Skip to main content

NHS Workforce

Volume 724: debated on Tuesday 6 December 2022

Debate resumed.

It is a genuine pleasure to close this debate on behalf of the Government. I start by placing on the record my thanks to the extraordinary staff of the national health service, on whom this country relies day in, day out. As the Chancellor told this House less than three weeks ago,

“The service we depend on more than any other is the NHS.”—[Official Report, 17 November 2022; Vol. 722, c. 849.]

Indeed, the NHS is one of the reasons why I took the decision to put myself forward for public office. The national health service diagnosed my type 1 diabetes at the age of three, and I have been genuinely moved and supported by the NHS ever since then. It is thanks to the NHS that I am standing at this Dispatch Box.

Maintaining the service relies, above all, on the foundations of a strong economy, which was exactly the purpose of the autumn statement. We acknowledge that there are specific issues that need tackling, and the Chancellor—himself a former Health Secretary—was frank in seeking to address them. Members may recall that we debated the pressures facing the economy, and the No. 1 issue facing the economy at the moment is inflation. It is precisely because inflation is at a generational high that the prices of everything our constituents buy and rely on have gone up, including, of course, food and heating. That hurts everyone, but it hurts the poorest the most. That is why, in the autumn statement, we laid out a plan to tackle inflation, to grow the economy and to protect public services.

One of the most effective measures according to the Office for Budget Responsibility was the introduction of the energy price guarantee coupled with payments for the most vulnerable in society. Again, should any colleagues need help with their constituents, they can direct their constituents to help on the Government website The OBR said that our plan has helped to dull inflation by a couple of points and to protect 70,000 jobs, and that it has ensured that this recession is shallower than it would otherwise have been. There was some discussion during the debate about growth. I gently remind the House that we had the third highest rate of growth in the G7 from 2010 to 2022.

I turn now to the important subject of the NHS workforce. The hon. Member for Wirral West (Margaret Greenwood) rightly acknowledged that this extraordinary organisation has just been through the worst public health crisis we have ever seen—I think she put it extremely well. I hope that we are all able to discuss this in a measured way that does not need to fall into ideological argument when we acknowledge the impact that that extraordinary event has had on our workforce. Members from across the House referenced the exhaustion that NHS staff feel and the impact it has had on waiting lists.

I also pointed out that the crisis predates the pandemic. I would be grateful if the Minister acknowledged that, too.

Forgive me. Perhaps the hon. Lady misunderstood me; I was trying to be collegiate in referencing what she had said about covid. We do know, of course, that there have been pressures on the workforce and on the NHS throughout its decades of history. Every generation has the new challenge of ensuring that the NHS meets the hopes, needs and expectations of our constituents.

In opening the debate, my right hon. Friend the Secretary of State for Health and Social Care set out our plans for the NHS and explained that we are taking specific steps on issues such as workforce shortages. We will have an independently verified plan for the number of doctors, nurses and other professionals that we will need in five, 10 and 15 years’ time, taking full account of the need for better retention and productivity improvements. That will build on what are already significant statistics. Between September 2019 and August 2022, the NHS had more than 14,000 more hospital doctors and more than 29,000 more nurses and health visitors.

The Minister spoke a few moments ago about the importance of approaching this issue in measured tones, so this is an important opportunity for her to say that her ministerial colleague was wrong to attempt in the media to associate our NHS staff with Vladimir Putin’s horrific invasion of Ukraine. I think it is really important that she rights that wrong by correcting that, please.

I have not seen it myself but, from descriptions I have heard, I am not quite sure that is what he was trying to—[Interruption.] Members ask why I have not watched it. I was actually getting ready for a birthday party for my 10-year-old. We are allowed lives outside this place.

For those who have commented on workforce figures over the past decade, between May 2010 and August 2022, 36,000 more hospital doctors and 38,000 more nurses and health visitors were recruited. We are also asking the NHS, like all public services, to tackle productivity and inefficiency. My hon. Friend the Member for Peterborough (Paul Bristow) emphasised the importance of that and brought his experience to the debate.

To help colleagues, the initial findings by Patricia Hewitt, the former Labour Health Secretary, will be delivered to the Department within three weeks, which shows the pace of work that Ms Hewitt and others are taking on this important project. In addition, we are boosting NHS funding by £3.3 billion next year and by another £3.3 billion the year after that, helping to ensure that the NHS can take rapid action to improve urgent and emergency care and to get elective performance back to pre-pandemic levels.

I will just make a little progress, if I may. Amanda Pritchard, the chief executive of the NHS, has said that this should

“provide sufficient funding for the NHS to fulfil its key priorities”

and shows that the Government are serious about their commitment to prioritise the NHS.

