Sonia Kumar MP interview

Torrin Wilkins: Hello, and welcome to the Centre Think Tank interview series in Conversation. My name is Torrin Wilkins, the Director of Centre Think Tank, and today we will be discussing how we can fix the NHS, the role of physiotherapists, the assisted dying bill, and also how we support small businesses. With me today, I am delighted to be joined by Sonia Kumar, who will be exploring these issues further with me. Sonia has a wide range of experience; she has been a Member of Parliament for Dudley since 2024, and she also previously worked in the NHS. She has seen firsthand the issues we will be speaking about today with her time in the NHS, and she has continued campaigning for the service as an MP. Thank you so much for joining me today, Sonia.

Sonia Kumar: Thank you for inviting me; it is a real pleasure.

Torrin Wilkins: To jump straight into my first question, you worked in the NHS for over a decade, and I am sure you have seen firsthand the amazing work that NHS staff do, but also the areas in the service that sometimes struggle. How did your time in the NHS shape your view of the service, and what needs to be done to fix it?

Sonia Kumar: First of all, I will say that I think the colleagues who work in the NHS are commendable for the work that they do. A lot of NHS workers work day and night; they will do extra shifts, they will do extra hours working during lunchtime, and they will come in early and leave late. A lot of it is worked on goodwill because we just want to provide excellent care for patients who are coming in.

In terms of what shaped my narrative, it is that there are some fantastic clinicians there, but they need the tools to deliver the services they want to see. I was one of those clinicians. I worked as an advanced practice physiotherapist and first contact practitioner. So a long title for my name, but I was working in an interface service at the Dudley Group Hospital, the Guest Hospital on that site, and then part of my job was working as a GP as a first contact practitioner.  I think when I was working in those two areas, you realise that when you refer patients to orthopaedics, whether you refer them to mental health services or social prescription, the length of time they are waiting for appointments is just phenomenally long. You start to think, “Why are patients waiting so long, and why are essential services being scrapped because we just do not have the funding for them”?

Because of the lack of funding over the last 14 years, it has just made me think we need more clinicians going into politics who have real-life experience. They know what they are talking about. I am a staunch believer that the NHS should be free at the point of contact. I will not agree with privatising the NHS at any time in my life. I think it is brilliant that we have now brought in 2 million more appointments, which has been delivered as a promise that we made at the election. I think it is fantastic news for clinicians and patients to alleviate some of that pressure. What is shaping my opinion is that I think we need to start thinking about the NHS differently. 

Initially, it was set up for acute care, and now we are getting patients who have chronic conditions and multifaceted problems. Therefore, we now need to look at it in a more holistic manner, which I do not think we are doing as well as we could be.

Torrin Wilkins: In terms of this multifaceted aspect of the NHS, at the moment, some of the big pressures are coming from social care and mental health care. Are those some of the root causes of the NHS crisis, or is there a lot going on within the NHS itself? Is it about sorting out the peripheral services as well, or is it just an NHS-focused problem?

Sonia Kumar: I think each hospital is unique and will have unique issues. I will say that, in particular,r some hospitals are doing quite well financially, and they are building revenue from different aspects, whether it is hiring or using community services and doing work in the community, while other trusts are struggling. I think there needs to be some sharing of information. I work at a hospital where we are still doing handwritten notes. Whereas, at College Hospital, when I initially started my career, they were doing electronic notes, and that was right at the beginning of my career, a decade ago. You can see there is a massive difference and disparity from region to region in terms of what work is being done. So I think we need to learn from each place. Some things are going well, ll and I think sometimes we do not celebrate that in the NHS. I think there is a picture that gets painted, which is that it is terrible, and people are not getting seen. Whereas, there are cases where people are getting seen and receiving some fantastic care; they do not get celebrated, and they are not highlighted. That is the first thing I want to put on the record.

In terms of what needs to be done, I do not think that the recognition of the importance of mental health and physical health on the same parity has been at the forefront of policy. I think we are taking it very seriously now as a Labour Member of Parliament and a Labour government, and I am pleased to see that that gap is closing.  

That is not just in adults but also in paediatrics. Having gone to so many schools in my constituency, the one thing they say again and again is “when we refer our children to services for mental health or for an assessment, it just takes too long”. It is not the clinician’s fault; it is just the fact that we do not have a workforce. When I think about the issues that we have in the NHS, it starts from the fact that we have been looking at a lot of secondary care, not primary care and community-based work, which I think is essential. When we start talking about that, we are also looking at preventative measures. We need to think prophylactically about how we are treating the general population to understand what a healthy lifestyle is and to ensure that they are not even touching primary care in the first place. That move is essential, and for me, that is where it starts before we get anywhere else.

