(8 years, 1 month ago)
Commons ChamberJust as I am in favour of a profitable private sector, I am in favour of savings in the NHS. We all know that we have to make savings, but let us make real savings from properly thought-through programmes. The NHS is often the best place to carry them out. We should not have badly planned impositions from the private sector, which does not know what it is going to do or how to do it.
We have to learn the lessons. It is not as if we have not had plenty of examples, as we saw in our debate last week on another private sector company that reviews benefits. That case was an absolute disgrace, but let us not get diverted on to that, because we had a good debate on it last week. Let us stay with the problem before us tonight. I look forward to hearing what the Minister has to tell us, but I must warn her that I have a few things to say yet; I have only just started. Correct me if I am wrong, Madam Deputy Speaker, but I understand that the debate can go longer than half an hour. I do not want to detain the House, but I urge any Member who wishes to contribute to do so, because we have at our disposal at least double the normal time. If I say that to the dismay and disappointment of the Minister, I am sorry, but we will not delay anybody unnecessarily.
Others have been in touch with me on this subject. I am pleased to say that the good old BBC was made aware of an issue and initiated an excellent survey of what is happening in Norfolk, Suffolk and Essex. The survey was carried out by Nikki Fox, who did a good job and presented a programme on this. She discovered that no fewer than 9,000 records had been lost. Some had been found flying loose on the ground in a car park. God knows what happened to the others—nobody knows. Some 9,000 patient records have gone missing in those three counties alone. It is very much to Mr Paul Conroy’s credit that he has written to me issuing a challenge, which I will come to later, to fulfil our public duty to reveal what has happened, which, as is usually the case, others are trying to hide. Capita says that it is unaware of the problems, yet three counties are up in arms and the BBC has conducted an exposé; it beggars belief.
No fewer than 20 practices in Coventry and Warwickshire have been surveyed, and every single one of them has said that there has been a more or less serious deterioration in services. NHS England itself has now stated that patients could be at risk. The whole purpose of tonight’s debate is to reveal that risk and to urge Capita to correct the problem.
I thank my hon. Friend for securing this debate. I have been approached by several GPs in Blackburn who feel that the service they are providing to the public is going under. They can no longer cope with the burden placed on them. Would it be in order to ask the Minister whether she can urgently step in? GPs are under a lot of pressure right now, and this added burden is a false economy and could put patients at risk.
I entirely agree with that. We see the problems extended across the border, and indeed they are not peculiar to any one part of the United Kingdom. By their very nature, they are systemic and infect, for want of a better phrase, the whole country, and I am pleased to welcome the Member from the Scottish National party to—
I am so sorry, dear. I shall not live that one down in a hurry, but I thought I had detected a Scottish accent. I welcome my hon. Friend to the debate. She is the only one who did not tell me she would be participating tonight, Madam Deputy Speaker. I do apologise, but I cannot correct Hansard and I am afraid to say that the error will stand. I am sure she will forgive me, even if others may enjoy the mistake I have made.
There is no doubt that we are facing a major threat with this situation, and we hope we can stop it before we get to a major incident or catastrophe of some kind. That is the point of tonight’s debate. There is no doubt that this threat exists in Coventry, and we want to see what the Minister has to tell us about it. It is also clear from the interventions, which I have been pleased to take and to respond to, that this problem is widespread in England as a whole. As we have heard, in Bristol and in Manchester, and in the constituencies of those others who have made interventions, the problem is growing, not waning. Given the situation, we have to take steps.
Although we have risen to the challenge put out by Mr Paul Conroy, it is not enough for any Member just to speak up and expose this situation. That is a public duty we have as Members of this House, and the BBC has a duty as the national broadcaster to speak about these problems. We have all had experience of this. Not only have I had my business experience, but I have had experience of problems of this kind while in ministerial office and from others. Everybody in the country knows—it is no secret—that these privatisations, unless they are carefully controlled and well thought out, go wrong, so why do we keep doing them? This particular one involves Capita—it is in the hot seat tonight. It should know what this is about by now, as it has been through several of these and got them all wrong—Capita seems to learn nothing either. Ministers change, and it may be that the Minister knows about it but then gets moved. That is the nature of our appointments system, and I would not want to change anything there, but the civil servants who run these Departments should start to understand these things.
