Keir Starmer's new Labour government have been in power now for 100 days. After big promises to raise pay, slash the backlog and reduce waiting times, have Labour and new Health Secretary Wes Streeting made any in-roads? On this episode, the Movers and Shakers are joined in the pub by Gaynor Edwards and Professor Michele Hu (Paul's neurologist), as well as (down-the-line) new social care minister Stephen Kinnock MP and Parkinson's UK CEO Caroline Rassell.
By Podot
Each week Rory Cellan-Jones guides us between the laughs and moans in the pub. To read Rory's summary of this week's episode click here.
Guest Biographies
Michelle Hu
(On the left in photo)
Michele Hu is a Professor at the Nuffield Department of Clinical Neurosciences, University of Oxford and Honorary Consultant Neurologist at Oxford University Hospitals. After obtaining her medical degree from the University of London in 1993, Michele’s interest in Parkinson’s disease started in 1998 when she was awarded an Action Research Training Fellowship to study brain function in Parkinson’s disease patients using MRI and PET brain imaging techniques. In 2001 she was awarded her PhD based on this work, and went on to train in Parkinson’s disease and movement disorders at the National Hospital for Neurology and Neurosurgery, Royal Free Hospital and Oxford University Hospitals.
Since commencing her NHS consultant appointment in 2005, Michele has led the medical Parkinson’s disease and movement disorders service, setting up one of only seven nationally-accredited atypical PD clinics (MSA, CBD and PSP) at Oxford University Hospitals NHS Trust, in addition to managing a caseload of more than 600 Parkinson’s patients. She is a member of the National Institute for Health Research (NIHR) Neurodegeneration Speciality Group, and is the NIHR Parkinson’s Speciality Lead for the Thames Valley and South Midlands region. Since 2015, she has chaired the Research Engagement Committee of the UK Parkinson’s Excellence Network, and is a member of the Parkinson’s UK Cohort Studies Council and Treasurer of the Association of British Neurologists Movement Disorders Special Interest Group (ABN-MDSIG).
Michele is co-Principle Investigator with Professor Richard Wade-Martins of the Oxford Parkinson’s Disease Centre, and leads the Clinical Theme of this £10.7 million Monument Discovery 10 year award funded by Parkinson’s UK to understand the earliest pathological pathways in PD. In 2013, she moved to a Senior Clinical Research Fellow, and subsequently Associate Professor Post at the Nuffield Department of Clinical Neurosciences, University of Oxford in 2015, before being awarded her Professorship in August 2019. Her current academic funding facilitates translational research in the field of longitudinal cohort studies and biomarkers for early and prodromal Parkinson’s disease, with particular focus on REM sleep behaviour disorder and how sleep affects neurodegeneration.
Gaynor Edwards
(On the right in photo)
Gaynor is the founder of Spotlight YOPD - the first charity globally to focus on Parkinson's as diagnosed in people under 50. Spotlight YOPD was registered as a charity in January 2016, just a little over three years after Gaynor herself was diagnosed at the age of 42. She previously played a crucial role as CEO until stepping into her role as Patron in 2023.
Gaynor trained as a journalist at the London College of Printing before working as an editor and sub-editor on numerous publications. She went on to run a PR agency in Tunbridge Wells. Now 13 years post diagnosis, she has first hand experience in how PD impacts on health, wealth (especially with help from Covid) and happiness.
Her hope and humour remains intact.
A note from Mark...
You would have thought the question at the heart of this episode was simple: has Labour’s emergency operation to cut NHS waiting times started yet? It is clear many of my colleagues thought it was fairly pointless measuring the Labour Government’s progress towards meeting the aims of the Parky Charter during their first 100 days in power. Yes, the journalistic obsession with 100 days is a bit arbitrary, even trite. Of course it is too short a time to have achieved much, but getting, (or not getting) answers can be pretty revealing about the speed and direction of travel. Generally, I’m a fan of sticking a thermometer in the chicken at random intervals to see how it is cooking. My experience making this episode suggests the bird is currently stone cold and the oven may not even be switched on. That’s worth knowing right now.
Like most hacks I get frustrated and cross when I can’t get to the bottom of what is going on, so I’ll admit I’ve got a bee in my bonnet over this, and that is why I am buzzing in your ear about it. At the very least it seems there’s a failure of strategic communication. At very worst there no real plan.
First a recap.
The new health secretary Wes Streeting delighted us by coming on the podcast just before Labour’s victory and promising to meet the first, and perhaps most important, point of our charter : to cut waiting times and make good the NHS’ constitutional pledge to wait no longer than 18 weeks from referral to consultation. There would be an extra 62 thousand neurology appointments every year. This reflects the manifesto promise to “deliver an extra two million NHS operations, scans, and appointments every year; that is 40,000 more appointments every week’. He told us the first phase would be paying extra consultants to work nights and weekends. He was clearly pleased to have secured a commitment from the Chancellor to fund this from closing non dom tax loopholes.
So I though it would be a doddle for the Department of health press office to answer my questions – ‘has work begun on clearing the backlog ? –‘yes or no’
-if so could they provide some facts and figures. And if not, why not?”
But they seemed unable to give a straight answer. They were obsessed with the fact I was using some clips of the minister of state Stephen Kinnock from a meeting I chaired on the labour fringe. They wanted chapter and verse on what he’d said. After a seemingly endless back and forth their eventual response was “Minister Kinnock addressed the progress towards the charter quite comprehensively and we don’t feel we have anything further to add.
