Health

Rosena Allin-Khan Excerpts

Tuesday 17th October 2017 Ministerial Corrections

The following is an extract from topical questions to the Secretary of State for Health on 10 October 2017.

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

There is a crisis in mental health staffing levels. Does the Secretary of State accept that today, throughout the country, there are 2,000 fewer mental health nurses than there were when he took charge five years ago?

Oral Answers to Questions

Rosena Allin-Khan Excerpts

Tuesday 10th October 2017 Commons Chamber

[Steve Brine]

At the last health oral questions, I committed to publishing the new tobacco control plan. I did that on 18 July. We have had a lot of legislation, from this and the previous Government. It is Stoptober, and there has never been a better time to quit. We now need to take that legislation, work with the control plan the Government have published and work it through local authorities and smoking cessation services, because my hon. Friend is absolutely right that where buddying services are used, we have better outcomes.

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

There is a crisis in mental health staffing levels. Does the Secretary of State accept that today, throughout the country, there are 2,000 fewer mental health nurses than there were when he took charge five years ago?

[Mr Hunt]

What I accept is that we have 30,000 more professionals working in mental health than when my Government came into office. There has been a decline in the number of mental health nurses, but we have in place plans to train 8,000 more mental health nurses, and that will make a big difference.[Official Report, 17 October 2017, Vol. 629, c. 6MC.]

NHS Pay

Rosena Allin-Khan Excerpts

Wednesday 13th September 2017 Commons Chamber

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

I must take the time to declare an interest: I am a junior doctor at St George’s hospital in Tooting.

When the Conservative Government began their programme of ideological austerity, they imposed the pay cap to secure our nation’s finances. It quite simply has not worked. We were told that the Government could not increase public sector pay beyond 1% because to do so would harm our financial security, but capping public sector pay has harmed us. It has put stress fractures in the foundations of our society—our public services. After seven years of austerity, this Government have borrowed more than all other Labour Governments in history combined. The Government have not paid off the budget deficit, and they lack any credible economic direction. Instead, they are attempting to drive our economy off the Brexit cliff like a lemming.

A decade on from a global financial crisis and seven years after the Government’s austerity programme began, our nurses, refuse collectors and teaching assistants are still paying the price. The stability of our society—the foundation on which we live our lives—depends on these vital services, from healthcare to our security, our children’s education and our local government. Since 2010, our nurses have suffered a real-terms pay cut of 14%. A hospital porter is £7,000 worse off, and a midwife has been left £18,000 short. These real-terms pay cuts have hit so hard that some of those who choose to stay in the profession are forced to use food banks, take on a second job and rack up personal debt, all because public sector pay rises have consistently failed to keep up with the rising cost of living.

The bravery of our emergency service personnel has been highlighted in recent months, following some truly tragic events, but when the media spotlight goes away they perform the very same duties, at the same risk and with the same courage. The Government absolutely do not value the people who put their lives on the line every single day to save ours.

[Anna Soubry]

I am grateful to the hon. Lady for giving way, but I think she should take back what she has just said. Whatever divides us when it comes to pay and financing, the one thing that cannot be said about any hon. or right hon. Member of this House, whichever party they may support, is that they do not care about the workers in the NHS. We certainly do, and we value and respect them.

[Dr Allin-Khan]

I thank the right hon. Lady for her intervention, but I have to say that a future Labour Government will not just talk the talk; we will walk the walk. A Labour Government will be on the side of ordinary people—those serving on Britain’s frontline. It is not right that in 2017 Britain, those at the top of our civil service can receive golden handshakes, taking home more than a quarter of a million pounds a year, while those on the frontline are stuck on the breadline.

[Fiona Onasanya (Peterborough) (Lab)]

In response to the comments from the right hon. Member for Broxtowe (Anna Soubry), does my hon. Friend agree that instead of just saying that we respect our public sector workers, we want to show them that respect? The cap has affected morale and retention. To say otherwise, when we can see that what is being done is harming people, is to be much like the people in the story of the emperor’s new clothes who said to the emperor, “You are not naked.”