Contract management has many attractions to Ministers and to Government, who contract the problem out and lose direct responsibility for things. Everybody then heaves a sigh of relief and closes the file as if the thing is nothing more to do with them, but that is an illusion, because it comes back to bite them harder than it would have done had they kept the problem under their direct responsibility. It is an illusion to think that we can contract out. The responsibility for a contract remains with the person issuing that contract, and where it is for a major national public service, that contract must be taken seriously. What I did learn in the private sector is that the best companies spent more time preparing the bids for a contract, the assessments of the validity of the contracts and the validation process for a contract than they ever spent in negotiating the thing, which civil servants and Ministers often like to think they are good at. They say, “We had a hard-nosed negotiation on that one. We got them down from Y to X and we saved all this. It is great. We really screwed the private sector, didn’t we?” That is all a total illusion.
The most important thing when we do a contract of this complexity and of this kind is to get to the basis of the issues: to see who is really competent to take it on; who can make the savings that are being claimed in the real world; and who can do the other elements of the contract that have to come into play in a difficult situation competently. It is a question of competence.
(8 years, 3 months ago)
Commons ChamberI have serious concerns about the lack of transparency in the process. If there had been more consultation, it would have been far more transparent. The plans’ only aim is to fit funding, rather than to examine and improve services.
Hospitals are under huge pressure in Blackburn and the surrounding Pennine area—as I am sure you are aware, Mr Deputy Speaker—with the closure of the A&E at Chorley hospital. Coupled with the huge burden facing local authorities, the Pennine Lancashire health authority has the challenge of finding £238 million over the next five years. With the best will in the world from local authorities, NHS trusts and communities, I fear that the change will not be for the better under that kind of financial pressure.
Let us not forget the savage budget cuts that local authorities have faced. Blackburn with Darwen Council alone has already had to cut £100 million from its budget, with another £48 million to cut by 2020. I am not opposed in theory to a system approach of hospital trusts and local authorities working together. In fact, that was always one of our main aims during my many years as leader of Blackburn with Darwen Council, but it was used to improve services. It is not fair that that council has effectively been handed the task of improvement with vanishing resources.
The exemption of adult social care from STPs has caused concern in local authorities across the country. It is not helpful that they have been told to leave that bit out of their submitted plans because it does not quite fit in with the budget. That will certainly not produce a more efficient and better service. The funding gap in adult social care is a real crisis that local authorities must face, but no remedy to fix it is currently forthcoming. Many pressure groups, experts and even the chief executive of NHS England, Simon Stevens, have publicly advised the Government to make extra funding available for social care, yet the Government have been silent. They have made no commitment to make additional funds available in 2017 to support adult social care. I would like to give them an opportunity today and will happily give way to a Minister if they are prepared to clarify that point. Will the Government make additional funds available to ease the burden on adult social care, leading to better transformation of services?
Like many of my constituents, I seek clarity on whether additional funding will be made available, because if it is not, STPs will fail miserably. If we really want a transparent process and improved services, before we move on to transformation I suggest that my colleagues and I are at least made aware of what the plans contain or are assured that resources will be available to stabilise NHS and local authority services.
(9 years, 1 month ago)
Commons ChamberAs the House is aware, social care is a matter of great importance as we head towards the spending review round. We are aware of pressures in the system, and there is always contingency planning to identify particular problems. We are working hard with the National Care Association to improve the quality of care provided by the sector, and my right hon. Friend the Secretary of State has commissioned Paul Johnson, of the Institute for Fiscal Studies, to look at pressures in the care home sector and how to ensure that we can meet the challenges. If challenges require more money, which they always seem to do according to the hon. Lady, she needs to come up with ideas for how to provide that money, but she never does. It is the Government’s responsibility to meet those challenges within the context of the overall economic position.
T1. If he will make a statement on his departmental responsibilities.
On Friday, I announced an ambitious plan to halve the rates of maternal deaths, neonatal harm and injury and still births by 2030 by learning from best practice in this and other countries. Following the tragic events in Paris, I know the House would also like my reassurance that we regularly review and stress test the NHS’s preparedness for responding rapidly to terrorist attacks. I have written to Madame Marisol Touraine, my French counterpart, to offer our solidarity and support. Vive la France!
Just after the election, the Health Secretary called childhood obesity a national scandal and made tackling health inequalities one of his key priorities. How will a flat-rate cut in the public health grant across all authorities, regardless of specific health challenges, as well as a further projected cut, under the reformulation, of £3 million in my constituency, help him to achieve his mission?