Healthcare

Baroness Wall of New Barnet Excerpts

Thursday 28th October 2010 Lords Chamber

[Baroness Wall of New Barnet]

My Lords, I too, thank the noble Lord, Lord Hunt of Wirral, for giving us the opportunity to debate this subject. The contributors to the debate will know just how important it is to everybody. I declare an interest as the chair of Barnet and Chase Farm Hospitals NHS Trust, an acute trust delivering general and highly specialised healthcare to a large area of north London.

The policies of any Government have a direct and profound effect on the quality and outcomes of patient care. For some time our trust motto has been, “Patients First and Foremost”. Our staff work towards this vision at every stage of their careers and throughout all government policies regardless of the party, or parties, in charge. That is why I have paid great attention to the Government’s policy on patient-led healthcare.

Much progress has been made on the timeliness of services within the NHS through the target-driven process initiated by the previous Administration—my Government. The present Government’s moves to dismantle this structure must not be allowed to lead to the loss of these crucial improvements, but rather build on them. However, the time may be right to move from the assessment of service quality by time, which was an imperative at the point these processes were introduced, to combine this with the more clinically sensitive indicator of outcomes. I feel that it is a pointer to the success of the previous Administration in upholding the original vision of the founders of the NHS that we are now able to consider such a transition. Within my own trust great strides have already been made in many areas, particularly with the reorganisation of the A&E services and acute medicine, leading to shorter waiting times and a better service for our patients. Future progress in these areas may be better measured by combining quality of outcome rather than timing alone, important as this has been in increasing our standards to the present levels.

In other areas such as modern cancer services, which received a massive investment under the previous Administration, the question of timeliness of care has again largely been addressed. Perhaps we should move to realising the benefits in terms of quality and outcome measures made possible by previous investment. However, I caution that we should do this without taking our eye off the ball as regards acknowledging the importance of timely action for those diagnosed with or suspected of having cancer of any kind—for those people, time is of the essence. In my trust, great changes have taken place in providing local, modern, advanced cancer services, with the use of laparoscopic and robotic techniques. It is important that this is maintained and monitored against the highest national and international standards.

Many patients served by my trust are elderly. We must recognise the demographic changes, as other noble Lords have said. The country as a whole must think about this in the design of its services. For this enlarging sector of our population, true quality of service demands not only timeliness and excellent outcome but an additional vital ingredient: local provision. Some services that my trust provides are excellent by national standards, and the outcomes are very important. We must not in any way threaten them by an ill thought-through, centralised agenda. The knock-on effect of removing these local services will, if allowed to progress, threaten to undermine excellence in other areas that they support. The White Paper says exactly the opposite of this. Localism is really important. I ask the noble Earl for that confirmation today. Localism is important: people know what is important to them locally. I am sure that the noble Earl, who is smiling at me, understands that from the recent visit that he made to my trust.

I finish by saying that the role of front-line health professionals is paramount in ensuring that the delivery of this White Paper, and more importantly of health services overall, is recognised by patients. The implementation of government policy is a weight that they carry. It must not become such that it interferes with the delivery of services. Make no mistake: we are being watched by everybody. As a trust, we think that it is very important that we are able to step up to the plate, as the saying goes.