[Dr Allin-Khan]

I agree 100% with my hon. Friend’s argument, which was most eloquently put. While those on the frontline work so hard, they are on the breadline. Our firefighters, teaching assistants, council officers, nurses, policemen and women, prison guards and hospital porters—the list is endless—are the glue that binds our country together. The services in which they work are vital, because they allow people in every part of the country to live their lives, feel safe and have opportunity. Those workers—I have the pleasure of working alongside many of them at St George’s hospital in Tooting—do not seek recognition; they serve our country selflessly on a daily basis. They are simply seeking a decent day’s pay for a decent, hard day’s work. That is why the Labour party would scrap the NHS pay cap and give our hard-working NHS staff pay that recognises the skill and dedication that they bring to their working lives.

[Simon Hoare (North Dorset) (Con)]

Will the hon. Lady give way?

[Dr Allin-Khan]

No, I am going to make some progress.

The quality of NHS services depends on the skill and talent of the people in them. Those in our NHS facing the everyday challenge of treating our most vulnerable should not be worrying about how they will put food on the table for their children—the very children who are having to accompany them to food banks.

Let us be clear: lifting the pay cap is not about recognition. It is about removing a cap that actively degrades our public services, weakening the foundations under our feet. Let us stop this demonisation of a workforce who hold this country together. We need an independent pay body to negotiate public service pay. Our services have been gutted by seven years of ideological austerity.

[Simon Hoare]

Will the hon. Lady give way?

[Dr Allin-Khan]

I will give way—this will be interesting.

[Simon Hoare]

I will let you work out whether it is an interesting intervention, Madam Deputy Speaker.

I am listening carefully to what the hon. Lady says. She speaks with passion and from chalk-face experience. I was interested to hear her make an open-ended pledge that her party would raise public sector pay in the national health service, but she has not said by how much, at what rate, on what timetable or how it would be funded. Can we have some detail?

[Dr Allin-Khan]

The hon. Gentleman heard the eloquent contribution from the Opposition spokesman today, and I would ask him where the £350 million a week is that we expected to see as a result of leaving the European Union. If his party has its way, we will have even less money for the NHS, so we will not only lose our valuable workforce who have come here from Europe but we will be further underfunded.

Lifting the public service pay cap would enhance the capacity and skill of each of our public services. In such high-pressure, stressful places of work, we demand that our nurses, police officers and firefighters make life or death decisions with a clear mind. How will they do that if, at the back of their mind they are worrying about how they will be able to feed their children or care for their parents? They will burn out—it is a recipe for disaster, and we are already seeing it happen. How long do we expect those public sector workers to carry on like that?

There are times when we in the House divide and times when we unite. This debate reaches far beyond a percentage increase on a payslip. It is about not just pay but the knock-on effect on lives. I implore the Government to look at the issue again and pay our public service heroes a decent wage.

Oral Answers to Questions

Rosena Allin-Khan Excerpts

Tuesday 4th July 2017 Commons Chamber

[Mr Hunt]

I heard a lot about Stepping Hill when I went to visit my hon. Friend; I think it was last year. I had the privilege of visiting the hospital more recently after the horrific terrorist attacks, and I commend the hospital for the brilliant work that it did in the wake of the bomb. The hospital has done a good job of recruiting; I think it has recruited 93 more doctors and nearly 300 more nurses since 2010. A national programme to help all trusts to retain their nursing staff has been launched by NHS Improvement in the last week.

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

In this country, we are short of approximately 40,000 nurses, and applications for nursing places have gone down by 23%. Can the Secretary of State tell us why he and his Government think that that is the case?

[Mr Hunt]

The hon. Lady happens to work in an NHS hospital in which there has been a big increase in the number of nurses. Across the country, there are actually 13,000 more nurses working on our wards than there were in 2010, but she is right: we need more nurses and nursing staff, and that is why we are expanding the number of nurse associates. This year we are, for the first time, opening up an apprenticeship route into nursing, which means that people from non-traditional backgrounds—particularly band 3 healthcare assistants—will find it much easier to get into nursing. That is how we will expand the workforce.

