The following Answer to an Urgent Question was given in the House of Commons on Monday 15 December.
“The NHS’s national medical director says:
‘This unprecedented wave of super flu is leaving the NHS facing a worst-case scenario’.
This is backed up by the data. On any given day last week, an average of 2,500 patients were in hospital beds—a 55% increase on the week before, and almost double the number from 2023. One hundred and six flu patients are in intensive care, compared with 69 the previous week. There are 1,300 more staff off than in the week before, and the number of calls received by NHS 111 last week was 446,000—8% higher than at this time last year.
It is clear from both the NHS and UK Health Security Agency data that there is a real risk for the NHS and for patients, and it is at this moment of maximum danger that the British Medical Association has chosen to go ahead with Christmas strikes, when they will inflict the greatest level of damage on the NHS.
The BMA said this dispute was about pay, but we gave doctors a 28.9% pay rise. Then it said it was also about jobs, so I offered a deal to halve the competition for jobs to less than two applicants per post. It is now clear what these strikes are really about—the BMA’s fantasy demand for another 26% pay rise on top of the 28.9% doctors have already received. I also offered to extend the BMA strike mandate, so it could postpone this action and go ahead once flu has subsided. The fact that it also rejected that offer shows a shocking disregard for patient safety. Since this strike represents a different magnitude of risk from previous industrial action, I am appealing to ordinary resident doctors to ignore the BMA strike and go to work this week. Abandoning patients in their hour of greatest need goes against everything that a career in medicine is meant to be about.
The entire focus of my department and the NHS team is now on getting the health service through the double whammy of flu and strikes. We have already vaccinated 17 million people, which is 170,000 more than last year, and 60,000 more NHS staff. We have invested in 500 new ambulances, 40 new same-day emergency care and urgent treatment centres, and 15 mental health crisis assessment centres. The NHS will also be recalling resident doctors to work in emergency situations, and we will not tolerate the dangerous attempts to block such requests that we have seen from the BMA in the past.
I am proud of the way that the NHS team has pulled together through strike action in the past, and I know they will move heaven and earth to keep patients as safe as they can this winter. I am just appalled that they are having to do so without the support of their colleagues in the BMA”.
My Lords, I want to ask the Minister about two cohorts in respect of which there are concerns about vaccination levels. The first is front-line health workers. Is the Minister aware of what percentage have been vaccinated and what action is being taken to improve the uptake of vaccinations, particularly among those front-line health workers? I know that there are stories and concerns expressed in the press about the rate of vaccination. On the second cohort, will the Minister tell the House which socio-economic or ethnic groups have the lowest update? What targeted plans does the department and NHS England have to increase uptake rates in these groups?
First, we have started earlier and done more than ever before to prepare for the winter pressures. The good news is that the flu vaccines are working well to protect people against severe disease, and they are certainly working well in comparison to how they used to. In fact, we are the first country in the world to show vaccines working this well. On the uptake of vaccinations, 60,000 more NHS staff have been vaccinated this year than last year, which is extremely welcome. We have delivered over 17 million flu vaccines, which is tens of thousands more than we had delivered this time last year. We have a particular programme of communication and support and availability to those groups which are less likely to take up vaccinations. Vaccinations are our best line of defence against RSV and flu. I will be pleased to provide more detailed information to the noble Lord.
My Lords, given that not all babies are currently able to benefit from protection under the two-pronged approach to the RSV programme, what efforts will be made to ensure that other babies, such as those born to unvaccinated mothers, who remain at risk, will be included in any extension to the RSV vaccination programme?
I know my noble friend is very familiar with the maternal RSV programme, not least because of her campaigning, for which I pay tribute to her. It only began in September, and it is already proving successful. We want to see more pregnant women being vaccinated; we have updated and made available information resources in 30 languages for better access to vaccinations. We encourage maternity services to have early discussions with pregnant women about vaccination, and we ensure that training is in place to allow staff to have the knowledge and confidence to address concerns and build confidence. I hope that this answer is helpful not just to my noble friend but to the noble Lord.
My Lords, I do not believe for one moment that the Minister is complacent. In answer to the question from the noble Lord, Lord Kamall, the reason why the staff vaccination rate is up from last year is because it was at an all-time low of less than 30%, down from 2020 when it was 75%. There are still 750,000 healthcare workers who have not had the flu vaccine and who are unprotected. Based on that figure, what extra steps will the Government take to further incentivise take-up by NHS staff to prevent the crippling of service delivery when it most needed?
The noble Lord is quite right. We have to protect our staff, who are under immense pressure and are not just at risk from flu but seeking to tackle the extra pressures of industrial action. We are focused on making vaccines available to staff in the easiest way possible. We will continue to do so. I should add that we are considering options on implementing advice to expand vaccinations to the over-80s and, in particular, older adult care residents to ensure that any change has the best possible impact. It is important that we continue to drive vaccination rates up. That will protect staff who are providing the care. As the noble Lord said, we also have to continue our programme to encourage NHS staff to take up the vaccine.
My Lords, one of the biggest winter pressures on the NHS is the forthcoming strike, which will have an impact on patients, of course, but it will also have a further extremely damaging impact on the crucial consultant cohort which has to cover throughout these periods, many of whom are now simply looking for a way out. What is going to be done to improve the morale and retention of this vital resource?
In my view, the BMA has chosen Christmas strikes to inflict damage on the NHS at a moment of maximum challenge. It has refused to postpone them to January, which would have helped patients and other NHS staff, as the noble and gallant Lord referred to, to cope over Christmas. At present, our position is that the offer that we made to prevent those strikes happening has not been accepted, as the noble and gallant Lord will know. We are now reviewing where we are going to go. We completely understand the effect on morale and the exhaustion among staff who are covering. We are managing that to the best of our ability. I am most grateful to NHS staff in supporting us to be ready for winter and tackling the industrial action’s effects.
My Lords, can I press the Minister a little on the reasons why NHS staff are reluctant to get vaccinated? The noble Lord, Lord Scriven, drew attention to the very low vaccination rate. What are the top reasons for those barriers? What is the Minister doing about it as a matter of urgency, given the significant numbers of people contracting flu this season?