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Category: Health

  • Rachel Maclean – 2023 Parliamentary Question on NHS beds Available in the Alexandra Hospital in Redditch

    Rachel Maclean – 2023 Parliamentary Question on NHS beds Available in the Alexandra Hospital in Redditch

    The parliamentary question asked by Rachel Maclean, the Conservative MP for Redditch, in the House of Commons on 24 January 2023.

    Rachel Maclean (Redditch) (Con)

    What steps his Department is taking to increase the number of NHS beds available in the Alexandra Hospital in Redditch.

    The Minister of State, Department of Health and Social Care (Helen Whately)

    Right now, we are putting an extra £750 million into our health and social care system to free up beds in hospitals. Looking ahead, we will shift the dial on the decades-old problem of delayed discharge by properly planning for discharge, making more care available at home, and joining up health and social care in a way that has never been done before. That is how we are freeing up beds in hospitals such as the Alexandra in Redditch.

    Rachel Maclean

    I thank the Minister for that answer. In Worcestershire, we warmly welcome the £2.6 million that has been allocated as our share of the discharge fund. Will the Minister set out when my constituents who use the Alexandra will start to see these changes flowing through? What practical changes will they see and what impact will there be on waiting times and waiting lists?

    Helen Whately

    I thank my hon. Friend for her excellent and important question about her local share of the £750 million of extra funding for discharge this winter. I can tell her that, in Worcestershire, money is already going into extra placements in homecare, community care and care homes, and into providing practical support to help people when they get home from hospital, in partnership with the voluntary sector. I assure her that we will publish the spending plans for her area and the rest of the country shortly.

  • Peter Aldous – 2023 Parliamentary Question on Access to NHS Dentistry

    Peter Aldous – 2023 Parliamentary Question on Access to NHS Dentistry

    The parliamentary question asked by Peter Aldous, the Conservative MP for Waveney, in the House of Commons on 24 January 2023.

    Peter Aldous (Waveney) (Con)

    What steps he is taking to improve access to NHS dentistry.

    Gill Furniss (Sheffield, Brightside and Hillsborough) (Lab)

    What recent assessment he has made of the adequacy of access to NHS dentistry.

    The Parliamentary Under-Secretary of State for Health and Social Care (Neil O’Brien)

    The Government are working to improve access. We have made initial reforms to the contract and created more unit of dental activity bands to better reflect the fair cost of work and to incentivise NHS work. We have introduced a new minimum UDA value to help sustain practices where they are low, and we are allowing dentists to deliver 110% of their UDAs for the first time to deliver more activity. Those are just the first steps; we are planning wider reforms.

    Peter Aldous

    On 20 October, the House passed a motion highlighting the continuing crisis in NHS dentistry and calling on the Government to report to the House in three months’ time on their progress in addressing this crisis. That time has now elapsed. I am grateful to the Minister for that update, but can he confirm that the Government will be producing a comprehensive strategy for the future of NHS dentistry, and can he inform the House when it will be published?

    Neil O’Brien

    It was very useful to meet my hon. Friend the other day, who is a great expert on this issue. As he knows, we are working at pace on our plans for dentistry. As well as improving the incentives to do NHS work, we are working on the workforce to make it easier for dentists to come to the UK. We laid draft secondary legislation in October to help the General Dental Council with that. We are working on our plans for a centre for dental development in Ipswich and elsewhere in the east of England, as he knows. Although we have not yet set a date to set out the next phase of our plans, my hon. Friend knows from our meeting that this is a high priority area for us and that we are working on it at pace.

    Gill Furniss

    I was contacted recently by my constituent Helen, who said:

    “I don’t know what to do. I have phoned 25 dental practices today and been told the same thing each time: all we can do is put you on a 3 year waiting list.”

    What does the Minister say to Helen and the thousands who, like her, cannot access an NHS dentist? When will he get a grip on this crisis?

    Neil O’Brien

    We are the first to say that the current situation is not satisfactory. That is why we invested an extra £50 million in the last quarter of last year, and it is why we are working at pace. Let us be clear: dentistry has not been right since Labour’s 2006 contract, and until we fix the fundamentals of that and the problems set up by the Opposition, we will not tackle the underlying problem.

  • Mohammad Yasin – 2023 Parliamentary Question on Access to GPs

    Mohammad Yasin – 2023 Parliamentary Question on Access to GPs

    The parliamentary question asked by Mohammad Yasin, the Labour MP for Bedford, in the House of Commons on 24 January 2023.

    Mohammad Yasin (Bedford) (Lab)

    What steps he is taking to help improve access to GPs.

