NHS: Five Year Forward View

Baroness Wheeler Excerpts

Monday 1st December 2014 Lords Chamber

[Baroness Wheeler (Lab)]

My Lords, I thank the Minister for reading out the Statement. This weekend, a 16 year-old girl in need of a hospital bed was held for two days in a police cell because there was not a single bed available for her anywhere in the country. As we have warned before, this is by no means an isolated example. The BBC reported on Friday that seven other people had died recently waiting for mental health beds, and it is not just mental health. Last week, we were told of a stroke patient being ferried to hospital by police on a makeshift stretcher, made from blinds in his house, and who later died. This was one of a number of alarming reports of people waiting hours in pain and distress for ambulances to arrive.

To listen to the Statement today, you would have no idea that any of this is happening. That is the problem. Nothing the Minister has said today will address these pressures ahead of this winter. On mental health, does the Minister not accept that there is an undeniable need to open more beds urgently to stop appalling cases like the one at the weekend? What assessment has he made of the ability of the ambulance service to cope this winter and is there a case for emergency support on top of what has been announced? This Statement offers no help now to an NHS on the brink of its worst winter in years.

However, there is another major problem with the Statement. This weekend’s headlines promised £2 billion extra for the NHS but the small print revealed that it is nothing of the sort. It is interesting to note that the figure of £2 billion has not been used in the Statement today but is what the NHS is being led to believe it is getting. Will the Minister confirm that £700 million of the £1.7 billion that he talked about is not new money but already in his budget? A few weeks ago, his department told the Public Accounts Committee that it expects to overspend this year by half a billion pounds. If this is the case, would the Minister care to tell us where this £700 million is coming from and what services are being cut to pay for it? At the weekend we exposed NHS England’s plans to cut the funding for clinical trials, which would have affected thousands of very poorly patients. Is this one of the planned cuts to pay for this? Will the Minister now guarantee that funding for research and clinical trials will not be cut?

Not only is the £700 million recycled; we gather that another £1 billion will be funded from cuts to other departments. The Institute for Fiscal Studies has warned of “staggeringly big cuts” to local government in the next Parliament. The NHS Confederation has said that:

“If additional NHS funding comes at the expense of tough cuts to local government budgets, this will be a false economy as costs in the NHS will rise”.

Have the Government not learnt the lessons of this Parliament, namely that the NHS cannot be seen in isolation from other services and that cutting social care only leads to extra costs for the NHS?

Figures released on Friday revealed record numbers of older people trapped in hospital because the care was not there for them at home. This is the human consequence of the severe cuts to social care in this Parliament, and it is clear that the Government are preparing to do the same again in the next. Hospital A&Es have now missed the Government’s own target for 71 weeks running. Cancer patients are waiting longer for treatment to start. Everyone is finding it harder and harder to see a GP. Is it not the case that most of what the Government have announced will go to patching up the problems they have created, leaving less than a quarter for the new models of care outlined in the NHS Five Year Forward View? The reality is that what has been announced provides nothing for the NHS now, is not what it seems and, because of that, will not be enough to prevent the NHS tipping into full-blown crisis if the Government are re-elected next year.

It is impossible to see how the Government can find any more for the NHS than this because they have prioritised tax cuts for high earners and have not yet found the money to pay for those. That explains the desperate attempts to inflate these figures and make them sound more than they are. I ask the Minister: is it not the case that, to deliver the Five Year Forward View, the NHS needs truly additional money on the scale that Labour is proposing—an extra £2.5 billion over and above everything that he has promised today—and an ambitious plan for the full integration of health and social care?

The Government have said that they would be the Government who cut the deficit, not the NHS, but it is this Health Secretary who has created a deficit in the NHS and it is because of that deficit that cancer patients are waiting longer, A&E is in crisis and children are being held in police cells, not hospital beds. The reality is that the Statement has nothing of comfort to offer to these patients.

Finally, I want to comment on the terrible irony of the reference in the Statement to the Government rejecting the top-down reorganisation approach. The Statement says that the Government,

“have listened to people in the NHS who say that more than anything the NHS wants structural stability going forward”.

I am sure that the House would be very pleased to hear how the Government consider their £3 billion, top-down reorganisation has delivered structural stability and whether, with hindsight, the Minister can admit that the money would have been much better spent on improving patient care.