I congratulate my hon. Friend the Member for Leeds East (Richard Burgon) on securing this important debate, especially at the moment.
In essence, the NHS is about people. It is about its workforce. There can be as many hospitals and clinics as we want, but without any staff in them, they will not make anyone’s health any better. I am painfully aware that after covid, so many of the people who work in the NHS are—I think the medical term is—knackered. They are completely and utterly exhausted. I know of dermatologists and pathologists who ended up helping out in intensive care units in addition to doing their ordinary day job. They were doing hours and hours every week and have got to the end of the year and are completely and utterly exhausted.
There is a phenomenal backlog; we all know about the numbers of people on waiting lists. That is partly because lots of people did not to present to their doctors because they did not want to bother them or were frightened of getting covid. There are lots of terrible stories of people who are presenting very late, particularly with cancers. I had a stage 3B melanoma, and I am painfully aware that if I had left it a few more months, I might not be here today. At the time, I was given a 40% chance of living a year. I know what it is like for all those families who feel desperate that someone has been delaying, and then get terrible news. It is also a phenomenal additional cost to the NHS if somebody presents later, because the surgery and the treatment will be far more complicated.
There are all the cancelled operations for elective surgeries that are not necessarily life threatening but life enhancing, such as knees and hips. When I was first elected in 2001, we still had the waiting list hangover from the previous Government, with people waiting five years for a new hip or knee. That is where we are now. That leads me to a real concern that the Government, with their new healthcare levy, are frankly putting the cart before the horse. If we do not have the people to deliver, throwing money at the NHS will not make the blindest bit of difference to health outcomes.
In the UK, we have roughly three doctors per thousand head of population. The rest of the EU, including countries that have many, many fewer than us, have 4.2. We are 1,939 consultant radiologists short. That is one of the things that will make a difference to whether people with late-stage cancer live or die. In oncology,
189 more clinical oncologists are needed in the UK now, and that is without considering the increase required to deal with the backlog, as well as the new presentations. We have roughly 650 consultant dermatologists in the country; we need roughly another 200. Skin cancer is one of the fastest-growing areas of cancer death in the UK. Only 3% of diagnostic laboratories in the UK are fully staffed at the moment. That means delays in getting results, in particular from histopathology, to doctors to be able to start the necessary treatment.
I have some quick-fix answers, and I hope the Minister will implement all 11 of them. First, reward staying on in the profession, because lots of people are retiring early. Secondly, reward coming back into the profession, because getting more retirees back in would really help with the workforce problem.
Thirdly, sort the gender pay gap. That is one of the problems that is making it much more difficult for lots of women to stay in the profession.
Think about providing sabbaticals to people. Sometimes burnout can be prevented just by allowing somebody to have a three-month or six-month sabbatical, knowing they will come back in.
Sort out the pension problem. I know the Government think they have done that, but it is still an issue and is why lots of people are not carrying on.
We have to deal with the fact that overtime is now paid less than it was five years ago. Lots of people are saying, “I don’t really want to do an extra clinic on a Saturday morning or a Sunday afternoon.”
We have to deal with pay erosion—a point that was made earlier. If we keep on not paying doctors enough in the NHS, in the end they will choose to go to Australia, Canada or New Zealand.
We have to sort out the issue of private sector capacity sucking far too many consultants out of their NHS work, day in, day out. That simply means that people, including in very poor constituencies such as mine, will say, “You know what? I’m going to find the £5,000, £6,000 or £7,000 to have that hip or knee operation for my Auntie Val, because it is about the quality of her life.”
We have to train more people. I do not know why we are still lagging behind what we know we need. We should have more places for training, and we should be encouraging other disciplines, such as pathology, dermatology, emergency care and so on.
We have to sort out the immigration factors, which play into all this and mean that so many doctors who have worked here for some time are going back to the countries they were born in because they do not feel that they have a place here in the UK. Finally, please stop putting the workforce last in deciding what we do about the NHS. We cannot run an NHS permanently at 95% or 98% capacity, because then when there is a crisis, such as the one we have had over the past two years, the whole thing is—and this is a technical term—buggered.
3.18 pm