    The Secretary of State for Health and Social Care (Steve Barclay)

    We recognise that increased demand has had an impact on GP services. That is why we are investing at least £1.5 billion to create an additional 50 million GP appointments by 2024.

    Mohammad Yasin

    There is a clear failure to invest in critical infrastructure across the primary care estate, for example, in modernising in-patient mental health services and GP hubs. To make matters worse, Government bureaucracy is holding up capital funding allocations. My constituents deserve better community care and hospitals need relief, so when will the Government finally release the funding to build the facilities desperately needed in Bedford and Kempston?

    Steve Barclay

    We have literally just heard in this questions session from my hon. Friend the Member for Walsall North (Eddie Hughes) about the investment the Government are making in infrastructure across the NHS. That is why we have also, alongside the investment we are making in primary care, invested in the new hospitals programme, as part of this Government’s commitment to the NHS estate.

    Dame Caroline Dinenage (Gosport) (Con)

    Since the beginning of January, Gosport patients have learnt that one of our GP practices is threatened with closure, while another is about to merge with an already very subscribed group of practices. Partners are retiring, with no replacements. Will the Secretary of State confirm what he is doing to ensure that my constituents can access a GP? Will he please meet me to discuss this issue?

    Steve Barclay

    My hon. Friend raises an important point, and we are investing over a fifth more than in 2016, as part of our wider investment programme. I am very keen to work with her on the role of her ICB. It was set up operationally last summer, and its role is to commission primary care services for the community and to assess the needs of her Gosport constituents. I am very happy to work with her and her ICB on the issues she raises.

    Emma Hardy (Kingston upon Hull West and Hessle) (Lab)

    Hull has the second highest ratio of GPs to patients in the country. Even though GPs see 46 people a day on average, it is clear that demand for their services outstrips supply. Of course the Labour Government will have a plan to resolve this, but in the meantime will the Secretary of State look at giving women direct access to specialist nurses and services, such as endometriosis or menopause specialists, to prevent them from having to go via their GP each time they need renewed treatment and updated medication?

    Steve Barclay

    First, that is exactly what the women’s health strategy is doing through designing women’s health hubs. It is exactly why we are appointing a wider portfolio of roles into primary care. The hon. Lady says that Labour has a plan, but Labour’s plan is to divert £7 billion out of primary care property, which will not improve services for women and will actually impede the ability to deliver exactly the sort of services she is calling for.

    Paul Maynard (Blackpool North and Cleveleys) (Con)

    Thornton Cleveleys will see a 17% increase in new patients registering for primary care in the next five years, exceeding the physical capacity. Cost-effective solutions have been found, but the obstacle is the integrated care board, which keeps changing its mind as to whether money is or is not available. The clock is ticking on the need for this new capacity. Will the primary care Minister meet me to resolve this impasse and get the ICB to sort its act out?

    Steve Barclay

    My hon. Friend brings welcome transparency to the issue. The Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Harborough (Neil O’Brien) was listening intently, and is nodding his head about meeting him to discuss it.

  • Ellie Reeves – 2023 Parliamentary Question on Women’s Health Strategy for England

    Ellie Reeves – 2023 Parliamentary Question on Women’s Health Strategy for England

    The parliamentary question asked by Ellie Reeves, the Labour MP for Lewisham West and Penge, in the House of Commons on 24 January 2023.

    Ellie Reeves (Lewisham West and Penge) (Lab)

    What recent steps he has taken to implement the women’s health strategy for England.

    Alex Davies-Jones (Pontypridd) (Lab)

    What recent steps he has taken to implement the women’s health strategy for England.

    The Parliamentary Under-Secretary of State for Health and Social Care (Maria Caulfield)

    Last summer we published the first Government-led women’s health strategy for England, which sets out our 10-year ambition to boost the health and wellbeing of women and girls and to improve how the health and care system listens to them. I am pleased that we have set out the first eight priorities for the first year of the women’s health strategy, and that we are already delivering on many of them.

    Ellie Reeves

    After 13 years of Conservative Government, more than half of maternity units now consistently fail to meet safety standards. Almost 40,000 women now wait over a year for gynaecological treatment, up from just 15 women 10 years ago. Women in the poorest areas are dying earlier than the average female in almost every comparable country. At every stage of a woman’s life, her health is being compromised. When will these failures be reversed, and when will we see real investment in the NHS workforce and in women’s health?

    Maria Caulfield

    I am sorry that the hon. Lady does not welcome our announcement of this country’s first women’s health strategy, which is putting women as a priority at the heart of the health service.

