National Health Service Funding

Andrew Murrison Excerpts

Tuesday 22nd November 2016 Commons Chamber

[Dr Andrew Murrison (South West Wiltshire) (Con)]

I start by commending all the hard-working people in our national health service—doctors and nurses—for the increased activity in our NHS over the past several years. The NHS has never worked harder. We have never seen so many patients treated in our NHS and standards are certainly improving. However, we must face up to the fact that indices of mortality and morbidity that are amenable to healthcare are poor against reasonable international comparators. I am not satisfied by comparing the UK with the OECD average; I want to compare the UK with countries with which my constituents would wish it to be compared, such as France, Germany, Holland, Belgium and Denmark. I am afraid that our performance is behind the curve on such comparisons, and that is the challenge that we face.

Like my hon. Friend the Member for Totnes (Dr Wollaston), I am increasingly cautious about the £10 billion figure, so I urge my Front-Bench colleagues to provide clarity on it. We need to be clear about what it actually relates to. I commend the Government for spending this amount on our NHS, despite the opposition from Labour Members. If we are to have a collaborative and collegiate debate, we need some humility from them on this point, as Labour undoubtedly opposed such an amount at the last general election. However, we need to understand what the £10 billion is and what it is not. According to the Nuffield Trust, the King’s Fund and the Health Foundation, we are more likely to be talking about £4.5 billion. The reason for that, which was elegantly laid out by my hon. Friend, relates to which year we use to baseline, which year we use to base our prices on, and whether we include or exclude the money that has been removed from the public health function of local government and from Health Education England. I would contend, as I believe she would, that those moneys need to be included in the sum total for healthcare in this country, and I think that that is what our constituents would understand as the totality of healthcare. That alternative figure therefore seems to be more reasonable.

I am also worried about the £22 billion in savings on which Simon Stevens based his five year forward view. The National Audit Office report published today suggests strongly that this process is not likely to result in anything like £22 billion and that those savings are “untested”—that is polite speak for unachievable. We know that the deficit is being dealt with through a transfer from capital to revenue, and from the sustainability element of the sustainability and transformation fund. That is not sustainable in the long term. We want more transformation; we do not want to have to rely increasingly on the sustainability bit.

Tomorrow, we must look for a big cash injection to sort this out, but I submit that we then need a long-term commission—perhaps not a royal commission, as royal commissions take for ever and cost the earth—that will involve a debate about how we pay for our health service in the long term, given the pressures that we face. That might involve a hypothecated tax. The end to the triple lock could save £2.1 billion by 2020-21, and that money could then be hypothecated to the NHS in the interests of generational fairness, given that the elderly consume the largest portion of healthcare spend. We also need to look at fiscal incentives relating to employees’ private medical insurance. But we need to do all this within a Beveridge envelope that delivers an NHS that is free at the point of need.

--- Later in debate ---

[Justin Madders]

I am delighted that the hon. Gentleman has actually seen his STP; many Members have still not got hold of theirs.

[Dr Murrison]

How much worse does the hon. Gentleman think that the deficit in South West Wiltshire would have been had Labour won in 2015 and uprated NHS spending by just £2.5 billion, rather than the figure we are currently enjoying?

[Justin Madders]

Our manifesto was very clear that we would put in £2.5 billion immediately, plus whatever was needed. Indeed, research by the House of Commons Library has shown that if health spending had continued at the levels maintained by the previous Labour Government, there would be an extra £5 billion a year by 2020.

The NHS has deteriorated on every headline performance measure since the Health Secretary took office. It now faces the biggest financial crisis in its history, with providers reporting a net deficit of almost £2.5 billion last year. That deficit was covered only by a series of one-off payments and accounting tricks that do not disguise the true picture of a service that is creaking at the seams, of a workforce stretched to the limit, and of a Health Secretary in denial about his own culpability for this shocking state of affairs. While he rightly paid tribute to the work of NHS staff, he must know that when morale is so low, his platitudes are just not enough.