NHS Workforce

I inform the House that I have not selected the amendment. I call the shadow Secretary of State for Health and Social Care.

I beg to move,

That this House recognises that the National Health Service is facing the worst workforce crisis in its history with a shortage of 9,000 hospital doctors and 50,000 nurses; condemns the Government’s failure to train enough NHS staff to tackle this crisis; regrets that, as a result, patients are finding it impossible to get a GP appointment, ambulance or operation when they need one; calls on the Government to end the 200-year-old non-domiciled tax status regime which currently costs taxpayers £3.2 billion a year; and further calls on the Government to use part of the funds raised to invest in the NHS workforce by doubling the number of medical training places, delivering 10,000 more nursing and midwifery clinical placements, training twice the number of district nurses per year and delivering 5,000 more health visitors to guarantee that the NHS has the staff to ensure every patient can access the care they need.

The NHS is facing the worst crisis in its history. Seven million people are waiting for NHS treatment, and they are waiting longer than ever before; 400,000 patients have been waiting for more than a year. Heart attack and stroke patients are waiting an hour for an ambulance, on average, when every minute matters. “24 Hours in A&E” is not just a TV programme; it is the grim reality facing patients in an emergency. Behind those statistics are people being held back from living their lives: people forced to give up work because they cannot stand the pain; young people, still bearing the scars of lockdown, unable to get the mental health support they need to step into adulthood; families losing loved ones for no other reason than that the NHS was unable to treat them in time.

My friend and colleague the shadow Leader of the House shared with me an email from one of her constituents. A patient with suspected cancer was urgently referred by his GP, which ought to mean being seen by a specialist within a fortnight. Four weeks later he had heard nothing. He phoned the hospital and was told, “two weeks currently means six weeks” and that he would be contacted, not seen, within the next two weeks. He has now had his appointment, during which the doctor identified cancerous cells. He has been told that he will wait up to eight months to have that cancer removed. He said that until waiting lists are down,

“more people will die unnecessarily from cancer. I hope not to be one of them.”

That is not uncommon. That is where we are. That is why Labour is today putting forward our plan to solve this crisis, make the NHS fit for the future, and get patients treated on time again.

Yesterday I spoke to a paramedic who had been with a patient with sepsis, waiting for two and a half hours to be taken in. There were 98 calls at that same Yorkshire hospital waiting to go in. Are we now post-crisis and in complete breakdown, and do we need Labour’s plans to come in now, and not have to wait?

I strongly agree with my hon. Friend. As the Leader of the Opposition has said, the NHS is not on its knees; it is on the floor. How many times were we told during the pandemic that restrictions were needed to stop the NHS falling over? It has now fallen over, and for the first time in its history people no longer feel certain that, when they phone 999 or arrive at A&E, they will be seen in time. It is the first time in our country’s history that people have not felt confident that emergency medicine will be there for them when they need it.

The Conservatives blame the crisis in the NHS on everything from the weather to the pandemic, and even NHS staff. Of course there is no doubt that the pandemic has made things worse, but the Government—the Conservative party—sent the NHS into the pandemic with 100,000 staff shortages. They spent a decade disarming the NHS, before sending it into the biggest fight it has ever faced. They cannot pretend that the NHS was well prepared. The problem for the Conservative party is that people are not stupid. Their memories are not that short. They know that the NHS was struggling to treat them on time before the pandemic, and they know who is to blame.

Is not the point that health is devolved across four different nations, which are each led by a different party? Does this mean that the pandemic has hit all health services, including across the western world? This is a rising tide of the problem of the pandemic and dealing with an ageing population. This is not party political at all, and it is remiss of the hon. Gentleman to try to make it that. What does he say to that?

I would say two things. As I have already said, I accept that the pandemic made the challenge right across the United Kingdom worse. I also accept that, in every part of the United Kingdom, the NHS is under severe pressure. I would say two things in response. First, even if some of our friends on the SNP Benches do not want to acknowledge it, there is no doubt that every part of the United Kingdom would be better off with a Labour Government and every part of the NHS in every part of the United Kingdom would be better off if there were a Labour Government, because the investment that we are proposing in NHS staff today would benefit countries right across the United Kingdom. [Interruption.] In response to the outgoing hon. Member for Peterborough (Paul Bristow), do not say that politics does not make a difference. Do not expect the people to believe that somehow there was an inevitable sense of decline in the NHS. I am sure people remember that, when Labour was last in government, we delivered the shortest waiting times and the highest patient satisfaction in history.

Is the hon. Member planning to cross the Floor? I look forward to hearing from him.

Certainly not. The hon. Member’s plan seems to be simply vote Labour—there is no detail to it and nothing else to it. I suggest that he looks at the good people of Wales, who suffer under a socialist healthcare system. They are certainly not very happy, are they?

I do not pretend that our plan is not vote Labour, but of course those are the means by which we get to better ends. What we propose today is the biggest expansion of the NHS workforce in history. I will explain how that will benefit patients across the country and how we will pay for it. I think that people in Peterborough, 2,788 of whom are waiting more than a month to see a GP, will welcome Labour’s plan for investment. That is why, after the next general election, Peterborough will have a Labour MP.

I want to raise the case of my constituent, Mr Simpson, whose wife died last Tuesday after waiting 16 hours for an ambulance. On 29 November, his wife was confused. At 3 pm, he first called for an ambulance and was told that one might be sent and that he might hear from the service. At 6 pm, he rang the ambulance again. The person wanted to speak to his wife, but she was very confused and unable. He tried to give her a drink at 2.30 am; there was still no ambulance. His wife went to sleep, but she was still moving a bit. He fell asleep. He woke at 7.30 am and found that his wife was not moving; she had passed away. All the while they were still waiting for the ambulance to arrive. I do not believe for one moment that that happened because the ambulance service does not care. Does my hon. Friend agree that the service is desperately understaffed, desperately short of resources and in desperate need of adequate funding?

