Sophy Ridge on Sunday Interview with Dr Sarah Wollaston MP, Chair of Health Select Committee, 15.01.17
ANY QUOTES USED MUST BE ATTRIBUTED TO SOPHY RIDGE ON SUNDAY, SKY NEWS
SOPHY RIDGE: The NHS is in the middle of what has been called a humanitarian crisis with hospitals issuing over 200 serious alerts in six days this month. Meanwhile Downing Street is trading blows with doctors and the Head of the Health Service over who’s to blame. Well I’m joined now by the Chair of the Health Select Committee, Dr Sarah Wollaston, thanks for being with us. It feels as if we are getting these almost continual warnings of the NHS being in crisis, is there a risk that it’s a bit like the boy who cried wolf, we just stop listening. Are things really worse this time?
DR SARAH WOLLASTON: Well we should be listening. I think what’s different is that whereas in the past, yes, we’ve always had winter pressures, I worked in the NHS for 24 years and there was always winter pressures but what’s different now is those pressures are year round and are getting much more severe over the winter so this is very genuinely a serious situation.
SR: The Red Cross has referred to it as a humanitarian crisis, would you agree with that?
DR SARAH WOLLASTON: I think that goes too far. I think what people think of when they use that term is the absolutely catastrophic situations faced by people across places like Syria and Yemen, but that’s not to underestimate the fact that this is a very serious situation for us here but no, I wouldn’t have used that terminology myself.
SR: There have been warnings before about this happening, some of them coming from your own committee, the Health Select Committee. Back in October your committee wrote to the government, I think we’ll have a look at what you said shortly, which was that accident and emergency departments in England are managing unprecedented levels of demand and then you went on to say ‘We call on the government to make sure that sufficient funding is available’. Was that warning actually taken seriously enough?
DR SARAH WOLLASTON: Well I think that certainly much more needs to be done. We carried out our study early in the autumn because we wanted the NHS to be ready and there is no doubt that the NHS has made some plans this winter to put in place measures where they are under pressure to try and respond to that with the so called opal alerts or black alerts as they used to be called in the past, but what we need to do is think of this as a whole system. Right through from trying to avoid people going to casualty who don’t need to be there but more importantly, to think about this as the frailty and the complexities of problems that people are coming to casualty with and how we actually move them through hospital and critically, out back at home when they are ready to be discharged. That’s where we’ve got to think of social care as well as the NHS together rather than these two separate systems, a health pound and a social care pound, it’s got to be a patient pound and a taxpayer pound and how that all works together.
SR: So really just looking at the system as a whole?
DR SARAH WOLLASTON: The whole system, it’s complex.
SR: When I spoke to Theresa May about the NHS last week when she was on this show, she said quite clearly that the NHS was asked what it needed and then she goes on to say ‘We gave them that funding’, in fact she actually said we gave them more funding than they required. Is that true?
DR SARAH WOLLASTON: Well I don't think that is strictly true. Certainly the figure that the government gives, a 10 billion figure, what that does just refer to is NHS England spending but of course there were trends first from other budgets into that that we would normally think of as health spending but it also refers to a longer time period, six years rather than five, and it changes the basis over which we calculate what’s called a real terms increase. So yes, you can see how the government has reached that figure but the committee felt that a fairer figure, if we were using the usual measures, was actually 4.5 billion which is a very different number and if we are going to think of this as a whole system you’ve also got to think of social care and what Simon Stephens, the Head of the NHS, was very clear when he spoke to the committee about was if you have cuts to social care that has an enormous impact on the NHS. So that’s why he doesn’t agree and I would agree with him, that in fact the NHS hasn’t been given everything it asked for because it doesn’t actually consider social care and it doesn’t consider the cuts to public health budgets, the kind of prevention work that we know is essential if we are going to reduce demand on the NHS.
SR: It sounds like you’ve got some sympathy then for Simon Stephens because there have been news reports that the government was trying to blame him for actually not doing enough to try and alleviate the crisis.
DR SARAH WOLLASTON: Well personally I think that is unreasonable. As a public servant and as somebody who heads the NHS, the government needs to give him their unequivocal support in the very hard job that he is undertaking to try and get this whole system to work. His five year plan is a very important plan and I think that it’s very important that he’s not undermined and also there is a very important principle here. We hear NHS all this time, NHS staff being told that they have to be transparent and honest in the way that they talk about data – it would send a terrible message if the Head of the NHS wasn’t free to be exactly the same and I think that what he said was absolutely correct.
SR: So you seem quite critical then of some aspects of how the government has handled it, are you personally disappointed at all with how Theresa May is dealing with what you would see as a crisis in the NHS?
DR SARAH WOLLASTON: Look, she has a huge agenda with Brexit and I think the government has to be very careful that they are not distracted from what I think is the most important domestic agenda and that is how we’re managing health and social care together. I think really what she could do, because government is going to be so distracted with this, is to try and take some of the party politics out of this and what myself and others are calling for is to allow a cross-party group to get on and examine all the ways we could move our spending closer to those of our comparable European neighbours, as a percentage of what we spend and earn as a nation, so that we can actually deliver the results that we know the NHS is capable of delivering. It’s very efficient, it is very effective and it is hugely important to the public but we need to try and take the politics out of this and work out how we are going to properly fund it.
SR: Talking about how to fund it of course is the big question. The government is trying to say that GPs need to do more, that actually they should have their funding withdrawn unless they are open longer. They have got a bit of a point there haven’t they? With all the pressures on A&E how can it be right that some doctors surgeries are shutting up shop at lunchtime?
DR SARAH WOLLASTON: Well as a former GP I would just reflect that sometimes just because they’re not actually holding surgeries at that time, they are very often doing other vital things so a huge amount of administration and home visits and so forth.
SR: At the same time though, there are lots of other professions that have to do paperwork – teachers for example get paid much less than GPs, they have to do administration but they don’t shut their schools at lunchtime.
DR SARAH WOLLASTON: But very often that needs to take place during working hours because very often you are chasing up results and so forth and actually liaising with colleagues or going to meetings with colleagues so it is quite complex and certainly as somebody who has worked in the NHS for 24 years, what I would say is it is entirely wrong to blame just one section of the workforce for this. GPs are extraordinarily stretched, working under relentless pressure as bed number as being cut – we now have the lowest numbers of beds per head in Europe – and what we are finding is more and more complex conditions coming back to primary care so the work of GPs is changing and the pressures on them are relentless, the workforce simply isn’t there in many parts of the country so I think to then be suggesting that all of this problems is due to GPs not seeing people is really stretching it, it’s just not the case and it’s wrong to scapegoat them in my view.
SR: Complex problems need some big solutions and big thinking as well, Sarah Wollaston thank you very much for being with us today.
DR SARAH WOLLASTON: Thank you.
