Asked by
To ask His Majesty’s Government what assessment they have made of
the statement by the Institute for Fiscal Studies on 15 November
that NHS waiting lists have risen in 2022 alongside increased
spending on NHS England.
The Parliamentary Under-Secretary of State, Department of Health
and Social Care () (Con)
The Government continually assess data and reports on waiting
lists from a wide range of sources, including the Institute for
Fiscal Studies. The IFS statement confirms that the Government
are right to support and challenge NHS England to continue to
identify and address factors that constrain further activity, and
to reduce waiting lists. The Autumn Statement announced a further
£3.3 billion for 2023-24 and 2024-25 to enable rapid action to
improve emergency, elective and primary care performance.
(Con)
My Lords, I thank the Minister for his reply. Last week, the
Institute for Fiscal Studies said that
“NHS spending in England is, in real terms, 12% above its 2019
level. Yet it is getting fewer people off waiting lists and into
hospital treatment than it was … in 2019.”
We used to have a slogan: “Labour isn’t working”. The NHS is no
longer working. The Royal College of Obstetricians and
Gynaecologists has asked me whether we could ring-fence its
money. I do not think we can. Can some of the hundreds of civil
servants on six-figure salaries in his department get down to
sorting out what is clearly a dysfunctional department?
(Con)
My noble friend is correct. Efficiency is very important, as
pointed out in a previous Question. I have done some work in this
space, and there are some trusts that are absolutely on the path
to the 130% increase in elective treatments compared with 2019,
for which the funding is in place. There are other trusts that
are not. Clearly, my job and the job of all the department’s
civil servants is to understand why that is and to challenge
those trusts that are not; to support them where they need that
support; and to ensure they are introducing best practice and
innovation in order to make sure they all get back towards that
level. There are some very good performers and others that are
not so good.
(CB)
My Lords, we hear a lot in this House about the recruitment of
doctors and nurses. However, any organisation facing the kind of
challenges confronting the NHS would ordinarily be doing its
utmost to retain its talent. The NHS, in many ways, seems to be
doing the opposite. When will it develop a comprehensive strategy
for the retention of its experienced clinical personnel, without
whom it would simply be unable to function?
(Con)
I thank the noble and gallant Lord for his question. I was
delighted to see in the Chancellor’s Statement a commitment to a
workforce strategy for five, 10 and 15 years, something that all
of us in this House have been asking for. It will look at all the
needs in respect of recruitment and, crucially, retention. That
is very much part of the agenda.
(Lab)
My Lords, the current shortage of 60,000 nurses is devastating,
and its impact on waiting lists even more so. It is obvious—to
me, anyway—that the main cause of this staffing crisis is low
pay, with many nurses opting to leave for jobs in supermarkets
and other sectors for better wages. Does the Minister accept that
the best way to tackle these problems is to allow more qualified
nurses into the UK from the EU and beyond, grow the economy and
fill the gaps in the skills that the NHS needs? Most importantly,
we need to pay our heroes, who we all clapped for, a decent
living wage to live on.
(Con)
I thank the noble Lord. For the record, there are 29,000 extra
nurses since 2019-20, so we are well on course for the 50,000
increase. At the same time, we do need to recruit from overseas,
and that is very much part of the plan. Again, this will go into
the workforce strategy, but I completely agree that we should be
looking to recruit from around the world, which we are. I am
delighted that we are adding more and more people to the
essential workers list, so to speak, to enable us to do that,
because we all know that the workforce plan will show that we
need to recruit people and retain them.
(LD)
My Lords, the last time the figure of 92% of patients being seen
within 18 weeks was achieved was in 2016. Since then, the numbers
who are waiting have doubled: it is now 7.1 million. What does
the Minister say to the 16 year-old in Shrewsbury who has just
been told that he has to wait nearly three years for a first
appointment at his local hospital? The hospital says that it has
recruitment problems. When will we see the details of this
workforce plan, particularly for rural areas?
(Con)
I thank the noble Baroness. As I say, we have committed to that
workforce plan, and it will be detailed. We will look at every
place in every part of the country because we understand that
that is needed, and it is part of the critical plan to get on top
of the 7.1 million waiting list. As I think we have accepted, it
is not a quick win; it will get higher before it gets lower
again. Clearly, however, we need to get on top of it, and we are
focused on it. It is very much about the plan and the new
spending plans that we put in place to address it.
(CB)
My Lords, last year NHS trusts paid an interest bill of almost
£500 million on PFI hospital contracts. This year, that bill will
rise again. Can the Minister tell us what proportion of the
increase in NHS budgets will go just to pay interest charges on
these dreadful contracts, and what plans he has to try to
renegotiate them?
(Con)
I thank the noble Baroness; I will need to get back to her in
writing on the detail of that. However, looking into the PFI
contracts is very much part of my agenda; I had a meeting on that
just last week, and we are reviewing it.
(Con)
My Lords, with the increasing conflict between inputs and outputs
that the noble Lord, Lord Reid, mentioned earlier, does my noble
friend the Minister agree that the need and time for a royal
commission on the NHS is fast approaching?
(Con)
I thank my noble friend. To be honest with him, I am hoping we
can act quicker than that—that is absolutely the plan. I can tell
him that we know the areas where they are performing and they are
on the elective recovery plan, and we know those that are not. I
do not need a royal commission to tell me that. To my mind, it is
about understanding what those hospitals are doing well and
putting in place focused action and support to help those that
are behind the plan.
(Lab)
My Lords, on an earlier Question, I and other noble Lords asked
the Minister if the Government were still committed to their
target of 18-weeks between GP referral and consultant-led
treatment, and their other targets for A&E waiting times,
ambulance responses and cancer treatment. I offer the Minister
another opportunity to say to your Lordships’ House whether this
is the case.
(Con)
I thank the noble Baroness. As I am sure the House is aware from
the statements of the Chancellor and the Health Secretary, in a
lot of areas we are trying to make sure that we place fewer
targets on the health professions and GPs and allow them to
manage. At the same time, we make sure that if they are not
performing, action is taken, but generally we trust them to
manage. The beauty of Google is that I have been able to check
the 18-week target, and it is a statutory commitment, so I can
give that assurance. However, on the others, we are making sure
that we look at the performance measures that really matter.
(Lab) [V]
My Lords, whatever efficiencies are achieved, given that the
growth in demand for NHS services will continue to exceed the
growth of our ailing economy, should not the Government be making
a major commitment to preventive strategies to stop people
becoming ill or injured in the first place? With the Government’s
reversion to austerity, however, has not the prospect
deteriorated for the investment needed in public health and
non-clinical approaches such as the successful warm home
prescription pilot? How can we hope that the Government will
systematically address the social determinants of health, such as
poor housing?
(Con)
I thank the noble Lord, and I agree that prevention is better
than cure. I refer to the earlier Question and analysis by , the Chief Medical Officer,
who pointed out his concerns about cardiovascular health arising
from people not having had the check-ups they should have had
during the pandemic. I completely agree that there are some very
cost-effective measures which can really help with the prevention
agenda, such as heart blood pressure machines and lateral flow
screening devices that can be sent to homes. We are looking at
that issue, because I agree that prevention is better than cure.
