NHS Funding (York and North Yorkshire)

Debate between Baroness McIntosh of Pickering and Julian Sturdy

Wednesday 7th January 2015 Westminster Hall

[Julian Sturdy (York Outer) (Con)]

It is a privilege to serve under your chairmanship, Mrs Riordan. I am delighted once again to have secured an opportunity to address the important issue of health care funding in York and North Yorkshire and, ultimately, the formula used to calculate the per patient funding from which clinical commissioning groups—and, before them, the primary care trusts—derive their money. Other North Yorkshire and York MPs and I have been campaigning on this issue since 2010, and I am delighted that my hon. Friends the Members for Skipton and Ripon (Julian Smith) and for Harrogate and Knaresborough (Andrew Jones) are here to support me this afternoon. I strongly believe that the nettle has to be grasped on what I accept is a difficult issue, albeit one that cannot continue to be ignored.

The quality of local health care is of the utmost importance to many, if not all, people because, ultimately, it is something upon which we all come to rely at some point in our life. Health care provision is a measure of the local community’s economic well-being and happiness, and it is in our moral and economic interest to ensure the widest availability of health services, the shortest waiting lists and that the most impressive health outcomes are available to all, which I stress. Ensuring such health care standards for all is truly one of the Government’s most essential roles. Indeed, I am sure that all hon. Members from North Yorkshire, both those who are here and those who are not, will agree that health-related concerns crop up frequently in our constituency mail. That is certainly the case in my constituency, as I am sure it is in yours, Mrs Riordan. As such, I welcome the £2 billion of health care spending promised by the Government for this financial year in the autumn statement. That injection of cash has led to every area’s budget increasing ahead of inflation in the recently released allocations. It is for such reasons that I believe the Government can stand proudly on their NHS funding record.

I have called this debate, however, to address the fair allocation of funding and the impact on health care delivery due to a funding formula that works to my CCG’s disadvantage. In a previous debate on this issue I outlined my concern that the now-abolished primary care trusts would pass on their historical debts to the new CCGs. Vale of York CCG inherited a deficit of some £7 million in April 2013 due to the current funding formula. NHS England has acknowledged that the previous York and North Yorkshire PCT received approximately £17 million less than the allocation should have provided for the local population demographic because the funding is phased in over time. Although I am pleased to say that Vale of York CCG has cleared the deficit it inherited, it is still struggling to offer many services that constituents have a right to expect. Allocations made for the newly formed CCG in 2013-14 were a straight uplift of the historical allocations, which resulted in a postcode lottery for certain health care services in my area.

Why does Vale of York CCG, in particular, receive such a poor allocation? The Government decide how much money should be allocated to each CCG. Officials begin by dividing the total budget by the number of people living in each respective area. Money is then added or taken away to account for local characteristics, including the proportion of people claiming benefits, the teenage pregnancy rate and the number of people who leave education early. That is where the problem lies. Of the 10 characteristics, nine reduce the amount of money allocated to our area. That disparity in the allocation is due to the funding formula failing to take account of both the rural nature of the region and, most importantly, age. Instead, the current formula provides a significant weighting that awards additional funds to areas with high levels of social deprivation. The allocations for 2015-16 have now been announced and, once again, Vale of York CCG has received, by a substantial margin, the lowest per capita funding of all the CCGs in the area. Although I recognise that health needs are generally greater in more deprived areas, the current formula provides far too much weighting for deprivation and insufficient weightings for age and rurality.

Age and rurality are even greater problems in my constituency and in other North Yorkshire constituencies because York and North Yorkshire have the highest proportion of over-85s in the north, but Vale of York still receives among the lowest funding per head of any northern CCG. The area also has a high number of people in care homes, with a typical GP practice informing me that up to 50% of home visits are taken up by care home residents, who account for only 2% of patients on the practice’s roll. The distribution of health care costs is strongly age dependent, and it is difficult to argue against that. On average, it costs approximately eight times more for the NHS to care for a patient over 85 than for a patient in their 40s, which, of course, is due to elderly people being more likely to have additional health problems. We are all living longer, which is obviously a good thing, but we are living longer with more complicated conditions. Age is increasingly becoming a defining factor in health care funding.