The next bit would be making sure that when we have services, and when people do come to a GP, they are getting to see the right clinician. There is a lot of talk about empowering GPs and making sure that they have more GPs, more appointments, and then getting the ability to be able to go for radiology or imaging. But actually, 25% of patients who come into GPs are musculoskeletal patients who need a specialist MSK physiotherapist to see them. I think we need to be banging that drum. I am someone who bangs the drum about AHPs ( Allied Health Professionals) and physios who work in GPs and are essential for that care. So getting the right clinician and getting the right person at the right time is essential.

Then waiting lists are important; we are making sure that we are optimising whether these patients are going to the right route of care and pathway. So if you are going to see us, and you have back pain or knee pain, or you have a simple flu or something like that, you can be seen by a nurse, or you can be seen by a physio or a first contact practitioner. The waiting list is not so long that they are now coming out of the workforce, and we are losing the labour force and economic value. I think whenever I talk about healthcare, I always talk about the economic value that we are losing and the inactivity that we have. People do not always link it together, which is frustrating because you cannot have a workforce if they are not healthy.

Then you are right when you talk about health and social care. It is an area that past governments have struggled with, particularly in terms of how we support people through the system. Too often, intervention happens at the very end of a person’s journey, after they have moved through primary and secondary care. Now, they want to be released from the hospital and moved out into a more independent life to improve their quality of life.

It is discharge planning, which is the sticking point, having worked on wards myself. So it has got to be cross-party. I do not think this is something that Labour is going to do alone. I think Wes Streeting has welcomed a cross-party approach, because we need it to stick and that it will be future-proof and have longevity. We cannot keep changing the health and social care policy every four and a half years or whenever there is a new government. It just does not work. We need some stability in what we tackle.

I think it is multiple facets that I have spoken about, and I think that is what I would say.

Torrin Wilkins: Linking to your point about the technology side of the NHS, one of the greatest challenges I think the government faces is integrating AI and making the NHS more digital.  I have heard plenty of issues on this and had some myself, with vaccines, getting across borders,s and NHS systems not talking to each other. Did you ever see that issue within the NHS yourself? And how do we streamline NHS services using technology?

Sonia Kumar: This is probably my biggest bugbear as a clinician. I think every clinician you speak to will say that digitisation in the NHS is just not happening fast enough. If you want to refer someone for an MRI, you can do it at Dudley Group Hospital. But then, if you want to get that image to Birmingham, to the Royal Orthopaedic Hospital, and send someone to tertiary care, they may not get that image. They may need to re-image again, which is a colossal waste of money.

I think integrating services, just in what we are saying nationally, even regionally, would be a good idea so that people are not duplicating the imaging or the results or whatever investigations that we are doing. I think it is essential. I think starting with some basics, the days that I am still writing handwritten notes, and we are getting a wad of notes sent down to the clerks in the basement, getting archived for X amount of years, those days need to disappear. Because it is not efficient in any way or form. For me, digitalisation is a route forward in a positive way, whether it is writing notes, imaging, or just detecting disease earlier.

I have spoken to some radiographers, and they are talking about how AI is looking at chest X-rays and CTs and how we can pick up pathology quite early on. Not because radiographers are not fantastic, because those colleagues of mine I have worked quite closely with do some brilliant work, but it is just making sure we are positively using AI and using the tech innovation in a way that is enabling our patients to have better care in the service.

I am very much pro-tech being incorporated into the NHS. I think it is about time that we started, and I am really glad that we have started to think about how we can do that.

Torrin Wilkins: An area that you also spoke about recently is the vital role of physiotherapists in tackling MSK and the need for increased investment in that area. What would further investments be useful for, and more widely, how can we better support physiotherapists? 

Sonia Kumar: I am a staunch supporter of physiotherapy. As an allied health professional, that is the umbrella term, there are 14 professionals in MSK, so physiotherapists are the largest workforce in that group of 14. That does not dismiss the other professionals, because I think they are so important; just because they are smaller, their voices are not always heard. When we are looking at physiotherapists, we need to be looking at what they can do. I believe, and it is one of the things I said in my debate, that we need to be thinking about healthy lifestyles from birth to the end of life, because if a child is born with any disabilities or any MSK conditions, then they are having the right care from then on. Whether it is gait re-education, neurological conditions, or when it comes to end-of-life and palliative care, looking at how we can improve the last days for a patient in a dignified manner.

