My Lords, I congratulate my noble friend Lord Hunt on securing this debate and on outlining not just current problems but potential ways forward, which is what we should be concentrating on. This is an important debate, because few issues are more significant for us as individuals and indeed as society. Our individual and collective health and well-being very much depend upon a robust NHS. The figures my noble friend gave, including the 7.8 million on the waiting list, showed very clearly that we do not have that today, I am afraid.
Time is always limited in these debates, and there are certainly many aspects of the current state of the NHS that warrant mentioning—alas, far too many to mention. However, unusually, I want to start by mentioning some of the briefings we have probably all received in the last few days since this debate was announced. I was particularly struck by the briefing paper from the Association of Directors of Adult Social Services. It highlighted that in August, more than 470,000 people were waiting for a care and support assessment to begin, up 8% on March of this year. It highlighted the almost universal view that increased pressures on the NHS will put even more pressure on adult social care—a significant and growing problem.
We also had an interesting paper from a well-known opticians, pointing out that greater use of the glaucoma referral system, with optometrists working with the NHS, can significantly benefit patients and the whole of the NHS service; a similar situation arises with audiology services. The Royal College of Psychiatrists told us in its detailed paper about the contribution that early support hubs can make. The Bowel Cancer UK group gave us striking figures that nine in 10 people will survive bowel cancer if diagnosed early, but only four out of 10 are actually being diagnosed early. The most significant point about all these examples is that they highlight issues that are not simply about asking for more funds. They are pointing out and giving examples of how early invention can not only benefit patients and individuals but reduce long-term costs.
All of those examples and that theme link up with what we were told by Universities UK, which has outlined the problems we are seeing with applications from students for positions in critical areas of nursing and the whole range of medical specialties. Even if we did get the increase in the number of students, we are
also short of clinical academics and people to do the teaching to get the placements they need in our hospitals. This area is particularly critical to the way forward. Although the Government sometimes boast about increasing student numbers, there is still a very long way to go before we recover from the cuts made from 2010. That is one of the reasons why we are in such a serious situation.
I want also to mention one other issue that particularly alarms me. In October, just a month ago, the Care Quality Commission rated 65% of maternity services in England as inadequate or requiring improvement. Its report says, having inspected 73% of all maternity units:
“The overarching picture is one of a service and staff under huge pressure”.
Despite the efforts of staff, who are often praised because of their efforts by people on the receiving end, many women are still not receiving the safe, high-quality care they deserve. The CQC went on to say that this was particularly a problem for ethnic-minority women, for whom the service was particularly poor. Its overall assessment was that we have a deteriorating position in maternity services. All of us who have children know that the moment a child is born is one of the most important times of your life. It really is alarming that, in 2023, 75 years after the establishment of the health service, which was partly formed to improve maternity services, we have that situation.
I must just mention a related issue from my local area. Last week, it was reported that no babies have been born in Kirklees for around 18 months. Kirklees is one of the largest metropolitan council areas, covering Huddersfield, Dewsbury, Batley and lots of other smaller towns, yet there are no facilities for childbirth there. The units in Huddersfield and Dewsbury have been closed. Just imagine being a pregnant woman going into childbirth and having to travel potentially for an hour in those circumstances. The reason given is staffing issues. There are plans for the future, but in some cases it will take nearly two years before that service becomes available.
I have the figures for the increasing number of doctors, midwives and consultants under a Labour Government, but I end by echoing what my noble friend said: we fixed it last time; we are going to have to fix it again.
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