Asked by
To ask His Majesty’s Government what plans they have in place to
ensure the National Health Service meets its key targets.
The Parliamentary Under-Secretary of State, Department of Health
and Social Care () (Con)
The NHS has made progress against its targets, especially given
the challenges of recovering from Covid-19, the changing
demography and winter pressures. The Government recognise that
there is still a way to go and are working non-stop to support
the NHS to do better. I take this opportunity to thank all NHS
staff for their hard work to improve performance this winter.
My Lords, I would like to join in thanking NHS staff, who are
doing a fantastic job. There are some structural problems here.
In particular, I am concerned about ambulance response times,
which are causing a great deal of concern despite the Government
having increased the category 2 call response times from 18
minutes to 30 minutes. Category 2 calls deal with such
life-threatening events as strokes and heart attacks, so this is
deeply worrying. What are His Majesty’s Government doing to
reduce the response time? Will they consider returning to the
18-minute response time for category 2 calls?
(Con)
I agree with the basic point, as I am sure all noble Lords will,
that ambulances are on the front line and are the most important
service in all of this. That is why we have invested in 800 new
ambulances, with over £200 million of funding. It is early days,
but that is starting to take effect. Regarding the category 2
issue, we have managed to halve the time it takes since last
year, but it is still too long and we absolutely need to make
more progress in this area.
(CB)
Does the Minister agree with me that, if you really want to hit
the targets for the NHS, you need to deal with the fact that 50%
of people who present themselves at the NHS are suffering from
food poverty? Why do we not concentrate on lifting the great
weight on the NHS by doing serious work on getting rid of
poverty?
(Con)
I agree with the noble Lord that prevention is key. About half
the number of people who turn up at A&E do not need to go to
A&E and can be seen in other settings. I completely agree
that all the elements in terms of prevention and getting ahead of
the problem are key, including where there are issues around
food.
(Con)
My Lords, following on from the question from the right reverend
Prelate and his reference to stroke patients, given that there is
a three-hour window for stroke patients during which, if certain
treatments are given, the outcome is so much better, what have
the Government done to ensure that, adding on the ambulance time
to the time when the patient then arrives at hospital, more
patients are being treated within that window? Is there a target
specifically for stroke patients? It makes such a difference.
(Con)
My noble friend is absolutely correct, and strokes have been a
major focus. I am glad to say that was one of the first areas
where we rolled out AI everywhere, with the result that we were
able to improve treatment times so much—and I will get the
precise figures to my noble friend—that the recovery rate has
increased by two-thirds as a result. It is absolutely right that
this is an area of top focus.
(Lab)
My Lords, the Government keep telling us—and I understand why and
congratulate them on it—that the number of people employed as
doctors and nurses has risen in recent years. Can the Minister
explain why productivity over the same time has reduced by
4%?
(Con)
The noble Baroness is correct: staff numbers have gone up but,
for a number of reasons that we are exploring, output has not
gone up by the same amount. It is a key point, and I think all
noble Lords agree that making sure we are getting value for money
out of the service is important. We are engaged in a productivity
study to discover the reasons right now.
(LD)
My Lords, back in 2013, the Government set a target for the NHS
to become paperless by 2018, which they later extended to 2020
when the target seemed too ambitious. This may come as something
of a surprise to the millions of people who continue to have
regular paper-based interactions with the NHS. Could the Minister
tell the House when he now expects the target for the NHS
becoming fully digital to be met? Would he agree that it is now
even more important that we achieve it than when it was first set
over a decade ago?
(Con)
I definitely agree that it is more important, and that is why I
am pleased that we have made such progress. If we look at one
area in terms of hospital records being available and doctors’
records to patients, that has gone up since the beginning of the
year from about 1% of GPs to about 90% today. About 90% of all
our hospital records are now digitised, compared to less than 3%
in Germany. We have made massive progress, and it is key to all
of the reform and to improving productivity across the NHS.
