Is Steve Barclay ‘playing politics’ at the expense of people’s health?

At the Conservative Conference Party in Manchester this week, the health secretary, Steve Barclay, laid out a series of long-term measures to support the NHS, which give patients “more control and choice.”

This includes:

• Investing £30 million in innovative technology for the health service, such as AI to speed up brain scans for stroke patients
• Providing additional medical school places at three universities (Worcester, Chester and Brunel) from next September and further places at Edge Hill and the University of Central Lancashire
• Updating the NHS constitution to ensure “privacy and dignity” for women receiving care.

While the additional investments have been welcomed by health leaders, the health secretary’s plans to change the NHS constitution have come under fire.

Mr Barclay has also been criticised for his “tone” surrounding industrial action, especially in the week that junior doctors, consultants and radiographers are all staging walkouts.

Health leaders also say further clarity is needed surrounding his plans to expand medical school places and how the government plans to retain the experienced doctors and nurses we already have.

Additional investment in health tech welcome but a greater focus on vacancies needed

In his speech, Barclay announced a £30 million funding package for new health technology. This technology includes artificial intelligence, wearable medical devices and virtual ward beds in a bid to reduce pressure on the NHS.

Health leaders have welcomed the additional investment, but Matthew Taylor, chief executive of the NHS Confederation says the government must ensure this extra money is “easy to access” and is also available to primary care, as these services are often “the first door for many patients.”

However, the key message from health leaders is that to reduce pressure on the NHS, what the health services really needs is more staff.

Royal College of Nursing (RCN) Chief Nurse, Professor Nicola Ranger, said: “Record numbers of unfilled nurse jobs are detrimental to good care – one nurse can be left looking after 10, 15 or even more patients. These kinds of ratios are unsafe and require urgent action from government.”

Despite these dangerous ratios, Prof Ranger said Barclay’s speech failed to “address the nurse vacancy issue head-on”, and accused the health secretary of “play[ing] politics and court[ing] controversy at the expense of people’s health and good care.”

Similarly, BMA council chair, Professor Phil Banfield, said Barclay’s speech offered “nothing new” for those who rely on the NHS, and “failed to acknowledge” the 7.6 million patients currently waiting for treatment.

“While doctors are supportive of patient choice and the enhanced and safe use of technology, we are acutely aware that right now our patients desperately want to be seen in good time and close to home. Mr Barclay claims to be focused on outcomes all while refusing to speak with those who deliver care,” he said.

Changes to NHS constitution could “incite discrimination and harassment of transgender and non-binary patients”

Mr Barclay also announced that the government would stop spending “huge sums of taxpayer’s money on diversity consultants” or hiring “bloated diversity and inclusion team”.

With this, Barclay promised to listen to patient’s voices, “especially women’s voices when it comes to the importance of biological sex in healthcare.”

He said: “I know, as Conservatives, we know what a woman is, and I know the vast majority of NHS staff and patients do too. That is why I ordered a reversal of unacceptable changes to the NHS website that erased references to women for conditions such as cervical cancer and stopped the NHS ordering staff to declare pronouns to each new patient.

“And that is why, today, I am going further. By announcing that we will change the NHS constitution following a consultation later this year to make sure we respect the privacy, dignity and safety of all patients, recognise the importance of different biological needs and protect the rights of women.”

Health leaders are now concerned that Barclay’s plans to change the NHS constitution and scrap inclusion teams could prevent certain groups from coming forward to get the care and support they need.

Professor Banfield says this policy is a “distraction from serious NHS problems” and “has the potential to incite discrimination and harassment of transgender and non-binary patients, limiting them from accessing vital NHS services.”

He added that this new policy is “in breach of the Equality Act” and will amount to “nothing except more hurt and harm to trans patients.”

“Hospital Trusts should not follow unlawful guidance, and this is another, frustrating, example of the Government’s refusal to listen to and value the views and opinions of those who work within the NHS,” he said.

Health secretary’s tone surrounding industrial action is “depressing”

During his speech, Mr Barclay also described the BMA as demonstrating “militant … leadership”, and said ongoing strike action from BMA members is resulting in “countless cancelled appointments” and poses a “serious threat to the NHS’ recovery from the pandemic”.

Barclay said consultants and junior doctors are “relentlessly demanding massive pay rises even if that means diverting resources from patients.”

“This clearly shows that the BMA leadership is not on the side of change and they are not on the side of patients,” he said.

In response to this, Professor Banfield said: “Instead of using his address to highlight plans to ensure our NHS remains fit for purpose he spent a significant amount of time making false claims that the BMA poses a threat to the post-pandemic recovery of the NHS, when in fact it’s the BMA that has been long pleading with the Health Secretary to undo its more than a decade long mishandling of the health service.

“Steve Barclay has to come and speak to doctors; we know our patients and the system that we work in so we are best placed to help the Government develop policy that will actually have an impact on patients and NHS outcomes.”

The NHS Confederation also criticised the health secretary’s handling of this matter, and said his “tone around industrial action is depressing” particularly in a week of walkouts from junior doctors, consultants and radiographers.

“It is unclear what it will take to move from this prolonged stalemate position,” said Mr Taylor.

Clarity needed surrounding additional medical school places

Health leaders also want more detail about how the government plans on bolstering the NHS workforce. While their plan to expand medical places is welcome, Professor Banfield highlights that currently, there will only be 205 additional spaces, a drop in the ocean compared to the 10,800 doctor vacancies.

John Dean, RCP clinical vice president, is now urging the government to work on retaining the staff we already have.

“Dissatisfaction and attrition rates are a significant challenge for the NHS,” he said. And he urges the government to “take a lead” on bringing strike action to an end.

“More widely, doctors must feel valued by the NHS including being able to work flexibly, get time off for significant events, have rotas in good time, have hot food and drink available, have the equipment, tools and time to fulfil their professional duties and not face discrimination and harassment at work. This is key to the success of the NHS today and its ambitious long-term workforce plan.

“For now, we need to make sure there are enough training places so that current junior doctors can progress, and that they receive the quality of the training they need to look after their patients. This means their trainers are supported and given appropriate time to train too. We are looking forward to working with NHS England to understand what the future workforce and training needs are for the population’s health.”