hazylavender/hi huggingface dataset:
Date: 2023-04-17
Steve Barclay: The shadow Secretary of State seems to ignore the fact that we have negotiated a deal with the NHS Staff Council, and it is a deal that it has recommended to its members. Indeed, the largest health union has voted in favour of the deal--indeed it is his own health union that has voted in favour of it--and yet he seems to suggest that we should tear it up even though other trade unions are voting on the offer, and their leadership had recommended it. Secondly, the shadow Secretary of State says that we should sit down and negotiate. We have made an offer of 10.75% for last year, compared with the Labour Government in Wales, who have offered just 7.75%, which means that, in cash terms, the offer in England is higher than that put on the table by the Welsh Government, whom, I presume, he supports. He says that he does not support the junior doctors in their ask of 35%, and neither does the leadership there. We need to see meaningful movement from the junior doctors, but I recognise that they have been under significant pay and workforce pressures, which is why we want to sit down with them. The bottom line is that the deal on the table is reasonable and fair. It means that just over PS5,000 across last year and this year will be paid for a nurse at the top of band 5. The RCN recommended the deal to its members, but the deal was rejected by just under a third of its overall membership. It is hugely disappointing that the RCN has chosen not to wait for the other trade unions to complete their ballot and not to wait for the NHS Staff Council, of which it is a member, to meet to give its view on the deal. It has chosen to pre-empt all  that not only with the strikes that come before that decision of the NHS Staff Council, but by removing the derogations--the exemptions--that apply to key care, including emergency care, which is a risk to patient safety. Trade unions are continuing to vote on the deal. The deal on the table is both fair and reasonable, including just over PS5,000 across last year and this year for nurses at the top of band 5. The deal has been accepted by the largest union in the NHS, including, as I have said, the shadow Health Secretary's own trade union. It pays more in cash to Agenda for Change members than the deal on the table from the Labour Government in Wales. It is a deal that the majority of the NHS Staff Council, including the RCN's own leadership, recommended to its members. We have always worked in good faith to end the disruption that these strikes have caused and we will continue to do so. None the less, it is right to respect the agreement that we have reached with the NHS Staff Council and to await its decision, which is due in the coming weeks.
Date: 2023-04-17
Steve Brine: Reports over the weekend suggest that the British Medical Association has asked its members not to engage with trusts if they intend to strike, as the Secretary of State has confirmed today. That is putting trust chief executives--and this is not their fault--in an impossible position. They are being asked to meet very challenging targets that we are rightly setting them, not least with respect to the covid backlog. What more can he do by his good offices to break that impasse? It is patients who are losing out.
Date: 2023-04-17
Steve Barclay: I agree; it is extremely surprising that the BMA has asked its members not to liaise with NHS managers as they put in place those contingency plans. I urge the BMA junior doctors committee to think of those colleagues who have to provide the cover for those strikes. I reaffirm my thanks to all those staff in the NHS who provided cover following the Easter period, but it puts more pressure on other NHS staff if the BMA junior doctors committee is not willing for its members to liaise with management on sensible contingency measures, as I urge them to do.
Date: 2023-04-17
Steve Barclay: In part, that is why my door is open and I am keen to discuss with junior doctors the pressure they face not just on pay, but on non-pay issues. There is the issue of support for the number of doctors and the workforce plan we have committed to bring forward to boost recruitment, but other non-pay issues are also frequently raised by junior doctors, such as booking annual leave and rostering. I am keen to work constructively with junior doctors to address those, but for us to do so they need to move from an unrealistic and unaffordable 35%, which the Leader of the Opposition himself has recognised is an unreasonable position.
Date: 2023-04-17
Steve Barclay: I very much agree with my hon. Friend that this is a fair and reasonable settlement. As I say, it is more than PS5,000 at band 5, and the NHS Staff Council has recommended it. The majority of trade unions, including the RCN, recommended this deal to their membership. That is why we should respect the NHS Staff Council process, respect the ballot that is still live and allow those votes to continue.
Date: 2023-04-17
Jon Trickett: Has the Secretary of State seen the recent report on the BBC that billions of pounds--my words, not the BBC's--are being squandered on agency labour from private providers, with huge profits being generated? Is it right that one doctor alone received PS5,200 for a single shift, as was reported by the BBC? What does the Secretary of State think the impact of that would be on his own staff? How can it be right for him to use bellicose language about the staff associations and unions while larding money into the pockets of the private agency providers?