    We have eight priorities for this year. We are rolling out women’s health hubs around the country as a one-stop shop to make healthcare more accessible to women. We are improving women’s health provision by setting out a women’s health area, with reliable information, on the NHS website. We are working with the Department for Work and Pensions to support women’s health in the workplace. We are recognising pregnancy loss by developing the first ever pregnancy loss certificate for babies who are born and lost before 24 weeks. We are improving and standardising access to in vitro fertilisation for same-sex couples around the country. And we are launching the first ever hormone replacement therapy prepayment certificate in April. That is some of the work we are doing, and I am disappointed the hon. Lady does not recognise that effort.

    Alex Davies-Jones

    A stated intention of the women’s health strategy is to explore mechanisms to publish national data on the provision and availability of IVF, on which there has since been no Government progress. This issue affects families and would-be parents across the country. We know all too well that a postcode lottery exists, and it is just not good enough. Will the Minister support my private Member’s Bill to address this issue, which is due to have its Second Reading on 24 March?

    Maria Caulfield

    I pay tribute to the hon. Lady for the work she is doing in this space. I was in the Chamber when she presented her Bill last week and I can reassure her that, as part of the work we are doing with integrated care boards, we are collating and publishing data on the commissioning of fertility services, so that women in each part of the country can not only see what services are available to them, but compare what is being offered locally. That is happening in England; I cannot comment about what is being done in Wales. Let me also say that the Human Fertilisation and Embryology Authority is publishing data about add-ons, which I know is a particular interest of hers. We want to make sure that that information is available on the NHS, so that women can make an informed decision.

    Chloe Smith (Norwich North) (Con)

    I welcome that update, and the tone and, as always, the calm confidence with which the Minister provides it. Does she agree with me and with the Chancellor that the NHS has to help people back into work?

    Maria Caulfield

    I thank my right hon. Friend for her kind words. I absolutely agree on that, which is why helping women back into work and dealing with their health issues in the workplace is one of the first eight priorities of the women’s health strategy. We are working with colleagues in the Department for Work and Pensions on that. Last night, I had a roundtable with tech and STEM— science, technology, engineering and maths—employers, and they were desperate to keep their women in the workforce and to recruit more. Whether we are talking about young women who need support as they go through endometriosis or IVF treatment, or older women who are dealing with the menopause, we are absolutely committed to supporting women’s health needs in the workplace.

    Mr Philip Hollobone (Kettering) (Con)

    I welcome the recent announcement of enhanced breast cancer facilities at Kettering General Hospital. Is that not just the sort of extra investment we need to improve the delivery of women’s health services?

    Maria Caulfield

    I thank my hon. Friend, who has always been campaigning for better health services in Kettering. Let me reiterate what he has just said: that announcement followed the announcement last week of £10 million for NHS breast screening services, to provide 29 new mobile units and static breast care units across England.

    Mr Speaker

    I call the shadow Minister.

    Feryal Clark (Enfield North) (Lab)

    The women’s health strategy was an opportunity to fundamentally change the inequalities women face. Women were promised a clinical women’s health lead in the NHS, yet a former Health Minister, the hon. Member for Sleaford and North Hykeham (Dr Johnson), admitted that there has not even been a discussion about establishing the role. Women in east Kent were promised change after the damning review of local maternity services, yet the Care Quality Commission is now threatening the trust there with enforcement action. Time after time, women’s voices are at best being ignored and at worst being silenced. So I ask the Minister: when will this Government stop letting women down with empty promises? Is the women’s health strategy worth the paper it was written on?

    Maria Caulfield

    Perhaps the shadow Minister will reflect on her comments when she receives the “Dear colleague” letter later today outlining the eight priorities areas for our first year of the strategy, with work such as the prepayment certificate for hormone replace treatment being done already; it is launching in April and saving women hundreds of pounds on the cost of HRT. May I say that I am gobsmacked by the Labour party’s position on this? Not only does it struggle most days to define what a woman actually is—for reference, it is a female adult human—but it cannot stand up for women either. There was no greater example of that than what we saw in this Chamber last week, when Labour Members were heckling the hon. Member for Canterbury (Rosie Duffield) and intimidating my hon. Friend the Member for Penistone and Stocksbridge (Miriam Cates). Come back to us when the Labour party is reflecting on the behaviour of its own MPs before dictating to us.

    Mr Speaker

    Let me just remind people: these are questions to the Government.

