NHS and Social Care Funding

Nicholas Brown Excerpts

Wednesday 11th January 2017 Commons Chamber

[Mr Nicholas Brown (Newcastle upon Tyne East) (Lab)]

claimed to move the closure (Standing Order No. 36).

Question put forthwith, That the Question be now put.

Question agreed to.

Question put accordingly (Standing Order No. 31(2)), That the original words stand part of the Question.

National Health Service Funding

Nicholas Brown Excerpts

Tuesday 22nd November 2016 Commons Chamber

[Mr Dunne]

Thank you, Mr Deputy Speaker. I have explained to the hon. Lady that I do not intend to give way to her. I have only a limited amount of time left, and I would like to remind her of what Chris Ham, the chief executive of the King’s Fund, said. He regards the STPs as

“the best hope to improve health and care services”.

Hon. Members referred to the role of the independent sector in the provision of NHS care. The test for commissioning decisions must always be the value provided for patients and taxpayers, not the type of provider. The vast majority of NHS care has been and will continue to be provided by public sector organisations, but Opposition Members would do well to listen to Stephen Dalton, the chief executive of the NHS Confederation, which represents commissioners and providers of NHS services, who wrote today in The Guardian, of all papers, that private and wider independent sector health care providers

“increase the system’s capacity to respond to demand, help meet waiting time targets and enable investment bring important benefits for patients—most of whom are entirely relaxed over who provides their care, so long as it’s of high-quality and remains free at the point of use.”

I entirely agree with him.

My right hon. Friend the Secretary of State and I have acknowledged that the NHS faces challenges, and I recognise concerns raised by many in the House today. As I have made crystal clear, however, this Government are fully committed to the NHS.

[Mr Nicholas Brown (Newcastle upon Tyne East) (Lab)]

claimed to move the closure (Standing Order No. 36).

Question put forthwith, That the Question be now put.

Question agreed to.

Question put (Standing Order No. 31(2)), That the original words stand part of the Question.

Social Care

Nicholas Brown Excerpts

Wednesday 16th November 2016 Commons Chamber

[Mr Nicholas Brown (Newcastle upon Tyne East) (Lab)]

claimed to move the closure (Standing Order No. 36).

Question put forthwith, That the Question be now put.

Question agreed to.

Question put accordingly (Standing Order No. 31 (2)), That the original words stand part of the Question.

NHS Sustainability and Transformation Plans

Nicholas Brown Excerpts

Wednesday 14th September 2016 Commons Chamber

[Mr Nicholas Brown (Newcastle upon Tyne East) (Lab)]

I welcome the Minister and shadow Minister to their new responsibilities. The Labour party was right to choose this topic for the Opposition day debate. I wish the Minister well in confronting the financial difficulties that face him.

In confronting those difficulties, the Government’s “Five Year Forward View”, which was published in 2014, called for £22 billion of efficiency savings to be found by 2020, on top of the £20 billion of efficiency savings to be found between 2010 and 2015. I simply do not think that should or can be done. The total deficit in all national health service trusts reached £2.45 billion in 2015-16, a figure that is almost three times greater than in 2014-15 and almost half a billion pounds higher than the national health service’s own revised plan. Monitor estimates that even if all realistic efficiency savings were made, a deficit of £1.5 billion would remain in this financial year. It is simply not possible to deal with the situation through efficiency savings. The Government know that and are stuck, hence the sustainability and transformation plans covering the next five years, organised along 44 footprint areas that do not have any existing coherence with existing health service organisational boundaries. In the north-east, the Northumberland and Tyne and Wear footprint covers five clinical commissioning groups, six local authorities and seven foundation trusts.

Newcastle, the city I have the honour and privilege to represent, enjoys well run and efficient health services, which is testament to staff working at all levels in the NHS there. Our health services are well regarded in the local area, but the sustainability and transformation plans raise at least three serious questions. If NHS England and NHS Improvement think that more than half of clinical commissioning groups are underperforming, why are they asking CCGs to draw up the key documents that will transform the structure of the NHS? Given that many CCGs will have to merge, where is the motivation for them to create clear, competent and credible plans? Given that the footprints will have no formal structure, who is accountable for the long-term consequences of the plans?

