(7 years, 9 months ago)
Commons ChamberI am always somewhat disappointed by the right hon. Gentleman’s rhetoric, given that we are spending about £1 billion more every year than when he was mental health Minister. This April, we will reintroduce maximum waiting times for eating disorders. As he knows, we have committed to publish pathways for all conditions during this Parliament. That will include his constituent who, I agree, is waiting much too long at the moment.
Some GP practices in east Lancashire have, through sheer frustration, started publishing the number of missed appointments. When will the Secretary of State consider giving GPs the power that they want, and that the public want them to have, to charge those who miss repeated GP appointments, including in east Lancashire?
(8 years, 6 months ago)
Commons ChamberI absolutely agree with the hon. Gentleman. In fact, I wanted to come on to talk about that perceived tension between money and the quality of care. Until three years ago, we did not have an independent inspection regime to go around ambulance services and tell the service, the public, constituents and Members of Parliament how good the quality of care is in each area. The first step is to have that inspection regime so that we know the truth, and then things start to happen, as is beginning to be the case in ambulance services across the country.
The big point—this is precisely what I wanted to move on to—is the worry, which is shared by many people, that an efficiency ask of this scale might impact on patient care. They should listen to the chief inspector of hospitals, Professor Sir Mike Richards, who points out that financial rigour is one of the routes to excellent quality, and that there is a positive correlation between hospitals offering the best care and those with the lowest deficits. In other words, it is not a choice between good care and good finances; we need both.
Before my right hon. Friend moves on, I want to draw him back to the question of charging international visitors for the use of the NHS. The Government now charges non-EU citizens £200 per person as part of their visa application. Will he tell the House why he has chosen the figure of £200, which seems extremely low? An equivalent private healthcare policy for a year would be £800, £900 or £1,000, and an equivalent level of travel insurance for the same period would be £400 or £500. Is there not an opportunity to tier this and perhaps charge people more as they get older and become more likely to rely on the NHS?
I recognise why my hon. Friend has asked that question. We do think very hard about the level at which we set that charge, which was introduced for the first time only a couple of years ago. The reason that it is set that low—I recognise that it is quite a low charge—is that a large number of people paying it are students who tend to have low health needs and be low users of the NHS. We want to ensure that we do not create an inadvertent disincentive for people coming to the UK when they can, at the same time, choose to do their studies in Australia and America. However, it is something that we keep constantly under review.
My right hon. Friend will of course be aware that there is a differential charge for students—some £150 a year rather than £200. Will he go away and consider whether there is a possibility of charging high earners who come to this country more than a couple of hundred pounds a year, because the charge does seem so low? Will he also specifically look at whether there is a possibility of charging people who are older more, as they are much more likely to rely on the NHS?
Let me repeat that we do keep this matter constantly under review. The important thing is that, for the first time, we are charging people who come to the UK on a long-term basis for their use of NHS resources. That is something that did not happen before.
Let me return to the crucial issue of this link between the quality of care and good finances. Why is it that it is so important not to see this as an artificial choice between good care and good finances? Very simply, it is because poor care is about the most expensive thing that a hospital can do. A fall in a hospital will cost the NHS about £1,200, as the patient typically stays for three days longer. A bed sore adds about £2,500 to NHS costs, with a patient staying, on average, 12 days longer. Avoidable mistakes and poor care cost the NHS more than £2 billion a year. We should listen to inspiring leaders such as Dr Gary Kaplan of Virginia Mason hospital in Seattle, which is one of the safest and most efficient hospitals in the world. He said:
“The path to safer care is the same one as the path to lower costs.”
That brings me on to the second way that this Government are fiercely defending our public services, which is our restless determination to raise standards so that people on lower incomes can be confident of the same high quality provision as the wealthiest. To their credit, the last Labour Government succeeded in bringing down NHS waiting times. I hope that that decade is remembered as one when access to NHS services improved. However, because of poor care identified in many hospitals post Mid Staffs, we should surely resolve that this decade must become the one in which we transform the safety and quality of care. Mid Staffs was the lowest point in the history of the NHS, so we must make it a turning point, or a moment that we resolve to offer not just good access to care, but care itself that is the safest and the highest quality available. The record of the past three years shows that we can do just that.
The King’s Fund has given credit to the Government for their focus on safety and quality of care. Patient campaigners have said that the NHS is getting safer and the main indicators of hospital mortality and harm are going in the right direction. However, there is much more to do, so what are our plans? First, we must deliver a seven-day NHS. It should never be the case that mortality rates are higher for people admitted at weekends than for people admitted in the week. Last week’s junior doctor contract agreement was a big step forward, but we also need to reform the consultants’ contracts, improve the availability of weekend diagnostic services and increase the number of weekend consultant-led procedures.
Secondly, a seven-day NHS also means a transformation of out-of-hospital services, especially access to an integrated health and social care system that needs to operate over busy weekends as well as during the week. It also means more GP appointments at convenient times, which is why we want everyone to be able to see a GP in the evening or at weekends. We are backing general practice with a £2.4 billion increase in its budget.
(9 years, 5 months ago)
Commons ChamberWell, I can, but may I gently say that under this Government and under the coalition we increased the proportion of money going into the health budget, whereas the Scottish National party decreased the proportion of money going into the NHS in Scotland? The £8 billion is what the NHS asked for to transform services, and that will have an impact, meaning that more money is available for the NHS in Scotland. I hope the SNP will actually spend it on the NHS and not elsewhere.
I thank the Secretary of State for personally intervening to enable the Ilex View medical centre in Rawtenstall to open for longer hours, despite that being precluded under its private finance initiative lease of that building. Will he update the House on what steps can be taken to ensure that where GPs are in a building that is subject to a PFI lease, he will be able to intervene to ensure that they can truly open seven days a week and for extended hours?
This is one of the main reasons why the Chancellor allocated £1 billion to modernise primary care facilities in the autumn statement. We recognise that many GP premises are simply not fit for purpose. If we are going to transform out-of-hospital care, we need to find ways to help GPs move to better premises, to link up with other GP practices, and that will be a major priority for this Parliament.