  • Janet Daby – 2023 Parliamentary Question on the Retention and Recruitment of NHS Workers

    Janet Daby – 2023 Parliamentary Question on the Retention and Recruitment of NHS Workers

    The parliamentary question asked by Janet Daby, the Labour MP for Lewisham East, in the House of Commons on 24 January 2023.

    Janet Daby (Lewisham East) (Lab)

    If he will bring forward a plan to increase (a) retention and (b) recruitment of NHS staff.

    Jim Shannon (Strangford) (DUP)

    What steps he is taking to ensure that gaps in the NHS workforce are filled.

    Karl MᶜCartney (Lincoln) (Con)

    What progress he has made on increasing the number of doctors and nurses in the NHS.

    The Secretary of State for Health and Social Care (Steve Barclay)

    The long-term workforce plan that is being developed by NHS England will help to ensure that we have the right staff numbers with the right skills to deliver high-quality services in the future.

    Janet Daby

    Is the Secretary of State fully aware that under this Government every part of the NHS is in crisis? Are the Government satisfied with the fact that, as medical students in their second year told me recently, the shortage of staff on hospital wards and the pressures on those wards are affecting their training? The students also told me that they had little aspiration to work as junior doctors in the UK after qualifying, because of the acute strain on the NHS and because they felt undervalued. Does the Secretary of State know about this, and what is he going to do about it?

    Steve Barclay

    We see a considerable number of applications for medical undergraduate places, far in excess of the number of places available. We have boosted the number of places—[Interruption.] The hon. Member for Ilford North (Wes Streeting) chunters from the Opposition Front Bench, but when I was last in the Department and the Chancellor had my role, we increased the number of medical undergraduate places by 25%. Indeed, we have more doctors and nurses than we had last year, and 3.5% more full-time equivalent staff: we have over 42,000 more people working in the NHS than we had last year.

    Jim Shannon

    The British Heart Foundation has reported that by the end of August 2022 a record 346,000 people were waiting for heart care. Despite the best efforts of NHS staff, workforce shortages are affecting primary and secondary care services. Can the Secretary of State explain how the Government’s comprehensive NHS workforce plan will address specific gaps in the workforce, especially those in cardiology services?

    Steve Barclay

    The hon. Gentleman has raised an important issue. I think that, in particular, we should look at our approach to major conditions, and I will say more about our thinking in that regard at the start of topical questions. I also think that we need to look at the issue of heart conditions in the context of the wider debate about excess deaths; we know that there is a particular issue in the 50 to 64-year-old cohort. As well as providing those extra doctors and clinicians—and from next autumn we will also have the additional medical doctor degree apprenticeship route—we need to look at methods of upstream testing, particularly in respect of heart conditions.

    Karl MᶜCartney

    In reference to my right hon. Friend’s earlier answers, we are keen to see the success of the new Lincoln medical school leading to more locally trained NHS professionals working across Lincolnshire. What more can the Government do to remove barriers to entry to ensure that anyone who can do so is able to train to become a doctor, nurse, dentist or dental nurse in our NHS, specifically in Lincoln and Lincolnshire?

    Steve Barclay

    My hon. Friend raises an important point on two levels. The first relates to how we boost recruitment in areas such as Lincolnshire, and the new medical school in Lincoln will play a key part in that. The second relates to how we increase the retainability of staff in those parts of the country, and having more on-the-job training and apprenticeships is a key way of doing that. That is why things like the new medical doctor degree apprenticeship will be particularly relevant to cohorts of the population in areas such as Lincoln.

    Mr Louie French (Old Bexley and Sidcup) (Con)

    One of the biggest issues my local hospitals raise with me in outer London is the impact of Sadiq Khan’s ultra-low emission zone expansion, with nurses and other staff facing charges of £12.50 per shift or £25 if they are working nights. Given that 50% of London’s emergency service workers live outside the capital, does the Minister agree that the Mayor and the Labour party should stop ignoring Londoners and drop their ULEZ tax rate?

    Steve Barclay

    My hon. Friend raises an important point about the additional costs that the London Mayor is imposing not just on NHS staff but on all staff working in the capital, in contrast to the approach the Chancellor has taken to energy support to help staff across the workforce, including in the NHS, with the cost of living.

    Sir Gary Streeter (South West Devon) (Con)

    Most of the GP practices in South West Devon report to me that their biggest challenge is recruiting new doctors. Does my right hon. Friend have an estimate of the number of young doctors finishing their training this year who are likely to want to become GPs, and can he reassure us that that is a greater number than the number who are likely to retire in the next 12 months?