That might just be, they want to be able to walk from A to B to go to the toilet, to be able to just do their bodily functions in a way that they feel comfortable. For me, I am a very big supporter of physios, and if I were ever in a place where I needed palliative care, I would want to make sure that I can at least look after myself, because that is just something that I want.

Everybody is different. Someone might say I would just like to make sure that I can go for a walk. It is whatever the goal is, whatever it means for you and that purpose for you that we achieve. I do not think there is a big enough onus on it, and I think I will say this in my debates. I was talking about cardiovascular disease on Thursday, and I talked about cardiac rehab, another place where people do not realise that physios are integral.

I think it needs to be in all aspects of what we are looking at. It comes back to when I was talking about first contact practitioners being physios in primary care, that we recognise the importance of them. The,n when we are looking at whether it s’ MSK problems, neurological strokes, neuro rehab, lung conditions or ITU, these are all places where physios put their hand in to help people be enabled to be able to get on with their life. I think we need to see an increase in the workforce for all AHPs, all allied health professionals,s and I believe that we cannot have a resilient NHS without a full MDT. The allied health professionals are integral to the MDT as when you come into the hospital, you will be clocked in by a receptionist, you will see a healthcare assistant, you will see a nurse, then you may see a physio, you might see the occupational therapist, you might get enrolled into the board, maybe if you have had a neurological problem, you might see a speech and language therapist. You might be referred to podiatry for an insole.

Therefore, so many professionals go on that journey of your care. The benefit of the AHPs is that we normally spend more time with patients. So we will affect your quality of life. You will spend 45 minutes with an occupational therapist or speech and language therapist, whereas the doctors and nurses you will spend less time with. That is not dismissing what they are doing, because as I have said, they are integral, but I want to make sure that we are highlighted on what we do and what benefit we bring.

Torrin Wilkins: One of the debates recently, and we touched on it there slightly with end-of-life care, is the assisted dying bill that is going through Parliament at the moment. You said one of the reasons for voting to support the bill was your experience of “The trials and tribulations of patients in their final days”. What issues did you see in the NHS and more widely that made you vote for the bill, and what can be done to improve the bill? Are there any changes that you think could be made?

Sonia Kumar: I voted for the bill because I felt like it needed to be debated. I think we have got a democratic process where we have a committee that will go through line by line, word by word, just to look at the bill and what we can do to scrutinise it and put amendments forward and how we can strengthen it.

In regard to the second reading, I believe it was the right idea for us to say that this is no longer debated further. I think the public wanted that to happen. Whether I vote on the third reading or not, I will need to read the bill myself in detail and see what has been amended. I know there are changes in terms of what we do in terms of a judge, and how we have a psychologist and how we decide on the decision at the end of life care.

But I am not going to say yes, I will vote for the third reading. I need to have a read through the whole bill itself, what has been amended and whether it is good enough for patients.

When I was working in ITU, I did a stint on ITU, and I worked on care for the elderly as a junior physi, rotating; some patients will not tolerate pain relief. So these people are going to be in dire pain for days and weeks until they take their last breaths. I am pro-choice. I believe that if somebody wants to look at their life and go, “Right, I have lived a fantastic life. I am 98; I have lived my life. I have an allergy to these drugs, or I have decided, for whatever reason, that I cannot take them. I have got severe cancer; I have got metastases all over. I do not want to prolong my life when I know I can live a life in a dignified manner. And I have got six months to live. I have spoken to a doctor, I have had a mental health assessment, I know I am competent; it is consented”. There are a lot of things that need to be said, yes, yes, yes, for me to say we need to go forward. Then, I think you should have a choice about whether you would like to end your life.

I do not believe it should be in our hands as a government. I think it should be in the hands of patients. This is not a choice that I think should be made for everybody. It is not one for paediatrics. It is not for those with mental health issues.

The bill initially has taken out many patients who could potentially be targeted by this. To safeguard some of these things, they have been put aside. I look at the suffering of patients at the end of their life, and those people with neurological conditions have said to me, “So, I mean, I am done now. I do not want to be here anymore”, and those days are dark, especially when you are in pain and you have a terminal illness.

