Jonathan Ashworth speech to the House of Commons in the Queen’s Speech debate
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Jonathan Ashworth MP, Labour’s Shadow Health Secretary, speaking to the House of Commons in the Queen’s Speech debate today, said:
I beg to move the amendment that stands in the name of my Rt Honourable Friend the Leader of the Opposition and other honourable members.
Can I also take this opportunity to note that while amendment in the name of my Rt Honourable Friend the member for Rhondda has not been selected its contents on brain injury are important and I hope ministers takes its recommendations on board.
We remember the 127,691 who have lost their lives to Covid including the 850 health care workers.
It does not make the scale and gravity of the loss any less shocking.
We do grieve as a nation.
We pay tribute to health care staff.
And we must dedicate ourselves in good faith to learning lessons for the future in an era when pandemics are predicted to become more regular because of climate change and biodiversity loss.
Mr Speaker we know the B.1.617.2 variant is spreading. It has a growth rate advantage over the B117 variant of 13 per cent. It could become to the dominant strain in the UK.
The Government still has a responsibility to do all it can to contain its spread, minimise sickness and not disrupt the June 21st target being met.
It’s why as I said on Monday we need surge vaccinations in the hotspot areas. We know with vaccination there are always pocket where rates are lower than necessary and we need to increase those rates. We see that with measles outbreaks for example.
We need sick pay and support for isolation fixed.
We need enhanced contact tracing with resources for the local authorities affected.
We need ventilation and air filtration systems installed in premises and public buildings and enforced infection control in all workplaces.
And we need transparency in decision making.
For the first time in my life I find myself agreeing with Dominic Cummings who tweeted yesterday “with something as critical as variants escaping vaccines, there is no justification for secrecy, public interests unarguably is open scrutiny of plans”
Mr Cummings, on this occasion, is right – which is why our amendment today calls for the publication of the Government’s lessons learnt review so we can use these lessons in our efforts to contain variants and to ensure we are better prepared for the future.
This should have been a gracious address that unveiled a new NHS plan to bring down the elective waiting lists now close to 5 million, and outline proposals to tackle the backlog of 436,000 people waiting over 12 months for treatment; many of them waiting in pain and anxiety or facing permanent disability.
So where is the plan to bring down the rocketing waiting lists for treatment and surgery?
Where is the plan to roll out technology such as in Ophthalmology for the thousands waiting for a cataract operation?
There are already 81,762 of our constituents waiting over 12 months for orthopaedic surgery alone, how much longer will they have to wait?
24,407 of our constituents are waiting over 12 month for gynaecological surgery, how much longer will they have to wait?
Everyone understands of course there has been a pandemic, and that meant care pathways would be disrupted. But the NHS was forced into this unprecedented position because we went into this crisis on the back of 10 years Tory underfunding and cutbacks.
And on the back of 6 per cent reduction in bed numbers between 2010 and 2019, that’s why at the beginning of 2020, 4.5 million people were on the waiting list for treatment. The target for 92 per cent of patients to begin treatment with 18 weeks of referral from their GP has not been hit for five years.
But we need a resourced plan now because the queues are set to lengthen further as those who may have delayed seeking treatment for fear of Covid infection begin to emerge once again.
The NHS, even when dealing with significantly less Covid patients is still operating at much less capacity than is needed to treat everyone in need of care. Infection control measures meant that bed numbers fell by 9 per cent in the first quarter of last year. They only partially recovered over the last three months but are still 6 per cent below the previous year.
What that actually means is that in most recent figures, there was an average of almost 14,000 fewer patients in NHS general and acute beds than the equivalent period pre-Covid.
The Prime Minister has delayed the review of social distancing for understandable reasons. But the solution to these capacity issues cannot be a multi-billion pound deal with the private sector.
Because loss of capacity in terms of beds in the NHS is far larger than the whole capacity of the private sector, and to reopen these closed and empty NHS beds depends on more capital investment instead. This investment is needed to build up capacity to carry on routine surgery in the years to come. And the budget and Queen Speech failed to deliver that.
We also need capital investment in diagnostic capacity and wider technology. We still have some of the lowest numbers of CT and MRI scanner per capita in the OECD and only average amounts of RTE radiotherapy machines.
And in the last year or so we’ve seen 4.6 million fewer diagnostic tests for cancer; 46,000 fewer people starting cancer treatment. We shouldn’t have to choose between Covid care and cancer care but for too many that has been the reality this past year.
And it means 4,500 additional avoidable cancer deaths are expected this year. It means progress in survival rates for colorectal cancer, breast cancer, and lung cancer are expected to be undone and the proportion of cancers diagnosed while still highly curable has dropped from 44 per cent to 41 per cent.
The Long Term Plan the Secretary of State fought an election on promised rapid action on cardiovascular disease. Yet experts are now predicting the highest cardiovascular mortality in a decade with an expected 12,000 additional heart attacks and strokes over the next five years. So we needed proposals to expand access to the appropriate health care but also interventions tackle smoking rates, alcohol abuse and reduce salt intake.
Yes there is a commitment to a Tobacco control plan but will there be a reversal of the 17 per cent cuts to smoking cessation services?