The approach that is being adopted bears a striking resemblance to the previous top-down, unwanted revision of the NHS that we were promised would not happen when the Government came to power in 2010. They are doing something that one would have thought difficult—they are breaking their promises twice.

This is not the first threat that the north-east has faced. We have faced the redistribution of moneys and the downgrading in the distribution formula of the social deprivation component, with far more emphasis being placed on the age-related part of the formula, which affects the well elderly rather than people who are ill.

In government, Labour promised to increase health spending to match the then European average of 8.5% of GDP. We kept that promise, but successive Governments since—the coalition Government and the Tory Government—have failed to commit funds to the NHS. That is why health spending as a proportion of GDP will fall to 6.6% by 2020-21, which will leave us lagging behind the OECD average spend of 9.1% and comparable countries such as Germany, which spends 11%.

The Government should be honest with people about the challenges the national health service faces and the response needed to meet them. The sustainability and transformation plans are a fundamentally bureaucratic response to the funding crisis in the NHS. As such, the Government completely misunderstand the fact that the NHS needs not more meetings but more money.

North East Ambulance Service

Nicholas Brown Excerpts

Wednesday 4th May 2016 Westminster Hall

[Mr Nicholas Brown (Newcastle upon Tyne East) (Lab)]

I wish to make a brief contribution to the debate. It is a pleasure to serve under your chairmanship, Mr Bailey. I congratulate my hon. Friend the Member for Washington and Sunderland West (Mrs Hodgson) on securing a debate on a matter that is of importance throughout the north-east of England. This is an important service, run by good people under extraordinary pressure. To give an example, on Monday 7 December last year, there were 1,837 emergency calls to the service. That is equivalent to new year’s eve and was a 46% increase on the year before. That was accompanied by 1,664 calls taken by the 111 service.

The service is fast becoming a gateway to healthcare as others become more difficult to access and some, such as walk-in centres, are no longer there at all. Repeated requests to the public to call the service only in life-threatening situations can do only so much. I accept that a certain amount of problems are caused by hoax calls and other misuse of the service. People who do such things are completely irresponsible and stand to be condemned, but that is not at the heart of the problems faced by the service in our region.

I would like to touch briefly on a number of issues. The first is commissioning, which is not one of the strongest features of the Government’s national health service reorganisation. How focused are the commissioners on the service they are supposed to be in charge of? Are they working alongside the chief executive in a supportive and encouraging way? When has their role ever been reviewed or carefully considered by those in charge? There is a case for looking at that and at staff morale, as my hon. Friend rightly said, and asking ourselves why it is as it is. Surveys of the service show that 90% of staff are stressed. That is consistent with the picture that came from her address—and no doubt will come from colleagues—of a service that is trying to do its best under enormous pressure.

Like my hon. Friend, I welcome the establishment of the diploma of higher education in paramedic practice, which will start in September at the University of Sunderland. That two-year course has been created to try to meet the shortage of paramedics in the region as well as the national shortage. Evidence suggests that the grading of posts may be too low, and I would be interested to hear the Minister’s views on that. It seems odd that, in a region such as the north-east, where unemployment levels are still higher than the national average, there should be a persistent vacancy rate of between 10% and 15% in the service.

[Anna Turley (Redcar) (Lab/Co-op)]

One of the issues raised with me on recruitment challenges is that it costs £1,200 to get a driving entitlement for C1 vehicles. For many people, that cost is extremely prohibitive and constituents have said to me that that has put them off applying for those kinds of jobs.

[Mr Brown]

My hon. Friend is on to a good point. There is something odd if, in a region of higher than average unemployment, it is difficult to fill those vacancies not just in a single moment in time but persistently. We should look at all barriers to entry into the service. I accept what she said, but I harbour the thought that gradings may have been set too low and that there is a case for upgrading the job.

I have two other points to mention briefly. Legal highs are again putting more pressure on the service as young people in particular misuse them. I suggest that it is not a good idea to take them at all, but taking them results in the ambulance service being called out. There were something like 20 incidents, including a cardiac arrest, in a single day—8 February—and so far this year there have been about 300 call-outs because of the use of legal highs. I harbour the view that they should not be legal, but perhaps that is a different debate.

Finally, I want to mention the pressures that will be put on the service if the supported accommodation proposals that the Government are considering come to pass. If vulnerable people who are housed in projects and given support to lead their day-to-day lives are denied that support and left to their own devices, the consequence for the police, accident and emergency services at hospitals and ambulance services will be much greater, rather than lesser, pressure. That is not the right direction of travel for our society.