Date: 2023-04-17
Steve Barclay: One of the concerns at the moment is the BMA rate card, which is significantly increasing the cost of providing the required cover for the strikes, and in turn taking money away from things NHS staff have raised with me, such as improving our tech offer, improving the NHS estate and the many other priorities on which money could be spent. I am keen, as I am sure the hon. Gentleman is, to bring down the cost of agency workers. That is why we have the commitment to the NHS workforce plan and why I am keen to sit down constructively with the junior doctors committee, in the same way that I did with the NHS Staff Council. After we reached our deal, the leader of those negotiations for the trade unions commented on the meaningful and constructive approach that we took with the Agenda for Change negotiations. We are keen to do the same with the junior doctors, but that has to be based on a reasonable opening position from them.
Date: 2023-04-17
Paul Bristow: When union bosses open their pay demands at 19% for nurses and 35% for junior doctors, is it any wonder that some ordinary members feel let down when they have been asked to settle for a generous and fair 5%? Would it not be far better if the BMA junior doctors committee revised its ludicrous demand for 35%, got around the table and did its members some service by negotiating for a fair and reasonable pay offer?
Date: 2023-04-17
Steve Barclay: I agree with my hon. Friend. The fact that even the Labour party does not support 35%--the Leader of the Opposition himself says that is not affordable --indicates how out of step the junior doctors committee co-chairs are on what is realistic to get the balance right in bringing down inflation and on the wider economic pressures we face. We stand ready to engage constructively  with the junior doctors committee but, as my hon. Friend says, that has to be on the basis of a meaningful opening position.
Date: 2023-04-17
Steve Barclay: We have agreed an offer with the Agenda for Change staff council. That is something that the staff council and the majority of trade unions have recommended to their own members, and that the largest health union has voted in favour of. I think we should allow that ballot to take place; it reflects meaningful and constructive engagement. That was reflected in the fact that trade union leaders themselves recommended the deal to their members. I hope that, when we come to the 75th anniversary, we can celebrate that.
Date: 2023-04-17
Steve Barclay: As ever, my right hon. Friend raises an extremely important point. As part of the negotiation with the AfC staff council, a number of non-pay issues were discussed. Job evaluation is one such issue. Likewise, for junior doctors, areas such as e-rostering are extremely important. I share his desire for investment in technology, and to look at the time spent by clinicians that could be spent by others in the skills mix or through better use of artificial intelligence technology and a better estates programme. That is why it is important that we continue to have that funding, as well as reaching the offer that we have with the AfC staff council.
Date: 2023-04-17
Zarah Sultana: Nurses, junior doctors and paramedics do not take strike action lightly; it is a last resort after more than a decade of working harder and longer for less and less. The Secretary of State will say that there is no money for a fair pay deal, but that is not true: it can be paid for by taxing the richest and redistributing the wealth. Ending non-dom status would raise PS3 billion; introducing a 1% tax on assets worth over PS10 million would raise PS10 billion; and equalising the capital gains and income tax rates would raise PS14 billion. What do the Secretary of State and Conservative Members prefer: nurses having to use food banks, or taxing the richest and making them pay their fair share?
Date: 2023-04-17
Steve Barclay: The odd thing is that the hon. Lady seems to be disagreeing with the trade union leadership, which is not her usual position. Unison described it as a "decisive outcome" when 74% of its members voted in favour of the deal. It is odd that she wants to deny the GMB and other trade unions the space to vote on what their leaders have recommended--the GMB leadership  has also recommended the deal to its members. Even the RCN leadership recommended the deal to its members. As Pat Cullen herself said: "Negotiations work by compromise and agreement. We did not get everything and nor did the government. Ministers made improvements every day of those three weeks because we were able to say that returning to striking was the clear alternative. No union could enter negotiations and flatly say 'no' until you get everything you want. These talks will not be reopened if members reject this pay offer." The leadership of the RCN recommended the deal, as did the leaderships of the GMB and Unison. It is odd that the hon. Lady does not want to recognise that.
Date: 2023-04-17
Chris Grayling: It is ironic to hear the British Medical Association complain about staff shortages when it has in the past resisted the expansion of training places for doctors. When there have been disputes in the health service, those involved have always taken steps to ensure that lives were not endangered by the dispute. That appears to be no longer the case. That is, to my mind, a dereliction of professional duty. Will my right hon. Friend send the strong message to those involved that preserving life is a professional duty that must be maintained?
Date: 2023-04-17
Steve Barclay: My right hon. Friend is absolutely right to focus on patient safety and the duty that all involved have to safeguard it. Indeed, I have previously given the Royal College of Nursing's leadership credit and praise for granting strike exemptions, known as derogations--notwithstanding our disputes, I was happy to recognise that on the record. Given that less than a third of the RCN's total membership has voted against the deal, and that the RCN's leadership recommended it, it is very odd that it has now hardened its position and removed those exemptions. I very much hope that it will reflect further on the matter in the coming days, because I think its previous stance of granting exemptions was right.
