NHS

Anne Main Excerpts

Wednesday 5th February 2014 Commons Chamber

[Mr Hunt]

I commend what is happening; it is very important that locally driven solutions are providing good alternatives to going to A and E. One of the most important things we can do for my hon. Friend’s constituents is make sure we have proper continuity of care so that for our most vulnerable patients there is a doctor who knows what is up with them at any time, whether they are in or out of hospital, and who can give them joined-up care and make sure they have a proper care plan wrapped around them. That is the kind of care we need to see.

[Mrs Anne Main (St Albans) (Con)]

My right hon. Friend is making a very pertinent point about transparency, because again what the Opposition refuse to acknowledge is how many patients were left off the books. It has been discovered in my hospital trust that a significant number of patients who were not discharged because there was not a link-up with social care were left off the books and so did not show in the statistics.

[Mr Hunt]

I think my hon. Friend is talking about the issues in West Hertfordshire trust, which I am extremely concerned about. The whole House will want to get behind the efforts of the outstanding chief executive there, who is sorting out those problems.

It is of course challenging when we read about these things in the media, but we have to remember that it is essential that poor care or cover-ups such as the ones that may have happened in that case are brought to the surface very quickly. That is the big change we want to make.

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[Paul Burstow]

I entirely agree that if there is any doubt about the figures, it needs to be resolved, but there seems to be a disconnect between what people think is happening and what the figures show. I have been to events at which clinicians have said that the problem is the local social services, but when they are shown the figures they are surprised. Perhaps that is why we need, as the hon. Lady says, to ensure that there is an agreed way in which such things are reported, which is what, I think, was put in place by the previous Labour Government. These figures have been collected for a long time, and they have consistently shown that social care is not the principal driver of delayed discharges.

[Mrs Main]

I am sorry to have missed the beginning of my right hon. Friend’s speech, but as he knows there is a big lobby going on. That was the point I was trying to make to the Secretary of State, although obviously I did not make it very well. Under the previous Government, West Hertfordshire Hospitals NHS Trust had a significant number of delayed discharges—although that is coming right down now—and the figures were not on the books, so to speak, thanks to a very creative form of accounting. It is nuanced and there have been problems on all sides. To try to paint it as one-sided is totally wrong and it certainly is not a new phenomenon; it has been going on for a considerable time.

[Paul Burstow]

That is absolutely right. For example, in continuing health care there is often a great deal of contestability that leads to discharge delays, but they are NHS-caused delays. I am not saying that the NHS should be blamed any more than social services, but I want some honesty about how the figures are presented as they do not bear close scrutiny in the argument made by the right hon. Member for Leigh. His solution is simplistic, too. It is good to have a debate about competition policy—I remember Labour Ministers trumpeting the introduction of the first competition policies in the NHS and the establishment of the competition and collaboration committee in the Department of Health. Labour established those policies.

Monitor’s role is to protect the interests of patients—that is what it says in the Health and Social Care Act 2012—not to promote competition. The idea that we can solve the problem by sweeping away Monitor opens the doors to competition red in tooth and claw. Of course, the Competition Act 1998, the EU’s competition legislation and procurement law would still apply without any of the fetters, barriers or protections that Monitor can and should be providing in its role as the regulator of competition in the NHS.

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[Priti Patel (Witham) (Con)]

I apologise to both Front Benchers for missing the opening statements due to a commitment I had at the Foreign and Commonwealth Office. Thank you, Madam Deputy Speaker, for calling me to speak.

I want to discuss problems with the NHS in my locality. My constituents have been affected by a number of difficulties in the NHS in recent years, predominantly down to the legacy and failings of the previous Labour Government, particularly the deficit of NHS local health care provision. Mid Essex has suffered as a result of the bloated bureaucracy of the primary care trusts and strategic health authority, which took money away from front-line care and patients. That is Labour’s legacy.

To put that in context, between 1997 and 2009 the number of managers and senior managers in the East of England strategic health authority more than doubled from 1,300 to well over 2,700. The number just kept increasing. The worst case involved Mid Essex PCT—I was so thrilled when PCTs were dismantled—and its predecessor trusts, whereby between 2001 and 2009 the number of managers and senior managers soared from 10 to 102, while the proportion of administrative staff working in the PCT itself doubled from 17% to 33%. That money should have gone to front-line patients in Witham and Mid Essex. That is the legacy we are trying to overcome.