I thank my hon. Friend for raising that heartbreaking case. It is every family’s worst nightmare. All of us now know someone who is waiting for treatment. Many of us know someone who has called for an ambulance and waited for hours and hours—and, in some cases, given up on it and gone to hospital. I have spoken to ambulance service staff who, like many other staff across the NHS, feel a real sense of deep personal moral injury because they know that, despite their best efforts and busting a gut at work every single day, their best simply is not good enough because the system has collapsed. Ambulance turnaround times are not fast enough because A&E waiting times are too high. That is because people cannot see a doctor and the social care is not available, so the beds are full of people who are well enough to go home and would be better off at home. This is the problem in the NHS: the whole system is broken. I am afraid to say that political decisions made in this place by the Conservative party have led us to this tragic situation.

My hon. Friend is making an excellent case. At the James Cook University Hospital in Middlesbrough, the number of people still in hospital who could be discharged into social care amounts to three full wards. That is the situation that we have got to. It is a perfect storm, with ambulances queueing outside and people turning up at A&E because they cannot get to a GP. That will only ever be addressed if we also address staffing in our GP services to ensure that they can attract people who are offered Agenda for Change terms and conditions to alleviate the backlog. Does he agree that we need to invest in all the elements along that supply chain?

My hon. Friend is absolutely right. This is the tragedy of where we have got to on social care in particular. The Government have allocated half a billion pounds to alleviate pressure this winter, but not a penny of it has reached social care providers. Not a penny of it is currently being worked in action to try to deal with delayed discharges. I have no doubt whatsoever that one reason why it has taken so long from that commitment to getting money to the frontline is the constant churn of Ministers that we saw over the summer. The absolute circus that we saw in the Conservative party has had a direct impact on the competence of effective Government in this country. We now have ineffective Government, so even when the Government seek to do the right thing and allocate the resources, they cannot get the money out the door far enough because Ministers seem to change week in and week out.

I commend the shadow Secretary of State for what he is saying. When it comes to staffing issues, one thing should clearly be done. Does he agree that part of the reason why we rely so heavily on agency staff is because our NHS staff have migrated to agency working, where there is less pressure, so the Government should spend less money on agency workers and give our NHS staff greater support and appropriate pay so that they can stay in the NHS?

I strongly agree with the hon. Gentleman. I will come shortly to talk about industrial action, but this should be at the heart of the Secretary of State’s thinking. The demands from staff trade unions, whether on pay, terms and conditions or the wider pay machinery, should be seen not just as a negotiation with staff unions but as a retention issue. We are losing staff faster than we can recruit them in some places—especially in areas such as midwifery—and if we lose the staff that we have, even Labour’s plans to undertake the biggest recruitment in the NHS’s history would not be as effective as they would be if we kept staff in the service today. That is why I urge the Secretary of State to treat those NHS staff with respect, get their representatives around the table, and negotiate a solution.

I am aware that the situation in the NHS in Northern Ireland is the worst that we see throughout the United Kingdom. The shadow Secretary of State for Northern Ireland, my hon. Friend the Member for Hove (Peter Kyle), visited NHS services in Northern Ireland only recently. I have no doubt that we need to get effective governance back up and running again in Northern Ireland as well. I urge the Government to discharge their responsibilities in that area, too. Certainly, when Labour was last in government, I do not remember Labour Prime Ministers taking such a complacent, lackadaisical or indeed absent approach to the governance of Northern Ireland. I hope that we can see a breakthrough of the deadlock so that the people of Northern Ireland get the Government they deserve in Stormont, as well as the United Kingdom getting the Government it deserves here in Westminster.

Waiting lists were already at a record 4.5 million before the pandemic. Ambulances were taking longer than is safe to reach patients in an emergency before the pandemic. Patients were waiting longer than four hours in A&E before the pandemic. The 18-week guarantee for elective treatment had not been met for four years before the pandemic, and more patients have waited longer than two months to start their cancer treatment every year since 2010. From the moment the Conservatives entered power, things began to deteriorate. It is not just that the Conservatives did not fix the roof while the sun was shining; they blew off the roof and ripped up the floorboards, and then they wonder why the storm did so much damage.

My hon. Friend mentioned cancer diagnosis rates. I believe he will be aware that one in four people diagnosed with pancreatic cancer dies within a month of their diagnosis, with 70% receiving no treatment at all because they die before they could be treated. Does he agree that cancer diagnosis rates are a disgrace and that early intervention, early diagnosis and early treatment are vital for people with all forms of cancer, particularly the most aggressive types such as pancreatic cancer, to have any chance of survival?

My hon. Friend is absolutely right. One reason why this country has much poorer cancer outcomes than many comparable economies is precisely because of late diagnosis. I know from my own experience how vital early diagnosis can be for good cancer outcomes. I am terrified by the fact that, within those 7 million patients waiting in the elective backlog, there will undoubtedly be cases of undiagnosed cancer and other conditions. If the NHS had eyes on the patients, they would be detected faster, patients would receive treatment much more quickly and the outcomes would be better. One of the tragedies for the NHS is that, because we do late diagnosis, we get more expensive and less effective treatment. If we could diagnose faster, patients would get better outcomes and taxpayers better value for money. That is the kind of reform to the model of care that Labour would like to see.