NHS Long-term Workforce Plan

Debate between Steve Barclay and Liz Kendall

Monday 3rd July 2023 Commons Chamber

[Liz Kendall (Leicester West) (Lab)]

I thank the Health Secretary for advance sight of his statement. I say “statement”, but what I really mean is “admission”—an admission that, after 13 long years, the Conservatives have run out of road, run out of ideas, and turned to Labour to clear up the mess that they have made. Make no mistake: at its heart, this is Labour’s workforce plan. It is a plan that we have called for since last September; a plan that we have begged the Government to adopt again and again. They say that imitation is sincerest form of flattery, and I, for one, am relieved that the Government have finally seen sense, but the question that the Health Secretary and Conservative Members need to answer today is: what on earth took them so long?

This week, the NHS celebrates its 75th anniversary as it faces the biggest crisis in its history—a crisis that has been building for years under this Government: a staff shortage of 154,000, 7.4 million patients stuck waiting for treatment, people across the country finding it virtually impossible to see a GP, and families desperately worried that if they need an emergency ambulance, it just will not arrive on time. Ministers constantly blame covid for those problems, but the truth is that waiting list numbers were rising and staff shortages increasing long before the pandemic struck.

Patients now want to know when they will finally see a difference. Can the Health Secretary confirm that, under his proposals, the NHS will not have the staff that it needs for at least eight years? Does he now regret the cut in medical school places that his Government brought in in 2013? Does he regret the decision taken last summer to cut the number of medical school places by 3,000 just when the NHS needed them most?

The Health Secretary claims that this is the first long-term NHS workforce plan, but let me set the record straight. In 2000, the last Labour Government produced a 10-year plan of investment and reform—a plan that delivered not only 44,000 more doctors and 75,000 more nurses, but the lowest-ever waiting times and the highest-ever patient satisfaction in the history of the NHS. That was a golden inheritance that Conservative Members can only dream of and that they have squandered through a decade of inaction and incompetence.

Let me turn briefly to what is missing from the proposals. Without a serious strategy to keep staff working in the NHS, Ministers will be forever running to catch up with themselves. Yet the Secretary of State has completely failed to put forward a proper plan to end the crippling strikes that are having such a huge impact on patient care. Six hundred and fifty thousand operations and appointments have been cancelled because of industrial action. Next week, junior doctors will walk out for five days, followed by two days of consultants’ strikes. After seven months of disruption, can the Health Secretary tell us when he and the Prime Minister will finally do their job, sit down and negotiate with staff, and bring an end to this Tory chaos?

The one part of Labour’s workforce plan that Ministers have not stolen is our plan to fund it by scrapping the non-dom tax status. In fact, when the Health Secretary was touring the media studios yesterday, he was asked nine times how he was going to pay for the plan and he completely failed to answer. He has had a little more time to prepare, so I am going to try again. Will he fund it through higher taxes, when we already have the highest tax burden for 70 years, or will he fund it through higher borrowing, when our nation’s debt is at record levels? Labour will introduce plans only when we can show how they will be paid for, because that is what taxpayers deserve. It is high time that Conservatives did the same.

From the windfall tax to help for mortgage holders to a proper plan for the NHS workforce, where Labour leads, the Conservatives only follow. This tired, discredited Government have had their day. The public know that it is time for change, and in their hearts Government Members too know that it is time for change. It is time for them to move aside and let Labour finally deliver.

[Steve Barclay]

Well, that really was a confused response. The hon. Lady began with reference to Labour’s proposals and the claim that our plan followed them. I took the precaution of bringing Labour’s announcement with me to the Chamber. Members can look at it in their own time, but it does not use the word “reform” once, despite the fact that “Train, retain, reform” is a key part of our proposals. Proposals for reform include moving from five-year to four-year medical undergraduate training; the expansion of roles such as physician associate; a significant expansion in the use of apprenticeships; and flexibility for retiring consultants, so that they can return to roles in, for example, out-patient services. A wide range of reforms came about as a result of the consultation with 60 different NHS organisations and are a key feature of the plan, but in Labour’s proposals reform is not mentioned once.

In addition, Labour’s proposals are for a 10-year period. Our plan covers 15 years. Its proposal covered 23,000 additional health roles; our proposal deals with 50,000. I could go on and talk about the fact that the Labour proposal does not even mention GP trainees. Labour Members keep coming to the House and saying that primary care is important, but their proposals did not even touch on the workforce with regard to GPs. They did not even mention pharmacists, even though, as part of a primary care recovery plan, a key chunk of our proposal is Pharmacy First. It is extremely important that we can deliver services to patients in innovative ways. The ultimate irony is that the shadow Health Secretary, in one of his many interviews, including interviews to promote his book, said that the NHS “must reform or die”. He said that it must reform, yet Labour’s proposals do not mention reform at all.

Labour welcomes the plan, but it goes on to say that it will take too long to implement, while claiming that it is its plan, which, again, points to the confusion among Labour Members. Let me remind the House of what has been done. We had a manifesto commitment for 50,000 additional nurses—we are on track to deliver that, with 44,000 in place. We had a manifesto commitment to have 26,000 additional roles in primary care, and we have met that, with 29,000 roles in place. In 2018, we made a commitment to five new medical schools in parts of the country where it is hard to recruit. We have delivered that—a 25% expansion in the number of medical students, who will come on stream in hospitals next summer. However, as we celebrate the 75th anniversary of the NHS, it is right that we also look beyond that to the longer-term needs of the NHS. That is exactly what the plan does with its doubling of medical places, but alongside that, it innovates by embracing things like a medical apprenticeship so that we can look at different ways of delivering training.