    Steve Barclay

    My hon. Friend raises two important themes. The first relates to how many are in training, and I think it is around 4,000. We have boosted the number of GP training places and we have looked at medical schools as a specific issue. Also, he will have seen some of the changes being made around pensions in order to better retain staff, mindful of those clinicians who are leaving the profession, and further discussions are taking place with Treasury colleagues in that regard.

    Helen Morgan (North Shropshire) (LD)

    In Shropshire there are 14% fewer GPs and 29% fewer GP partners than in 2019, yet in the period from April to November 2022, they provided 6% more appointments. It is this additional workload that is causing burnout in GP practices and a flight from the profession. What is the Secretary of State doing to improve the retention of GPs as well as recruitment?

    Steve Barclay

    It is important to look at the number of doctors in general practice, and those numbers are up. There are 2,298 more than there were in September 2019, so we are increasing the number of doctors. What is also important is getting the right care at the right time within primary care, which is about the wider workforce—the paramedics, the mental health support and others working in primary care—and there are an extra 21,000 there. This is enabling GPs to see more patients a day and allowing more patients to get the right primary care, perhaps not from a doctor but from others who can offer specialised support.

    Eddie Hughes (Walsall North) (Con)

    One of the best ways to improve recruitment and retention is to make sure that staff have an excellent working environment, which is why I campaigned for a new urgent and emergency care department at Walsall Manor Hospital. I was successful, and it is opening in March. Will one of the ministerial team join me to celebrate this success?

    Steve Barclay

    I welcome my hon. Friend’s drawing attention to the investment that has been made, which is in no small part due to his campaigning and championing his constituents, as he does so assiduously. I think the Minister of State, Department of Health and Social Care, my hon. Friend the Member for Colchester (Will Quince) has plans to join him to mark the opening of that important facility, which shows our investment in the estate within the NHS.

    Mr Speaker

    There will be a 24-hour service at Chorley as well, I hope.

    Gareth Thomas (Harrow West) (Lab/Co-op)

    One way to improve retention and recruitment of NHS staff at Northwick Park Hospital, which serves my constituency and which I believe the Secretary of State visited last Thursday, would be to invest in doubling its intensive care beds. Did the Secretary of State discuss that issue with the chief executive of Northwick Park when he visited last week? Will he tell us when he might be able to announce funding for the new 60-bed unit that Northwick Park needs?

    Steve Barclay

    The hon. Gentleman is right to highlight the importance of bed capacity at Northwick Park, but my discussions with the chief executive were more in the context of how step-down capacity will relieve pressure on A&E. The hon. Gentleman will know that Northwick Park has one of the busiest, if not the busiest, A&Es in London on many days, and the chief executive spoke to me about the value of adding extra bed capacity from a step-down perspective, much more so than from an intensive-care perspective. If there are specific issues for intensive care, I am happy to follow them up with the hon. Gentleman.

    Mr Speaker

    I call the shadow Minister.

    Dr Rosena Allin-Khan (Tooting) (Lab)

    In mental health we rely on staff, not shiny machinery, so why is the Secretary of State rehashing old announcements and scrapping plans? It is because the Government have run out of ideas. Labour has a plan. We will recruit 8,500 more mental health professionals, ensuring a million more patients get treated every year. We will double the number of medical school places. We will train 10,000 extra nurses and midwives every year, and we will focus on retaining the fantastic staff we already have. Where is the Government’s plan? We have had our plan for two years, but they are binning theirs.

    Steve Barclay

    It is slightly odd for the hon. Lady to talk about a plan when she does not agree with the plan of the shadow Health Secretary, the hon. Member for Ilford North (Wes Streeting). He plans to use the private sector, which he describes as “effective and popular,” whereas the hon. Lady said:

    “In my own brief in mental health we have use of the private sector, which ultimately often lets patients down.”

    First, the hon. Lady does not agree with the shadow Secretary of State. [Interruption.] The hon. Lady chunters, but she asked about a plan when she does not agree with her own Secretary of State.

    Secondly, the hon. Lady talked about shiny new equipment. I am delighted that she allows me to draw the House’s attention to yesterday’s announcement of a fleet of 100 new mental health ambulances, which will relieve pressure on A&E. I am delighted that she gave me an open door to highlight that investment, which is part of our £2.3 billion investment in mental health.

  • Jack Lopresti – 2023 Parliamentary Question on Ambulance Cover on Strike Days

    Jack Lopresti – 2023 Parliamentary Question on Ambulance Cover on Strike Days

    The parliamentary question asked by Jack Lopresti, the Conservative MP for Filton and Bradley Stoke, in the House of Commons on 24 January 2023.

