National Health Service Funding

Andrew Selous Excerpts

Tuesday 22nd November 2016 Commons Chamber

[Andrew Selous (South West Bedfordshire) (Con)]

I want to make five constructive proposals to help NHS funding. The first relates to prevention, which we have not heard nearly enough about in the debate so far. It is wholly unacceptable that a third of our children are obese by the age of 11. We have learned today that many children typically consume the equivalent of a bathful of sugary drinks every year. We also know that England and Wales are ranked at D minus in the global fitness matrix, and that Scotland is ranked at F.

If we could get these things right early on in our children’s lifetimes, we would be in a much stronger position. One way of doing that would be to extend the excellent work of St Ninian’s primary school in Stirling, which has pioneered the use of the daily mile. All the children run—if they cannot manage that, they walk—a mile at some point each day. This has had dramatic results: not one of the school’s 57 children is overweight, and there has been a significant reduction in coughs and colds. The exercise has helped to develop the children’s social, emotional and mental wellbeing as well as their physical wellbeing. The idea has been taken up across the Netherlands and Belgium, and I would like to see a lot more of it across our own country.

Secondly, we need to do a huge amount of work on health literacy in relation to self-care. I commend to Members the report from the all-party parliamentary group on primary care and public health, which came out in March this year. It showed that there were 3.7 million visits to A&E and 52 million visits to GPs for self-treatable conditions in 2014. It is estimated that if we could deal with that by persuading people to go to the appropriate place, we could save the NHS more than £2 billion a year.

My third point relates to gatekeeping in our hospitals. I commend the initiative taken in Fife in Scotland, where having senior consultant input in A&E has led to a reduction of 30% in acute surgical admissions. My own local hospital, the Luton and Dunstable, has introduced a similar methodology for patients with acute conditions, and that is also bearing fruit.

My fourth point relates to quality, which we have not heard nearly enough about today. I urge Members to look more fully at the work of the Getting it Right First Time initiative, which the Government have now spread across 18 medical specialties. It started in orthopaedics, and the Government estimate that it will save £1.5 billion a year. This is about not only a financial saving, but better outcomes for patients, who may have undergone the wrong operation or received poor-quality care and had to have significant revisions. That project is getting data from across the country. For example, the rate of return for another procedure within 90 days following oral and maxillofacial cancer surgery varies from 8.33% in some hospitals to over 80% in others. That degree of variation is simply unacceptable. If we can get a higher level of quality, that can lead to much better outcomes for patients and the NHS saving money, too.

Finally, enhanced recovery programmes, such as the advanced transfer team in South Warwickshire, have led to significant increases in productivity with better outcomes for patients. We need to see much more of that across the country.

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[Justin Madders (Ellesmere Port and Neston) (Lab)]

This has been at times a high-quality and passionate debate that has made clear the concerns across the House about the sustainability of our health service. The Chancellor sadly could not be with us this afternoon—I assume he has a few other things on right now—but had he been here to hear the contributions from Members on both sides of the House, he would be in no doubt about the severity of the challenges facing the health and social care sector, or about the dire consequences that will follow if he does not deliver the rescue package that is needed tomorrow.

We have heard some excellent contributions. As right hon. and hon. Members have said, while we might have our political differences, we all appreciate the work that our staff in the NHS do—as we do the work of all public sector workers—and we thank them for it. The hon. Member for Totnes (Dr Wollaston), the Chair of the Health Committee, calmly and clearly explained how cuts to the health budget were used to help the Secretary of State reach his figure of £10 billion. Despite the huge volley of figures he mentioned in his speech, he failed to mention that amount at all. The hon. Lady pointed out how many of the cuts will store up other problems in the long term, and she is right that the moving of the goal posts that has taken place does nobody any credit.

My hon. Friend the Member for Mitcham and Morden (Siobhain McDonagh), who described the savings required in her area as implausible, is clearly going to fight the closure of St Helier hospital. She rightly pointed out that that closure will undermine other services and hospitals in her area, and I have no doubt that her constituents will be relieved to have such a doughty champion on their side. The hon. Member for Strangford (Jim Shannon) spoke with great sincerity and passion about the variations in cancer treatment and alarming statistics setting out anticipated increases in incidences of cancer. He also rightly highlighted the expenditure on emergency cancer treatments, showing that much more needs to be done on earlier detection.

My hon. Friend the Member for Darlington (Jenny Chapman) said that there seemed to be a focus in her area on consolidating services where there was no problem with clinical outcomes, and she made it clear that her constituents would not be fooled into accepting a downgrade in their local hospital. Her local health chiefs have won the award for the worst use of management speak today by calling patients “passive recipients of care”. My hon. Friend the Member for Tooting (Dr Allin-Khan) brought her recent experiences of the health service to the Chamber and said of the NHS that everywhere we look the answer is a lack of funding. She told us that staff and patient morale were now at all-time lows, and she should know what she is talking about.

We also heard from the hon. Members for South West Bedfordshire (Andrew Selous), for South West Wiltshire (Dr Murrison), for Calder Valley (Craig Whittaker), for Henley (John Howell) and for Bosworth (David Tredinnick), although none of them referred to the deficits their own STPs were facing—perhaps they do not think there is a problem. I can tell the House, however, that in South West Bedfordshire, the deficit is £311 million; in South West Wiltshire it is £490 million; in Calder Valley it is a staggering £1.07 billion; in Henley it is £479 million; and in Bosworth it is £700 million.

[Andrew Selous]

I am well aware of the financial challenges in my own area, but I noted in my STP the 26% increase in funding up to 2020-21, which I think is quite commendable.