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NHS Winter Update
08 January 2024
Lead MP
Victoria Atkins
Debate Type
Ministerial Statement
Tags
NHSEmployment
Other Contributors: 35
At a Glance
Victoria Atkins raised concerns about nhs winter update in the House of Commons. A government minister responded. Other MPs also contributed.
How the Debate Unfolded
MPs spoke in turn to share their views and ask questions. Here's what each person said:
Government Statement
The Secretary of State for Health and Social Care, Victoria Atkins, addressed the House regarding winter pressures facing the NHS and social care systems in the UK. She highlighted that the NHS employs around 1.3 million people while the social care system has approximately 1.5 million workers, providing care to millions daily. The statement emphasised early preparations with a £1 billion investment for emergency capacity, including 5,000 new permanent beds and over 11,000 virtual ward beds for remote monitoring of patients. Additional funding of £200 million was allocated to bolster the ambulance service and improve response times. To aid patient discharges, every acute hospital received access to care transfer hubs with extra funding of £600 million for social care. The minister also discussed the BMA’s junior doctors’ strikes, noting over 90,000 cancelled appointments since December. Despite these challenges, she highlighted the NHS's efforts to maintain patient safety and acknowledged the dedication of staff during strikes. She pledged to negotiate fair deals with unions when they are reasonable, but criticised ongoing strikes as damaging and unaffordable for taxpayers, urging junior doctors to return to the negotiating table.
Grahame Morris
Lab
Easington
Question
The MP asked whether it was fair for the minister and the Prime Minister to characterise junior doctors as “doctors in training” when many have extensive experience. He also questioned why the Government chose not to intervene earlier to prevent strikes, despite clear indications of their impending impact.
Minister reply
The Secretary of State acknowledged that while she understands junior doctors’ concerns and respects their dedication, it was necessary to refer to them as “junior” in the context of negotiations. She defended her decision not to intervene further, stating that this would have undermined ongoing discussions with other stakeholders and risked prolonging disputes without resolution.
Steve Brine
Con
Winchester
Question
The MP asked about specific measures taken to ensure patient safety during the strikes and whether there are any plans for additional support for patients in urgent need of care.
Minister reply
Minister Atkins explained that significant efforts were made by NHS trusts to prepare for strikes, including rescheduling appointments and deploying extra staff. She also mentioned the availability of emergency care services, with a focus on vital neonatal and maternity units, ensuring patient safety remains paramount.
Wes Streeting
Lab
Ilford North
Question
The shadow Secretary of State welcomes the Health Secretary back and notes that the NHS is facing a crisis due to the government's failures, with heart attack and stroke victims waiting longer for ambulances and A&E waiting times being the worst they have ever been. He criticises the government for allowing strikes without intervening and questions why patients are paying the price.
Minister reply
The Health Secretary welcomes the shadow Secretary of State back from his book tour and notes that under Labour in Wales, people are almost twice as likely to be waiting for treatment and they wait an average of five weeks longer. She corrects the claim about new ambulances being just replacements and mentions the 5,000 extra beds in hospitals. On the 'doctors in training' terminology, she explains that it is a term agreed with the BMA. Regarding strikes, she notes that the Labour shadow Minister did not condemn them.
Steve Brine
Con
Fareham
Question
The Member asks if his right hon. Friend shares concerns over the longer dispute affecting goodwill among consultants and damaging the career pipeline for junior doctors.
Minister reply
Yes, he thanks his hon. Friend for asking and notes the enormous efforts of clinicians across the NHS who have been covering strikes. Clinicians have had a tough few Christmases, and these strikes impact those picking up extra shifts to cover absences.
Amy Callaghan
SNP
Motherwell and Wishaw
Question
The Member notes the unprecedented winter pressure on the NHS with inflationary costs, viral infections, staff shortages, and criticises the government for cutting capital funding and not negotiating with trade unions.
Minister reply
Junior doctors received an 8.8% increase in basic salaries as of September, along with rare pension contributions. The Health Secretary wants to find a fair settlement but cannot while strikes continue.
David Evennett
Con
Bexleyheath and Crayford
Question
The Member welcomes the factual statement on the state of the NHS in her winter update and asks if she would return to negotiating with the BMA if they call off strikes.
