National Health Service Funding
Debate between Jeremy Hunt and Robert Flello(8 years ago)
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Mr Hunt
It is noticeable that the two potential solutions we have heard have been from Opposition Back Benchers—the right hon. Member for Leicester East (Keith Vaz) and the former shadow Chief Whip, the right hon. Member for Doncaster Central (Dame Rosie Winterton)—and not from the Opposition Front Bench. My hon. Friend makes an important point.
The shadow Health Secretary is right to hold the Government to account for the funding of the NHS and the social care system, but it is a big mistake to distil all issues around the NHS into the simple issue of money. That subcontracts the responsibility for safe, high-quality care to politicians. If we are going to be the safest and the best quality system in the world, that has to be everyone’s job, everyone’s focus and everyone’s commitment—politicians, yes, but managers, doctors, nurses, porters, healthcare assistants and every single person working in NHS.
On the way forward, we first need to move to accountable care organisation models and the “Five Year Forward View”, including the STP process. The shadow Health Secretary called STPs “secret plans”, but in fact 28 of the 44 have been published and the rest will be published before Christmas. Many in the House, on both sides, objected to the Health and Social Care Act 2012 because they felt it did not do enough to support integrated care. Well, now we have a process that is bringing together the NHS and the social care system, acute trusts and primary care, at a local level. That is a big prize and we should support it, not try to make political capital out of it.
Robert Flello
In Stoke-on-Trent, the CCGs sit on the STP group. We have still not seen the report, but we have seen an executive summary. When the STP group suggests one thing, the CCG undermines it by closing community hospitals and cutting community beds. They are not working together; they are working against each other.
Mr Hunt
That is exactly what we need to sort out. We have the STP process to stop people doing their own thing, instead of having a co-ordinated, well-planned strategy. If we stick with this process, embrace innovation and technology and retain a relentless focus on safety and quality of care, in this Parliament we will see a million more people accessing mental health treatment every year; 5,000 more doctors working in general practice and a transformation of services through GPs; a new four-week cancer waiting time standard that will save 30,000 lives a year; more failing hospitals turned around; the weekend effect tackled; more doctors and nurses; and an NHS staying true to the promise made to patients in 1948 that safe, high-quality care would be there for everyone, regardless of income. That is what this Conservative Government will deliver, and I urge the House to support the amendment.
Social Care
Debate between Jeremy Hunt and Robert Flello(8 years ago)
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Mr Hunt
The hon. Gentleman is absolutely right to say that the presence of social workers in hospitals is vital in discharging people, but I think he will be quite shocked to know that 50% of all the delayed transfers of care in the entire NHS happen in just 20 local authority areas. There are many places that are doing these things well, even in the current challenging financial circumstances, but there are others that, frankly, could do a lot better.
Overall, what we see is a picture where the best councils have expanded funding and provision. For example, last year, Windsor and Maidenhead increased its spend by 6.4%, and the number of people accessing long-term care is up by 8%. That was a Conservative council, but the Labour council in Doncaster also chose to increase its social care budget by 10%—nearly £8 million—and it is looking after nearly 7% more people.
This is not just about funding; it is also about the speed of health and social care integration and about local leadership. Where such leadership exists, important changes are happening even now. For example, in Cheshire East, dedicated workers are supporting people with early-stage dementia, saving more than £4,000 a year per client in social care costs while improving the service for patients. Milton Keynes is another good example: its innovative pilots have cut delayed days attributable to social care by nearly three quarters.
Others, regrettably, have chosen to cut funding and provision. There are many reasons for that, but the one thing that is difficult to explain to the public is why, at times of such challenge, local authority reserves have increased by nearly £10 billion since 2010. The hon. Member for Worsley and Eccles South made a fair point when she said that there has never been greater financial or operational pressure on all councils. Like the NHS, there is huge pressure, but unlike the NHS, it has not been possible to protect their budget since 2010.
What is the way forward in this very difficult situation? I think that it is a combination of the right financial decisions locally and recognition by local authorities and the NHS that they are part of the same team. That is why, as has been said, the sustainability and transformation plan process is so important.
It is easy to knock a process whereby local areas come together to have yet more meetings, which we are pretty good at doing in the NHS and social care system, and it is also easy to characterise those meetings as secret, but the fact is that people do not want to publish their plans until they are ready, and they will all be published by the end of this year. Many Members on both sides of the House criticised the Health and Social Care Act 2012 because they felt that it did not do enough to promote integrated care, but now we have a process to do that. That is massively important for the social care system, as this is the first time that local authorities are properly involved in NHS planning. Indeed, four of the STPs—namely those for Greater Manchester, Norfolk and Waveney, Nottinghamshire, and Birmingham and Solihull—are headed by local authority leads. On Monday, the head of operations at NHS England told me that there was not one STP meeting that he had been to where a local council was not represented. At the moment, it is a planning process and it needs to be delivered, but planning needs to happen collaboratively. It is a significant change for the NHS and social care system, but it is finally happening.
Robert Flello
So why is it that Stoke-on-Trent City Council tells me that no council officers or councillors have been involved in the Staffordshire STP? Given that it covers the whole of Staffordshire, the more deprived areas of Stoke-on-Trent and north Staffordshire will, in effect, subsidise south Staffordshire, because it has greater debts. Why cannot MPs have input into the plan? It is absolutely disgraceful.
Mr Hunt
Everyone will have input into the plan, but the hon. Gentleman might want to ask his council why it is complaining about pressures on the social care system when it has refused to use the social care precept and raise extra money, which could be desperately used for social care. That would make a real difference to his constituents.
Where councils and local NHS organisations are working together, we are seeing some real financial savings that are having a big impact. For example, Northumberland has saved £5 million through integrated services with Northumbria NHS Trust, and there has been a 12% reduction in demand for residential care as a result. In Oxfordshire, where the local authorities, clinical commissioning groups and trusts are all working together, discharge delays are down 40% in six months, and those due to social care have more than halved.