‘MPs must oppose government plans that threaten nurses and others with dismissal’ – Bishop of London and RCN General Secretary article

The following article, jointly authored by the Bishop of London and Pat Cullen, appeared in The Times Red Box on Monday May 22 2023

Nursing has come a long way since we both entered the profession for the first time in the 1980s. But the values that underpin it have remained constant: compassion, selflessness, dignity, and integrity.

Nurses will stop at nothing to look after their patients. The nursing profession is the beating heart of this country’s health and care system.

Ministers stood on their doorsteps during the pandemic clapping the heroic efforts of nurses. Now that seems like a distant memory.

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Bishop of St Albans asks about ambulance response times

The Bishop of St Albans asked a question on bringing down ambulance response times on 11th May 2023, during a debate on financial resourcing of the NHS:

The Lord Bishop of St Albans: My Lords, I welcome what His Majesty’s Government are doing to try to get on top of this very difficult problem. Will the Minister give us a little more information, particularly about ambulance services? In Hertfordshire, which is in my diocese, category 2 call-outs, for strokes and hearts attacks, should have an 18-minute response but the response is averaging two hours and six minutes at the moment. There is a great deal of anxiety among ordinary people when these things happen. When do we think that the money going to the ambulance service is going to bring response times down?

Lord Markham (Con, Department of Health and Social Care): I am pleased to say that the figures announced today show that response times are coming down. For category 1, the most serious, we achieved the 15-minute target for 90% of calls. We are moving in the right direction, albeit there is a lot more that needs to happen in this space. That is what the investment in 800 new ambulances is about, as well as the £200 million of funding. Most importantly, it is about making sure we have the right services in place. Some 50% of ambulance calls do not result in a trip to the hospital. There are fall services, which are often best placed to help, which will pick people up in their home.


Bishop of St Albans asks about sufficiency of NHS nurses

The Bishop of St Albans asked a question on the government’s response to large numbers of people leaving nursing on 10th May 2023, during a debate on the sufficiency of the number of nurses in the NHS:

The Lord Bishop of St Albans: My Lords, the Royal College of Nursing has published figures showing that, between 2018 and 2022, 43,000 nurses left the nursing and midwifery register. We have seen this huge leaching of people moving out of nursing. What are His Majesty’s Government doing to listen to why these people are leaving and to see what we can do to retain these people who have been very expensively trained, have huge skills and are part of the reason why we have a shortage?

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Strikes (Minimum Service Levels) Bill: Bishop of Guildford speaks in support of amendment on compliance with work notices

On 26th April 2023, the House of Lords debated amendments to the Strikes (Minimum Service Levels) Bill. The Bishop of Guildford, on behalf of the Bishop of London, spoke in support of an amendment to the bill tabled by Baroness O’Grady of Upper Holloway that “would prevent failure to comply with a work notice from being regarded as a breach of contract or constituting lawful grounds for dismissal or any other detriment.”

The Lord Bishop of Guildford: My Lords, I will speak in support of Amendment 4, to which my friend the right reverend Prelate the Bishop of London has signed her name. Bishop Sarah sends her apologies that she cannot be here, but we both strongly support the amendment, not least given reports that many important voices across the healthcare world, including the Royal College of Nursing and NHS Providers, are similarly supportive.

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Bishop of Carlisle asks about publication of the government’s NHS Workforce Plan

The Bishop of Carlisle asked a question on when the government’s NHS Workforce Plan would be published, during a debate on junior doctors strikes on 30th March 2023:

The Lord Bishop of Carlisle: My Lords, we know that a major cause of the strikes that we have recently seen in the health service relates to staff who are overstretched. That is the result of chronic shortages, which suggests a lack of adequate workforce planning. We have just heard that there are currently over 124,000 reported vacancies, according to the NHS Confederation. I repeat a question that was asked earlier, or shall at least reinforce it: when will the workforce plan be published? Without it, healthcare staff will continue to struggle to provide the level of care that they would like.

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Archbishop calls for a reimagining of the adult social care system

On 30th March 2023 the House of Lords debated adult social care. The Archbishop of Canterbury drew attention to the recent report from the Archbishops’ Commission on Reimagining Social Care.

The Archbishop of Canterbury: My Lords, I am very grateful to the noble Baroness, Lady Andrews, for securing this important debate, for her Select Committee’s outstanding report on adult social care and for including the recent report of the Archbishops’ Commission on Reimagining Care in the debate title. I am also very grateful to my noble friend the right reverend Prelate the Bishop of Carlisle, who co-chaired the commission. He will be addressing some of its specific recommendations later. I would like to speak about the motivation for its commissioning by the most reverend Prelate the Archbishop of York and myself.

