National Health Service

Andrew Gwynne Excerpts

Monday 16th July 2012 Commons Chamber

[Andrew Gwynne (Denton and Reddish) (Lab)]

We have had a good debate, albeit one slightly curtailed by statements. We have heard 10 speeches from Back-Bench Members and I would especially like to commend my right hon. Friends the Members for Greenwich and Woolwich (Mr Raynsford) and for Holborn and St Pancras (Frank Dobson) and my hon. Friends the Members for Easington (Grahame M. Morris), for Ealing, Southall (Mr Sharma), for Brent North (Barry Gardiner) and for Stockton North (Alex Cunningham) for their contributions. I also rightly want to pay tribute to the many thousands who work in our national health service, doing a tremendous job in often challenging and difficult circumstances.

As we have heard in the debate today, there are growing problems in the national health service. We know that two thirds of NHS acute trusts—65%—are reported to have fallen behind on their efficiency targets. As we have heard from right hon. and hon. Members, we are starting to see temporary ward and accident and emergency closures, while a quarter of walk-in centres are closing across England. Despite the “Through the Looking Glass” world of Ministers—one where the Secretary of State for Health closes a debate—we now have growing rationing across the national health service, with treatments—including cataracts, hip and knee replacements—being restricted or stopped altogether by one primary care trust or another.

[John Pugh (Southport) (LD)]

Does the hon. Gentleman not acknowledge that the real weakness of this debate, as specified by the Select Committee Chairman, is that the Labour party has at no point spelled out how it would meet the £20 billion Nicholson challenge? Will he tell us?

[Andrew Gwynne]

We set out the Nicholson challenge, but I notice that the hon. Gentleman does not defend the decisions being taken by his Government to restrict or stop these treatments.

It is becoming increasingly clear that there is a gap between Ministers’ statements on the NHS and people’s real experience of it on the ground. In opening, the Minister of State, Department of Health, the right hon. Member for Chelmsford (Mr Burns) incorrectly said that GP referrals have gone down. Figures published by the Department of Health on 13 July 2012 show that GP referrals are up by 1.9% year on year. Those are statistics from the Minister’s own Department’s. He is out of touch. Furthermore, the Minister said that NHS Hull is not restricting procedures on ganglia, but a freedom of information request we received says:

“NHS Hull will not routinely commission excision of ganglia”.

That was in April 2012, and it is a fact, again showing that Ministers are out of touch. The Secretary of State claimed that there is no such evidence of treatments being restricted or decommissioned.

[Dr Daniel Poulter (Central Suffolk and North Ipswich) (Con)]

Will the hon. Gentleman give way?

[Andrew Gwynne]

I will not, as I do not have time now.

In the Secretary of State’s annual report to Parliament, he dismissed restrictions on bariatric surgery as “meaningless” and continued to say:

“Time and again, he says”—

that is my right hon. Friend the Member for Leigh (Andy Burnham)—

‘“Oh, they are rationing.’ They are not”.—[Official Report, 4 July 2012; Vol. 547, c. 923.]

But Opposition Members all know the truth. Aside from the evidence presented by the Labour party and the GP magazine, verified by Full Fact, primary care trusts acknowledge that they are restricting access to bariatric surgery. The National Institute for Health and Clinical Excellence recommends surgery for anyone with a body mass index of 40 or a BMI of 35 and co-morbidity. Many PCTs, including NHS Stockport in my own constituency of Denton and Reddish, impose additional restrictions.

Recent freedom of information requests of PCTs and shadow clinical commissioning groups across England have revealed that 149 separate treatments, previously provided for free by the NHS, have been either restricted or stopped altogether in the last two years, with 41 of those being entirely stopped in some parts of the country. This provides the clearest evidence yet of random rationing across the NHS and of an accelerating postcode lottery, which appears to be part of a co-ordinated drive to shrink the level of NHS free provision. From our study, it is clear that many patients are facing difficulties in accessing routine treatments that were previously readily available, and there is evidence that some patients are being forced to consider private services in areas where the NHS has entirely stopped providing the treatment.

Of course, there has been a real reduction in the number of nurses working in the NHS. The Government have claimed that there are only 450 fewer nurses, and at Health questions last month, the Minister, the right hon. Member for Chelmsford said that the figure was “nowhere near 4,000”. But now we all know the truth: figures for the NHS work force in March 2012 showed clearly that there are 3,904 fewer nurses than in May 2010. We have seen broken promise after broken promise, including on reconfigurations.

It was this Government who, when in opposition, spent millions of pounds during the general election putting up posters throughout the country reassuring the electorate that under the Conservatives there would be a moratorium on hospital and A and E closures. Indeed, in opposition, they pledged to overturn some very difficult reconfiguration decisions taken by the previous Labour Government. Yet, as we have seen, the moratorium has not materialised, and there is now evidence of major changes to hospital services across the country.

It is worth remembering that the Prime Minister gave a firm pledge not to close services at Chase Farm hospital, but in September 2011, this Secretary of State accepted the recommendations and approved the downgrading and closure of services at Chase Farm. And there are several others, such as the Hartlepool, the King George hospital in Ilford, the East London, the Trafford General, the North London, the St Cross in Rugby and, as we have heard today, the West London, too, that have either closed or are set to close. What is becoming clear is that when it comes to reconfiguration, Ministers are hiding behind their new localism and are happy to blame the soon-to-be-abolished structures for the forthcoming closures.

In the brief time remaining, I want to deal with Government spending on the health service. As we have learned, actual Government spending on the NHS in 2011-12 fell by £26 million.

[Mr Graham Stuart]

Will the hon. Gentleman give way?

[Andrew Gwynne]

No, I will not.

This was the second successive real-terms reduction in NHS spending, following a reduction of £766 million in the Government’s first year in office. This is in clear breach of the commitment given by the Conservatives and Liberal Democrats in their coalition agreement.

Of course, a long line of professionals have come, one after the other, to express their concern about the damage that will be done to the health service if hospital is pitted against hospital, and doctor against doctor. That is where we start. The Health and Social Care Act 2012 now allows hospitals completely to change character over time. The Government have essentially set everybody on their own. Hospitals are being told, “You’re on your own. There’s no support from the centre any more; no more bail-outs.”

We know that there are problems with the NHS meeting efficiency targets. Indeed, a survey of NHS chief executives and chairmen found that one in four believe that the current financial pressures are the

“worst they have ever experienced”,

with a further 46% saying they were “very serious”. More than half of foundation trusts missed their savings plan targets, according to Monitor’s review of the last financial year.

Ministers have said that every penny saved will be a penny reinvested to the benefit of patient care, but in reality £1.4 billion of the £1.7 billion not spent by the Department of Health has been returned to the Treasury—more broken promises. It is therefore clear for all to see that there is an increasing gap between what the Government are saying and what is going on in the NHS, and the experience of ordinary patients on the ground.

The Government have increasingly broken their promises on the NHS. They promised no top-down reorganisation and a moratorium on hospital closures and they promised to maintain spending levels in the NHS. They have broken all those promises—they are the three biggest broken promises in the history of the NHS. There is clearly a yawning gap between what the Prime Minister and others say and the reality of patients’ experience.

During the general election, the Prime Minister said:

“I’ll cut the deficit, not the NHS.”

It is now clear that the Government are cutting our NHS. The NHS is important for the people of our country, and they deserve better. I commend the motion to the House.