Health and Social Care

Ben Bradshaw Excerpts

Tuesday 2nd June 2015 Commons Chamber

[Mr Ben Bradshaw (Exeter) (Lab)]

I congratulate the hon. Member for Central Ayrshire (Dr Whitford), who is the health spokesperson for the SNP, on an excellent maiden speech. I am sorry that the Secretary of State and the Under-Secretary of State for Health, the hon. Member for Battersea (Jane Ellison), are not in their places because they are the Ministers who have a little bit of historical knowledge about the past couple of years in the NHS. I hope that the Under-Secretary of State for Health, the hon. Member for Ipswich (Ben Gummer), will relay the comments of other Members to them, so that the hon. Member for Battersea can respond to them fully at the end.

I want to stress how pleased I am that my right hon. Friend the Member for Leigh (Andy Burnham) spoke mainly about the deteriorating financial situation facing the NHS. To be perfectly honest, I was astonished that the Secretary of State had nothing at all to say about that. He cannot say that he and fellow Ministers have not been warned, because many MPs on both sides of the Chamber have been sounding alarm bells about this for some considerable time.

Last February the Government commissioned a series of reports on what they called the most financially challenged health economies in the country, of which Devon was one. Since then, nothing has happened: the Government have refused to publish those reports. I tabled a freedom of information request just before Dissolution asking where the consultants’ report was, and was told it could not be published because it would, in time, inform the making of decisions that would affect local NHS services in Devon. Why have we been waiting so long for action by this Government to address the financial situation, which in the meantime has got much, much worse?

Let me give some of the figures for my area. My local commissioning organisation, the Devon clinical commissioning group, announced last week that its deficit has risen to £40 million this year. My local hospital, the Royal Devon and Exeter hospital, which is one of the best performing and best managed hospitals in the country and which had never registered a deficit until the last two or three years, is now going to register a £20 million deficit this year; and Derriford hospital in Plymouth is looking at a deficit of £30 million. That is £90 million in deficits in just part of a county in part of our country. It is simply unsustainable for the Government to claim that there is no problem with NHS finances. The longer the Government delay action, the bigger the impact will be on services and on patient care.

The Minister may recall, because it received national publicity, that the response of my local CCG last autumn to the serious situation it faced was to announce a widespread programme of rationing and cuts. The measures, which hit the national headlines, included preventing anyone who was obese or who smoked from having any routine operation, and rationing cataract operations to one eye and hearing aids to one ear. That provoked such widespread condemnation, not only from the public in Devon, but from across the country and from all the professional organisations, that, following an Adjournment debate I had with the Under-Secretary of State for Health, the hon. Member for Battersea, the plans were dropped. However, the underlying financial situation has not been addressed, and it has got worse.

I was told by Health Ministers just before the election that there was a plan afoot—a success regime, which is a rather unfortunate way to describe a way to address a not-very-successful situation—but that nothing would be announced before the general election. How much longer do we have to wait for that so-called success regime, or some sort of action to remedy the Government’s failure, to be introduced? People in Devon and across the country want to know when action will be taken and delivered.

Members have said that the disastrous Lansley reforms have made the job of Health Ministers much more difficult. One of the reasons why we have been unable to grip the problem in Devon and elsewhere is that we now have so many different organisations in the NHS responsible for regulation and performance management. We have Monitor, responsible for foundation trusts; we have the NHS Trust Development Authority, responsible for non-foundation trusts; and then we have NHS England, responsible for CCGs. No one has gripped this problem: Ministers have not gripped it, the different bits of the NHS have not gripped it, and that is why it has got out of control.