When 7,400 died last year from alcohol abuse – record numbers – will he reverse the cuts to drug and alcohol addiction services that have seen budgets cut by 15 per cent over the past 3 years?
We are promised action – again – on banning junk food advertising but will he reverse the cuts to public health weight management services?
Narrowing health inequalities should be at the heart of every government policy. There can be no levelling up while life expectancy advances stalls for the poorest in society.
Levelling up and tackling inequalities applies to mental health outcomes as well. More people suffer from depression in the poorest areas of the country than the richest.
Black men, in particular, are more likely to be detained under the Mental Health Act, more likely to be subjected to seclusion or restraint but less likely to access psychological therapies. So we welcome commitment to reform the Mental Health Act like last year and I want to put on record our thanks to Sir Simon Wessely for his pioneering work. I know Simon is committed Chelsea fan so I dare say he will be more responsive to my felicitations than perhaps he would have been in Saturday evening.
But we face a crisis in mental health for which action is needed now. When 235,000 fewer people have been referred for psychological therapies, when eating disorder referrals for children have doubled and when pandemic has driven a reduction in almost 11% fewer beds occupied – equivalent to 1,700 fewer patients over the last three months compared to a year earlier.
When will the Government implement its promise of significant increases in staff and resources for mental health to ensure mental health care is genuinely given parity of esteem with acute services?
Which brings me to staffing more generally. When we are short of 200,000 staff across health and social care why was there nothing new in this Queen’s Speech to recruit or train more doctors, more nurses, more social care staff?
And why was there no plan to give our NHS staff the pay rise they deserve? NHS staff including nurses who have cared for those with Covid on wards and district nurses in the first wave who cared for those discharged home from hospital earlier than planned, safely at home.
Yet they feel the 1% pay rise – a probable pay cut in real terms, is a kick in the teeth.
Is it any wonder we have nurses leaving the profession including one who cared for the Prime Minister blasting ministers for treating NHS workers with a lack of “respect”?
The gaping hole of course in this Queens Speech is the plan for social care.
Two years ago the PM stood on the steps of Downing Street and said he had the plan to fix social care. He said: “We will fix the crisis in social care once and for all with a clear plan we have prepared to give every older person the dignity and security they deserve”
Not a plan that was to be developed. Or a work in progress. No this plan was already done. Oven ready you might say. But two years on where is it? Has the Health Secretary seen it? What do we need to do to see it? Pay for some cushions for the Downing Street flat?
They promised us cross party talks In fact, they now brief cross party talks have taken place. When? Did they forget to send me the Zoom link?
But there is a consensus on social care. Care workers should be paid the living wage and proper sick pay.
There should be a cap on costs – as the House legislated for.
And when the IPPR, social care and older people’s charities and House of Lords Committee consisting of Norman Lamont and Michael Forsyth – true blue Conservatives – all call for free personal care, surely the Secretary of State should be engaging in this debate?
But lack of cross party talks isn’t an excuse for not getting on with reform. A Prime Minister with an 80 seat majority should be able to show some leadership and get on and fix it
If he wants to talk social care reform, I’m free this afternoon he knows where I am.
Mr Speaker the Secretary of State and I have developed something of a bond these last 12 months. The Health Secretary has been so very friendly to me across Despatch box. I’m half expecting him to offer me a lucrative PPE contract.
So I have comradely advice for him. I know he’s bringing forward a bill to neuter the independence of the NHS Chief Executive and give powers back to the Secretary of State. I’ve been around long enough to remember when Tories used to complain that the NHS needed independence from the Secretary of State.
Can I just suggest he ought to be careful what he wishes for?
But he’s pressing ahead with a bill to take back control – to coin a phrase from Simon Stevens – just at the moment that we read in the Standard courtesy of Mr Tom Newton Dunn that not only was Simon Stevens the best man at the Prime Minister’s wedding, but the Prime Minister it’s said is about to appoint Simon Stevens, sorry Lord Simon Stevens, to, yes you’ve guessed it, the newly empowered post Secretary of State of Health and Social Care.
Mr Speaker it brings a whole new meaning to the phrase …. the best man for the job.
This is the Secretary of State who set up Test and Trace, PPE procurement, failed to protect care homes. Dominic Cummings described the Department as a ‘smoking ruins’ and now he wants more control.
The Queen’s Speech was remarkably unspecific in its description of the content of the coming Health and Care Bill. But can the Secretary of State commit to ensuring that neither the NHS nor the partnership Boards to be set up in each Integrated Care System will permit the inclusion of private sector participants?
Can he guarantee that as statutory bodies ICSs will meet in public, publish board papers and be subject to the Freedom of Information Act?
And what guarantees can he give this house that the establishment of Integrated Care Systems will not lead to more private corporations – American, European or British – taking over GP practices (as has happened recently with Centene) or services currently delivered by NHS providers?
Mr Speaker, nearly 5 million on the waiting list and rising, ever lengthening queues in our constituencies waiting for hip replacements and cataract removal, cancer survival rates worsening, mental health care in crisis, social care reform kicked into the long grass.
A costly, morale sapping reorganisation of the NHS in a pandemic.
We need a fully resourced 10 year rescue plan for our NHS and I commend our amendment to the house.