Gray. I speak in full support of the petition. I would like to make particular mention of the recent Health and Care Bill. The clearest example of what could happen to our NHS if this Bill goes ahead lies in NHS dentistry. Net Government spend on general dental practice in England has been cut by about one third in the last decade. The results of this are stark; there are reports of people resorting to pulling out their own teeth because they cannot afford private treatment.

The British Dental Association states worryingly that the Bill worsens the situation and

“does not ensure that the voice of three quarters of NHS primary care professionals is heard in the making of commissioning decisions”.

Whose voices will be heard, then? The Bill would put private companies right at the heart of NHS decision making and service delivery—on the new integrated care system boards, where they will be given power to make decisions about people’s care and how NHS money is spent. The Bill will allow private healthcare providers to award contracts for clinical care without considering any other bids. The doctor-led campaign organisation EveryDoctor states:

“This Bill will embed private companies in the NHS in England, and give them the power to decide who gets what treatment when.”

Members on the Government Benches might wax lyrical about the NHS being free at the point of use, but what happens when people cannot access the care that they need? It might be because of rationing, or because of lengthy waiting lists due to lack of funds. It might simply be because those with a seat at the integrated care system board table determine that a person’s care should not be available on the NHS, because it is just not profitable enough. The result is this: if a person cannot afford private medical cover, they do not receive treatment. That is already happening in NHS dentistry, where it has been normalised. The risk is that it will be normalised throughout the healthcare system.

This is not a Bill to tackle the crisis facing the NHS. It is not a Bill to tackle the care backlog, or to properly fund our NHS. It is a Bill to reduce our rights to access healthcare and to privatise our NHS. It must be scrapped.

Health Inequalities: Office for Health Improvement and Disparities

Rebecca Long Bailey Excerpts

Wednesday 26th January 2022 Westminster Hall

[Rebecca Long Bailey (Salford and Eccles) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Twigg. I thank my hon. Friend the Member for Bootle (Peter Dowd) for having secured this important debate, and for his eloquent and detailed speech. Salford is currently the 18th most deprived local authority area out of 317 in England, yet it is a tale of two cities: more than 30% of the city’s population reside in a highly deprived area, yet we are also home to some of the wealthiest suburbs in Greater Manchester. That disparity is shown starkly by our life expectancy. It has been improving over the past few decades, but there remains a gap between Salford and the rest of England of three years for males and two years for females.

Male residents living in the most affluent areas of Salford can expect to live more than 11 years longer than those in the most deprived areas, while females in the most affluent areas can expect to live seven years longer. I think we can all agree that that is morally wrong. Sadly, we have known for decades—from the Beveridge report to the Marmot report—that poor health, discrimination, housing, employment and income are inextricably linked, yet we have seen very little action in recent years. Of course, there was a burst of radical policy development in the late 1940s, with the creation of the welfare state and the NHS, for example, and we saw policy approaches in the late 1990s and early 2000s, but since then we have lacked a comprehensive health inequality strategy. What is worse is that austerity has resulted in the unravelling of many of the positive policies put in place and the undermining of the remaining ones.

The creation in October 2021 of the new Office for Health Improvement and Disparities and the announcement of a new cross-Government agenda to track the wider determinants of health and to reduce disparities were met with cautious optimism. However, since the creation of the OHID, there has been little information on what it will actually do or what it has done so far. Will the Minister clearly set out how the Office for Health Improvement and Disparities will reduce health inequalities? Indeed, what is the new cross-Government agenda? Can she confirm that the Health Promotion Taskforce will be given a remit to act outside of the Department of Health and Social Care, to address the true socioeconomic causes of poor health? Finally, can she set out how OHID will work with the new integrated care systems, and how it will support them to address health inequalities in their area?

As the Inequalities in Health Alliance states:

“If we are to prevent ill health in the first place, we need to take action on issues such as poor housing, food quality, communities and place, employment, racism and discrimination, transport and air pollution. All parts of government and public services need to adopt reducing health inequality as a priority.”

Of course, I fear that the Government will not do that. It would show that an active state that supports communities, industry and workers to increase living standards for all within a new, democratic economy is the only way to do this properly, and that goes against everything the Government believe in. None the less, I hope that the Minister will at least address some of the questions I have asked today.

Support for Carers

Rebecca Long Bailey Excerpts

Thursday 22nd July 2021 Westminster Hall

[Rebecca Long Bailey (Salford and Eccles) (Lab) [V]]

It is a pleasure to serve under your chairmanship, Mr Hollobone, and I thank the right hon. Member for Kingston and Surbiton (Ed Davey) for securing this important debate. I agree with everything he said about the plight of unpaid carers. We must increase and expand the carer’s allowance, properly fund respite breaks and recognise unpaid carers in legislation.