NHS Shared Business Services

Rosena Allin-Khan Excerpts

Tuesday 27th June 2017 Commons Chamber

[Mr Hunt]

The company has been stripped of that contract; it was relieved of the contract back in 2015. We are very clear that it will have to fulfil all its contractual requirements, including paying its fair share of the costs that have been incurred as a result of this wholly regrettable incident.

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

Patient confidentiality and safety must be treated with the utmost seriousness at all times, and the NHS fails if it loses the trust of its patients, so how did the Secretary of State for Health come to the conclusion that risk to more than 1,700 patients was merely due to an issue of mail redistribution?

[Mr Hunt]

I did not come to that conclusion. The hon. Lady is right, as a doctor, to say that patients’ trust in the way we hold their records is very important. In this case, the correspondence concerning patients was not forwarded, but it was not lost either. It was held securely, so no patient data were put at risk, but it should have been forwarded to another part of the NHS, and it was not; it was effectively stockpiled. That is what caused the concerns. We have been going through the high-priority cases. So far, the vast majority of cases have had two clinical reviews, and the ones we are still concerned about are having a third clinical review. We are taking this extremely seriously.

Oral Answers to Questions

Rosena Allin-Khan Excerpts

Tuesday 21st March 2017 Commons Chamber

[Mr Hunt]

The hon. Lady needs to be very careful in her use of statistics, because she will know that one reason for the drop in the number of nurses coming from the EU is that prior to the Brexit vote we introduced much stricter language tests, as that is better for the safety of patients and a very important thing that we need to get right. We are very confident that nurses will continue to want to work in the NHS, because it is a great place to work.

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

2. What estimate he has made of the number of patients who waited more than 12 hours for treatment in A&E in the last 12 months.

[Christian Matheson (City of Chester) (Lab)]

6. What assessment he has made of the reasons for the increase in the number of patients waiting more than 12 hours to be admitted to A&E in the last 12 months.

[The Secretary of State for Health (Mr Jeremy Hunt)]

Between February 2016 and January 2017, there were just under 3,500 waits of longer than 12 hours from decision to admit to admission. That is completely unacceptable, which is why the Government took urgent steps to free up NHS bed capacity in this month’s Budget.

[Dr Allin-Khan]

Earlier this month, the chair of the Royal College of General Practitioners said that the “best place for GPs” is working within their communities to provide the highest possible general practice quality. What forecast has the Secretary of State made of the reduction in A&E waiting times next winter as a result of the new GP triage units in A&E departments? Does he agree that this is simply a small sticking plaster on the gaping wound that is our drastically underfunded NHS?

[Mr Hunt]

Let me just tell the hon. Lady what is happening to what she says is a “drastically underfunded NHS”. In her local hospital, St George’s, we have got 36 more doctors—[Interruption.]

NHS and Social Care Funding

Rosena Allin-Khan Excerpts

Wednesday 11th January 2017 Commons Chamber

[Maria Caulfield]

I thank my hon. Friend, but that is obviously not of interest to Labour Members. I have been a nurse for over 20 years and have seen 20 years’ worth of winter crises. They are not unusual. There is no doubt that there is more pressure this year than ever before—we have heard about record numbers of people attending A&E—but there have been winter crises under many previous Governments. It was not unusual when I worked in A&E for patients to be treated in corridors or on chairs—wherever there was space. It was not unusual for ambulances to be queued up around the block, waiting for hours to unload patients—[Interruption.] I still work in the NHS and disagree with the chuntering from the Opposition Benches.

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

Will the hon. Lady give way?

[Maria Caulfield]

I will not. I must make progress and others want to speak.

It was not unusual for my hospital to declare a major incident because we could not take any more patients. It was not unusual for us to take on the extra work when neighbouring hospitals declared major incidents. The truth hurts, but that is what has happened over my 20 years of working in the NHS and what has happened over the past few days of this winter crisis. It outrageous for Labour Members to suggest that it is something new. They are in denial if they believe that it has not been happening for many years.

