UK Parliament / Open data

A Plan for the NHS and Social Care

I want to make a bit of progress. If the hon. Gentleman wanted more beds in the NHS and greater diagnostic capacity, he would have been arguing for capital investment in the NHS, which we did not get in the Budget and we did not get in the Queen’s Speech.

That brings me to diagnostic capacity—I have just given the hon. Gentleman his local diagnostic figures. [Interruption.] This is not about new hospitals; this is about diagnostic capacity. The Secretary of State knows that we still have some of the lowest numbers of computerised tomography scanners and magnetic resonance imaging scanners per capita in the OECD. We still have only average amounts of RTE radiotherapy machines. We need investment in this technology, which we are not getting in sufficient amounts. That is why, in the past year or so, we have seen 4.6 million fewer diagnostic

tests for cancer. Some 46,000 fewer people are starting cancer treatment. We should not have to choose between covid care and cancer care, but, for too many, that has been the reality of the past year, and it means that 4,500 additional avoidable cancer deaths are expected in the next 12 months. It means that progress in survival rates for colorectal cancer, breast cancer and lung cancer is expected to be undone. The proportion of cancers diagnosed while still highly curable has dropped from 44% to 41%.

The long-term plan, on which the Secretary of State fought the election, promised rapid action on cardiovascular disease. Experts now predict the highest cardiovascular mortality in a decade, and they predict 12,000 additional heart attacks and strokes over the next five years. The Queen’s Speech needed to include proposals to expand access to the appropriate cardiovascular healthcare facilities, but it also needed to include real interventions to tackle smoking and alcohol rates, and to reduce salt intake. Yes, there is a commitment to a tobacco control plan, but will there be a reversal of the 17% cuts to smoking cessation services? Given that 7,400 people died last year from alcohol abuse—a record number—will the Secretary of State reverse the cuts to drug and alcohol addiction services, with budgets being cut by 15% over the past three years?

We have been promised action, again, on banning junk food advertising, but when? I have heard the Secretary of State—and, to be fair, his predecessor—make that promise at the Dispatch Box many, many times, but when will we have the ban? When will he reverse the cuts to public health weight-management services?

Narrowing health inequalities should be at the heart of every Government policy, but there can be no levelling up while life expectancy advances stall for the poorest in society. Levelling up and tackling inequalities apply to mental health outcomes as well. More people suffer from depression in the poorest areas of the country than the richest. We know that the mental health problems are prevalent among certain minority ethnic communities —black men, in particular, are more likely to be detained under the Mental Health Act 1983, more likely to be subjected to seclusion or restraint, and less likely to access psychological therapies. We therefore welcome the commitment to reform the Mental Health Act, as we welcomed it last year, and I look forward to working constructively with the Secretary of State on reforming the Act. I would like to put on record my thanks to Sir Simon Wessely for his pioneering work on this front. Simon is a committed Chelsea fan, so I dare say that he will be more responsive to my felicitations this morning than he might have been on Saturday evening.

We face a crisis in mental health now, and we need action now. Two hundred and thirty five thousand fewer people have been referred for psychological therapies; eating disorder referrals for children have doubled; and the pandemic—again, because of infection control measures —has meant a reduction of almost 11% in beds occupied, which is equivalent to 1,700 fewer patients over the past three months compared with a year earlier. When will the Government implement their promise of significant increases in staff and resources for mental health, to ensure that mental healthcare is genuinely given parity of esteem with acute services?

That brings me to staffing more generally. Given that we are short of 200,000 staff across the health and social care sector, why was there nothing new in the Queen’s Speech to recruit more doctors, nurses and social care staff? Why was there no plan to give our NHS staff the pay rise that they deserve? NHS staff, including nurses who have cared for those with covid on wards, and district nurses who, in the first wave, cared for those who were discharged from hospital earlier than planned so that they could stay at home safely, have gone above and beyond, yet they feel that the 1% pay rise, which could well turn out to be a real-terms cut because of inflation, is a kick in the teeth. Is it any wonder that nurses are leaving the profession, including the nurse who cared for the Prime Minister, blasting Ministers for treating NHS workers with a total lack of respect? It is simply not fair. Our NHS staff deserve better.