    Jack Lopresti (Filton and Bradley Stoke) (Con)

    What steps he is taking to ensure that ambulance services continue to operate during strikes.

    The Secretary of State for Health and Social Care (Steve Barclay)

    We have introduced a range of contingency measures, such as the provision of military personnel, who are available to assist with the driving of ambulances, and community first responders, who can help before ambulances arrive on the scene.

    Jack Lopresti

    Will my right hon. Friend join me in thanking call handlers at the South Western Ambulance Service NHS Foundation Trust—and the public—for halving the number of 999 calls to the trust over the last month, and reducing average call answering times by 95%, to just three seconds? Will he also join me in expressing dismay at the approach taken by the Leader of the Opposition during the most recent session of Prime Minister’s Question Time in seeking to sow fear in the hearts of my constituents and others for his own narrow political gain?

    Steve Barclay

    I am happy to join my hon. Friend in paying tribute to the work of call handlers at the South Western Ambulance Service, and to the staff there as a whole. He is right to draw attention to the improved performance that we have seen in recent weeks, and also right to point out that all parts of the United Kingdom have faced considerable challenges, particularly over the Christmas period when we saw a significant spike in flu levels.

    Rachael Maskell (York Central) (Lab/Co-op)

    We have just heard in the Health and Social Care Committee that on strike days there was a drop in service demand, but also value added by the increased clinical support, resulting in better and more cost-effective decisions. Why does that happen on strike days rather than on every single day of the year?

    Steve Barclay

    We are taking a number of steps to improve performance, and not just on strike days—but I thought the hon. Lady was going to refer to the comment that she made about those on her own Front Bench, when she said:

    “I think what our health team need to do is really spend more time in that environment with clinicians to really understand what drives them.”

    We on this side of the House are spending a significant amount of time with clinicians, and it is important that those on the hon. Lady’s Front Bench do so as well.

  • Wes Streeting – 2023 Comments on Sajid Javid’s Suggestion of Charging for Using NHS

    Wes Streeting – 2023 Comments on Sajid Javid’s Suggestion of Charging for Using NHS

    The comments made by Wes Streeting, the Shadow Secretary of State for Health and Social Care, on Twitter on 21 January 2023.

    Over my dead body.

    An NHS free at the point of use has been its central equitable principle for 75 years. Patients should never have to worry about the bill.

    It’s up to Labour, which founded the NHS, to grip the biggest crisis in its history and make it fit for the future.

  • Richard Murphy – 2023 Comments on NHS Funding and Sajid Javid’s Proposals

    Richard Murphy – 2023 Comments on NHS Funding and Sajid Javid’s Proposals

    The comments made by Richard Murphy, the Professor of Accounting Practice at Sheffield University, on Twitter on 21 January 2023.

    Sajid Javid says we need to pay £20 for a GP appointment and £66 to go to A&E as a way to solve the NHS funding crisis. He’s wrong because there are so many better options in my new report on funding the NHS.

    There are 367 million GP appointments in the NHS each year. Assuming everyone had to pay (and I bet children and pensioners would not) at £20 a time that would raise £7.3bn in extra revenue.

    In England there are roughly 27 million A&E appointments a year, which at £66 each, assuming everyone paid, would raise £1.8 billion a year.

    So, Javid wants to raise £9.1 billion a year by imposing a sickness tax on those wanting to see a doctor. But that’s before exemptions and before the massive cost of actually collecting this money, which can’t be ignored. So, let’s guess it’s £6 billion after exemptions.

    In my new report on NHS funding out today I suggest the NHS needs £30 billion extra a year to function properly. So Javid is not proposing anything that will make any big difference to its fortunes. But he is going to hit the poorest hardest.

    I have suggested how to find the £30 billion required to pay for the NHS we need. Half would come from extra taxes paid simply as a result of spending the extra money on the NHS or by making people well enough to work again. In the real world that’s what happens.

    But that stills leaves £15 billion to find. That could come from halving the tax reliefs given to the wealthiest 10% in the UK on their pension and ISA accounts which cost a staggering £30 billion a year in total. Wouldn’t that be better than charging the sick?

    Or we could double the rate of capital gains tax and collect maybe £15bn a year. It is absurd that right now this tax, paid almost entirely by the wealthiest, is charged at half the rate of income tax. Wouldn’t that be better than charging the sick?

    Alternatively, we could invest £1 billion in HM Revenue & Customs to tackle tax abuse. It is reckoned they collect £18 for every £1 spent. So that could also raise the money needed. Again, wouldn’t that be better than charging the sick?

