Healthcare

Baroness Armstrong of Hill Top Excerpts

Thursday 28th October 2010 Lords Chamber

[Baroness Armstrong of Hill Top]

My Lords, I rise with some trepidation, following that. I congratulate the noble Lord opposite on this debate. I declare an interest. I have only just become a member of the board of County Durham and Darlington Foundation Trust as a non-executive. I claim no knowledge or benefit from that for this debate, however.

I have been delighted to see that the Government—and the Conservative Party, before the election—have really discovered how much the National Health Service is valued by the British people. We have that to thank for their commitment to the National Health Service during the election, and to ring-fencing the money for it. However, as we are now discovering, that ring-fencing has lots of problems within it. The rounding-up of figures, which all Governments do, means that the annual increase will be 0.1 per cent. In fact, it is a little less than that, but that is the rounded-up figure. We all know that that will give the National Health Service incredible challenges. I want to ask the Minister some questions arising from that settlement and the ideas in the White Paper.

The financial challenge is significant. What does the Minister think the number of redundancies within the National Health Service will be this year and next? How will those redundancies be funded? There are rumours that the funding for redundancies will come from some of the money put into the service to control demand—for example, in accident and emergency, by encouraging more people to be referred, and refer themselves, to urgent care centres. However, there are also rumours that some funding may come from budgets that are about trying to get healthcare to the most vulnerable, such as the homeless, who are frequently not on a GP’s list.

I know that many Members welcome the abolition of targets. I am amused to hear them now called “objectives”, but that is another matter; I am determined not to be cynical. When I was a directly elected Member of Parliament the main concern expressed to me by constituents about the National Health Service was, “I have been to see the doctor and been told that I can have the operation in about 18 months to two years. I could go next week if I was private”, with all the horror, anger and shame of that. That has not happened over the past five years. How many NHS patients does the Minister think will be waiting six months for orthopaedic surgery in February 2012? Does he think it will be 10, 100 or 1,000? I know that Ministers think carefully before they make any decisions. The decision to abolish the targets means that the Government must have estimated what effect that will have. I want them to share that thinking with us.

Inevitably, the change to the regime that the Minister envisages in the White Paper clearly means that some NHS hospitals will fail. How many does the Minister think will have failed by April 2013?

Finally, on parliamentary accountability, the Government are going to create the largest quango we have known in this country. That will take it outside direct questioning by Parliament. How is Parliament going to hold to account the decisions and actions of the NHS when, in fact, the money will be spent by the largest quango, the commissioning board? Who will appoint the chair? Can the Minister assure us, now that the appointments commission is to be abolished, that it will be an impartial appointment? Will it be done before the appointments commission is abolished?