The situation for paid carers is equally dire. The Resolution Foundation found that between 2017 and 2019 more than half of care workers were paid well under the real living wage. Despite this, after a decade of cuts and Government underfunding of care, Salford has done its best to try to lift wages to a standard that carers can actually live on. Salford City Council and Salford clinical commissioning group, following a campaign by Salford City Unison, set aside funds to give care workers a significant wage increase and covid sick pay when isolating. This so-called Salford offer was offered to private care providers, but staggeringly, even when public money is made available, some companies have actually refused to take it if it means improving pay or terms and conditions for workers. What can the Minster suggest to address this?

Sadly, that is only one symptom of the structural problems that exist in care. As the Women’s Budget Group states,

“the structural problems with the sector…have arisen from allowing uncontrolled consolidation by private providers, including private equity.”

Salford City Unison further told me:

“We also see every day that even where we are able to secure contractual guarantees for workers, companies invest so little in back-office services that workers are regularly paid the wrong amount, get rotas at the last minute and find that the days they booked for leave are not recorded in the system and are therefore cancelled at short notice.”

I will read the Minster two quotes from care workers in Salford. Paul says:

“Private companies—and even so-called charities—only care about how much money they make. Not us workers or the people who need our care and support. We want more Government money for social care, but we’ve seen in Salford that loads of private companies would rather turn down public money offered by the council and the NHS, than use it to improve our wages or pay us when we’re off because of COVID.”

Diane, another care worker, says:

“I work in Homecare, often working 7am until 2pm, then back on at 4pm until 10:30pm and then back on at 7am the next day to do it all again. Bear in mind that means I have to get to my first call at 6:30am and don’t get home until 11pm. I am not the same carer when I work that many hours and that breaks my heart. When I ask for holidays, the company asks ‘Are they important? Do you need to be off that long?’ They tell you your days off have changed so that you have to cancel your appointments made in your own time. I am always being given extra calls. Once I actually covered 32 calls in one day. You cannot be a good carer when you are forced to work like that.”

That is not how we should treat those people we charge to look after the most precious people in our lives, is it? It is no way to run a care system. I hope that the Minster agrees that care workers must receive the pay and security they deserve; that unpaid carers must receive the allowances and respite they deserve; and ultimately that the Government must recognise care as a form of public social infrastructure and fund it as such.

Covid-19 Update

Rebecca Long Bailey Excerpts

Monday 17th May 2021 Commons Chamber

[Matt Hancock]

The red, amber and green lists reflect the risks that there are in other places around the world. The amber list means that people need to quarantine at home, the red list means that they need to quarantine in a hotel, and the green list means that we think it is safe to travel. My hon. Friend should get his passport out—he can get on a plane to Portugal or one of the other countries. The system allows for some careful foreign travel. However, my first duty is to protect the lives of people here in the UK, and the best way to do that right now is to make sure that we are cautious on international travel to protect the opening up here at home.

[Rebecca Long Bailey (Salford and Eccles) (Lab) [V]]

The Secretary of State will know that analysis of the data published by Public Health England shows that the spike in cases in Bolton so far is mostly confined to schoolchildren and young adults who are socially mobile and have not yet been vaccinated. There are valid concerns, therefore, that as lockdown eases today, it might lead to a rise in cases within unvaccinated cohorts across Salford, which borders Bolton. Can he confirm that he will act now to protect people in Salford by curbing any spread beyond surge hotspots and accelerating the vaccine roll-out programme in Salford not just for second doses, but for first doses for young, unvaccinated cohorts?

[Matt Hancock]

Yes, we are opening up vaccinations for those aged 37 tomorrow, and anybody in Salford who is in one of the eligible groups and has not been vaccinated should come forward. If you are in Salford and you were vaccinated more than eight weeks ago but have not yet had your second jab, please come forward. We now have a very good surveillance system in this country and we publish all the data from it so that we can all see the cases day by day. We can also see the impact on hospitalisations. I am glad to say that, thankfully, the almost inexorable link from cases through to hospitalisation and death that we saw in the past is now broken. The link is not completely severed, but it is much, much weaker because of the protection of the vaccine. Those are the things that people can do in Salford, and I look forward to working with the hon. Lady to get those messages out to everybody.

Health and Social Care Update

Rebecca Long Bailey Excerpts

Thursday 18th March 2021 Commons Chamber

[Matt Hancock]

Yes, my hon. Friend puts it characteristically well. It is very important to take all considerations into account when making decisions like these. Of course, the precautionary principle is important, but when there are such huge benefits to vaccination, over-precaution is a mistake. We have to take overall public health into account.