Given this interview was recorded recently, we’re happy for his words to reflect the government’s position on these issues.” Stonewalled !
Not very satisfactory, given neither I nor anyone else had asked him those specific questions.
When I said that wasn’t that wasn’t good enough, they said ‘asking about efforts to “clear the backlog generally” doesn’t really give us a lot to go from.’
All this set my alarm bells ringing – the trouble is I’m not sure if they are warning of a small fire, a huge conflagration, an attempted break in or end of a lunch time break.
It’s pretty clear the press office can’t or won’t give a straight answer. Can’t ? They are clearly worried about crossing their new political masters and so are sticking like glue to the minister’s words. This suggests some internal tensions. But it would be a huge own goal if the Government really hadn’t put anything in place to measure how it was doing on meeting one of its highest profile manifesto commitments – ministers surely need to know if they’re doing what they said they’d do and what is being done, where. Surely I’m not the only one asking.
As my fellow Movers & Shakers suggested it is very early days and simply to say they were still working on implementing the programme would have been easy and would have shut me up. As it is, I smell something fishy. I suspect that one of the roots of this is Labour’s biggest tactical errors since coming to power – holding back the budget so long after victory. It may make economic sense but has created huge political problems. Vital questions are left hanging in the air, while negatives stories have been given full reign.
While we were in the middle of recording this episode a new message came through from the press office rather suggesting this was the case. I didn’t read it until after we had finished but it said:
“More details on our efforts to cut waiting lists will be confirmed after the Budget.
More generally, hospital appointment numbers are already currently published on a monthly basis in Hospital Episode Statistics, which can be found at the following here.
Waiting time data - including for neurology services – can be found here.
Why wait for the budget ?
It could mean one of two things – perhaps that ministers are over wedded to a pre designed timetable of announcements. But it is far more likely that there’s an argument over where the money is coming from. As Wes Streeting told us the plan was, and far as we know still is, to pay for doctors to work over time to clear the backlog. The cash would come from taxing non doms. But there’ve been multiple reports - see here - suggesting this won’t raise much money. So I suspect there’s been something between a detailed discussion and a blazing row between health and treasury about how to pay for the promise.
But what Michele Hu told us complicates things. At least in her Oxford Hospital they quite literally have no time to do overtime. Their days, including nights and weekends, are already overstuffed with stuff. If that is true in many other places around the country, the quick fix won’t happen. But it’s worse than that. Prof Hu believes is the only solution, in the long and short term, is bigger teams and more neurologists being employed. That means finding the huge amounts of money needed to employ hundreds of new doctors when trusts and NHS England are in many areas demanding cutbacks. That means not just the Chancellor finding the money, but ministers finding the right levers to pull make it happen everywhere, even when trusts have different priorities. And that, as Prof Hu predicts, will take, not 100 days of a committed Government but three terms - fifteen years. I’m watching and waiting and still eager to hear your stories. E-mail me at: feedback@moversandshakerspodcast.com
We had a great time at the fringe at labour conference with Parkinson UK's Caroline Rassell and Stephen Kinnock MP (+ not in first pic Shafaq Ali, Camille Carroll).
Listen here to my full interview with Caroline Rassell
Here are some comments from the Minister of State for Care, Stephen Kinnock...
The following is a response from the Media Relations team at the Department of Health & Social Care...
"More details on our efforts to cut waiting lists will be confirmed after the Budget. More generally, hospital appointment numbers are already currently published on a monthly basis in Hospital Episode Statistics, which can be found at the following link: Provisional Monthly Hospital Episode Statistics for Admitted Patient Care, Outpatient and Accident and Emergency data, April 2024 - August 2024 - NHS England Digital
Waiting time data - including for neurology services – can be found here: www.england.nhs.uk/statistics/statistical-work-areas/rtt-waiting-times/"
Some background information from NHS England
Data published on 10 October 2024 covering August 2024 shows that NHS staff have delivered 11.96 million treatments so far this year - 570,263 or 5% more than the same year pre-pandemic (11.39 million in the year to August 2019).The number of waits longer than a year for treatment has fallen to 282,664, down 28% on last year (395,170 in Aug 2023) and now make up 3.7% of the waiting list - the lowest proportion since September 2020. However, the total waiting list rose in August by 18,614 to 7.64 million, while the estimated number of patients rose by 30,000 to 6.42 million. Only 58.3% of patients had been waiting less than 18 weeks, the constitutional standard.
Latest data also shows that the waiting list for Neurological Service treatment function was 60,250 in August 2024 – a decrease of almost 4,000 when compared to the year previous (63,948 in August 2023). The number of completed admitted pathways in the Neurological Service treatment function in August 2024 was 2,426 – up from 2,158 in August 2023. There were also 6,663 completed non-admitted pathways in August 2024, and 7,254 in August 2023.
Completed non-admitted pathways are those patients whose treatment started during the month but did not involve admission to hospital, or their clock stopped for another reason (e.g. it was decided that treatment wasn’t needed).
In February 2024 we issued a release on NHS rolling out ‘wearable’ 24-hour infusion for advanced Parkinson’s– which stated that hundreds of NHS patients with advanced Parkinson’s disease are set to benefit from a portable drug infusion that is gradually released around-the-clock to help better control their symptoms.
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