Date: 2023-04-17
Richard Burgon: We need to be clear: junior doctors have had a 26% real-terms pay cut. Restoring their pay would cost around PS1 billion a year. That is less than half the giveaway handed to the super-rich through the non-dom tax avoidance scheme. Is it not the case that a proper pay rise for junior doctors is affordable--it is just that the Government have the wrong priorities?
Date: 2023-04-17
Steve Barclay: It perhaps will not surprise the House to hear that the hon. Gentleman disagrees with his party's leader on that, because the Leader of the Opposition says: "I don't think 35% is affordable". The hon. Member for Leeds East (Richard Burgon) is also wrong on the quantum, because the cost would be PS2 billion, not PS1 billion as he says. [Interruption.] Well, that has never been how departmental budgets operate--not when his party was in power, and certainly not now. He is wrong on the amount and wrong on the policy.
Date: 2023-04-17
Julian Lewis: Given that the terms "emergency care" and "intensive care" imply that the life of those who need them is at risk, does my right hon. Friend share my dismay that people in that predicament are now clearly being targeted by strikers?  Will he--and hopefully his Opposition counterpart--represent to the medical unions that whatever other strike action they take, they should not endanger the life of people in emergency or intensive care?
Date: 2023-04-17
Margaret Greenwood: Nurses and junior doctors are being pushed to breaking point, because there simply are not enough of them, and the Government have failed to plan the workforce properly. A nurse I spoke to at the weekend told of the terrible queues in corridors, and said that patients were waiting in pain, and not in the dignified environment that they should be in. She also spoke of the lack of care packages to enable the safe discharge of many patients. Why are we still waiting for the NHS workforce plan, which the Government promised? Can the Secretary of State tell us on what date we can expect to hear a statement on it? Also, what urgent action will he take to address the social care crisis?
Date: 2023-04-17
Steve Barclay: On social care, which relates to the hon. Lady's point about discharge, she will recall that in the autumn statement the Chancellor put additional funding into adult social care--funding of up to PS7.5 billion over two years, which is the largest ever increase in funding for social care. Also, I announced at the Dispatch Box in early January a reprioritisation of funding in the Department--it was a PS250-million package--in the light of urgent and emergency care pressure. That included funding to support greater discharge, to get more flow. I touched on the workforce plan earlier. We will publish it shortly; in the autumn statement, the Chancellor committed to doing so.
Date: 2023-04-17
Steve Barclay: I do agree with my hon. Friend. If that demand were agreed to, it would mean some junior doctors receiving a pay rise of over PS20,000. We need to find a balance, with a fair and reasonable settlement for NHS staff, recognising the huge pressure from the pandemic and the backlogs it has caused, while at the same time bringing inflation down, because that matters not just to NHS staff, but to all working people who are impacted by inflation.
Date: 2023-04-17
Matt Warman: I welcome the Secretary of State's acknowledgement that junior doctors deserve a pay rise, and not just because my wife is a junior doctor, and his focus on non-pay issues. For all the talk about ACAS from Opposition Members, is it not the case that so long as the BMA leadership maintain that their starting point is 35%, there is no point in going to ACAS, because the BMA is not prepared to negotiate? It is setting its face against the interests of doctors and patients. The only way to get through this is to get around the table with a meaningful starting point, and that cannot be 35%, as the Leader of the Opposition has said.
Date: 2023-04-17
Steve Barclay: I very much agree with my hon. Friend, and he is right to highlight the wider issues that we want to discuss. The previous negotiation with the junior doctors included, for example, setting up a higher pay band, which has meant that there has been a cumulative increase of over 24% over four years. It included targeted action such as a PS1,000 a year allowance for junior doctors who work less than full time, and targeted action around unsocial hours and weekend work. Those are the meaningful discussions that we want to enter into with junior doctors, but that has to be on the basis of a realistic and deliverable discussion, and 35% is not that.
Date: 2023-04-17
Diana R. Johnson: I am not sure the Secretary of State understands just how angry people are. My constituents are absolutely furious with the Government's stewardship of the NHS. Hull is the most under-doctored area in the country; we have the longest waits in A&E in the country; and we have had a very poor Care Quality Commission report on our local hospitals. On the junior doctor strikes, when will the Secretary of State start to put patients first? I want to make sure that he goes away from this Chamber and gets ACAS involved, so that we can get the junior doctors back at work, with no further delays and cancellations for my constituents and patients in Hull.
Date: 2023-04-17
Steve Barclay: The rather odd thing is that we have a larger cash offer on the table for 2022-23 than the Labour Government in Wales, and we have reduced our longest waits far more than they have in Wales. We have a deal that the trade union leaders themselves have recommended, that the majority of staff councils have recommended and that the largest health union has voted emphatically in support of. It is right that we allow time for that deal to go through, and we stand ready to have similar meaningful and constructive engagement with the junior doctors once they move from what is an unrealistic position.