[Rebecca Long Bailey (Salford and Eccles) (Lab) [V]]

The Salford system has delivered the covid vaccine in an unprecedented way. Everyone from cohorts 1 to 9 has been invited at least once—some three or four times—and I understand that, even with the vaccine shortage and guaranteed second doses factored in, we will run out of people in cohorts 1 to 9 to give our current vaccine supply to. Will the Secretary of State authorise Salford to proceed to cohorts 10, 11 and 12 and begin to prioritise the vulnerable members in those age groups, so that we can maximise the doses we have?

[Matt Hancock]

No. What everybody in Salford and around the country needs to do is make sure that every last effort is made to reach every last person in groups 1 to 9, because they are the most vulnerable. Only in exceptional circumstances should people under the age of 50 who are not in groups 1 to 9 be invited for vaccination. The message is incredibly clear and I speak very directly to the whole team, including in Salford: please put all your efforts in the forthcoming weeks into delivering vaccines for groups 1 to 9.

Covid-19: Vaccinations

Rebecca Long Bailey Excerpts

Monday 11th January 2021 Commons Chamber

[Nadhim Zahawi]

I am grateful to my hon. Friend, who always asks very important practical questions. He is absolutely right to say that it has been challenging. Part of the challenge, which I think we have addressed today, is the amount of notice primary care networks and GPs have of a delivery. That will only get better as we stabilise deliveries to the warehouses and are then able to take them out into the primary care networks and hospitals. I will of course work with primary care networks and the whole of the NHS family to make sure our communications get better and better.

[Rebecca Long Bailey (Salford and Eccles) (Lab) [V]]

In Salford, we receive little or no notice that a delivery of the vaccine from the Government is due. Some batches have not turned up at all. When they do arrive, we act quickly. It was therefore staggering when, late last night, our clinical commissioning group was instructed to cancel 924 pre-existing second dose Pfizer appointments, with little time to book new appointments before the batch expires at midday on Wednesday. Will the Minister now allow local CCGs to plan and order their own vaccine batches? Can he assure those whose time before their second Pfizer dose has been elongated that they will be 70% to 90% protected for up to 12 weeks?

[Nadhim Zahawi]

I shall take the hon. Lady’s questions in reverse. The four chief medical officers have looked at the issue of the up-to-12-week dosing and all agree that it is the right thing to do. I apologise to the people Salford for that cancellation, if that is what happened yesterday. We have touched on this, but part of the issue has been the lumpiness in the deliveries in the early days, which will begin to become much smoother. The NHS central team, with Brigadier Prosser and the 101 Logistic Brigade, are absolutely focused on making sure that we give as much notice as possible to primary care networks so that they can plan ahead, and that will only get better and better as we smooth out the delivery process from manufacturer into warehouse.

Public Health: Coronavirus Regulations

Rebecca Long Bailey Excerpts

Tuesday 13th October 2020 Commons Chamber

[Rebecca Long Bailey (Salford and Eccles) (Lab)]

Madam Deputy Speaker,

“I am not confident, and nor is anybody confident, that the tier 3 proposals for the highest rates…would be enough to get on top of it.”

Those were the words last night of the chief medical officer, but sadly the Government knew this in September, when SAGE scientists advised the immediate introduction of a list of measures including a circuit breaker. In the following days, the Prime Minister went ahead with only the work-from-home U-turn and the 10 pm curfew. Now we know the truth. Last night, we saw that the SAGE minutes clearly stated that the curfew measure was likely to have a marginal impact, as it also seems the Government’s tiered approach will do.

Further, after the initial lockdown, any semblance of economic normality that would have kept the public safe was predicated on a comprehensive test, track and trace system, but with people still making vast round trips to get a test and risking their details being lost in an Excel spreadsheet never to be seen again, it is clear that we do not have a comprehensive testing system. And how can we forget Operation Moonshot? Salford was to be one of the pilot areas testing the Moonshot programme. However, my local council confirmed to me this morning that, some time ago now, it asked the Department of Health and Social Care to share the clinical validity data behind this new technology. To date, that query remains unanswered, and until this morning Salford City Council had been told to pause the programme. So can the Secretary confirm his current plans for the development of mass testing?