Minister reply
Yes, she is extremely disappointed that discussions were walked away from. She wants to look at other aspects of working conditions but cannot negotiate while there are strikes.
Rachael Maskell
Lab Co-op
York Central
Question
We have had 14 Tory winters. A quarter of patients in my local hospital are waiting for social care, causing accessibility issues in the NHS. When will the Secretary of State publish a proper plan for social care?
Minister reply
The Government announced £7.5 billion and an additional £600 million at the 2022 autumn statement, bringing total funding to £8.1 billion over two years to support the care workforce.
Caroline Johnson
Con
Sleaford and North Hykeham
Question
Strikes are causing suffering to patients; when will the Secretary of State bring forward minimum service levels to protect patients from dangerous strikes?
Minister reply
Minimum service levels have been introduced for ambulance services, consultations on hospital minimum service levels are closed and being analysed, 40 patient safety mitigations were made by NHS leaders but only two were granted by the BMA.
Daisy Cooper
Lib Dem
St Albans
Question
A rise in respiratory illnesses is pushing NHS to its brink; when will the Government get serious about public health interventions?
Minister reply
The flu and covid vaccination programme was brought forward on clinicians' advice, but the strikes have had a negative impact.
Question
40 patient safety mitigations were requested by NHS leaders with only two responded to positively; we need inspirational leadership and condemn BMA actions.
Minister reply
I trust the judgment of local NHS trusts who have put forward patient safety mitigations.
Diana R. Johnson
Lab
Kingston upon Hull North and Cottingham
Question
Public health director in Hull reported a double jeopardy for disadvantaged communities; why is that after 14 years of Conservative Government?
Minister reply
We have worked with NHSE to bring about 800 new ambulances on the roads, and about 5,000 more core beds into the NHS to address urgent and emergency care needs.
Question
Worcester hospital is still facing intense pressure despite delivering extra capacity; will the Secretary of State join me in paying tribute to staff?
Minister reply
Thanking staff for their efforts, we are working with NHSE regional and local leaders to improve hospital flow.
Tim Farron
Lib Dem
Westmorland and Lonsdale
Question
NHS winter pressures impact cancer surgery; will the Secretary of State meet me to discuss investing in radiotherapy?
Minister reply
We have made progress with urgent cancer checks, delivering record numbers. Additional £8 billion funding has been provided across the spending review period.
Question
Welcoming additional 11,000 virtual ward beds; will she confirm her intention to roll it out further?
Minister reply
Virtual wards represent a step change in treating long-term conditions at home. We have delivered more than the initial ambition of 11,000 places.
Clive Efford
Lab
Eltham and Chislehurst
Question
The BMA says that junior doctors’ pay has been cut in real terms by 26% through consistent below-inflation increases. If the Tories really cared about this strike and about the NHS, would they not have avoided creating the circumstances that made junior doctors so angry that they felt the need to go on strike?
Minister reply
The figure cited is from 2008 when Labour was in government; independent organisations show a difference of 11% to 16%. Graduate doctors received a rise of 10.3%, and negotiations for further settlements are open.
Question
Is the Health Secretary aware that the impact of these strikes on the Royal Cornwall Hospitals NHS Trust has seen more than 7,000 appointments and operations cancelled and several million pounds in extra costs to the trust? Does he share my concern that the junior doctors are pursuing an unreasonable pay demand and causing lasting damage to patients and the finances of the NHS?
Minister reply
The challenges faced by rural communities due to geography must be acknowledged, but the behaviour on picket lines is uncomfortable. Fair and reasonable settlements require a willingness from junior doctors to act reasonably.
Sarah Edwards
Lab
Tamworth
Question
Recently, Tamworth had clarification that mental health provision at the George Bryan Centre would not be invested in; patients must now travel to Stafford for crisis care. Why have the Government not put in place a plan to recruit more NHS mental health staff?
Minister reply
The NHS long-term plan sets an ambition to grow the mental health workforce by 27,000 staff between 2019-20 and 2023-24 with additional funding of £2.3 billion a year.
Question
We are fighting to prevent the loss of some hospital services in Scunthorpe; over 98% of local residents agree that these services must not be lost. Does my right hon. Friend agree that, in order for the NHS to provide resilience during the winter and the services it wishes to provide to patients, hospital bosses need to listen carefully to what patients think?
