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Question
Why is the Secretary of State addressing competition for places now, close to damaging strikes? Can he provide details on the specialisms and capacity for the additional training places?
Minister reply
The situation has worsened over the last two years. The 4,000 new places include an increase from 1,000 this year, with specific focus on GPs, surgery, obstetrics, anaesthetics, among others. Capacity and trainer availability will be addressed through collaboration with NHS trusts. Specifics about application processes and specialisms are still being finalized.
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Question
What is the plan if BMA rejects the offer? What measures are in place to manage winter pressures?
Minister reply
In case of rejection, we will continue dialogue but must prepare for potential strikes. Additional resources and contingency plans have been put in place to mitigate impacts on NHS operations during winter.
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Question
As a massive advocate for all medical and nursing staff, I urge the BMA to see sense at this difficult time when flu is running rampant and most NHS staff are suffering. Will the Secretary of State join me in urging the leadership of the BMA and doctors to put patients first?
Minister reply
I agree entirely with my hon. Friend. She speaks for so many other NHS staff who do not want to see nurse pitted against doctor or NHS staff pitted against each other. I urge the BMA to think again, even at this late stage. Extending the strike mandate tomorrow and giving Jim Mackey and NHS leaders an opportunity to stand down planning for strikes next week would be a Christmas present for the country, benefiting doctors and patients.
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Question
People are alarmed at the threat of more industrial action before Christmas. Given that resident doctors received a 29% pay rise last year, I think most of the public feel pushing for another 28.9% this year is unaffordable and unreasonable. Can we ensure that the extra 4,000 placements announced today will address acute shortages in general practice and psychiatry?
Minister reply
I thank the Liberal Democrat spokesperson for his support and constructive challenge. We are seeking to deal with the challenges inherited from previous governments by taking a number of steps, including promising to recruit an additional 1,000 GPs to the frontline and expanding speciality training places. The international medical graduate dimension of the deal means that extra speciality training places go even further in addressing shortages.
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Question
My mum, a former shop steward, always drummed it into me that there are no winners in a strike. Never is that as stark as in the situation we are facing now. There will be healthcare workers in my constituency, already under tremendous pressure, who will be looking at the situation coming up in the next few weeks with dread. The Secretary of State has been incredibly reasonable and has set out a plan that I plead the leadership of the BMA to get on board with. Call off these strikes to get us through winter and through this difficult period for the benefit of patients and for the whole NHS.
Minister reply
I am grateful to my hon. Friend and I hope that point is not lost on the BMA. On the Labour Benches, we are the party of labour. We were created by the trade union movement to represent the interests of working people. That has been our calling for more than a century, since this party was founded. We have shown through our actions, not just our words, that this is a Government who are committed to defending and extending the rights of working people.
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Question
These strikes will have a massive effect on my constituents in Farnham and Bordon. I am already getting emails from constituents who are concerned about the fact that their operations will be cancelled. The BMA is being entirely irrational and it holds the lion’s share of the blame for this situation, but the Secretary of State also has to take some responsibility for what is going on.
Minister reply
I thank the hon. Gentleman for the first bit. As for the rest of it, let me just say that the NHS workforce plan we inherited came in the 14th year of the Conservative Government. It was so absurd—it was so absurd—that on its trajectories for the increase in staffing numbers, within this century, 100% of the public would have to work for the NHS to sustain that level of workforce growth.
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Question
With a 28% pay rise and 4,000 extra specialty training places, it is starting to feel like the BMA resident doctors committee is deeply committed to not taking yes for an answer. It is not just about the services; it is about the parent who wants their kids to have their elective appointment before Christmas.
Minister reply
My hon. Friend is absolutely right. I do wish the BMA would take yes for an answer sometimes; I would like it even more if the BMA gave yes as an answer to me once a while, but that has not happened in a little while. He is right to talk about the need for workforce planning.
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Question
I find it rather shocking that when the Secretary of State for Health has offered the BMA leadership an opportunity to strike a few weeks later, they have turned it down, presumably because they prefer to strike at Christmas, when, frankly, lives will be lost as a result. Am I missing something here? Why is it, according to the Secretary of State, that the BMA leaders seem to be so determinedly militant?