The Labour Government was so fixated on the four-hour rule that managers used to bully us and tell us which patients would get a bed based not on clinical need, but on the need to meet a target that was about to expire. I want to tell the House a story. One night I was working in a busy A&E when an elderly gentleman was admitted. He had fallen at home and broken his hip and had to be nursed on a trolley in the middle of a busy corridor. The four-hour target was looming, and at three and a half hours he called out to me and said, “Nurse, I desperately need to go to the toilet.” I had no cubicle to put that man in. He could not get off his trolley owing to his broken hip. The best that I could do under that Labour Government was to wheel a curtain around him and he went to the toilet there in the middle of a busy hospital corridor, with his war medals on his chest. Now, he got to a ward within four hours—his target was met—but that was not good care. If Labour Members think that it was and think that this is a new problem, they have buried their heads in the sand.

[Dr Allin-Khan]

Will the hon. Lady give way?

[Liz McInnes (Heywood and Middleton) (Lab)]

Will the hon. Lady give way?

--- Later in debate ---

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

After four years of having responsibility for the national health service, the Secretary of State for Health has declared:

“We need to have an honest discussion with the public about the purpose of A&E departments”.

We, who have seen his work from this House, and those who have felt the effects of his work on the frontline know exactly what he means:—“Let me tell you why everyone is to blame except for me.”

Earlier this week, the Secretary of State told the UK that nearly one in three visits to accident and emergency do not need to be made. That was his reasoning for weakening the target that every patient should be seen within four hours. That target applies only to people whose condition is serious and urgent enough, so I find staggering the sheer hubris of those comments, the avoidance of accountability in that decision and the danger inherent in both. As an A&E specialist doctor, I have treated patients who arrive in A&E with what seem like minor injuries or illnesses but develop into much more serious and life-threatening issues. The fact that the Secretary of State, both in his words and in that decision, is telling the people of the UK that they should self-diagnose before heading to A&E could have disastrous consequences, for which he would be responsible.

What if, because of the Secretary of State’s words, patients decided to stay at home after a serious bang on the head that turns out to be a life-threatening bleed to the brain? What about a potentially deteriorating case of pneumonia that is not serious enough to warrant being in A&E but eventually results in somebody becoming severely septic and dying?

As a citizen of this country and a patient of the NHS, I find the Secretary of State’s refusal to accept responsibility for the state of A&E departments deplorable. Instead, he blames patients for visits that “do not need to be made”. However, patients do not go to A&E for fun. They go because they are ill and cannot get a doctor’s appointment for two weeks. We have heard today from Members on both sides of the House who have taken their own young children to A&E. Did they do so for fun, or because they felt there was a need for their child to be treated? People go to A&E because their GP does not have resources at their practice, in some cases for something as simple as handing out crutches. They go to A&E because there is something wrong and they are worried sick and simply desperate to speak to somebody professional about their health.

[Victoria Atkins]

Will the hon. Lady give way?

[Dr Allin-Khan]

No, I will not. [Interruption.]

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

Order. Let us just calm it down. Government Members did not give way before, and let us not get into the habit of shouting at each other. Let us have a nice, sensible debate.

[Dr Allin-Khan]

Many people who go to A&E know that they should not be there. I have had elderly patients saying to me, “I’m so sorry, doctor, for wasting your time.” But what other option are the Government leaving them? That is what we are debating today. The Secretary of State wants an honest conversation—well, let us have it. Let us talk about the impact that the current state of the national health service, which he has been in charge of for four years, is having on accident and emergency departments and throughout hospitals in this country. Let us talk about rock-bottom staff morale. Let us talk about the breakdown of staff marriages, a rise in depression among staff and the fact that waiting times are not the responsibility of patients. They are not to blame.

Rising waiting times are the Secretary of State’s responsibility, yet he blames them on the number of people going to A&E since the target was set. It is his responsibility to lead a national health service that can meet the needs of its people, but again he pleads innocence. He says that no other countries have such stringent targets, suggesting that it is unfair that we do. The meeting of the A&E target in particular, not watered down but in full, is what establishes the NHS as the best health service in the world, and one that we can, should and would be proud of under a Labour Government. After all, emergency departments’ ability to meet the four-hour target is directly related to the health of the NHS itself. It is simple: more people go to A&E when they have no other options available.

