Future of the National Health Service

Rosena Allin-Khan Excerpts

Wednesday 22nd September 2021 Westminster Hall

[Dr Rosena Allin-Khan (Tooting) (Lab)]

It is such a pleasure to serve under your chairwomanship today, Ms Bardell. I want to declare an interest: I am proudly an NHS doctor and have been for 16 years.

It is an absolute pleasure to wind up today for the Opposition. I thank my hon. Friend the Member for Leeds East (Richard Burgon) for securing this hugely important debate, and I thank all hon. Members for their thoughtful contributions and suggestions. My hon. Friend the Member for York Central (Rachael Maskell) reminded us of the inequalities that are already deeply rooted in our society, and my hon. Friend the Member for Liverpool, Wavertree (Paula Barker) spoke movingly about residential care. My hon. Friend the Member for Rhondda (Chris Bryant) spoke about the value of our NHS staff, and my hon. Friend the Member for Wirral West (Margaret Greenwood) reminded us in no uncertain terms how life looks without the NHS. My hon. Friend and neighbour the Member for Streatham (Bell Ribeiro-Addy) spoke of the privatisation by stealth that she already sees in her community and the detrimental impact that it will have.

There is no institution that unites us quite like our NHS, and it represents the very best of our values: collective, compassionate and co-operative. Our health service was once the envy of the world and laid the blueprint for publicly run, universally free healthcare for the modern age. The outbreak of coronavirus reinforced the need not only for a universal health service, but for health services to be properly funded and fully resourced. I am in no doubt that we lost more lives than we needed to because of the drastic and protracted underfunding of our NHS over the last decade. The pandemic reminds us of the risks of Conservative underfunding and undervaluing of our NHS, leaving it ill-prepared to handle winter, let alone a global pandemic.

Despite our unwavering pride in our NHS, it has suffered a decade of decline under consecutive Conservative Governments, and we have already lived through a botched reorganisation in 2012, which was supposed to cut down bureaucracy and deliver better care for patients. Instead, the Lansley reforms had the opposite effect, by complicating processes and increasing the reliance on private providers. The reforms introduced market elements, putting shareholders and companies ahead of patients. Shame! The changes meant that services went out to tender to anyone, resulting in private companies competing against public ones to deliver care at a local level. Those changes completely fragmented our health service, creating a route for private companies to make a profit on community services.

The damage of that reorganisation is still being felt profoundly today. Waiting lists are skyrocketing and people are finding themselves stuck in A&E. Routine operations are being cancelled and cancer waiting times are not being met. Operations are being postponed at an alarming rate, and the backlog in mental healthcare is reaching an all-time high. We are letting down a whole generation of young people, who are so reliant on timely access to mental healthcare services.

Like my medical colleagues across the country, I have been in A&E to comfort young people with eating disorders, who are stuck there because there are no appropriate beds for them. They feel that they cannot trust anyone, because they continue to be passed from pillar to post. I have been with families who hope that their elderly relatives get discharged so that they can spend their final days at home. What must it feel like for a family who are waiting for the person they love to be discharged, just so that person can die with dignity at home and in the arms of those they love? Because of fundamental flaws in social care, however, they find that they cannot be reunited with and cared for by the ones they love. Shame!

We have seen a rise in the use of more expensive agency staff throughout the last 10 years, while nurses, doctors and porters have had their pay squeezed. During this decade of decline, we have also had the first doctors’ strike in the history of the NHS, with junior doctors forced to take industrial action because of contract disputes. The Government expect doctors to work longer for less. The last thing that we frontline NHS staff want to do is to strike. We want to be serving our patients but, sadly, the Government have given us no choice but to know that the best thing that we can do for our patients is to demand better pay and working conditions.

Our NHS staff have worked incredibly hard throughout the pandemic. Through each lockdown, each wave and each new variant, NHS staff have kept going, putting themselves at risk in order to keep us safe. The personal sacrifice is astounding, and we know that so many have paid the ultimate price with their lives. Staff are exhausted, burnt out and in desperate need of respite, and yet they are not receiving sufficient support from the Government. Throughout the pandemic, I have had medics, nurses and colleagues from all around the country messaging me in the middle of the night, unable to sleep from the stress that they have been put under and the amount of death that they experienced in such a short period of time. They were not trained for such conditions.

As hon. Members have said, it is no wonder that around a third of NHS staff stated in the most recent survey that they were considering leaving their jobs. With vacancies already high throughout the healthcare service, losing more staff would be absolutely catastrophic and would definitely impact on patient care. Healthcare staff need to feel valued and appreciated by the Government, but despite the sacrifices they have made and continue to make, their only rewards so far have been empty claps and a real-terms pay cut. If the Government truly appreciated the efforts of NHS staff, they would offer those staff a fair pay rise. The Government might also consider taking up my offer to work with them on a cross-party basis to address the mental health crisis among NHS and care staff. There is nothing I would like more than to work with the Government to deliver what our frontline NHS and care workers need.

On the subject of pay, fair pay is not simply a moral imperative; it is about the future functioning of our NHS. The NHS is one of the single largest employers in the world, but it is in the midst of a workforce crisis. By refusing to offer a fair pay rise, the Government risk causing workers to leave the health service. That would create more vacancies, further shortfalls of staff during shifts and increased workload for the staff who remain. We know that 56% of NHS staff already work unpaid additional hours, and that percentage will only increase if the workforce becomes even more stretched. It is a cycle that will lead only to further burnout among staff and eventually to more staff looking to leave. The Government have known for years that further action must be taken to recruit, retain and train more staff, yet nothing is being done at a fast enough pace to ensure that future demand will be kept up with.

Despite the mishandling of the NHS since 2010, it seems the Conservatives have not learned their lessons, because they are forcing through another reorganisation. The Health and Care Bill, like the Lansley reforms before it, fails to grasp the real challenges facing the NHS. It will only serve to create more problems, rather than solutions, and it will put our entire health service at risk. It does nothing to stifle the market forces present in NHS services, meaning that we will have more private companies running vital community services. A modern NHS has to take a whole-society approach, working closely with local authorities and other public services to reduce the inequalities that drive poor health. A joined-up approach would better serve communities, but the new Bill fails to outline how such an approach would be achieved, and that will result in more fragmented services and worse outcomes for patients. Instead of adopting such an approach, the Conservatives are more interested in consolidating power and guaranteeing private providers a voice in how local services are run.

As we look ahead to the future of the NHS, it is important that we never forget the principles on which it was founded: free at the point of delivery, publicly funded and publicly run, universally available and based on clinical need, not the ability to pay. The Conservatives, who voted against the creation of the NHS 22 times, have been working hard ever since to slowly erode the collective foundations on which it was built. We cannot let that happen. We must never, ever lose sight of the founding principles of the NHS, and we must never let the market control healthcare in this country.