    And there are other tax options as well on top of which the government could simply run a deficit to pay for this or do QE to fund the NHS as the Tories did for other crises.

    But what we do not need to do is charge the sick what is, in effect, a new tax when being sick is already a good indicator of being on lower than average income and Javid’s sole aim in doing this is to pave the way for NHS privatisation, and his scheme raises insignificant money.

    We need a debate on NHS funding but crass ideas from Sajid Javid and his like on NHS charging need to be dismissed out of hand when vastly better options from taxing the best off more fairly or from borrowing are available.

    My report is at https://www.taxresearch.org.uk/Blog/2023/01/21/the-nhs-funding-crisis-and-how-to-solve-it/.

  • Sajid Javid – 2023 Article on Charging for NHS Treatment

    Sajid Javid – 2023 Article on Charging for NHS Treatment

    A section of the article published in The Times, written by Sajid Javid, the former Health Secretary and the Conservative MP for Bromsgrove on 21 January 2023.

    Too often we hear doctors and nurses frustrated at people making unnecessary trips to frontline services, which takes time from other patients. Would the same level of demand exist here if this Irish model were adopted? This extends to GP appointments. In Norway and Sweden a visit to the GP comes with a contribution of about £20. For some people, just like my parents, that is a noticeable part of the weekly budget. But as demonstrated by so many other countries, it is possible to means-test this provision. Even a tiny fraction of patients reconsidering their visit to the GP (and perhaps visiting a community pharmacist instead), would save thousands of clinical hours.

    Co-payments are not the only alternative. Germany’s social health insurance model gives the structural benefit of a greater choice of providers, including non-profit community hospitals, and therefore less pressure on the public system. In the UK, more and more people are moving towards private healthcare (including within NHS Trusts). But provision is limited in comparison. Other systems with a contributory principle have seen a range of providers emerge. Patients in the UK are all directed towards the front door of the NHS, which only worsens the queueing.

    For patients, this is not cost free. More waiting can mean an increased risk of illness and discomfort. And for NHS staff, it also means a constant tide of pressure (and sometimes abuse). We have already instilled an element of contribution into the NHS: we ask people who can afford it to pay towards the cost of prescriptions, and dental and optical care. Labour and Conservative governments have had a role in this. We should look, on a cross-party basis, at extending the contributory principle.

  • Keir Starmer – 2023 Parliamentary Question on Ambulance Waiting Times

    Keir Starmer – 2023 Parliamentary Question on Ambulance Waiting Times

    The parliamentary question asked by Sir Keir Starmer, the Leader of the Opposition, in the House of Commons on 18 January 2023.

    Keir Starmer (Holborn and St Pancras) (Lab)

    I join the Prime Minister in his comments about the dreadful case of David Carrick.

    It is three minutes past 12. If somebody phones 999 now because they have chest pains and fear it might be a heart attack, when would the Prime Minister expect an ambulance to arrive?

    The Prime Minister

    It is absolutely right that people can rely on the emergency services when they need them, and that is why we are rapidly implementing measures to improve the delivery of ambulance times and, indeed, urgent and emergency care. If the right hon. and learned Gentleman cares about ensuring patients get access to life-saving emergency care when they need it, why will he not support our minimum safety legislation?

    Keir Starmer

    The Prime Minister can deflect all he likes but, for a person suffering chest pains, the clock starts ticking straightaway—every minute counts. That is why the Government say an ambulance should be there in 18 minutes. In this case, that would be about 20 minutes past 12. I know he does not want to answer the question I asked him, so I will ask him again. When will that ambulance arrive?

    The Prime Minister

    Because of the extra funding we are putting in to relieve pressure in urgent and emergency care departments, and the investment we are putting into ambulance call handling, we will improve ambulance times as we are recovering from the pandemic and indeed the pressures of this winter. But I say this to the right hon. and learned Gentleman again, because he makes my case for me: he describes the life-saving care that people desperately need, so why, when they have this in other countries—France, Spain, Italy and others—is he depriving people here of that care?

    Keir Starmer

    The Prime Minister obviously does not know or does not care. I will tell him: if our heart attack victim had called for an ambulance in Peterborough at 12.03 pm, it would not arrive until 2.10 pm. These are our constituents waiting for ambulances I am talking about. If this had happened in Northampton, the ambulance would not arrive until—[Interruption.]

    Mr Speaker

    Order. Mr Bristow, I hope you want to see the rest of the questions out. I want you to be here, but you are going to have to behave better.

