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Health and Care Bill

I draw the House’s attention to my declaration in the Register of Members’ Financial Interests as a practising NHS doctor. I welcome the Government’s concessions on modern slavery and procurement and on the reconfiguration of NHS services. However, I remain concerned about two issues: the care cap and independence in the staffing assessment process.

To touch briefly on the issue of the care cap, a number of years ago I took through this House the Care Act 2014, as a Minister in the coalition Government. We based that Act and the care cap on the Dilnot proposals. I continue to be concerned that the current

proposals deviate from the Dilnot proposals, in that those with lower or more moderate net assets will be asked to pay disproportionately more than those with greater assets. That is something I find very difficult to accept. It deviates from the principles of the 2014 Act and the Dilnot proposals, and I hope that even at this late hour the Government will reconsider their position on it.

I rise in particular to speak in support of Lords amendment 29B and the comments by my right hon. Friend the Member for South West Surrey (Jeremy Hunt). It is undoubtedly the case that we cannot have safe staffing in the NHS if we do not have the right number of staff. We cannot meet the increasingly complex care needs of patients with not just one, two or three but sometimes four comorbid conditions if we do not have staff with the right skills and in the right numbers to meet those care needs.

We talk often of building new hospitals and of our programme of capital investment in hospitals, but unless we have the right numbers to staff those hospitals, we will not be able to deliver safe care. In every constituency represented in this Chamber, we recognise that there are staff shortages in the local NHS. We recognise particular challenges in the medical workforce among fully qualified GPs—over the past seven years the number of full-time equivalent GPs has fallen. We recognise challenges in the midwifery workforce, which were brought tragically to our attention by the Ockenden report, and we recognise challenges in areas such as intensive care and paediatrics and throughout the health service.

The problem with health workforce planning is that Governments see the NHS in electoral cycles, but workforce is much more complicated than that. From starting medical school to becoming a consultant it takes perhaps 15 years, and to become a fully qualified GP takes about 10 or 11 years. It is important that we have a genuine independence to the process of workforce planning. I have great faith in Health Education England and I am sure it will produce a good report and assessment, but unfortunately it will be doing so with one hand tied behind its back, because it must do so within the confines of the financial envelope in which it is working, and it lacks the genuine independence to say what the NHS really needs.

If we care about patients and about the future of the NHS and its needs, true independence in a report on workforce is required. That is in the best interests of patients, of the health and care workforce and of the future of our health service. I hope the Minister will reconsider.

7.45 pm