When this Government came to office, those two PCTs were spending a combined total of £25 million on management costs alone, which is simply shocking and appalling. That is why the reforms are not just welcome, but vital to Mid Essex and my constituency: money can now be spent on providing care and investing in the health and care services that my constituents and patients desperately need. The actions taken by this Government mean that more of the record levels of spending on the NHS—which the Government are committed to and which the Opposition opposed—will be spent on patients in my constituency, rather than on administrators, managers and bureaucrats.

One of the most damaging aspects of Labour’s legacy in my constituency is the incredible health deficit in Witham town. Witham is a growing town and I am very proud of it—it is incredible. Despite the NHS deficits we have faced, our patients have campaigned and I have worked alongside them. My hon. Friend the Member for Suffolk Coastal (Dr Coffey) has been clear and consistent in making the point that this is about campaigning together, on a united front at a local level, to make the case for reform and change.

The town’s population is set to grow by more than 11% over the next decade, yet we have a chronic shortage of GPs and health services. That is well documented and I have raised the issue in the Chamber and in Westminster Hall on a number of occasions.

[Mrs Main]

Does my hon. Friend share my concern that Labour Members have made no apology for the fact that GPs were allowed to opt out of out-of-hours services? That resulted in many more people presenting themselves at A and E simply because they were unaware of where they could go. Surely Labour should have foreseen that that would happen when it made dramatic changes to GP contracts.

[Priti Patel]

My hon. Friend is absolutely right. This is a challenge we all face, particularly in rural constituencies. That deficit needs to be addressed.

There are about 2,200 patients per GP in Witham town, compared with the national average of 1,500. Patients would also like to see more out-patient services delivered locally in the community, rather than have to travel to Braintree, Chelmsford or Colchester. Colchester and Chelmsford both have hospitals that are undergoing major reviews at present. The challenge we face is to bring in new services to serve our expanding town. The prospects of achieving that objective are enhanced by the fact that this Government are putting record sums into the NHS and by the dialogue at community level between the town council and NHS England. I commend both, but specifically Witham town council for its support, and particularly Andrew Pike of NHS England and his team for working closely with me to examine the options, despite significant pressures and resistance in some quarters.

I know that we can count on the encouragement of Ministers, who have listened and been incredibly supportive. That brings me back to the fundamental point that if the Labour party, when it was in government, had bothered to take the issue seriously, more progress could have been made. The issue is of course about the allocation of resources: we need less on management and bureaucracy, and more on front-line patient care.

Another very significant health care concern for my constituents is that raised by my hon. Friend the Member for Suffolk Coastal about the East of England Ambulance Service NHS Trust. It has been a disaster, as the Secretary of State and Health Ministers are well aware. My hon. Friend the Minister of State has been part of our campaign. He was assiduous in his support of us all in pushing for and achieving the resignation of board members last year, and in relation to the trust’s poor performance in getting ambulances to patients efficiently and on time, rather than having four-hour waiting times and some deaths. We must not forget that deaths and casualties have resulted from that neglect.

I welcome Ministers’ involvement and support and, by contrast, we have now seen changes. The previous members of the trust’s board, many of whom, including a Labour councillor, were appointed under the previous Labour Government, ought to have provided strategic leadership—this is all about leadership—but they left the trust in an appalling state, under-staffed, poorly resourced and ill-equipped. They did not scrutinise the management of the trust, but left a serious black hole in its finances and a shortage of paramedics and ambulances that has caused my constituents and patients throughout the region to suffer unnecessarily.

As the House has heard, the trust is now led by Dr Anthony Marsh, and it is on a massive recruitment drive to bring in the paramedic numbers it needs to serve my constituents and the rest of the region. I commend him, because he is working incredibly hard: we are climbing Everest to deal with the legacy we were left. Collectively, local MPs are supporting him in his task to repair the damage to the structures left to us, including in relation to the formation of the trust, because in effect we inherited an appalling and devastating legacy.

It is quite clear from our time in government that if such problems had arisen under the previous regime, they would have been swept under the carpet. We have seen with the scandal of Mid Staffs and other trusts, to which the Labour party turned a blind eye, that there is no doubt that Labour closed its eyes and completely ignored the fact that patient care was neglected and the overall cost in lives, which is appalling. I therefore welcome the commitment from our Health Secretary and the Government to support us not only in facing the challenges, but in bringing transparency and shining a light on the NHS, which is vital.

To make one other point, the teams in our ambulance trust have been working so hard. We really commend and praise the front-line teams, because they have had an appalling time. We are now improving services for my constituents, which, frankly, was not possible under the previous Labour Government.