NHS Strikes

(Urgent Question): To ask the Secretary of State for Health and Social Care if he will make a statement on the NHS strikes.

I am grateful to the hon. Member for his question, which I am taking on behalf of the Department as the Secretary of State is attending a COBRA meeting focused on minimising the disruption experienced by patients because of today’s walkouts.

In preparation for today’s industrial action, we have again drawn on extra support from a range of places, including military service personnel, volunteers and the private sector. People should continue to use NHS 111 if they need medical help and to dial 999 in the event of an emergency. Yet even such strong contingencies, including more people trained to drive ambulances and doctors redeployed to other parts of the system, are no replacement for having the right people doing the right jobs.

Any strike inevitably means that some patients will have their treatment delayed, and I know that people are being contacted if their appointments need to be changed. About 88,000 procedures or outpatient appointments have been postponed as a result of industrial action over the last eight weeks, so I am disappointed and concerned that patients are facing disruption once again, especially because strikes by Royal College of Nursing members have now come together with action by GMB and Unite members in eight ambulance trusts.

I recognise that there have been efforts on behalf of unions to ensure that derogations are in place to keep people safe, and I acknowledge that some aspects of that can indeed be challenging, but it is essential that all unions adhere to a set of derogations at a national level so that we can plan and act with certainty. I have also been heartened to hear that on previous strike days, some devoted ambulance workers and nurses who received calls while on the picket line returned to work where derogations were not going to be met. That is a real tribute to the care and dedication we see on the frontline day in, day out.

Ultimately, both staff and the public should no longer be in this situation, because we all know that industrial action is in nobody’s best interests, especially given the collective challenges we face to help the NHS recover from the pandemic. Despite what the hon. Member for Ilford North (Wes Streeting) might imply, there is much common ground, not least our shared desire to improve the NHS and deliver better care. Last week we announced our plan to recover urgent and emergency care—the second of three plans to cut waiting times in the NHS, including our elective recovery plan and our primary care recovery plan, which will be published in the next few weeks. With such important missions ahead of us, and fewer than two months left of this financial year, it is time to move forward, to look ahead and to come together in the interests of the patients we all serve.

This week will see the biggest strike in the history of the NHS, with nurses, ambulance workers and physiotherapists all driven to walk out. Some 88,000 appointments, including 10,000 operations, have already been cancelled, with much more disruption to patients expected this week, yet Government Ministers still speak as if they are mere observers or commentators, not leaders key to solving this dispute. This is the cost of the Prime Minister’s failure to sit down and negotiate with nurses, paramedics and other NHS staff.

Let us be clear about this fact: there has not been a single minute of negotiation on pay. NHS leaders are asking the Government to negotiate. Chief nurses are desperate for the Government to negotiate. The unions have offered to call off the strikes if the Government are willing to negotiate. The public cannot understand why, even now, they will not get around the table to sort this out. What on earth are they playing at?

Developments in Wales show that there is a deal to be done. The general secretary of the Royal College of Nursing has written to the Prime Minister, but she has not heard anything from the Government for weeks. It looks to the country like the Prime Minister and the Health Secretary are the ones on strike. Where is the Prime Minister? Where is the Health Secretary? In the week of the biggest strikes in the history of the NHS, during the biggest crisis the NHS has ever faced, the Health Secretary was not available for interviews this morning and he is not available to MPs today. Are we meant to believe that at 4 o’clock in the afternoon he is talking about how to avert disruption that has been taking place all day? Don’t make me laugh. Perhaps the Health Secretary is busy briefing against the Chancellor, just as the Chancellor is busy briefing against him. All the while, the Prime Minister is too weak to do anything about it.

The power to stop these strikes is in the Government’s hands. Patients have suffered enough disruption as it is. Is it not time for the Prime Minister to swallow his pride, sit down with NHS staff and negotiate an end to these strikes by paying NHS staff fairly?

I am not going to engage in the playing of party politics on this. The hon. Gentleman already knows that the Secretary of State is due to attend a Cobra meeting, which he and I rotate, and the hon. Gentleman may have missed it, but this morning the Secretary of State did do a media clip, and Members will have seen that across multiple outlets.

Where I do agree with the hon. Gentleman is that he is right to talk about the amazing job that our NHS colleagues do on the frontline. I know he does that, and I thank him for that, but that is even more reason why we must find a fair resolution, and NHS colleagues certainly will not get one from those on the Opposition Benches. The Opposition say that they back the independent pay review process, while disagreeing with the body’s decision when it does not suit them. They say they would not increase public spending, while failing to set out any plans for how they might pay for unaffordable pay increases. They say they believe in public safety, too, while criticising the common-sense steps we are taking to ensure safe minimum staffing levels, just as they do in many other European countries. We have got a plan—they do not.

More than 1 million NHS staff have been given at least a £1,400 increase in their pay, representing a 9.3% rise for those on the lowest salaries. NHS staff also received a 3% pay rise last year—even when pay was frozen across the rest of the public sector. We have done this because we know how hard NHS colleagues work and we recognise that there are cost of living pressures on NHS staff.

