NHS: Finances and Services

Baroness Jolly Excerpts

Tuesday 27th January 2015 Lords Chamber

[Baroness Jolly (LD)]

We agree with the King’s Fund that very real financial and operational challenges face our health and care services. However, we are committed to a sustainable future for our NHS. This is demonstrated by our protection of NHS funding and our further funding commitment for 2015-16. This will begin to deliver the vision for transformation set out in the NHS Five Year Forward View.

[Lord Hunt of Kings Heath (Lab)]

My Lords, the King’s Fund quarterly monitoring report of NHS finance directors shows a worrying picture of 42% of NHS trusts facing a financial deficit this year, services under pressure, operations cancelled and a 50% increase in the wait for packages of care by patients in hospitals. Finance directors describe the situation as critical. What specific action are the Government taking to respond to this crisis? Are the Minister and her Liberal Democrat colleagues now prepared to say that they regret their role in helping the passage of the 2012 Act, which has caused so much damage and fragmentation?

[Baroness Jolly]

To take the last point first, I do not regret that. I do not regret parity of esteem for mental health. I do not regret health and well-being boards in local authorities. On the noble Lord’s first set of points, we have seen rising demand in emergency and waiting lists, a reduction in unplanned financial support, and focus on safer staffing ratio guidance. Various things are happening. The noble Lord, Lord Carter, one of the noble Lord’s noble friends, is looking at procurement within hospitals. Right across the piece, local NHS and foundation trust boards are concentrating on how they can restructure services to improve the situation.

[Lord Fowler (Con)]

On the financial position, did my noble friend hear the interview given this morning on the “Today” programme by the Labour health spokesman, Mr Burnham? Given the pressure on health budgets, which we all accept, would it not be idiotic, as he advocated, to turn our backs on the sensible economies that can be achieved from the contracting out of ancillary services?

[Baroness Jolly]

This brings us, I think, to Section 75. We are absolutely clear that no contracting out or commissioning should be done unless it is in the interests of the patient.

[Baroness Tyler of Enfield (LD)]

My Lords, a recent report from the Nuffield Trust on the state of NHS finances showed that spending on agency and contract staff had increased by roughly 20%. Given that this increased reliance on temporary staff has significant costs attached, as well as raising concerns about quality and continuity of care, can my noble friend say what the Government plan to do about it?

[Baroness Jolly]

Agency staffing cost the NHS £2.5 billion last year. This is nothing new. For as long as I have been involved in the NHS, there has been a hefty agency bill. The Government established Health Education England to ensure that the NHS has access to the right number of staff, with the right skills and available at the right time. The Department of Health expects trusts to have a strong grip on their finances.

[Baroness Howarth of Breckland (CB)]

My Lords, does the Minister accept that, until we have a system in which care and health are linked together, we will never manage to get a secure system? Does she not agree that we are in real difficulties when hospitals are blamed for not having good-quality staff, because those cost money, and yet are blamed for overspending when they do have the quality staff?

[Baroness Jolly]

This Government have introduced the better care fund, which aims to produce seamless care across health and social care. There are also 150 local plans, 120 of which are fully approved. We shall watch those pilots with interest.

[Baroness Farrington of Ribbleton (Lab)]

Would the Minister care to comment on the fact that cuts in local authority spending are spoiling the chance of getting proper care in the community? The Government’s allocation of targets and grants is disadvantaging most of all the most deprived parts of England.

[Baroness Jolly]

I understand that local authorities have to struggle very hard to put together packages of care; I have even spoken to my own local authority very recently. We have to do the best with what we have. Currently, that is where we are.

[Lord Forsyth of Drumlean (Con)]

My Lords, can my noble friend help me and explain why it is that the health service both in Scotland and in Wales, where it has more money, is doing considerably less well than the health service in England under this Administration?

[Baroness Jolly]

My noble friend makes a very interesting point. Perhaps they should look at some of the examples that are actually used in the NHS in England.

[Lord Brooke of Alverthorpe (Lab)]

Is it not true that in Scotland and in Wales, there are more chronic, long-term sick patients than there are in the UK generally? Will the Minister say why, each time a Minister replies to questions on the failing performance, they pray in aid the number of additional patients who are now going into the NHS? Is this coming as a great surprise? Is it a surprise that people are getting older? What is the projection for the next five years about the numbers that we have to deal with? Surely this should be planned for.

[Baroness Jolly]

Indeed it should be planned for. There are now a million more people over 65 than there were at the beginning of this Parliament, but at the beginning of this Parliament there were no plans to cope with that onward growth.

[Baroness Tonge (Ind LD)]

My Lords, does the Minister agree with me that chaos is reigning in the health service at the moment? We really must stop this piecemeal approach of throwing bits of money at it and putting on patches where it is failing, and have a proper all-party conference to discuss the future of the health service and how we are going to fund it. That is the only thing that the general public would respect.

--- Later in debate ---

[Baroness Jolly]

I am not sure whether that will happen, but there is an awful lot of agreement across the main political parties about what should happen. In particular, we all agree that health and social care should be joined together.