NHS Success Regime

Andy Burnham Excerpts

Thursday 4th June 2015 Commons Chamber

[Andy Burnham (Leigh) (Lab)]

(Urgent Question): To ask the Secretary of State for Health if he will make a statement on the success regime.

[Hon. Members]

Where is he?

[The Parliamentary Under-Secretary of State for Health (Ben Gummer)]

I welcome the success regime, details of which were published by Monitor yesterday. The purpose of the success regime is to improve health and care services for patients in local health and care systems that are struggling with financial or quality problems. It will build on the improvements made through the special measures regime, recognising that some of the underlying reasons may result from intrinsic structural problems in the local health economy. This will therefore make sure issues are addressed in the region, not just in one organisation.

The regime is designed to make improvements in some of the most challenged health and care economies. The first sites to enter the regime—North Cumbria, Essex and North East and West Devon—are facing some of the most significant challenges in England. They have been selected based on data such as quality metrics, financial performance and other qualitative information.

Unlike under previous interventions, this success regime will look at the whole health and care economy: providers, such as hospital trusts, service commissioners, clinical commissioning groups and local authorities will be central to the discussions. It will be supported by three national NHS bodies, whereas existing interventions tend to be delivered by individual organisations and to concentrate on one part of a health economy—for example, the commissioning assurance framework led by NHS England that concentrates solely on commissioners, or special measures led by NHS England, the Trust Development Authority or Monitor, which focuses on providers.

Together, Monitor, TDA and NHS England, with local commissioners, patients, their representatives such as Healthwatch England and health and wellbeing boards will aim to address systemic issues. The national bodies will provide support all the way through to implementation, with a focus on supporting and developing local leadership through the process.

[Andy Burnham]

As we have just heard, this announcement has far-reaching implications for people in Essex, Cumbria and Devon. It was being finalised on Tuesday, when the House was engaged in a full day’s debate on the national health service, yet there was not one single mention of it during the debate. What are we to make of that, and why was the Secretary of State not here to make this announcement to the House? Why does he think that it is always more important to make announcements in television studios or to outside conferences than to Members of Parliament in the House of Commons? That is not acceptable. People in Cumbria, Essex and Devon will be worried about what the Minister has just said, and what it means for health services in their areas.

First things first. Can the Minister confirm that services in those areas are safe and sustainable? Are there enough staff, and will work be undertaken immediately to deal with staff shortages? Are plans being drawn up to close A and E departments, or other services, as part of this process? Could it mean mergers between organisations, and job losses?

We welcome action that means taking a broader view of challenged health economies—indeed, my hon. Friend the Member for Copeland (Mr Reed) has long called for such action—but what will the new regime mean for local NHS bodies? Will it be possible for NHS England to overrule them? The House will recall the last occasion on which the Secretary of State tried to take sweeping powers to close health services over the heads of local people in south London. It did not end well; indeed, it ended with his being defeated in the High Court. Can the Minister assure us that patients will be consulted before any changes go ahead?

Is not the fact that NHS is taking drastic powers over whole swathes of the NHS in three counties a sign of the failure of the Government’s plans for local commissioning, and evidence of five years of failure of Tory health policies? Is it not evidence that care failures are more likely, not less likely, on the Tories’ watch?

This is no way to run a health service, and no way to treat Parliament. The Minister, along with the Secretary of State, is trying to shift the blame for things that have gone wrong in the NHS on their watch—for problems that are of their making. We will not let the Secretary of State do that. He should have been here to do Members who are affected by this announcement the courtesy of giving them answers, and I ask his junior Minister to relay that to him directly after the debate.

[Ben Gummer]

The shadow Secretary of State has spoken at length—in his answer to his urgent question—about NHS bodies. He has spoken about local commissioners, about NHS England and about the Department of Health, but Members will have noted that there was one group of people about whom he did not speak, and that was patients. It is extraordinary that, once again, he has come here to speak, again and again, about structures—about the NHS and its bodies, about jobs, about providers and about deliverers—but not about the people who are being failed at local level, namely patients in Essex, west and north-east Devon and north Cumbria.

Let me deal with the right hon. Gentleman’s points in detail. First, he made accusations about television studios. I think it is a bit of a cheek to make such claims—and I should tell the House that the Secretary of State will very shortly be addressing the NHS Confederation.

[Andy Burnham]

So that is more important than this?

[Ben Gummer]

The urgent question was submitted this morning.

Coming from a shadow Secretary of State who is, one might suspect, using urgent questions and the subject of the NHS not to address issues relating to the quality of care, but for his own political reasons—as he always has—this was a shameless attack. It reflected rather badly on the right hon. Gentleman himself, rather than reflecting on the cause that he should seek to pursue: the better care of patients, which lies at the heart of what NHS England is attempting to do. If he had read what Simon Stevens said when he announced the plans yesterday to the NHS Confederation, he would have noted that they are being drawn up, co-ordinated and, in part, led by local commissioners rather than—as was the case before—by monolithic centralised bodies headed by bureaucrats. This process is being led, locally, by clinicians, who are being supported and helped by NHS England and professional regulators.

The right hon. Gentleman asked about staff shortages. I am surprised that he mentions that, given that he was in part the author of the staff shortages that hobbled the NHS at the end of the previous Administration and that led in part to the problems at Mid Staffordshire that we have been seeking to address. Only this Government, in their previous incarnation, promised to correct that situation, in part through our pledges on GP numbers over the next five years.

The right hon. Gentleman asked about plans for accident and emergency departments and about job losses. I would say to him that it is different this time. These plans are being drawn up by local commissioners, who are now beginning the process of working out how to improve their local health economy. This is not a plan that will be devised centrally in Whitehall, imposed on local areas and announced as a done deal for local people. I know that that is what the right hon. Gentleman is used to, but in this instance it is a genuine conversation between local patients and local commissioners with the aim of improving their local health economies, and it will be supported by national bodies.

The right hon. Gentleman asked about south London and about consultation. I was a candidate in a constituency that had a solution imposed on it, during his tenure as Minister for Health, without any decent consultation. That proposal was eventually thrown out. The previous Government never consulted local people properly when he was in control, but we have changed that. These local plans will involve local people, patient bodies and health and wellbeing boards from the outset.

The shadow Secretary of State asked about the powers of NHS England, about localisation and about the co-ordination of local services. I ask him once again to go back and read Simon Stevens’s speech. He will see how things have changed. This is not about decisions being made by politicians in Whitehall. I dare say that the right hon. Gentleman does not know the solution to the problems in the local health economies in Devon, Essex and Cumbria—