We all know what needs to be done. Any resumption of normal life depends on bringing the infection rate down, followed by robust test, trace and isolate systems, but for this to happen, we need clear direction from Government, and our businesses and workers need economic support to do what is required of them. So far, the Chancellor’s support still does not extend to the more than 3 million people who are excluded, and the watering down of economic support means that, even under tier 2, many businesses and workers across Greater Manchester will see a significant drop in income that they will not be able to sustain. So it seems we have a choice here: either we do not follow the science and instead impose the misery of prolonged tier 2 and tier 3 restrictions in many areas with little economic support, and cases and deaths will rise; or we follow the science and bring down transmission with a short national circuit breaker and a reform to test, track, trace and isolate. Frankly, the pandemic strategy so far has been akin to throwing a glass of water on a chip pan fire, and the Government need to change course today.

Coronavirus Act 2020 (Review of Temporary Provisions)

Rebecca Long Bailey Excerpts

Wednesday 30th September 2020 Commons Chamber

[Rebecca Long Bailey (Salford and Eccles) (Lab)]

I have listened to the Secretary of State’s comments and the revocations that he has set out have been welcome, but they are cosmetic and they certainly do not go anywhere near restoring the safeguards that those suffering from mental health problems, disabled people and those in need of care deserve. As for his promise for parliamentary scrutiny, frankly, it is nothing more than a gentlemen’s agreement.

The Act in its current form allows clumsy and asymmetric authoritarianism. Powers to restrict mass gatherings might well have been necessary, but broad police powers under schedule 21 to detain potentially infectious people have led to unlawful prosecutions 100% of the time. Where were the extra powers—the resources to inspect or restrict unsafe workplaces or to requisition private lab space, healthcare or other facilities for mass testing? Where were the powers to take charge of food supply in the event of future lockdowns to avoid further panic buying and ensure that shielding and vulnerable people receive the food that they deserve?

The Government demand that their citizens give up their liberties and livelihoods in the pandemic, yet they do not stand beside them. The Secretary of State’s comments today certainly do not deal with the issues that many of our constituencies face, and some of us begin to worry that the Government’s confused and often contradictory public messaging is not mere incompetence, but a studied chaos, designed to blame ordinary people instead of taking democratic political responsibility for some of the worst pandemic management in the world. The Government are at real risk of squandering public sentiment and public good will, and, at the very least, they must set out to revoke the most insidious parts of this Act tonight.

Oral Answers to Questions

Rebecca Long Bailey Excerpts

Tuesday 5th May 2020 Commons Chamber

[Gavin Williamson]

The consultation closed in October last year. We were hit by twin issues of purdah being imposed and now, obviously, our principal focus being on dealing with the coronavirus. We hope to respond to the consultation in the near future, but I am not currently in a position to give my hon. Friend an exact date.

[Rebecca Long Bailey (Salford and Eccles) (Lab)]

Constant speculation on when schools will reopen and whether it is safe to do so is leaving many parents, pupils and staff anxious. Last week, it was reported that the Government were looking at best practice in other countries; this weekend, it was reported that the Government would reopen schools for year 6 pupils on 1 June; and last night, it was reported that there were discussions in Government about giving schools and multi-academy trusts the flexibility to decide for themselves, amid concerns that Ministers were coming under pressure to help to kick-start the economy. I am sure the Secretary of State will want to reassure parents, pupils and staff that their safety is the Government’s No. 1 priority, so will he clarify the basis on which the Government are making decisions on school and college opening, and when will he make the scientific advice supporting his strategy publicly available?

[Gavin Williamson]

First, let me take this opportunity to congratulate the hon. Lady on her new appointment. I appreciate the time she has made available to speak with me, and I hope the regular briefings from officials that we are providing are of considerable assistance to her, as I think they were to her predecessor.

All SAGE advice is made public, and we will certainly do that. On the return of schools, I am sure the hon. Lady shares my desire for children to be given the opportunity to return to school when it is the right time to do so. The decision will be based on the scientific and medical advice that we receive. I assure her that we will take a phased approach to reopening schools, and we will always aim to give schools, parents and, critically, children maximum notice of when that will happen.

[Rebecca Long Bailey]

I thank the Secretary of State for his kind comments. He must understand that faith that children and staff are safe will be necessary to parents having the confidence to send their children to school, but nearly 1 million pupils in English schools are in classes of 31 or more—an increase of 28% since 2010—so there is understandable concern that social distancing will be difficult in schools. Everyone wants a return to vital education to support pupils and to stop the ever-widening attainment gap, but does the Secretary of State agree that first we need a national plan for social distancing and personal protective equipment, evidence of a sustained downward trend in cases, comprehensive access to testing for staff and pupils, a whole-school strategy for when cases emerge, and protection for the vulnerable? In the words of the National Education Union:

“Anything else will be a dereliction of duty from government”.