Minister reply
I will say to the right hon. Gentleman that we are doing everything we can to mitigate against harm during the proposed strike dates, but I cannot in all honesty and integrity assure him that no patient will come to harm next week should the strikes go ahead, because the situation is so dire.
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Question
This is a great deal, but we need to increase the number of consultants and GPs if we are to avoid pushing the bottleneck down the road.
Minister reply
My hon. Friend is absolutely right about addressing bottlenecks and workforce planning. We will ensure adequate increases in all areas necessary to support this initiative.
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Question
What assessment has the Secretary made of the impact of these announcements on the likelihood of future strikes?
Minister reply
We have been working closely with Agenda for Change unions to ensure fairer pay for all NHS staff. While we are optimistic about reducing strike action, it is crucial that resident doctors make their voices heard in the upcoming survey.
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Question
Can we urge those doctors to talk to their fellows and try to call off this strike?
Minister reply
I urge every resident doctor to make their views known during the survey. This is an opportunity for them to express their opinions on the deal.
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Question
Is he genuinely saying that if the BMA rejects this offer, it will not proceed?
Minister reply
Regrettably, if the BMA rejects this offer, we cannot move forward. We must ensure a transactional approach is maintained to avoid further industrial action.
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Question
What discussions has the Secretary had with the BMA about the impact of potential strikes?
Minister reply
We have been working constructively to address concerns. However, we cannot make guarantees regarding the quality or timeliness of care if strikes proceed.
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Question
What discussions has the Secretary had with the BMA about the impact this strike will have on emergency care?
Minister reply
We are doing our best to mitigate disruptions, but it is difficult to make guarantees due to the high occupancy rates in hospitals.
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Question
Does my right hon. Friend agree there is a striking inconsistency between what the BMA demands and its own record as an employer?
Minister reply
There certainly is a discrepancy, which I urge the BMA to address constructively in its negotiations.
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Question
Will all resident doctors of all specialisms be subject to fee waivers?
Minister reply
Royal college fees and exam costs will be waived for all resident doctors, backdated where necessary to cover already incurred expenses.
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Question
Does the Secretary of State agree that the BMA needs to take into consideration not just the deal on the table today but also the principle of the NHS?
Minister reply
My hon. Friend is absolutely right. We need to make sure we are not inflicting avoidable damage or setbacks on our progress, and it feels like this round of strike action represents such a setback.
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Question
Does my right hon. Friend agree that we need to urge the BMA to call off this strike and will he commit to continuing that dialogue with the profession?
Minister reply
I entirely agree with my hon. Friend. We are going to have to reset the relationship between the Government and resident doctors, as it has hit the buffers somewhat in recent weeks.
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Question
Will the Secretary of State send a message to my constituents to assure them that they will be kept safe should the BMA take this disastrous action?
Minister reply
I can assure everyone in our country that NHS leaders, frontline staff and I will do everything we can to mitigate harm during these strikes; however, I cannot guarantee there will be no harm.
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Question
Would the Secretary of State urge the BMA to take stock, think again about patients and its colleagues, and pause action while its members are consulted on the new terms?
Minister reply
I completely agree with my hon. Friend. There are no downsides for the BMA in this offer, which allows it to postpone strikes until January.
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Question
Does the Secretary of State share my worry that any strike action would make tackling this flu crisis much harder?
Minister reply
My hon. Friend is absolutely right. It costs us roughly a quarter of a million pounds each time the BMA does this, and we cannot afford to keep paying that.
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Question
Will he confirm that NHS England and local NHS leaders will have his full support in taking the difficult decisions that they need to take to keep patient flow going and emergency care going during this period if strikes do take place?
Minister reply
I can give him that assurance. I think its operational leaders will face some fiendish choices in the coming days and weeks if strike action goes ahead.
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Question
Does he share my concern about the human impact of this planned strike?
Minister reply
That is the only thing I have been thinking about in recent days, and it is why I have offered to extend a strike mandate for the first time. This avoids that dreaded phone call to patients who are gearing themselves up for tests or scans.