[Sue Hayman]

On those options, the use of A&E in my area of Cumbria is entirely down to the lack of GPs. With so many GPs reaching retirement age, the situation is only going to become more acute. Does my hon. Friend agree that the Government need to tackle this matter urgently?

[Dr Allin-Khan]

I wholeheartedly agree with my hon. Friend. She makes an eloquent point about the lack of GPs and the problems we will face when more retire. Three GPs in my constituency contacted me this week to say that they had been offered jobs that were subsequently retracted due to financial pressures.

The Secretary of State pleads innocence. He says no other countries have such stringent targets. We should not compare ourselves to the worst; we should be leading as the best. The explosion of waiting times is his failure and a sign of the dangerous erosion of one of the country’s greatest institutions. As we saw last week when the British Red Cross had to be drafted in to our hospitals, our NHS is in crisis. Yet instead of listening to doctors and fixing the systemic problems they have created, our Government are repackaging the A&E four-hour target to try to save face and take attention away from the real challenges: the challenge of social care packages not being in place, prohibiting flow through A&E departments; the lack of access to GPs across the country, making A&E the only resort; the chronic underfunding and significant cuts in funding at local authority level; doctors and nurses being forced to miss breaks, as we heard earlier today, and working 14 hours, some without a break, sleep-deprived and unsafe to practise clinical work; and an NHS staff who do not feel supported, encouraged or motivated by the Government. None of these things will be addressed by a watered down four-hour target.

Having spoken to the Royal College of Emergency Medicine, those working on the frontline at all levels, and those who are training our junior doctors, I would like to put forward questions for the Secretary of State to think about. Why has it been decided that the four-hour target will now be downgraded? Who has been consulted on that? Which body said it would be beneficial to patients and A&E staff across the trusts? How will he define major and minor health problems? How are doctors and nurses magically meant to know, at first sight without proper assessment, whether it is a major or minor health problem? Who is responsible if a seemingly minor condition is actually life-threatening? Will it be him? Who will be responsible? How will the Government explain that we will be going back to the days when patients could wait over 12 hours if they were not considered ill enough?

The Secretary of State must recognise the impact of this systemic crisis on A&E rooms across the country in his words and in this decision. In downgrading the target, the Secretary of State does neither, instead placing blame on patients and putting patients at risk. Let me tell it straight: I have been an A&E specialist doctor under a Labour Government and under a Conservative Government. There has been a change under this Government—and for sure it has not been for the better.

Mental Health and NHS Performance

Rosena Allin-Khan Excerpts

Monday 9th January 2017 Commons Chamber

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

It is great to see the Secretary of State here today in the Chamber after enjoying his Christmas recess. While he was away staff on the NHS frontline had to work double shifts, the London ambulance service computer system crashed and we found out that the Red Cross needed to be drafted into our hospitals. Will the Secretary of State tell us which hospitals he visited during the Christmas recess?

[Mr Hunt]

I was in touch with what was happening in the NHS every single day throughout the Christmas recess. As someone who has worked in a hospital, the hon. Lady might question whether it is particularly helpful for NHS hospitals to have visits by high-profile politicians right at their busiest periods. I have been very closely in touch. She talks about the problem at London ambulance service. That was a problem staff have been trained to deal with. The staff of her own hospital worked extremely well, but they do not welcome attempts—she is making one this afternoon—to politicise the problems the NHS faces.

Social Care Funding

Rosena Allin-Khan Excerpts

Monday 12th December 2016 Commons Chamber

[David Mowat]

The better care fund is predicated on the assumption that we will drive that integration. I also make the point that not just Leicester, for example, but many councils right across the country—something like 40%—have increased, and will increase, their social care budget in real terms next year.

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

By 2020, we will see a national shortfall of £2.6 billion in adult social care funding. If the Government are forcing councils to increase council tax, what percentage will they be expected to increase it by? How much of that percentage increase would go solely to adult social care services? How will the Government ensure that that happens?

[David Mowat]

The spending review increased the precept by 2%—that is what we brought in at that time. As I said earlier, this is not the local government settlement, and I have nothing to say on council tax.

