Unfortunately, I was not called to speak during the Report Stage of the Health & Care Bill in the Chamber yesterday.
The Covid-19 pandemic is one of the biggest crises that the NHS has ever faced, made worse by ten years of underfunding, understaffing and privatisation that has left the service in a critical condition.
This Bill falls far short of addressing the urgent issues.
This Bill has extremely concerning implications for services, accountability, funding, professional standards, privatisation, safety, and terms and conditions.
It is a poor attempt to make up for ten years of failure following the disastrous Health and Social Care Act of 2012.
The Bill introduces a new duty on the Secretary of State to report on workforce systems every five years. While welcome, this is woefully inadequate given the staffing challenges the NHS faces.
Worryingly, the Bill adds new provisions to allow the Secretary of State to deregulate professions and merge or abolish regulatory bodies; abolishes Local Education and Training Boards (LETBs) and gives local boards powers to vary local pay and terms for their staff, potentially undermining national terms and conditions.
We cannot address a staffing crisis by allowing the Health Secretary to deregulate the profession, merge or abolish regulators, abolish education roots and undermine national pay scales, terms and conditions.
The NHS needs a comprehensive and long-term workforce strategy that brings in legal obligations on safe staffing levels, protects professional standards, and maintains national terms and conditions of employment.
Trade unions must be at the heart of this, including on boards, shaping workforce planning and development.
We must invest in our people. The NHS is more than bricks and mortar. The system can only function with trained and skilled staff, and we desperately need more of them.
Cancer charity Macmillan Cancer Support maintains that workforce shortages remain the biggest challenge facing the NHS today.
Cancer patients are missing out on vital support due to ongoing specialist nurse shortages.
To help meet the Government’s NHS Long Term Plan Macmillan estimates we need an additional 3,371 cancer nurse specialists. That means doubling the number of cancer nurses by 2030.
The current vacancy rate for NHS radiotherapy workforce is the highest since records began.
Macmillan is calling on the Government to announce a Cancer Nurse Fund and invest a total of £124 million to train the next generation of cancer nurses.
I am also very concerned about the reconfiguration of power and controls.
The new Bill introduces sweeping new powers of control, restructure and decision-making for the Secretary of State but does not bring back the duties on the government to provide a universal health service, or sustainably fund NHS and social care services.
The Bill restructures the architecture of the English NHS, putting the new Integrated Care Boards (ICBs) in the heart of the new system.
I would question the democratic accountability within these new bodies, with only a limited role for local authorities, increased central government powers to intervene and appoint board directors and the potential role for private providers to sit on the boards, creating major conflicts of interest.
The Bill potentially opens up ICBs to representatives from private sector providers, hardwiring privatisation into the decision-making process.
Bitter experience during the pandemic has shown that this Government cannot be trusted with unregulated procurement.
The pandemic also laid bare the impact of centralisation and the deconstruction of local public health services. The wide-ranging “reforms” of the 2012 Health and Social Care Act were characterised by the dismantling of NHS regional services. I voiced my concerns about the proposals at the time and I will do the same today.
At the time, as now, I feared that the dissolvement of public health observatories and other regional services would result in a less focused and less effective public health service delivery.
A UK government that prioritises the health and wellbeing of the public must see the importance of rebuilding the disempowered and fragmented infrastructures of its public health system.
All new NHS organisations must be accountable to the communities that they serve and the staff they employ. We need a greater role for local authorities, a strong role for trade unions, including full recognition of bargaining structures and introducing workers representatives on boards as in the Scottish NHS.
The Bill must also include a duty on the government to provide a universal service and there must be a duty to sustainably fund the service including public health provision. These duties should also apply to social care.
This Bill is the wrong prescription for the English NHS.