Our goal has always been a resolution that is fair for colleagues and for the country: to find a way forward that ensures we are spending money where it is needed most, and helping the NHS to recover from the pandemic, but not on pay hikes that would stoke inflation and ultimately make us all poorer. I met GMB members last week, and—together with my ministerial colleagues—I remain fully committed to working together with the unions, the NHS and others to find a responsible and fair way forward.

I call the Chair of the Health and Social Care Committee.

The NHS Pay Review Body was in front of my Select Committee last week, but it will not produce its report for 2023-24 until the end of April. Surely the longer this process goes on, the slower the resolution will be for those on Agenda for Change. Does the Minister agree that a much earlier remit letter would have been helpful, and when does he expect the Department to produce its evidence to this year’s pay review body round?

I thank the Chair of the Select Committee for his question. He is right that we are committed to the independent PRB process, which is the right way to set public sector pay and has operated successfully for over four decades. We are not changing that process, but we decided to take the step to engage with the unions on our respective evidence so that it can be as informed as possible, and we very much thank the trade unions for working with us in that spirit. We need to wait for discussions with unions to finish across Government, so I hope I can use the word “shortly”; I am mindful that we want to get this done as quickly as possible.

What does the Minister think when he looks across the border to Scotland and sees that Unison, Unite and other unions representing the majority of NHS Agenda for Change staff have accepted the 7.5% pay rise offer? There are no planned strikes in Scotland while pay deals are being considered, which clearly illustrates that negotiating with the unions is a better way of ending strikes than picking fights with them. The UK Government are unique among the four Governments of the UK in that they are the only ones who have full financial powers, and therefore the only Government who are not acting with a hand tied behind their back in offering pay uplifts to their NHS staff. Why is it, then, that the UK Government are facing the greatest number of strikes and have failed to settle any pay disputes?

I remember another Scottish National party Member making a similar comment in a previous urgent question, crowing about how Nicola Sturgeon, the First Minister of Scotland, was directly negotiating with the unions and that they had paused their industrial action, but only a handful of weeks later that industrial action was renewed. Pay is of course a devolved matter for Scotland and for Wales.

I will not make unfunded promises or pledges from this Dispatch Box. I want to have an honest and open dialogue with the unions about what is affordable for the NHS, where we recognise and reward NHS staff—who do the most incredible job day in, day out—with one eye to recruitment and retention, but it also has to be fair to taxpayers; and that is the spirit in which I approach this matter.

Can senior managers of NHS England and its various trusts make more use of pay gradings, job evaluations, promotions and increments, using pay flexibilities so that staff who are doing a good job feel valued and can be paid more?

That certainly is an option. My right hon. Friend talks about NHS managers. Understandably, the Opposition focus on nurses and paramedics, but let us not forget exactly who we are talking about: the entire Agenda for Change workforce, which is 1.245 million people. That is exactly why every 1% equates to £700 million. My right hon. Friend is right that pay is a factor, but it is not the only factor, which is why we also focus on working conditions and environment.

Taxpayers want NHS staff to be there when they need them, but as more and more staff leave the service, flipping over to work for agencies because they simply cannot afford to work for the service on their salaries, their money is being spent in the wrong way. On Friday, when I met NHS staff who came in on their day off, they said that the thing that is breaking them is the Government’s contempt for them. They simply want the Government to negotiate—so why will they not?

I thank the hon. Lady for her question, but she could not be more wrong. I was in Darent Valley hospital today and I was in Watford hospital last week, and I have the utmost respect for all those who work in our NHS. Everybody in this Chamber wants those who work in our NHS—in fact, all public sector workers—to be paid more, but the independent pay review process is a tried and tested process that has been used for more than 40 years, and it is important that the unions engage with it so that we get this right from April.

Due to the covid pandemic, the NHS has a large care backlog, which my constituents in Kettering are keen to see addressed. Will the Health Minister confirm that spending on the NHS is at record levels and that the Government have a plan to reduce NHS backlogs, which the strikes are disrupting? For every day of NHS strike action, how many NHS operations and procedures are lost?

I will gladly write to my hon. Friend on the specifics, but he is right to point out that NHS spending in England this year is about 11.4% higher in real terms than it was in 2019-20. He is right to point to his constituents on the waiting lists, and I want to get the numbers down as quickly as possible, particularly for those who have been waiting the longest. On top of a £2 billion recovery fund, we have invested £8 billion over three years; we have already opened 92 community diagnostic centres, and we will open 160 by March 2025; and we have opened 89 surgical hubs, with an aim to open 140. Our aim is 9 million more treatments and diagnostic appointments by 2024, so that constituents of my hon. Friend who have been waiting too long get that service.

Ministers are hiding behind the independent pay review process. The Minister knows that recommendations have been ignored when it suited the Government in the past. NHS employers want negotiations, the unions want negotiations and the public want negotiations. The Minister says it is time to come together in the interests of patients. He is right, so why do the Secretary of State and the Prime Minister not come together with the unions and sort it out?

I have met employers, and I believe in open and honest dialogue. What the hon. Gentleman has not accepted—and I appreciate that being in opposition is the easiest job in the world—is that, as I have pointed out, every 1% is £700 million. I have a budget this year of £153 billion and, yes, that is rising, but I have some huge challenges. We have huge challenges to tackle within our NHS. The hon. Gentleman the shadow Secretary of State just says, “Negotiate, negotiate”—

Yes, yes!