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Strikes (Minimum Service Levels) Bill: Bishop of London speaks on inclusion of health services in bill

The Bishop of London spoke to a group of amendments related to health services during a debate on the Strikes (Minimum Service Levels) Bill on 9th March 2023, raising concerns of the effect of the bill on individual health service staff, pressure on staff levels, and low morale in the healthcare service:

The Lord Bishop of London: My Lords, I rise to speak to this group of amendments on the inclusion of health services in the Bill. I am sorry that I have not been able to speak before. I declare my interests as set out in the register.

I have been a union member. I joined as a nurse—and as an NHS manager and a civil servant in the Department of Health—because I wanted protection. The relationship with unions was critical; it was the way in which we improved patient care. One of my overall concerns about the Bill is that it has the potential to break down the relationship which is so vital for patient care, as the noble Baroness, Lady Noakes, said.

I am grateful to the Royal College of Nursing, which has helped me in considering the Bill. I am sure that it will not surprise noble Lords to know that it does not support the Bill, for what I see as some good reasons: not least because it curtails the freedom to participate in what otherwise is lawful action.

My right reverend friend the Bishop of Manchester regrets that he cannot be here, but he shares my concern that far too much power is given to the Secretary of State in what we have already heard is only a skeleton Bill, and that there is a complete lack of clarity about how it could be used. It is open to abuse. I am surprised that, as many others have said, the detailed policy that becomes legislation is not there. I am concerned that those who work in the health service probably cannot see whether they are in there or not.

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Bishop of Exeter speaks on healthcare in rural areas

The Bishop of Exeter spoke in a debate on healthcare in rural areas on 23rd February 2023, emphasising the need to address challenges in staff retention in the NHS and the care service:

The Lord Bishop of Exeter: My Lords, I begin by thanking the noble Baroness, Lady McIntosh, for securing this important debate. We all acknowledge that the NHS is operating under enormous pressure at the present time. Perhaps inevitably, publicity focuses on our inner cities but, as we have been hearing this afternoon, rural communities are also pinch points. My own county of Devon has the second-oldest population in the country. We should not underestimate the challenge, both logistical and financial, of delivering healthcare to an ageing population, particularly in coastal communities and remote rural areas.

In his 2021 report on coastal communities and their patchy provision of medical services, the Chief Medical Officer for England observed that some

“of the most beautiful … and historically important places”,

including in the south-west region,

“have some of the worst health outcomes in England, with low life expectancy and high rates of many major diseases”.

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Bishop of Chelmsford asks about cost of using agency staff to cover NHS shortages

The Bishop of Chelmsford asked a question about the cost of employing agency staff to cover NHS shifts, as compared to the cost of a pay rise for NHS staff, during a debate on the upcoming NHS industrial action on 13th December 2022:

The Lord Bishop of Chelmsford: My Lords, even prior to the strikes, agency nurses were being brought in to ensure that shifts were safely staffed. I should be grateful if the Minister would set out what assessment the Government have made of the cost to the NHS of employing agency staff, compared with that of a pay rise that would work towards an arguably better and more stable workforce?

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Bishop of London leads debate on ambulance handovers

The Bishop of London tabled a question for short debate on 3rd November 2022, concerning ambulance handovers in light of an upcoming strike:

The Lord Bishop of London: To ask His Majesty’s Government what progress they are making on ensuring swift ambulance handovers, as set out in Our Plan for Patients, published on 22 September, given the decision of ambulance workers across 11 trusts to ballot for strike action.

My Lords, I start by saying how grateful I am to your Lordships’ House for setting time aside for what I think is an important and timely debate. I am also grateful for the briefing from the House of Lords Library.

Last week, the GMB union announced that it was balloting ambulance workers over strike action across 11 trusts in what would be the biggest ambulance workers’ strike for 30 years. I think it would be wise to ask ourselves what has happened across the whole system to bring us to this point. Ambulance handover delays are an increasing issue across the trusts in England. The NHS contract for this year sets out that 90% of handovers should take place within 30 minutes and 65% within 15. However, the Association of Ambulance Chief Executives notes 40,000 cases of patients waiting longer than an hour for handover—this was recorded this year and is the third-highest volume on record.

Long handover delays increase the risk of harm to patients while they are in ambulances. The NHS Confederation says that eight out of 10 patients who were delayed beyond 60 minutes were assessed as having had an experience that had potentially harmed them, and nearly one in 10 experienced severe harm as a result. The number of ambulances waiting to transfer their patients also impacts on the availability of ambulances, and the response times therefore increase. This in turn risks increasing further harm to those who are waiting for an ambulance in the community. Florence Nightingale famously once said that hospitals should do no harm. It is a sentiment that I believe is appropriate to the wider healthcare system. The healthcare system should do no harm.

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