The gaping hole in the Queen’s Speech is the plan for social care. Two years ago, the Prime Minister stood on the steps of Downing Street and said he had a plan to fix social care. He said:

“we will fix the crisis in social care once and for all with a clear plan we have prepared to give every older person the dignity and security they deserve.”

It was not a plan to be developed, or work in progress; no, this was a plan that was already done—oven-ready, you might say, Madam Deputy Speaker. But two years on, where is it? Has the Health Secretary seen it? What do we need to do to see it—perhaps we could pay for some cushions in the Downing Street flat? The Government promised us cross-party talks. They now brief that cross-party talks have taken place, but when—did they forget to send the Zoom link?

However, there is a consensus on social care, isn’t there? Care workers should be paid the living wage and proper sick pay. There should be a cap on costs, as this House legislated for. When the Institute for Public Policy Research, social care and older people’s charities and a House of Lords Committee, which, at the time, consisted of true-blue Thatcherites such as the noble Lords Lamont and Forsyth, have all called for reform of free personal care, why is the Secretary of State not engaging in that debate with us? To be frank, though, lack of cross-party talks is not an excuse for not getting on with reform. A Prime Minister with an 80-seat majority should be able to show some leadership and get on and fix social care.

If the Health Secretary wants to talk social care reform, I am free this afternoon. He knows where I am. I am happy to sit down with him at any time and discuss it. I think we would have very constructive conversations on this one, because it is true to say, as Members have detected, that we have developed something of a bond these past 12 months. The Health Secretary has been so friendly to me across the Dispatch Box that I am half expecting to win a lucrative PPE contract by the end of the day.

Because we have this new friendship, I have, as we say on the Labour Benches, some comradely advice for the Health Secretary. I know he is bringing forward a Bill to neuter the independence of the NHS chief executive and bring powers back to the Secretary of State. I have been around a long time and I remember when Tory MPs used to complain that the NHS needed independence, but we will leave that to one side. I just suggest that he ought to be careful what he wishes for, because I have been reading the Evening Standard, where Mr Tom Newton Dunn

reveals not only that Simon Stevens, whom the Secretary of State is trying to neuter, was best man at the Prime Minister’s wedding, but that the Prime Minister is said to be about to appoint Simon Stevens—I beg your pardon, Lord Simon Stevens—to, yes, you guessed it, the newly empowered post of Secretary of State for Health and Social Care. It brings a whole new meaning to the phrase, “the best man for the job”, doesn’t it? But this is a Secretary of State who set up Test and Trace, who was responsible for PPE procurement and who failed to protect care homes. Dominic Cummings said the Department under his leadership was a “smoking ruin”—and now he wants more control.

The Queen’s Speech was remarkably unspecific in its description of the contents of the coming health and social care Bill, so perhaps the Secretary of State can reassure us today. Can he commit to ensuring that neither the NHS nor the partnership force to be set up in each integrated care system will permit the inclusion of private sector participants? Will he rule that out? Can he guarantee that as statutory bodies ICSs will meet in public, publish board papers and be subject to the Freedom of Information Act 2000? What guarantees can he give this House that the establishment of integrated care systems will not lead to more private corporations taking over GP practices, as has happened recently with Centene, or services currently delivered by NHS providers? I hope he can give us those very simple reassurances today.

With nearly 5 million people on the waiting lists and rising, ever-lengthening queues in our constituencies waiting for hip replacements and cataract removals, cancer survival rates worsening, mental healthcare in crisis, social care reform kicked into the long grass, and a costly, morale-sapping reorganisation on the way, we needed a fully resourced 10-year rescue plan for our NHS. I commend our amendment to the House.

Type
Proceeding contribution
Reference
695 cc736-9 
Session
2021-22
Chamber / Committee
House of Commons chamber
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