Managing Risk in the NHS

Andrew Gwynne Excerpts

Wednesday 17th July 2013 Commons Chamber

[Derek Twigg]

My right hon. Friend makes an important point. That is one of the things that we explored during the Committee stage of the Health and Social Care Bill and of course we got no answers. The then Minister, now Minister of State, Department for Transport, the right hon. Member for Chelmsford (Mr Burns), said that as time goes on the NHS will be more open to the competition laws of both the EU and the UK. That is the real story here, and we will not have that transparency. That is a major part of the problem we are having to deal with.

No matter what statistics we are talking about, losing a friend or loved one is a massive human tragedy that affects everybody. We want to do all we can to reduce the number of early and preventable deaths—that is absolutely right—and put patients’ interests and those of families first. Given what we have heard in the last day or so, one would think that we somehow left an NHS in crisis—an NHS that was not delivering—yet when we left office it had the highest satisfaction rate in history. We had the lowest waiting lists in history and massive reductions in early deaths from cancer, coronary problems and so on. We also saw massive increases in doctors and nurses. We hear this Government talking about increasing the number of doctors, but when did those doctors start their training? They started under Labour.

To give an example, so that we can be a bit fairer about the situation, the Commonwealth Fund produced an international health policy survey in 2010 that looked at 11 countries—and guess what? The UK health service came out best. Just as an example, when those on above average incomes and those on below average incomes were asked whether they were confident that they would receive the most effective treatment if sick, the best results—95% and 92%—were in the UK. That was an international survey. Another question was whether people were confident that they would receive the most effective treatment if sick—and guess what again? The UK came out on top, at 92%. That is the real picture of the NHS that we left behind in 2010—although it was not without its problems and challenges, because pressures were always building up.

I also noticed that pages 4 to 5 of the Keogh report say—this is an important comment that has not been looked at much in the press—the following:

“Between 2000 and 2008, the NHS was rightly focused on rebuilding capacity and improving access after decades of neglect. The key issue was not whether people were dying in our hospitals avoidably, but that they were dying whilst waiting for treatment.”

That is where Labour made one of the biggest differences. I remember regularly having people write to me back in the late 1990s and the early 2000s about having to wait over two years for an operation. People were literally dying because of that. Addressing that was one of the biggest gains that Labour made.

The Secretary of State has now left the Chamber, but earlier I raised with him the issue of mortality. He refused to correct the record. He said that there had been a “slight” improvement by 2010, yet Professor Keogh talks about a 30% improvement in mortality in all hospitals, including those that have been under investigation. That is not to say that those hospitals should not be doing better, but he was talking about all hospitals.

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

Professor Keogh’s report also shows that although mortality has dropped by 30% in all hospitals, it has dropped by between 30% and 50% in the 14 hospitals subject to the Keogh review. Although those hospitals are still outliers, the drop has been greater at those 14 hospitals.

[Derek Twigg]

My hon. Friend makes a strong and important point. I referred earlier to figures from the Library, but those figures are from the NHS. Just to repeat, the rate of deaths per 100,000 within 30 days of a non-elective hospital procedure in England was 4,850 in 2001-02 and 3,684 in 2010-11. That is a significant drop, so I hope the Secretary of State will correct the record, change his view that there was a “slight” improvement and confirm that it was a significant improvement, because that is what the evidence from his own Department says. Why is that important? It is important for a number of reasons. It is important to see improvements, but we should also bear in mind that the fall from 2001 took place against a massive increase—4 million additional admissions—in the number of people admitted to hospital. It is also important because people want to see continual improvements and be assured that their relatives and friends are receiving the best possible treatment.

In the short time I have available, I want to talk about a couple of local issues. Staffing plays a fundamental part in regard to risk. Many hospitals are having real difficulty with staffing at the moment, and many more will do so. I will say more about that in the context of my own hospital in a second. We need to address the problem, and the mix of staff is also a factor.

The Warrington and Halton Hospitals NHS Foundation Trust serves my constituency. We have been told by the chief executive and the chair of the board of governors that our hospital will run out of money in about 18 months’ time. It has already had to make savings in staff numbers of about 200, and implement a £7 million cut. The hospital will be unsustainable in that situation. What are the Government going to do about that? It is a foundation trust, and as far as I am aware, there are no significant performance issues. I get complaints about the different hospitals, but it is no worse than any of the others. It will run out of money, however.

My hon. Friend the Member for St Helens North (Mr Watts) has mentioned the St Helens and Knowsley NHS Trust. The Whiston hospital was rebuilt under Labour’s plan to rebuild hospitals. We replaced Victorian hospitals—and workhouses, as in the case of the Whiston—with more than 100 new hospitals. The deal on the Whiston hospital under Labour involved a private finance initiative, with the difference being paid for by the two primary care trusts. This Government have got rid of the PCTs, but they have still not put in place a way of funding the hospital on a long-term basis. The uncertainty continues, despite debates on the matter in this place and meetings with Ministers, and we still do not know what is going to happen. It is an excellent hospital with brand-new facilities, but it is facing a real challenge. We need the Government to make decisions about hospital funding, to ensure that it and others can continue; otherwise, many more hospitals will get into difficulty.