Date: 2023-04-17
Steve Barclay: In short, the position of the shadow Health Secretary seems to be to deny the vote of his own union, Unison, which voted 74% in favour; to not wait for the NHS staff council to reach its decision; and to unravel to some extent what has been meaningful and constructive engagement with the "Agenda for Change" staff council. My right hon. Friend is right to be confused about the Opposition's actual position.
Date: 2023-04-17
Chris Bryant: I can see at least two other Members in the Chamber who know from personal experience that early diagnosis and treatment of cancer can save lives. I very much hope that any action taken over the next few weeks will not affect that, because that could mean people losing their lives before their time. I have two significant worries about the long-term future of the NHS. One is seeing so many people, including those from poor constituencies and poor families, using all their life savings to buy an operation, because they know that that is their only means of getting back to work as there is such a long backlog. That feels like a form of privatising the NHS. Secondly, there are terrible problems with recruitment and retention, with more than 110,000 vacancies in the NHS. I really hope we will see the workforce paper soon. It has been promised for a very long time, and I suspect "summer" may go on until autumn--it tends to every year, I suppose. It would be good to see that paper soon, because there are so many different parts of the NHS where we need to recruit more people. Everybody in this round is worrying, "Will the NHS be worth working for in 10, 15 or 20 years' time?". We can only do this if there is real confidence in the future.
Date: 2023-04-17
Steve Barclay: The hon. Gentleman makes two important points. The workforce plan is critical, and I have referred to that already. He also raises the importance of early diagnosis of cancer, and he is absolutely right on that. He will have seen that the faster diagnosis standard was met in the latest operational performance data for February, which was extremely welcome news. There is obviously more still to do. That is why we are rolling out the programme of diagnostic centres and surgical hubs. We are redesigning patient pathways to streamline those journeys, and we are looking at variation in performance on such things as faecal immunochemical tests. There is a huge amount of work, but I hope he can see some progress in the latest figures. More widely in terms of elective recovery, we made progress in the summer on the two-year waits, in stark contrast to Wales, which was significantly above 50,000. We got it under 2,000 in the summer. I will update the House shortly on the 78-week waits. We are working through the key actions in our elective recovery plan as we deal with the consequences of the build-up from the pandemic.
Date: 2023-04-17
Steve Barclay: I do share my hon. Friend's concern. Full Fact has shown that the figure is inaccurate. It disregards higher pay later in the evenings and at weekends. It ignores the 20% that goes into pensions and that junior doctors, probably more than any other profession, have very quick pay and career progression. That is why, as part of our listening exercise, we made changes to pensions in the Budget. That was a reflection of the fact that senior doctors have often accumulated those pension pots, which is one of the other challenges we are dealing with. It is an indication of the career and pay progression that many junior doctors will see later in their careers.
Date: 2023-04-17
Jim Shannon: I thank the Secretary of State very much for his endeavours to find a pay settlement, ever mindful that it is more than pay that some NHS staff wish to see. To give an example of that, I recently sat listening to one of my constituents who is in foundation year 1. She was brought to tears by the stress and pressure on her young shoulders. When she finally finishes shifts, she lies awake going over the decisions made. In her view, she would keep her pay the same to have more qualified staff available. How will the Secretary of State's proposals make adequate support on the wards possible?
Date: 2023-04-17
Steve Barclay: The hon. Gentleman raises an important issue, and there is a lot more we can do around the skills mix in the NHS and ensuring that people operate at what is referred to as the top of their licence and make the maximum of the training they have. Often there are restrictions in place. We are looking at physician associates and medical examiners and at the role of pharmacists within primary care, as well as at how we get the right continuing professional development to train people, so that we get more of the career ladder from different roles. There is a lot that we are looking at, in the context of the workforce plan, around the right skills mix, the right training and job evaluation. That was one of the issues in my discussions with the staff council--for example, there was a particular focus on apprenticeships. Sometimes people take a pay hit when they go into an apprenticeship if they were at the top of their previous band. That is one of the things we agreed to work on with the staff council. Again, I am sure that an area of consensus in the House will be that apprenticeships offer great opportunities for people to progress, and we should not have a financial penalty when people pursue them.
Date: 2023-04-17
James Daly: Many hon. Members have raised extremely important points, but the central issue is that the reckless and irresponsible actions of two trade unions are putting the lives of my constituents and people throughout the country at risk. The right to strike can never trump people's right to receive healthcare and not have their life threatened by the actions of left-wing trade unions. Can I ask what my right hon. Friend is going to do to address this issue and to hold trade unions to account if they continue with this appalling behaviour?