[Gavin Williamson]

I think the hon. Lady would very much appreciate the fact that I take my responsibilities for the safety and the health of children who attend school as the absolute principal motivation for everything I do, as is the case for those who work in schools. I always welcome constructive dialogue with her, which is why we have made every effort to do so, about how best we can support children to be in schools. Let us not forget that the overwhelming majority of schools—over three quarters of them—are currently operating in a safe, considered and proper way, supporting the children of critical workers as well as those children who are most vulnerable in society. Every step we take is about making sure that we look after those who are the most important part of our society, and that is our children, but also about supporting those who work in educational settings.

NHS Bursaries

Rebecca Long Bailey Excerpts

Wednesday 4th May 2016 Commons Chamber

[Jeff Smith]

I thank the hon. Gentleman for his intervention. Parliamentary questions have shown that the Department of Health failed to consult the Royal College of Midwives, the Royal College of Nursing and Unison before the policy was announced in the autumn statement last year. It is not just the Labour party that is worried about this, but the Royal College of Midwives, the Royal College of Nursing, the College of Podiatry, the Royal College of Speech and Language Therapists and the NHS Pay Review Body, as well as Members across the House. It is little surprise, then, that the result fails to understand the unique characteristics of the sector and the hard-working professionals that work in it. This is a process that has been driven by short-term financial savings at the cost of tackling the big questions of how we adequately fund our NHS for the decades to come.

What about the effect of this policy on the nurses and midwives of the future? At the centre of any policy on healthcare education must be the students themselves. In this case, they are diverse: older than most—the average age is 28—and overwhelmingly female. There are greater numbers from black and minority ethnic backgrounds. We should not forget that completing a degree necessitates 2,300 hours of clinical practice over three years. Any legislation that we need to design to encourage students in the future and to guarantee high-quality care for patients must recognise those types of people. They are people like Katie, a nurse in my constituency, who wrote to me about her concerns about the prospect of debt. She said:

“It is particularly worrying for mature students, many of whom have dependants, and it could deter them from joining the profession altogether. I can relate to this as three of my close colleagues are mature students and have stated on multiple occasions that, without the bursary, nursing school would not have been an option. Student nurses are not like other students: 50% of their time is spent on unpaid clinical placements in hospitals and in the community and there are simply not the same opportunities for part-time work as other students. I could not have completed this course without the bursary. Studying nursing requires participation in extra-curricular activities. This is in line with a recent national initiative: revalidation…Therefore, finding time for part-time work becomes very difficult, and many of my friends have been turned away from part-time jobs as our weekly schedules, working shifts and time for completing university work are often sporadic. The bursary covers my rent and without that I would not be able to support myself and nor would my family.”

We need to take such views on board when looking at a new policy.

[Rebecca Long Bailey (Salford and Eccles) (Lab)]

Research from the House of Commons has shown that of the net savings made to the Treasury through measures taken by this Government since 2010, 86% will have come from women. Does my hon. Friend agree that these proposals are no different from those we have seen in the junior doctors’ contract dispute, and that they will adversely affect women rather than men?

[Jeff Smith]

My hon. Friend makes a very important point. It is important to remember that, and to think about how the prospect of paying off more than £100,000 worth of debt affects the calculation of a mature student looking to study a second time to become a mental health nurse. It is important to think about how a lone parent, who is hoping to become a midwife, might feel the pressure of £59,000 of repayments when considering the future of their family—that is the latest estimate of debt from the Royal College of Midwives.

It is important to wonder how a nursing student, taking part in a 48-week extended course, is expected to find part-time work to make their studies viable. Not only is the Government’s evidence base desperately weak, but research by the Higher Education Funding Council for England tells us that poorer students, lone parents and BME students—the demographics of many of the people attracted to nursing—are disproportionately dissuaded from applying to university by the prospect of large debts.

The policy fails on two fronts. The refusal to engage with experts in the field has led to a misguided policy that makes healthcare education the privilege of those who can afford decades of debt. It fails to ensure fair and equal access to healthcare education. Secondly, there is a real danger that this policy will fail to achieve its own aim of attracting future students. Everyone in health who knows about these issues will acknowledge the shortages of nurses, midwives and other health professionals, but moving the burden of payment to students is widely seen as a mistake. Deterring potential candidates by promising a lifetime of repayments immediately on graduation cannot be the answer.

I conclude by joining the calls of the Royal College of Midwives and the Royal College of Nursing for the Government to rethink the proposals and to scrap the NHS bursary. We need a thorough and inclusive consultation process so that those with experience of the system are able to contribute properly. I ask Ministers to ensure that future students at Manchester University’s School of Nursing, Midwifery and Social Work are not forced to bear the burden of a Government unwilling to listen. The Royal College of Nursing has said that the Government have not thought hard enough about the risks. Now is the time to do so.