The hon. Lady talked about strikes, which is a further area of confusion on the Labour Benches. Labour Members say that they do not support a 35% pay rise for junior doctors, on the grounds that the shadow Chancellor, the right hon. Member for Leeds West (Rachel Reeves), says that they should not. Either Labour Members want to support the junior doctors, or they do not—once again, their position seems confused.

I will finish with one final area of confusion on the Labour Benches. The hon. Lady talked about the elastic non-dom revenue raiser, despite the fact that the former shadow Chancellor, Ed Balls, has said that it would not raise the funds that are claimed. He has said that it would do quite the opposite: it would deter investment in the UK. In addition, Labour has already spent those funds on a range of measures, such as the breakfast clubs that Labour Members come to the House and talk about. The reality is that it would not fund Labour’s proposals, whereas we have made a commitment to back our plan with £2.4 billion of funding from the Treasury.

This is a historic moment as we celebrate the 75th anniversary of the NHS. It is a long-term commitment from a Government who are backing the NHS through the biggest investment in the NHS estate—over £20 billion —and a series of recovery programmes, expanding our diagnostic capacity and our surgical hubs. That is why the workforce plan is truly innovative. It does not just train more staff or offer opportunities to retain more staff; it reforms as well—something that is sadly lacking in Labour’s proposals.

European Union (Withdrawal) Act

Debate between Steve Barclay and Liz Kendall

Wednesday 9th January 2019 Commons Chamber

[Stephen Barclay]

My hon. Friend, as a former Member of the European Parliament, always speaks with great authority on these issues, and she is absolutely right. After 45 years, we are winding down a complex relationship with the EU, and certain things are incumbent on us in that process, including safeguarding citizens’ rights and honouring our legal obligations. As a Brexiteer who supported leaving on the basis that we should be trading with the rest of the world, I find it a strange idea that our first measure on leaving would be to walk away from our legal obligations. I do not think that other countries around the globe would find that persuasive.

I know that my hon. Friend is a huge champion of business in her constituency; it is important that we respond to the fact that businesses do not want a series of changes; they want one set of changes, and they want transitional arrangements in place to give them certainty as they go through that process. This is the challenge for the House. It is not enough for it simply to say what it is against, or to suggest that under WTO rules these risks could be mitigated.

[Liz Kendall (Leicester West) (Lab)]

Is not the reality that the so-called implementation period will essentially keep us in the EU—in the single market and the customs union—so that we do not harm our economy and have more time to sort out what on earth we are going to do, and that the so-called backstop is about aligning Northern Ireland with the EU, so that there does not have to be a hard border and we do not threaten peace in Northern Ireland? The Secretary of State talks about the House having to make up its mind. Why is he not more honest? Why does he not admit that this is essentially about keeping us in until we can make up our minds what on earth we are going to do? If that is the case, what is the point?

[Stephen Barclay]

No, I do not accept that, not least because 80% of the economy is outside the backstop. The political declaration is quite clear that the country will get control of its trade policy. That is one of the inconsistencies in the position of the Leader of the Opposition, who seeks both to be in a customs union and to have an independent trade policy. The shadow Business Secretary is on record as saying that is not a tenable position—[Interruption.] Sorry, the shadow International Trade Secretary.

The point is—this goes to the heart of the hon. Lady’s question—that we need to honour the result of the referendum, which was the biggest democratic vote in our history, in a way that gives us control over immigration through a skills-based system, and over agriculture and fishing, and in a way that allows us to put an end to sending vast sums of money to the EU. These were the key issues on which the British people voted. I recognise that some, in particular the Father of the House, did not vote for a referendum, but the vast majority of the House did, and the vast majority voted to trigger article 50. We need to honour that, but accept that we leave either with a deal or—by default, if the House does not support the deal—with no deal. We cannot run away from that reality.

Dangerous Waste and Body Parts Disposal: NHS

Debate between Steve Barclay and Liz Kendall

Tuesday 9th October 2018 Commons Chamber

[Stephen Barclay]

My hon. Friend makes a valid point about the lessons to be learned from this. Part of what I would expect to look at as we move forward are questions about when the NHS was first made aware of this and what powers are available to enforce at an earlier stage. As I have mentioned, enforcement notices cover a spectrum of risk. Some of those risks are more technical in nature than others, so while there have been 13 notices, their enforcement encompasses a range of severity.

[Liz Kendall (Leicester West) (Lab)]

According to its most recent accounts, HES made a gross profit of over £15 million last year. What financial penalty will it suffer because of its gross incompetence?

[Stephen Barclay]

The first financial penalty it has suffered is the prompt action we took over the weekend, with 15 NHS trusts cancelling those contracts and moving across. There is a clear financial penalty in that loss of business. As for fines, that is a matter of legal process, through the Environment Agency, in the normal way. That is not an NHS matter. The focus for the NHS is on maintaining continuity of service.