(Lab)
My Lords, the Minister well knows that we have raised the issue
of primary care again and again in this Chamber. Would he be kind
enough to tell the House how the Government feel they are doing
with regard to the retention of very highly qualified general
practitioners at the height of their career, who are currently
leaving early? Up to about 50% are considering retirement before
the retirement age. Will he comment on how he feels that is
going?
(Con)
Staff retention, particularly of GPs, is vital. That is why we
listened to the number one reason they were retiring, which was
the feeling that their pensions were being adversely affected. We
changed the rules in the last Budget to try to address that; it
is early days, but I hear that that is starting to make progress.
Primary care is the front line. That is why I am pleased that we
have increased the number of appointments by more than 50
million, ahead of our manifesto target. But it absolutely needs
to be a key focus.
(CB)
My Lords, I draw attention to my registered interests. The
long-term—and, indeed, the short and medium-term—sustainability
of the NHS is critically dependent upon active engagement in
research and the adoption of innovation at scale and pace. Is the
Minister content that His Majesty’s Government are doing enough
to ensure that the NHS is resourced to support that research and
innovation agenda?
(Con)
It is key, and I think we are all aware that a couple of years
ago—this was a result of the report of the noble Lord, Lord
O’Shaughnessy—we were not doing as well as we needed to be in the
clinical trials area. I am glad to say that, since then, there
has actually been a lot of progress towards it, so we are now
hitting similar levels to comparative nations. Innovation is at
the heart of everything we have done. We have some very good
examples of that; I mentioned the stroke AI treatment earlier. We
have just set a similar thing in terms of AI for looking at chest
cancers, but it is absolutely something we need to make sure we
continue to progress.
(Lab)
My Lords, the King’s Fund has highlighted a delay to the release
of additional funding to help NHS and social care services
prepare for winter, which will of course only worsen the
situation of missed targets and wait times for patients. Can the
Minister tell the House what the reasons are for this delay and
what steps are being taken to unblock the money to get it to
where it is needed?
(Con)
One of the key learnings from last year, which goes back to the
whole question about planning, was actually that if you put
social care moneys in too late, you do not get nearly as
effective spend. That is why we brought forward the £600 million
discharge fund much earlier—actually, into the summer—so that
local authorities and care providers could plan on that money. It
is starting to make a difference. A key thing that noble Lords
have heard me talk about is bed-blocking. Actually, we have seen
a 10% reduction in bed-blocking since these measures have come
into effect in the last few weeks. It is early days, but we are
actually making progress.
(Con)
My Lords, the number of over-85s is due to double over the next
30 years. Would my noble friend the Minister give some
consideration to government funding for extra care facilities and
at-home treatment, such as physiotherapy, in order that pressure
be taken off acute district hospital beds in respect of older
people?
(Con)
Funnily enough, I had this conversation in terms of productivity
just today. The virtual wards—the 11,000 extra beds we have put
in—are actually making a real impact on that, because of course
it is much better that people can be treated in their own home,
knowing they have the comfort of these virtual displays and
treatment to look after them. We have 11,000 extra beds, with 72%
utilisation, and, yes, it is really working.
(Lab)
My Lords, the Minister keeps talking about progress being made,
but if he looks at, say, the four-hour A&E target, he knows
that the latest figures show that the NHS reached only 69% in
December. In 2010, his party inherited a performance of 98.3%.
What does he think that says about his party’s stewardship of the
NHS?
(Con)
I can talk about what we are doing now, which is showing real
progress. But I have to say that the saying “People who live in
glass houses shouldn’t throw stones” comes to mind, because,
looking at those same targets, I notice that the Labour-run NHS
in Wales never reached the four-hour A&E target; the last
time it hit the 62-day cancer target was in August 2010, 14 years
ago; and the last time it hit the hospital treatment target was
in August 2010. I say politely that the noble Lord might want to
get his own house in order first.
