PARLIAMENTARY DEBATE
NHS England Funding: Announcement to Media - 25 October 2021 (Commons/Commons Chamber)
Debate Detail
I repeat to the Government that if they persist in making announcements first outside this House, Ministers will be called to account in this Chamber at the earliest opportunity. The Chair of Ways and Means, who oversees the Budget, is also very upset by the briefing that has gone out. At one time, Ministers did the right thing if they briefed before a Budget: they walked. [Interruption.] Yes, absolutely! They resigned. It seems to me that we are now in a position where if they have not got the information out five days beforehand, it is not worth putting out. Members are elected to this House to represent their constituents and those constituents quite rightly expect their MP to hear it first in order to be able to listen to what the Budget is about and also, in the days following that, to hold the Government to account. This is unacceptable and the Government should not try to run roughshod over this House. It will not happen.
Just as we are determined to keep this country safe from covid-19, we also want to tackle the backlog that the virus has brought with it. We know that “business as usual” will not be enough, so we will do whatever it takes to ensure that people get the treatment they need as quickly as possible. In September, we announced plans to spend £8 billion to tackle the elective backlog over the next three years, in addition to the £2 billion this year.
The House will have seen the announcement of £5.9 billion to tackle the NHS backlog of diagnostic tests and procedures and to support the delivery of millions more checks, scans and treatments for patients across the country. This includes £1.5 billion for increased bed capacity, equipment, new surgical hubs to tackle waiting times for elective surgeries and at least a total of 100 community diagnostic centres to help to clear backlogs of people waiting for clinical tests such as MRIs, ultrasounds and CT scans, as well as £2.1 billion of investment to modernise digital technology on the frontline.
This is an historic package of investment that will support our aim of delivering around 30% more elective activity by 2024-25 compared with pre-pandemic levels. That of course comes on top of the work we are doing to strengthen the NHS workforce, who have performed so brilliantly throughout this crisis. All of this is vital if we are to help get our NHS back on track and ensure that no one is left waiting for vital tests or treatments and that we have the right buildings, equipment and systems so that our NHS is fit for the challenge ahead.
Many hospitals in the Government’s so-called new hospitals programme, including those in west Hertfordshire, have been waiting months for funds to be released so that they can start renovation work. Is any of this so-called new money actually part of these existing commitments? There are almost 6 million people stuck at home in pain waiting for treatment. Senior medical staff are predicting thousands of early deaths if the Government fail to act. People are desperate to know how many more weeks they have to wait for their operation. Can the Minister tell them?
Finally, it is all very well announcing money for new diagnostic tests and medical equipment, but there are tens of thousands of vacancies in the NHS. Without the trained medical staff to use these new facilities, this plan is doomed to fail. Without a serious plan to recruit the NHS staff that we desperately need, England could face an epidemic of empty wards and shiny new scanners and superfast broadband going to waste because the staff who make our NHS what it is simply are not there any more.
The hon. Lady asks where the money is coming from. She tempts me, but I am afraid she will have to wait until Wednesday’s Budget for the Chancellor to set out how he is funding each of the announcements.
The hon. Lady touched on the single most important element of our ability to tackle the pandemic and to respond to the consequences for the elective waiting list and, as I know she would, I put on record our thanks and gratitude to those staff. Radiologists and radiographers are the key people in this space, and since 2010 we have increased the clinical radiology workforce by 48% from 3,239 to 4,797 full-time-equivalent posts. The number of diagnostic radiographers is up by 33% since 2010.
Does that mean we need to continue to do more? Of course it does, and she is right to highlight the need for continued investment in our workforce. She will have seen last month’s announcement of £12 billion of funding, a significant part of which will help to build that workforce, on top of the commitments we made at the last election and on which we are delivering.
“Tonight, in quick succession, I—& no doubt other reporters—received 6 Treasury press releases about what’s in next week’s budget—5 of them embargoed to various times over weekend… Whatever became of budget secrecy & announcing things to MPs first?”
The Government have put up a good Minister, so we cannot have a go at him for that, but why does he not go back and tell his friends in the Treasury, at the very least, to provide Members with copies of these embargoed press releases? If it is good enough for the media, it is good enough for us in this House.