Alongside age, the formula does not account for the additional cost of providing health care services in sparsely populated rural areas. Those additional costs are reflected, among other things, in longer average journey times for ambulances and community health staff, such as health visitors. There is also a need to provide additional smaller hospitals in rural areas in order to retain accessible and essential services for those communities.

The distortion in the funding formula has led to certain areas being awash with money, which in the past has sadly led to well publicised vanity health care projects, whereas York and North Yorkshire have consistently struggled to balance the books, resulting in their continuing to take difficult decisions on health care provision. Those decisions have had a massive impact on the quality of life of many of my constituents, hampering their ability to work and affecting their careers.

To my mind, Vale of York CCG does not provide some procedures due to the funding formula. I have been contacted by many constituents over the past few years regarding their inability to receive pain-relief injections free on the NHS. I have been actively campaigning for the removal of those charges for all who require such injections. I am sorry to say that the charges are symptomatic of the postcode lottery due to the current funding formula. The CCG reviewed its position on pain-relief injections and concluded that the injections are not clinically beneficial, which is why it decided to retain the charge, but I would argue that the injections can dramatically improve people’s quality of life and should be offered free of charge. Pain-relief injections are offered free of charge by many other CCGs across the country and across our region.

Alongside pain-relief injections, another procedure that has not been available through the Vale of York CCG is IVF treatment. In fact, for a long time the Vale of York was the only health authority in the country not to offer any free IVF treatment. I know from many constituents who have contacted me about the issue that infertility has an awful effect on people’s lives, causing stress and depression, and with the potential to tear otherwise healthy relationships apart. It must be extremely frustrating for someone to know that treatments are available just a few miles away but are inaccessible to them; nevertheless, that has been the reality in many parts of my constituency for a number of years.

I was pleased to hear the CCG announce in late December that it will now offer at least one cycle of IVF. Although that falls well short of the three cycles recommended by NICE, it is a welcome step in the right direction.

[Miss Anne McIntosh (Thirsk and Malton) (Con)]

I apologise to my hon. Friend for missing the start of his speech and congratulate him on securing this debate. This may tempt him toward a conclusion, but does he agree that spending more on primary care in the Vale of York and other North Yorkshire CCGs would keep people out of hospital, which would obviously be to the greater good of the health service and those living in North Yorkshire?

[Julian Sturdy]

I entirely agree with my hon. Friend. Given the rurality of the whole of North Yorkshire, which I mentioned at the start of my speech, we know that providing health care services is difficult and expensive. That is part of the argument for why the funding formula must be adjusted. At the same time, it must be more cost-effective to deliver services in people’s homes and offer more accessibility. Nevertheless, as my hon. Friend will know from the situation in her constituency, it is important that we also keep small hospitals open and accessible. I know that that is an important issue in the constituency of my hon. Friend the Member for Skipton and Ripon. This debate is all about ensuring that we have a fair formula so that we can deliver those services.

Food Fraud

Debate between Baroness McIntosh of Pickering and Julian Sturdy

Monday 8th September 2014 Commons Chamber

[Julian Sturdy]

I entirely agree with my hon. Friend, who makes the point well. It is important that the Government, of which DEFRA is one Department, lead by example, and I feel that they are doing that.

In the wake of the horsemeat scandal, it was clear that consumers want to see more British food on the shelves of supermarkets. They want to buy more British food and eat more British food, whether they get it through schools and hospitals, or by buying it in their local supermarket and from local producers. Buying British food is important, because animal welfare in our country is second to none. Our farmers are rightly proud of their world-beating record, which sets us apart from other global producers. We must celebrate that. For me, that is a gold standard, which we have to maintain.

I draw the House’s attention to the fantastic but often overlooked red tractor assurance scheme, which was mentioned by the hon. Member for Poplar and Limehouse (Jim Fitzpatrick). The logo, with the Union flag, shows not only that the food was produced in the UK, but that the highest standards of animal welfare, food safety, traceability and environmental management have been rigorously enforced. Almost 90,000 farmers now take part in the scheme, and the retail value of food carrying the logo is now estimated to be more than £12 billion a year. Next week is red tractor week, and I urge everyone to support the scheme where possible. Young people are being asked to become red tractor recruits, to spread the word of high-quality British produce on social media. Sadly, I can no longer claim to be a young person, nor have I ever been an avid tweeter, unlike some other Members, but I hope my contribution will convince some consumers to put British produce into their shopping basket—or to buy local, which we have not touched on yet—

[Miss McIntosh]

Yes we have.

