NHS Funding Bill (Money Bill) — House of Lords, 2020-02-26
Topic: Health
Anthony Young (Labour, Centre-left): My Lords, I was going to welcome the long-term funding, but now that my noble friends have suggested I should be cynical, sceptical or chiding, perhaps I will tone down that enthusiasm. Nevertheless, I want to comment on the commitment to build 40 new hospitals. I hope that, regarding the procurement contract, the Minister can assure us that we have learned lessons from the Carillion failure. If not, there could be more disasters in the making The Library briefing document states that Mr Hancock stressed that the sums in the Bill were "the minimum levels of funding, but actual spending could be more: he said they would ‘set a floor, but not a ceiling.’ He then listed some of the services which would be provided with the additional funds" I noted the reference to "more GP appointments" and thought that was to be welcomed, but the challenge, as a number of noble Lords have said, is whether we can recruit and train the new doctors and retain the doctors we have. The early retirements are a worrying indicator I welcome the Minister’s point about restoring the nurses training bursary. One might question why we took it away in the first place, given the huge number of vacancies, and what I regard as the shame of continually having to poach both nurses and doctors from overseas countries that badly need them too In talking about building new hospitals, perhaps the Minister can say something about the state of many GP surgeries, which require investment. If they do not get it, they cannot provide the additional service needed, which puts further strain on A&E. In a previous debate, I cited the problem my own local practice had. Here, I should declare an interest as a member of the patient care committee. New hospitals have to be staffed, as do existing ones. The figures have been quoted; I do not want to go over them again. However, I do want to refer—unsurprisingly, as an apprenticeship ambassador—to a couple of briefings I have received. One is from Unison, which quotes some interesting stats. It did a survey and 54% of trusts found that 80% of the money paid into the apprenticeship levy "was unspent as at May 2019. For these trusts alone, that amounted to £200 million of unspent funds." Those funds are starting to expire and if they are not spent in the two-year period, they go back into the system—to the Treasury, at worst—or they may be invested in other apprenticeship levies. It is worrying because of the huge number of vacancies in the NHS, and because the Government have said that 5,000 of the 50,000 more nurses they promised by 2023-24 will come from degree apprenticeships I suggest to the Minister—I do not wish to convey only bad news—that there is an example of good practice. A briefing from NHS England described an interesting collaborative approach, involving three trusts in the Gloucestershire area, to recruiting and procuring assistant practitioner apprenticeships. They had different requirements—people for mental health care, for acute care and for community care; all vitally important. By working collaboratively, they have made significant use of the apprenticeship levy. My plea to the Minister is that he should try to spread best practice. That will be a continuing theme of my contribution today The Library briefing mentioned an issue which the Secretary of State has committed to and which has already been referred to by the noble Lord, Lord Willis: investments in innovative technology. The NHS’s record in introducing new technology is not good. As I have mentioned in a previous debate, when I spoke to a registrar in an A&E department, he protested that he still cannot electronically transfer patient notes from one hospital to another. One starts to despair—we are talking about much more advanced innovative practice, but we still have not mastered some of the basics. So there are some easy hits in that regard I concur with my noble friend Lord Bradley on the issue of children’s mental health. I should declare a personal interest—I have a granddaughter who needs a lot of care. Her family have had to wait a long time to get anything at all, which has had an impact on them. It is not just about the huge impact the child, their education and future; it is the family who must struggle with the repercussions. This underlines the importance of spending on mental health, which a number of noble Lords have referred to My next point was covered by the noble Lord, Lord Warner. We might argue with the noble Baroness, Lady Penn, about who has spent most. That the previous Labour Government did spend a huge amount of money is a legitimate point to make. We reduced waiting lists and made some significant improvements. I do not want to carp about it, except to say that one thing everyone in your Lordships’ House can agree on is that, when we are spending these large sums of money, we want to get the best bang for our buck, to use that cliché I was really interested in a comment made, I think, by the noble Lord, Lord Willis. I had never thought about the role of all NHS staff in providing research. He made a really interesting point. There is a lot of knowledge, experience and good practice out there, which needs to be considered if you are going to spend these significant sums of money. Can the Minister say how the Government are going to spread best practice? Have they adopted this as a necessary strategy? I wish them well, because the view that we need this to succeed for the future of the National Health Service crosses all boundaries in this House.