Fortunately, I received the press release on Sunday. I should not have, but I was sent it, and obviously Members should have received it, too. Of course the NHS is in a desperate state and is under crushing, unsustainable pressure, partly because of a decade of under-investment in infrastructure, the cutting of thousands of beds and raids on the capital budget. It means that today, hospitals are facing a repair bill of £9 billion, and we have sewerage pipes bursting, ceilings collapsing and equipment breaking down. The number of safety incidents in hospitals as a result of these problems has increased by 15% in the last year alone. Not only is the equipment old and outdated but, on a head-for-head basis, we have some of the lowest numbers of computed tomography and magnetic resonance imaging scanners in Europe and the highest numbers of fax machines. Capital budgets have been raided throughout the last 10 years. Will the Minister confirm that, in what he is announcing, the total capital budget will be ring-fenced and not raided in the coming years?
The Minister has not mentioned mental health, but we have thousands of unsafe and undignified dormitory wards. Will there be extra capital investment to get rid of them? If so, by when? Will the diagnostics centres that he mentioned be provided and run by the NHS or run and supplied by private sector contractors? He said that we will clear the 1.3 million backlog in diagnostic tests by the end of the Parliament, but nobody wants to see ghost surgical hubs or new equipment standing idle. Who will staff the diagnostics centres? Who will staff the surgical theatres? Who will operate the new equipment?
The Minister mentioned diagnostics staff, but we are short of one in 10 of them. We are also short of 55% of consultant oncologists, short of radiologists and short of 2,500 specialist cancer nurses. Will he guarantee that the Health Education England budget will be not frozen or cut but properly funded to recruit the thousands of extra doctors, nurses and NHS staff needed to provide safe care and bring waiting times down?
On mental health, the right hon. Gentleman is right to talk about capital investment. In the context of those new hospitals, mental health facilities and hospitals are included. They have not been left out; they have got their share.
The right hon. Gentleman also rightly talked about staff, which, as I said to the hon. Member for St Albans (Daisy Cooper), is a key point. We have seen significant increases in the number of doctors and nurses. He is right to highlight the need for continued increases in specialisms such as radiographers and radiologists. I highlighted the increases that we have seen, but we know just how valuable they are. I alluded to the £12 billion that the Secretary of State announced back in September, a significant part of which will go to support the workforce in the delivery of elective recovery.
On how community diagnostic centres and community diagnostic hubs will both be selected and operate, we are working closely with the NHS on exactly how to do that to ensure that the workforce are sufficient and that we do not impose burdens over and above those already imposed on them. I think that I have answered the right hon. Gentleman’s questions, but I am sure that his hon. Friends will come back if I have missed anything.
Given that in the last two years very large sums of money have been spent on test and trace, establishing a successful vaccine programme, Nightingale capacity and other one-offs for the pandemic, how much of that money will become available to spend on the other work that is now so desperately needed in the NHS?
We are being realistic in setting expectations about how long it will take to clear the backlog. It is right that we do that with the public, because we must look after our workforce. One of the single biggest things we can to do help with retention is to be flexible with our workforce—recognising, exactly as my right hon. Friend says, the need for flexibilities, not just for female members of our workforce but for all our workforce, as well as the need for additional staff to come through and help ease the burden.
I have spoken with the Royal College of Surgeons and others of the royal colleges about how we approach the issue. We should look at a number of factors. Is it possible with these new approaches to deal quickly with a large number of high-volume, low-complexity treatments that impact on quality of life? Equally, there are very complex treatments for which a month, a week or even a day longer can lead to more adverse clinical outcomes.
It is right that we go for clinical prioritisation. Although I am keen that we should keep people informed and engaged as participants in the process, it is vital that we see this issue as clinically led.
On the hon. Gentleman’s key point, there are number of things. This is about not only tackling the urgent backlogs now, but building a system that is resilient for the future and that can actually tackle the broader challenges that we as a society face. That means more diagnostic capacity and more diagnostic capacity at an earlier stage, as some other countries have. I am quite happy to acknowledge that, under Governments of both political complexions, we could have done more, and that is why we are doing more now, and I say that to him gently. He talks about urgency; he is right. He also makes a very important point, which I tried to allude to in my earlier answer. If I did not land it clearly, I will attempt to do so now. He is absolutely right to highlight the risk of burn out and exhaustion, for want of a better way of putting it. As I said, it is very easy for people to say that X specialty was not working during the pandemic because that surgery was not happening, but you can bet your bottom dollar that the people involved were probably helping out—the anaesthetists and theatre nurses were—so we do need to address that point. I will be happy to see the hon. Gentleman.
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