Minister reply
I agree; I will ask the Minister for Health and Secondary Care to visit the hospital to discuss concerns with local residents.
Richard Foord
Lib Dem
Honiton and Sidmouth
Question
Two GPs from Seaton moved to Australia over two years ago; they wish to return to east Devon. Retesting them is lengthy, costly and bureaucratic—can NHS England make it easier for UK-trained GPs working in Australia, New Zealand or Canada to return?
Minister reply
I will look into this fair challenge.
Question
The Labour party has run the NHS in Wales for 27 years. The shadow Secretary of State mentioned waits for ambulances, GPs and operations; my constituents are waiting longer for these services. I advise caution before taking advice from Opposition Members.
Minister reply
I will take this advice with enthusiasm. Labour-run Welsh Government were hiding patients in A&E waiting figures, falsely claiming better performance than England.
Alison McGovern
Lab
Birkenhead
Question
Further to the question from my hon. Friend on mental health, it is disappointing that the Secretary of State did not mention mental health in her statement; what progress is she making in developing proper waiting times for people needing mental health services?
Minister reply
We are spending £7 million over two years on 100 mental health ambulances and funding more than 160 projects, including crisis cafés and safe havens, to ensure appropriate care.
Alberto Costa
Con
South Leicestershire
Question
Will the Secretary of State join local NHS stakeholders in South Leicestershire for a consultation on the future of Feilding Palmer Hospital before the deadline on 14 January?
Minister reply
I would be happy to do so; local NHS leaders are actively seeking views from patients and communities.
Justin Madders
Lab
Ellesmere Port and Bromborough
Question
A former Prime Minister promised to fix social care, yet fit-for-discharge patients remain in hospital. What is the current figure for such patients, and will it go up or down before the end of January?
Minister reply
We are making progress with extra investment in social care packages; other factors like practical measures also impact flow through hospitals.
Question
The shadow Secretary of State forgot that Labour closed 50,000 hospital beds when they were in government. I urge the Secretary of State to pay tribute once again to ambulance services and consider expanding community paramedicine.
Minister reply
I pay tribute to first responders; recent visits highlight how team work can make a real difference to patients’ lives.
Janet Daby
Lab
Lewisham East
Question
We have gone from no winter crisis when Labour left office to an annual winter crisis—and now a crisis all year round under this Conservative Government. Patient satisfaction with the NHS is at a record low. Instead of there being a blame culture, when will the Secretary of State accept responsibility for that appalling record?
Minister reply
I think the hon. Lady was claiming that there was no winter under Labour, but perhaps that is yet another thing that does not quite stack up. I fully endorse her call for an end to blame culture, but point her to the real and practical measures that we have taken to improve urgent and emergency NHS care. I assume that she joins those on the Government side in condemning the unprecedented strike actions that the junior doctors committee has called at this particular time of year.
Question
Having chaired more than 150 meetings between Gloucestershire MPs and our NHS leaders, this week I am handing over the baton to my neighbour, my hon. Friend the Member for Tewkesbury (Mr Robertson). My two thoughts are, first, to share the Secretary of State’s immense gratitude to everyone in the Gloucestershire Royal Hospital and our other services for all their continuing, amazing work; and secondly, to highlight that the biggest single impediment to reducing the elective surgery backlog—the hips, knees and much more of many of our constituents—is this continued strike by doctors in training. I am sorry, but the continued failure of the shadow Secretary of State to highlight whether he supports patients or strikers shows an absence of leadership. Will my right hon. Friend confirm that the doctors in training, the doctors on strike, have already received, in 2023, a pay rise of between 8.1% and 10.3%?
Minister reply
I most certainly can confirm that—those doctors have already received the rise. As I said, I wanted to continue discussions on more fair and reasonable settlements for junior doctors, recognising as I do how tough their job is and the conditions under which they work. May I thank my hon. Friend for the leadership he has shown with his local trusts and clinicians? I agree with him that the one thing we have not heard from the Opposition is that they condemn the strikes. They seem to prioritise union harmony over patient safety.
Helen Morgan
Lib Dem
North Shropshire
Question
Shrewsbury and Telford Hospital Trust has one of the most challenged A&E departments in England, for a number of reasons. In August last year, the Government awarded a grant of £21 million to provide extra beds to ease some of the issues in A&E, but those beds are not online and operational yet. What assurances can the Secretary of State give us that the measures that have been taken to ease winter pressures will be in place to help people before the winter is over?