I remember very well—I have the scars on my back—the time when we were in government and the finances got out of control. It happened for different reasons—we were increasing capacity in the NHS at such a rate that the NHS lost control of its spending. The situation now is much more serious, because spending has been so tight, so the impacts of the loss of control we are seeing in the NHS now are extremely serious cuts or the sort of rationing that my local CCG proposed last autumn, which Ministers rejected. I want the Minister who winds up the debate to give an assurance that the Government do not believe that that sort of model offers an answer to the financial crisis affecting many trusts and the NHS as a whole. I hope that Ministers will look carefully at the fragmented landscape of NHS management, performance management and regulation, which is preventing us from finding a solution to this problem.

Let me give one more example. We had cross-party support in Devon—I am pleased that the hon. Member for Totnes (Dr Wollaston) is still in her place—for the integration of community services in most of the county. They are currently delivered by North Devon district hospital, but everyone else, including Conservative Members such as the right hon. Member for East Devon (Mr Swire) and the hon. Members for Central Devon (Mel Stride) and for Tiverton and Honiton (Neil Parish), agree with me that it would make much more sense to integrate those services vertically in our parts of Devon. That has not happened, because the North Devon trust objected and Monitor launched an investigation, which is still dragging on, with no resolution reached.

We have lost months of time and millions of pounds, and we have not been able to get on with improving the integrated care that the Secretary of State and everyone with any sense in this Chamber has talked about during the course of this debate. Please, will the Under-Secretary of State for Health, the hon. Member for Ipswich, address the financial crisis that his Secretary of State failed even to mention in his opening remarks, and will he think carefully about the changes in delivery structures we need if the local health service is to deliver the improvements, the savings and the care that our public need?

--- Later in debate ---

[Jane Ellison]

No, I am sorry, I will not give way. As they have demonstrated today, the hon. Lady and many of her colleagues sought to weaponise the NHS in the last Parliament and they are seeking to do so again.

In return for NHS staff stepping up and working so tirelessly for their patients, the Conservatives have committed the money that the NHS says it needs. Two elections running, the Labour party failed to commit the money that the NHS says it needs. Until the Opposition do that and explain how they can deliver the strong economy that is needed to do it, they have no right to speak about this. It is only possible to deliver that if we have a strong economy and a long-term economic plan. Listening to the NHS, not running it down—that will continue to be our approach in this Parliament.

[Mr Bradshaw]

I regret that the Minister missed my speech, because she, like her right hon. Friend the Secretary of State, has so far failed to mention the elephant in the room: the record deficit facing the NHS. She knows about this, because we have debated it in this House; she knows exactly what I am talking about. What is she going to do about that deficit? When is she going to address it? When is she going to fulfil the promises she made to my constituents in Exeter and the population of Devon, which faces one of the worst deficits in the country? Without action, patient care and services will suffer.

[Jane Ellison]

I am sorry that I was not in the Chamber for the right hon. Gentleman’s speech. I was briefly attending a meeting of directors of public health, but I know he asked a specific question about the turnaround plan in his area. I believe it has been presented to the new governing body of Devon CCG, but I am happy to pick up the detail. As he says, we have debated the issue.

On the deficit in the NHS, my right hon. Friend the Secretary of State for Health responded in great detail in his opening address, but the thing about NHS finances that the Labour party never gets its head around is that, yes, they are under pressure, but one has to have a long-term plan for how to address that—plans for integration, out-of-hospital care and prevention. One has to be able to say—[Interruption.] The hon. Member for Denton and Reddish asks where the money will come from. That is a question the electorate asked the Labour party all the way through the election—that was the No. 1 question the electorate of this country asked the Labour party, and answer came there none.

I am proud of the work we have done in the past five years, in which the NHS has built capacity and improved the care it delivers. It is worth reiterating the facts that my right hon. Friend the Secretary of State gave at the beginning of the debate. The NHS is now performing more than 1 million more operations; it has 9,400 more doctors and 7,700 more nurses; it sees, treats and discharges more than 3,000 more people within four hours every single day. By the end of the last Parliament, public satisfaction with the NHS was up 5% and it was deemed the best performing health system in the world by the Commonwealth Fund.