National Health Service Funding

Rosena Allin-Khan Excerpts

Tuesday 22nd November 2016 Commons Chamber

[Mr Hunt]

As the hon. Gentleman knows, those things would certainly be unsustainable if we had followed the Labour party’s investment plans at the time of the previous general election. If he wants to know what is happening to staff, let me tell him that in the period I have been Health Secretary, we have got 5,000 more doctors and 10,000 more nurses. That is what happens when we have a Government who are prepared to invest in the NHS.

The shadow Health Secretary talked about A&E—he is right to say that we are not hitting the target, and we are doing something about that—but he did not tell the House that, since Labour left office, we have recruited 1,200 more doctors for A&E departments, which is a 25% increase, including a more than 50% increase for consultants. Every day, we are seeing 2,500 more people within four hours.

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

Will the right hon. Gentleman give way?

[Mr Hunt]

I give way, with pleasure, to a junior doctor.

[Dr Allin-Khan]

I am a junior doctor in A&E, of which the right hon. Gentleman speaks, and I can say that morale is at an absolute all-time low. We have a recruitment and retention crisis in A&E. We are losing all the fantastic staff whom we have been able to recruit because this Government are not recognising and accepting the fantastic workforce on our A&E frontline. All the doctors are leaving.

[Mr Hunt]

With respect, the hon. Lady might be on the wrong side of the House, because I started my speech by recognising the brilliant work done by doctors and nurses, something that the shadow Health Secretary conspicuously failed to do. Let us look at her own hospital: since 2010, St George’s has—[Interruption.] I do not know whether she is interested in hearing my response to her intervention. Since 2010, her hospital has had 884 more nurses and 240 more doctors, and her CCG had a £10 million funding increase this year.

[Dr Allin-Khan]

I thank the right hon. Gentleman for allowing me to speak again. I shall refer at length to St George’s hospital in my speech, but it is very unfair of him to bring it into this debate. It is because of this Government that St George’s hospital is operating at a £50 million deficit. It is because of this Government that we are now in special measures. It is—

[Madam Deputy Speaker (Natascha Engel)]

Order. The hon. Lady is hoping to catch the eye of the Chair later in the debate. As it is, there will be a five or four-minute time limit, so Members who intervene must do so very briefly and not very frequently. If they do not do so, I am afraid that they may not be called to speak.

--- Later in debate ---

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

For all the wrong reasons, St George’s hospital in Tooting has been in the news recently. First, it appeared on the front page of a national newspaper because it was requiring people to show an ID before coming in and giving birth. Secondly, it was rated inadequate in a recent CQC inspection. Finally, figures were released showing that one patient waited 36 hours in A&E before being admitted to the hospital.

The one question we are all asking is: why? Why are the roofs in the theatres leaking? Why are the computer systems inadequate? Why has Wandsworth Council been forced to cut almost £10 million from social care budgets? Why does my local hospital trust have a deficit of £50 million? Everywhere we look, the answer is a lack of funding.

We should not leave our hospitals with the bare minimum to function; we should prioritise their funding. It is a healthcare system: we cannot take risks. If we do, it will result in a loss of life—people die. The Health Secretary can point the finger at whomever he wants, but it is not because of our doctors, who always go the extra mile, our trainee nurses, who have had their bursaries cut, or our carers, who are overworked and underpaid. I am afraid the Conservative Government are to blame.

I have worked in our NHS under a Labour Government and under a Conservative Government, and there is a significant difference. Staff morale is at an all-time low, as is patient morale. This Government are failing patients. Government Members know it, and Opposition Members know it. St George’s has not had significant resources put into it since Labour was in government. This is not a one-off story; it is happening up and down the country.

When Labour was in government, our healthcare system was a truly national health service: we saw more doctors, better equipment, new hospitals, and happier and healthier patients. Under this Conservative Government, waiting times are rising, buildings are falling apart and patients’ lives are being put at risk. We are making life and death decisions on the basis of costs. Our NHS is in crisis, and this crisis is turning into a disaster before our very eyes. The NHS was built by a Labour Government, it was saved by a Labour Government and it will be a Labour Government who rescue it.