Minister reply
I will ask the Minister for Health and Secondary Care, my right hon. Friend the Member for Pendle (Andrew Stephenson), to liaise with the hon. Lady directly. As I say, the latest figures I have from NHS England, working with local trusts, is that more than 3,000 of the extra 5,000 beds were in situ in December, and we expect the 5,000 deadline to be met very shortly. I hope she will see that at local level in her hospital very soon.
James Wild
Con
North West Norfolk
Question
Is not the rejection by the BMA of derogation requests made on the basis of patient safety dangerously irresponsible? Rather than Dr Laurenson, co-chairman of the junior doctors committee, saying that the NHS hates doctors, it is past time that they called off this damaging strike action and put patients first.
Minister reply
Very much so—the NHS belongs to us all, as I say repeatedly. It goes without saying that doctors are a critical part of our workforce. That is why, since becoming Secretary of State, I have wanted to have a good, constructive working relationship with all of the representatives of doctors and the wider workforce. That was why I called in the BMA and “Agenda for Change” as soon as I possibly could, and I am pleased that I have been able to find fair and reasonable settlements with consultants and specialty doctors. I very much hope that junior doctors will call off their strikes and come back around the table so that we can find solutions for them too.
Samantha Dixon
Lab
Chester North and Neston
Question
The latest period of strike action by junior doctors has been the longest in the NHS’s history. We have seen trusts declaring critical incidents and A&E departments telling patients not to come in unless their lives are under threat. Can the Secretary of State tell me why the Prime Minister has not stepped in to resolve the dispute? Does he think it is not serious enough?
Minister reply
As I said earlier, strikes have very serious consequences for the NHS. We cannot pretend that the NHS can be switched on and off at whim. My one ask of the junior doctors committee was that it stop the strikes so that we can return to the table. As the number of patient safety mitigations has revealed—by the way, it is the highest number of patient safety mitigations that local NHS leaders have ever asked for, because of the unprecedented length and timing of the strike—and because the BMA has refused even those derogations, with the exception of two, we have to get to a place where it returns to a more reasonable frame of mind and comes back to the table with more reasonable expectations, so that we can try to find a solution. I will not put patients’ safety at risk: I have to enable NHS England to make preparations and continue the work it is doing day by day, hour by hour, to safeguard hospitals and patients during this very damaging strike action.
Question
My right hon. Friend the Secretary of State will be as concerned as my constituents in Kettering that, for every three days of junior doctor strikes, the cost to Kettering General Hospital is a staggering quarter of a million pounds, with hundreds of operations cancelled or delayed for patients in pain. In confirming that the 35% pay demand is both unrealistic and unaffordable, will she call for junior doctors to return to their posts so that that money can be better spent on reducing waiting lists and improving patient outcomes?
Minister reply
My hon. Friend puts it eloquently; there is a real human cost to these strike actions. It is why I did everything I could when we were in negotiations to try to find fair and reasonable settlements for junior doctors. I was very disappointed when they walked out, but we have to find solutions for the sake of our patients and of all 1.3 million people working in our NHS across England. There have been some brilliant examples of local trusts, local clinicians and other members of staff working really hard and pulling together to cover these damaging strikes, but all we ask of junior doctors is to come back to work, do their jobs and look after our patients.
Tan Dhesi
Lab
Slough
Question
NHS waiting lists have trebled since the Conservatives came to power almost 14 years ago. The Prime Minister’s pledge to cut waiting lists has effectively been abandoned, with the Government choosing to blame NHS staff instead of fixing the problems. Is it not the case that the longer we give the Conservative Government in power, the longer patients in Slough and across our country will, sadly, have to wait?
Minister reply
Waiting lists are coming down, but they are still too high. Towards the end of last year, we had a period without any strikes in the NHS. We saw the waiting lists fall by tens of thousands—indeed, by 65,000—over the period of October, which shows the impact of the industrial action. Sadly, we know that more than 1.1 million appointments have been rescheduled in the last 12 months. It is having an impact on waiting lists and, for the sake of patients, we ask the junior doctors to come back to work.