--- Later in debate ---

[Jane Ellison]

I intend to follow up on this debate with my colleague in the Department of Health, Lord Prior of Brampton, who leads on the topic, and I will follow up with the service itself. I will make sure that all points raised by hon. Members are drawn to its attention.

The root causes of the increase in demand often lie outside the hands of the ambulance service. NHS England’s review of urgent and emergency care is taking a system-wide approach to redesigning the way that care is delivered. It is important to look at the provision of ambulance services in that context. We need to ensure that people with life-threatening emergency needs are treated in centres of excellence to reduce risk and maximise their chance of survival and recovery. The first part of that is about relieving the pressure on emergency services.

The response time targets are being considered as part of NHS England’s review to ensure that they incentivise the most clinically appropriate response. My hon. Friend the Member for Berwick-upon-Tweed and the hon. Member for North Durham (Mr Jones) talked about having the clinically appropriate response in all contexts. I will ensure that we pick up on those points and draw attention to them. We hope to have advice from NHS England later in the summer on potential changes to ambulance standards in the context of that wider review of urgent and emergency care.

[Mr Nicholas Brown]

Will the Minister give way?

[Jane Ellison]

No, because I have an important point to make at the conclusion. If the right hon. Gentleman will forgive me, there might be another opportunity.

Ambulance services are vital to emergency care and the whole NHS. We all want to be sure that when loved ones suffer heart attacks or are involved in a serious accident, they will not be left waiting, although we have heard about some distressing cases. National targets in response to red, life-threatening calls exist to ensure that that happens, and we all have an interest in ensuring that the ambulance services perform well against them. I will follow up on the points made in the debate.

I draw hon. Members’ attention to the fact that a comprehensive Care Quality Commission inspection was carried out at the NEAS during the week commencing 18 April 2016. CQC’s formal report will be important for all hon. Members and Ministers to read. In the light of the strong feelings expressed in the debate, I think it would be appropriate for hon. Members whose constituencies are served by the NEAS to meet my colleague, the noble Lord Prior of Brampton, who leads on this portfolio, when the report is available to discuss. I hope that that will be helpful for hon. Members. In the context of that report, many of the points made this afternoon can be discussed with Lord Prior. I encourage all hon. Members to engage with the local NHS and to continue to work together to address the challenges in this critical element of our healthcare system.

If the right hon. Member for Newcastle upon Tyne East (Mr Brown) can make his intervention in less than a minute, he may do so now.

[Mr Nicholas Brown]

How does the Minister account for the rise in demand for the service?

[Jane Ellison]

I definitely do not think that that question can be answered in less than a minute. Much of the answer lies in the work that Sir Bruce Keogh is doing as part of the NHS’s wider urgent and emergency care review. It is vital that we get people the right care in the right place at the right time. It is a complex picture, of which ambulance services are just one piece. More will be said when we know more about that review later this year.

Question put and agreed to.

Resolved,

That this House has considered the performance of the North East Ambulance Service.

Oral Answers to Questions

Nicholas Brown Excerpts

Tuesday 7th July 2015 Commons Chamber

[Mr Hunt]

We will look at all the evidence. The evidence we have seen from other countries is very encouraging. Apart from ensuring that NHS patients and the public understand the cost of NHS care, one of the main reasons why we want to do that is to improve adherence to drug regimes by making people understand just how expensive the drugs are that they have been prescribed. We will of course look at all the international evidence.

[Mr Nicholas Brown (Newcastle upon Tyne East) (Lab)]

16. NHS England consulted in the last Parliament not just once but twice on downgrading the economic deprivation part of the funding formula, which would have had the effect of taking some £230 million per year out of the primary care budget for the north-east and Cumbria. Will the Secretary of State give the House a commitment—we got one from the Minister in the last Parliament—that he will not downgrade the economic deprivation part of the funding formula?

[Mr Hunt]

I give an absolute commitment that economic deprivation will be a very important part of the funding formula, but the right hon. Gentleman will appreciate that things such as the number of older people in a particular area is as important in determining levels of funding. We are committed to reducing health inequalities, but that also means making sure that similar levels of care are available in similar parts of the country. That has not always been the case.