NHS Long-term Plan — House of Commons, 2019-01-07
Topic: Health
Jonathan Michael Graham Ashworth (Labour, Centre-left): I welcome the advance copy of the Secretary of State’s statement, but may I quickly say at the outset that Churchill’s Tory party voted against Labour’s NHS 22 times We welcome many of the ambitions outlined today by NHS England. We welcome the greater use of genomics in developing care pathways. We welcome the commitment to early cancer diagnosis; after all, it was a Labour policy announced at the general election. We welcome the commitment to new CT and MRI scanners; it is a Labour policy. We welcome the greater focus on child and maternal health, including the expansion of perinatal mental health services; again, it is a Labour policy. We welcome the roll-out of alcohol teams in hospitals, because, yes, it is another Labour policy The Secretary of State did not mention this, but we will study carefully the details of any new proposed legislation, because we welcome the recognition that the Health and Social Care Act 2012 has created a wasteful, fragmented mess, hindering the delivery of quality healthcare. Healthcare should never be left to market forces, which is why scrapping the competition regime and scrapping the Act’s section 75 procurement regulations, as proposed today by NHS England, are long-standing Labour policies. The Government should be apologising for the Health and Social Care Act. But why stop halfway? Why not commit to fully ending the purchaser-provider split? Why not commit to democratic accountability when planning care? Why not commit to consigning the whole Lansley Act to the dustbin of history What about the other holes in today’s announcement? Waiting lists are at 4.3 million, with 540,000 waiting beyond 18 weeks for treatment. A&Es are in crisis, with 618,000 trolley waits and 2.5 million waiting beyond four hours in A&E. So why is there no credible road map today to restoring the statutory standards of care that patients are entitled to, as outlined in the NHS constitution? They were routinely delivered under a Labour Government. Is it not a damning indictment of nearly nine years of desperate underfunding, cuts and failure to recruit the staff we need that those constitutional standards will not be met as part of this 10-year plan The Secretary of State boasts of the new budget for the NHS. Will he confirm that once inflation is taken into account, once the pay rise is factored in and once the standard NHS England assumption about activity is applied, there is actually a £1 billion shortfall in the NHS England revenue budget for this coming financial year? When he answers, will he tell the House—I will be listening carefully to what he says—whether he has seen or is aware of any internal analysis from the Department, NHS England or NHS Improvement that confirms that £1 billion shortfall figure Can the Secretary of State also confirm that despite his rhetoric about prevention, the public health budget is set to be cut again in the next financial year as part of a wider £1 billion of cuts to broader health spending, and that when those cuts are taken into account, spending will rise not by 3.4%, as he says, but by 2.7%? That will mean deeper cuts again to smoking cessation services, deeper cuts again to drug and alcohol addiction services and deeper cuts again to sexual health services when infections such as gonorrhoea and syphilis are on the rise. By the way, why is HIV/AIDS not even mentioned in the long-term plan? What was the Secretary of State’s answer when asked about public health cuts in his weekend interviews? Targeted Facebook advertising. Given that life expectancy is going backwards, health inequalities are widening and infant mortality is increasing, the public health cuts should have been reversed today, not endorsed The NHS long-term plan admits that "the extra costs to the NHS of socioeconomic inequality have been calculated as £4.8 billion a year in greater hospitalisations alone." Does that not confirm that, for all the rhetoric on prevention, the reality is that the Government’s austerity and cuts are making people sicker and increasing the burden on the NHS? Nowhere have we seen greater austerity than in the deep cuts to social care, but where are the Government’s proposals today? They still do not have any With respect to social care, surely the Secretary of State agrees that: "It is not possible to have a plan for one sector without having a plan for the other."—[Official Report, 18 June 2018; Vol. 643, c. 53.] Those are not my words, but the words of the Foreign Secretary when he stood at the Dispatch Box last June as the Secretary of State for Health and Social Care. I agree with him; it is a shame that the current Secretary of State does not. By the way, the Foreign Secretary also promised that: "Alongside the 10-year plan, we will also publish a long-term workforce plan".—[Official Report, 18 June 2018; Vol. 643, c. 52.] Where is it? The Secretary of State has not done it. We all want to know where the staff are coming from to deliver the ambitions that have been outlined today. We are short of 100,000 staff. We are short of 40,000 nurses. The Secretary of State talks of doing more for mental health services; we are down 5,000 nurses in mental health. He talks of doing more for primary and community care; GP numbers are down by 1,000 and district nursing numbers are down by 50%. Now, the Home Secretary wants to impose a £30,000 salary cap on those coming from abroad to work in our NHS, ruling out nurses, care assistants and paramedics. The Secretary of State should do his job and tell the Home Secretary to put the future sustainability of the NHS first, instead of his Tory leadership ambitions, and ditch that salary cap for the NHS There are certainly many welcome ambitions from NHS England today, but the reality is that those ambitions will be hindered by a Government who have no plan to recruit the staff we need, who have no plan for social care and who are pushing forward with deep cuts to public health services. Patients have been let down as the Government have run down the NHS for nearly nine years. We do not need 10 more years of the Tories. The NHS needs a Labour Government.