That is the thing that you have got to highlight with this bill. It is not for everybody. Several residents who come in to see me in surgery say they are quite concerned about it, and when I said, “Actually, it is for the terminally ill”, they say, “Okay, that makes more sense” “Okay, this is not a blanket referral system that you have to go through.” For me, I look at when I was working with those in the hospital and with those vulnerable people,  you are in really dark moments, and lots of people just talk about this.

When you see a patient,t and they are saying they want to end their life, they are not going to just tell you; they are going to tell everybody. Those discussions will happen through the MDT. As a physio, I would have that discussion when they want to walk, do some palliative care in terms of walking or the OT with getting them, if they want to just make their meal, they put their meal in the oven or whatever goal they want to achieve. 

Therefore, we should be quite open with our thoughts about this and think, “What is the best decision that I can make for patients?, That is how I see it. I do not put my MP hat on; I put my clinician hat on. I also think that there are so many safeguards. Every single person who is in contact with that patient has a safeguarding responsibility to look out for concerning behaviour, mental health behaviour, things that would concern them to think, “Oh, they are not ready to make that decision,” and you would always highlight that in the MDT meeting and a handover in the morning.

That is the reason why I would say we need to be really quite sensitive with this matter. I think patients should be at the core of what we are doing. Those people who are hesitant about this bill, I think, should be open-minded, and I am quite open-minded to see what is going to come out of this at the end of it and decide then.

Torrin Wilkins: For the last part of this interview, I am going to speak a bit about the economy and small businesses, some of the things that fund the NHS itself and grow our economy. It is something Labour has been very vocal about, and something close to your family, as your dad ran a greengrocery for more than 45 years. How do we protect small businesses, especially with the cost-of-living crisis and economic instability around the world?

Sonia Kumar: I will just clarify, my dad is still running hisgreengrocer’ss. He is over 70 now, and he is still quite keen to get up in the morning, go to the market, get the fruit and veg and stock up. I have told him he needs to retire, but I do not think he is quite ready to take down the shutters yet. He still wants to continue working and serving the community, which is something that I admire about him. It is the values that have been instilled in me that’ community is essential when you are looking at giving back. That is what I am going to say first of all.

In terms of the NHS and small businesses, I am from an SME myself. This is why I put myself forward to the business and trade committee, which I was successfully elected to. I just graduated with my business and management MSc from Aston University. So I thought, this is the theory in practice. It would be great to put it into play.

I think we need to level the playing field for businesses by cutting business rates for shops, pubs, leisure centres, and properties so that the high street can thrive. Labour has committed to lowering these rates and ensuring that the online giants that have that competitive advantage are re-levelled and that they pay their fair share of tax.

The retail crime and funding prevention and training for police in terms of training. One of the things that we always get is petty crime; people just steal bottles of wine or bottles of alcohol or bits and pieces that they should not steal. Actually, now Labour has put a policy in place that anything under £200 can be reported, and it will not be ignored, which I think is fantastic for small SMEs. We have also increased the contribution threshold to £10,500 to help small businesses thrive. Then an additional 250,000 properties, including pubs and high street shops, will receive 40% off their business rate bills.

I think we have got to look at what we are going to do about these shops that we have got, and then what do we do with the empty shops? So I have started to run a campaign about how we tackle empty shops. The government has given powers to councils, so shops that have not been open for a year are to be kept open. Nobody wants to go on the high street and have 37 shops, which are like those in Dudley at the moment, that are empty. They want to make sure that these shops are filled with local businesses, SMEs, so that when people come into the town centre, market centres, or wherever you are in the country, you have got a place to eat, you have got a place to get some entertainment, a place to shop, and a place to be proud of. I think heritage is really important in places like Dudley, and people are proud of where they come from.

I am proud that I have opened my office in the town centre. I am occupying one of these empty shops so that people can come and speak to me.  I think Labour has got a lot that it is putting forward already, and it is protecting our micro businesses, which are a lot in my constituency, but more will be rolled out as the industrial strategy is rolled out in the spring, which I am quite looking forward to.

Torrin Wilkins: Thank you so much for taking the time to join me today to discuss the NHS, the economy, and so many other issues. Thank you so much.

Sonia Kumar: Thank you so much.

Note: This interview has been edited for grammar, clarity, and flow. The original recording is the final and definitive version.