    Keir Starmer

    I am talking about our constituents. If they were in Northampton, the ambulance would not arrive until 2.20 pm. If they were in Plymouth, it would not arrive until 2.40 pm. That is why someone who fears a heart attack is waiting more than two and half hours for an ambulance. That is not the worst-case scenario; it is just the average wait. So for one week, will the Prime Minister stop blaming others, take some responsibility and just admit that under his watch the NHS is in crisis, isn’t it?

    The Prime Minister

    I notice that the one place the right hon. and learned Gentleman did not mention was Wales, where we know that ambulance times are even worse than they are in England. Let me set out the reason that is the case, because this is not about politics; this is about the fact that the NHS in Scotland, in Wales, in England is dealing with unprecedented challenges, recovering from covid and dealing with a very virulent and early flu season, and everyone is doing their best to bring those wait times down. But again, I ask him: if he believes so much in improving ambulance wait times, why will he not support our minimum safety legislation?

    Keir Starmer

    The Prime Minister will not answer any questions and he will not take any responsibility. By 1 pm, our heart attack victim is in a bad way, sweaty, dizzy and with their chest tightening. [Interruption.] I am talking about a heart attack and Conservative Members are shouting—this is your constituent. By that time, they should be getting treatment. But an hour after they have called 999 they are still lying there, waiting, listening to the clock tick. How does he think they feel, knowing that an ambulance could be still hours away?

    The Prime Minister

    The specific and practical things we are doing to improve ambulance times are clear: we are investing more in urgent and emergency care to create more bed capacity; we are ensuring that the flow of patients through emergency care is faster than it ever has been; we are discharging people at a record rate out of hospitals, to ease the constraints that they are facing; and we are reducing the call-out rates by moving people out of ambulance stacks, with them being dealt with in the community. Those are all very practical steps that will make a difference in the short term. But I ask the right hon. and learned Gentleman this again and again, although we know why; the reason he is not putting patients first when it comes to ambulance waiting times is because he is simply in the pockets of his union paymasters.

    Keir Starmer

    This is not hypothetical; this is real life. Stephanie from Plymouth was battling cancer when she collapsed at home. Her mum rang 999, desperate for help. Stephanie only lived a couple of miles from the hospital, but they could not prioritise her. She was 26 when she died, waiting for that ambulance—a young woman whose life was ended far too soon. As a dad, I cannot even fathom that pain. So on behalf of Stephanie and her family, will the Prime Minister stop the excuses, stop shifting the blame, stop the political games and simply tell us: when will he sort out these delays and get back to the 18-minute wait?

    The Prime Minister

    Of course Stephanie’s case is a tragedy. Of course, people are working as hard as they can to ensure that people get the care that they need. The right hon. and learned Gentleman talks about political games. He is a living example of someone playing political games when it comes to people’s healthcare. I have already mentioned what has been going on in Wales. Is he confident that, in the Labour-run Welsh NHS, nobody is suffering right now? Of course they are, because the NHS everywhere is under pressure. What we should be doing is supporting those doctors and nurses to make the changes that we are doing to bring care to those people. I will ask him this: if he is so concerned about making sure that the Stephanies of the future get the care that they need, why is he denying those families the guarantee of emergency life-saving care?

    Keir Starmer

    So, that is the Prime Minister’s answer to Stephanie’s family—deflect, blame others, never take responsibility. Just like last week, he will not say when he will deliver the basic minimum service levels that people need.

    Over the 40 minutes or so that these sessions tend to last, 700 people will call an ambulance; two will be reporting a heart attack, four a stroke. Instead of the rapid help they need, many will wait and wait and wait. If the Prime Minister will not answer any questions, will he at least apologise for the lethal chaos under his watch?

    The Prime Minister

    The right hon. and learned Gentleman asks about the minimum safety levels. We will deliver them as soon as we can pass them. Why will he not vote for them? We are delivering on the people’s priorities. As we have seen this week, the right hon. and learned Gentleman will just say anything if the politics suits him; it is as simple as that. He will break promises left, right and centre. He promised to nationalise public services. He promised to have a second referendum. He promised to defend the mass migration of the EU, and now we are apparently led to believe—[Interruption.]

    Mr Speaker

    Order. I expect those on the Front Bench to keep a little quiet. If they do not, there is somewhere else where they can shout and make their noise.

    The Prime Minister

    If we are to deliver for the British people, people need to have strong convictions. When it comes to the right hon. and learned Gentleman, he is not just for the free movement of people; he also has the free movement of principles.