[Julian Sturdy]

I do apologise—buying local has been talked about already, but it is worth mentioning again. The best form of traceability and quality assurance is to go down to the local butcher, greengrocer or fishmonger and buy local. When we buy local, we know where the food has come from—we can ask the butcher where the meat has come from, even down to the individual farm.

The importance of farming to our economy should not be underestimated. Food production and farming contributes almost £100 billion to the British economy each year, employing almost 4 million people in the process. We can be proud that farming remains a family affair, with 90% of the more than 140,000 registered farming businesses run as sole traders or family partnerships. Food and drink products are now the country’s fourth largest export sector, with sales booming by about 5% a year. Indeed, some of the UK’s most lucrative exports are now from the farming sector, with lamb exports up 8% year on year, cheese exports up 9% and dairy produce up an incredible 18%. Such successes play an important part in creating jobs and fuelling our economic recovery and must be encouraged to continue.

We must also take the necessary steps to safeguard our hard-won reputation of excellence, which could easily be jeopardised by rogue elements operating in an increasingly complex international marketplace. Professor Elliott rightly calls for a zero tolerance approach as one of the pillars of food integrity. I understand that, at the request of the Food Standards Agency, the Sentencing Council is considering whether there is an opportunity to provide fresh guidance on food and hygiene offences. I urge that tough sanctions be brought to bear on anyone who would not only jeopardise the health of British consumers, but cheapen the reputation of the agricultural industry, which farmers have worked so hard to rebuild after the scares of the 1990s.

I welcome the Secretary of State’s response to the report, which recognises not only the value of British farming, but the importance of educating children about quality food. Cookery and food education will be a vital part of the national curriculum, and young children will now enjoy a much better understanding, not only of where their food comes from, but of why it is so important to eat fresh and healthy produce.

I could not let this debate pass without mentioning food security, as it remains a fundamental concern across the country. We are only 68% self-sufficient in food—a level that has, sadly, steadily declined over the past 20 years. Well meaning but poorly implemented schemes such as the common agricultural policy have limited our ability to increase food production in a sustainable way. Our competitive edge in quality and our capacity to increase yields can be promoted only through better understanding of the farming sector and investments in new technology.

It is all too easy to forget that the industrial revolution began with a revolution in Britain’s farming practices, transforming our island nation into the world’s foremost power for more than a century. With such a proud heritage we must remain focused on increasing yields, boosting exports and safeguarding our gold standards in quality produce and animal welfare.

Common Agricultural Policy

Debate between Baroness McIntosh of Pickering and Julian Sturdy

Thursday 8th March 2012 Westminster Hall

[Miss McIntosh]

For the sake of clarity, I am addressing the House as Chair of the Environment, Food and Rural Affairs Committee. I will leave it to my right hon. Friend the Minister to respond to the debate, and I commend the work that he does. Having been a shadow Minister, I am delighted to participate in this debate.

I will deal some of the points that my hon. Friend has made. On food security, the EU must have a significant degree of self-sufficiency. Speaking personally, I am concerned that we are less self-sufficient in this country than we have been historically. That is a comparatively recent development over the past five years. I hope that we can stop such a development in its tracks and that we can become not only increasingly self-sufficient but a major exporter, following the Foresight report in particular and some of the invitations to farmers in that report.

[Julian Sturdy (York Outer) (Con)]

I refer to my entry in the Register of Members’ Financial Interests. My hon. Friend is making a key point about food security and the importance that it will have not only in the UK but across the world, and also to the impact on food prices. Does she therefore agree that it would be dangerous to take all arable land out of production in the name of greening?

[Miss McIntosh]

We will return to greening measures in our further report. The greening measures are the most controversial part of the reform. We believe that the CAP should enhance food production capacity—not necessarily increasing production now—by keeping land in agricultural use and in good environmental condition so that the land is usable when we need it. We need a competitive and viable agricultural sector. We need to redress the imbalances, because farmers cannot get a fair return from the market.