Question
May I first thank Tracy Bullock, the chief executive of University Hospitals of North Midlands NHS Trust, who has announced her retirement today due to ill health. We have been making significant progress in north Staffordshire with improvements to health services. Nursing vacancies have declined significantly over the last year and £13.4 million has been invested in improving urgent and emergency care services, freeing up some beds, but what puts all that at risk are these reckless strikes. Some 867 appointments at the Royal Stoke have been cancelled, as have 38 operations. Does my right hon. Friend agree that all the progress we are making is put at risk by these reckless and unprofessional strikes?
Minister reply
First of all, I join my hon. Friend in thanking Ms Bullock for her work and public service, and I wish her a speedy recovery. On the progress made in my hon. Friend’s local area, he is right: there are some really encouraging signs for the future of the NHS. All the work that we have been doing across all the recovery plans—whether it is for urgent and emergency care, primary care or elective recovery plans—is about embedding progress in the future of our NHS in this year of all years, as we celebrate 75 years of its establishment. On the impact of the junior doctors’ strikes, my hon. Friend is right to refer to the number of new nurses and the progress that has been made locally. In fact, this year we have been able to announce that we have met a manifesto commitment to recruit 50,000 more nurses. We made that promise in 2019. We have met it early, as well as the commitment to have 50 million more GP appointments than in 2019—two manifesto commitments made, and two manifesto commitments kept.
Alex Sobel
Lab Co-op
Leeds Central and Headingley
Question
Happy new year, Mr Deputy Speaker. More and more of my constituents are waiting longer and longer for emergency care. In 2010, the target for emergency care was 95% of patients within four hours. The Government watered down that target to 76%, and are not meeting that. When will they meet their own target, and when can we expect to see 95% of my constituents being seen within four hours?
Minister reply
I hope the hon. Gentleman is injecting the same anguish into the conversations that I imagine he is having with his local junior doctors, asking them to come back to work. Of course, having junior doctors not working in hospitals across the NHS has an impact—of course it does; they are a vital part of our NHS. The attention of NHS leaders, medical directors and clinicians over past weeks has had to be diverted towards covering the strike action rather than making the sorts of improvements and progress we all want to see across urgent and emergency care, in line with our recovery plan.
Anna Firth
Lab
Southend West
Question
Happy new year, Mr Deputy Speaker. The majority of NHS staff at Southend Hospital are working incredibly hard. Despite winter pressures and industrial action, they have used winter money to open a new ward, adding extra bed spaces. However, the chief executive has written to tell me he is extremely concerned that approaching 40,000 out-patient and in-patient appointments across the Mid and South Essex NHS Foundation Trust have been postponed since this industrial action started. This afternoon, we learned from the Secretary of State that doctors in training have received above inflation average pay rises of 9%, so is it not time that they simply got back to work, delivering the care my constituents deserve and pay for?
Minister reply
I thank my hon. Friend. We know the figures for previous strike actions, but sadly we will hear the true extent and impact of the strike action over the last six days later this week, and I suspect we will have even more missed and cancelled appointments to add to the list she rightly sets out. On the point about pay, the basic pay of a foundation year one doctor has risen by 10.3%. Once one takes into account factors such as overtime and unsocial hours payments, that means the average salary is £40,800, a figure that I hope begins to reflect the importance we put on doctors and their role in the NHS. As doctors progress with their careers, there is a good package of development and progress, culminating in the pay settlement, currently out to ballot with the BMA, that I hope consultants, who are at the end of their career and do so much to help train younger doctors, will vote for. There is much work to be done, but progress has already been made on pay. That is why the decision by the BMA junior doctors committee to call strikes of such length at this time of year was so disappointing.
Shadow Comment
Wes Streeting
Shadow Comment
The Labour MP Wes Streeting responded by critiquing the Government's failure to adequately prepare the NHS for winter pressures. He highlighted that despite promises of improvements, actual conditions have worsened with longer waiting times and critical incidents before strikes began. The shadow accused the Government of failing to train enough staff, provide modern technology, or reform services effectively. He criticised the Secretary of State's refusal to reopen negotiations until after damaging strikes were carried out, expressing disappointment in her patronizing attitude towards junior doctors during interviews. Streeting further criticised the Prime Minister’s use of industrial action as an excuse for NHS failures and his lack of engagement with ongoing disputes involving nurses. He concluded by asserting that Labour offers serious solutions to address current challenges facing the health service.
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