The hon. Member for Coventry North East (Colleen Fletcher) and my hon. Friend the Member for Peterborough emphasised the role that pharmacies can play, and I hope we can discuss ways that different services can be delivered differently over the NHS in the coming months and years. My hon. Friend the Member for Winchester (Steve Brine), who chairs the Health and Social Care Committee, made the sound point that prevention is part of productivity.

Overall, the NHS resource budget in England is expected to increase to £165.9 billion in 2024-25, up from £123.7 billion in 2019-20. Our determination to deal with the covid backlogs has seen the NHS already hit its first milestone in terms of waits of over two years, and it will go further, eliminating waits of over 18 months by April next year, over 15 months by March 2024, and over 12 months by March 2025. My right hon. Friend the Secretary of State compared that with the figures in Labour-run Wales, and noted that a fifth of the population there is waiting for care and remarked on the curious anomaly that Wales stopped publishing its workforce vacancy rates in 2011.

The Minister talks about waiting lists dropping. I would like to hear an explanation as to how, in one 24-hour period last week, in the whole of the UK, there was one paediatric intensive care unit bed. What is her explanation for that?

The hon. Gentleman raises a serious point. I do not have the answer to hand, but I will ensure that the relevant Health Minister writes to him, because I understand why he raises it.

There has been a great deal of discussion about nurses’ pay, and we are extremely regretful and very much hoping that accommodations and agreements can be found. To put into context recent pay rises, more than 1 million staff including nurses have benefited from a pay rise of at least £1,400 backdated to April this year. That is on top of the 3% pay rise they received last year. My hon. Friend the Member for Winchester asked an interesting question: does Labour support or oppose the independent pay review bodies, which set the recommendations that have been accepted?

I will not, because I have to finish.

Turning to non-doms, I must congratulate the shadow Minister, the hon. Member for Ealing North (James Murray), on his florid use of language in relation to my advocacy efforts in the Finance Bill debates. I hope that I am able to answer his question in a moment. The motion deals with non-dom taxpayers. As I have said repeatedly—and I hope at some point it will get through—non-dom residents who live in the UK have to pay UK taxes on their UK income and gains, just like everybody else. That raised £7.9 billion last year, and non-doms have invested £6 billion.

The area over which there is disagreement is the rules relating to foreign income, and the Opposition ask whether this is the answer. I have listened with great interest to how the sum they have put in their motion is apparently going to answer all sorts of economic difficulties, particularly during consideration of the Finance Bill, and I am not sure it will quite add up. Interestingly, it was a Conservative Government who reformed non-dom laws to end the ability to claim this status permanently, and I note that the non-dom status survived during 13 years of Labour government. In any event, the Chancellor said very frankly in evidence to the Treasury Committee last week that he has asked officials to look at it.

We have the workforce strategy, which will be delivered. NHS England has done considerable work, and we hope that it will report as soon as possible. It has been a real pleasure for me to be able to praise the NHS and thank its extraordinary staff. What the NHS needs is a Government making the right decisions for the economy, so that we can actually afford a world-class health service. That is what this Government are determined to deliver.

Question put.


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.

On a point of order, Madam Deputy Speaker. Once again we have had an Opposition day debate where the Government have refused to vote. We had an incredibly important motion in front of the House, on a matter of significant importance and interest to my constituents. In the first seven years I was in Parliament, we always had votes on Opposition days, and this is one of the ways that the Government are undermining the House of Commons and refusing to listen. The motion was passed by the House and contains a specific request, which the Government will go on and ignore, as they have done before. Has there been any discussion by Mr Speaker about reasserting the position of this House? It was never the case in the past that the Government ignored Opposition days; in fact, the Blair Government changed the policy on Gurkhas as a result of an Opposition day debate that they lost. Has there been any discussion about reasserting the voice of Parliament, so that when the House passes a motion, the Government listen to it?

I thank the hon. Gentleman for his point of order. I am sure he is well aware that a motion such as the one we have just passed would not be binding. As he says, it was the case that Governments might participate a little more in the votes than they have recently, and it was the case some time ago that the Government agreed to give a response to motions that have been passed. It is up to individual Members and the Government to decide whether they wish to participate in votes; it is not the job of the Speaker to compel them, which I am sure the hon. Gentleman appreciates as well. I am not aware of any current discussions with the current Leader of the House, but perhaps the hon. Gentleman could raise this issue in business questions if he wished, and I am sure that those on the Treasury Bench will have heard his comment.