The National Health Service

Bill Grant Excerpts

Wednesday 23rd October 2019 Commons Chamber

[Dr Whitford]

Well, I am afraid that it was the Labour party that set up independent treatment centres. I am a surgeon, and one of the issues was that such centres were sucking away the routine elective work that contributes to training future surgeons, and leaving the NHS to deal with the complex, chronic, expensive cases. Before the Health and Social Care Act, the NHS usually managed to find enough money down the back of the sofa that, at the end of each year, it would have about £500 million left. After the changes, it was £100 million in debt, £800 million in debt, and then £2.5 billion in debt. That is because money is sucked out in all these different ways, leaving a lack of funding that leads to rationing, which is pushing people to have to pay for more of their own care. We are hearing about that with co-payments—paying for a second cataract operation or for a second hearing aid. My Choice, which the Health and Social Care Act also brought in, raised the cap from 2% to 49% of income that an NHS hospital could earn through private patients. The highest amount at the moment is over 27%.

The idea that that does not impact on NHS patients is nonsense, because surgeons have limited capacity in terms of who they can operate on during the day, so if someone is able to jump the queue within the NHS, they are taking someone else’s place. As we saw with Warrington and Halton Hospitals NHS Foundation Trust, price lists have been pinned up in clinics suggesting to people that they might want to pay £7,000 or £8,000 for a hip or knee replacement, and there were also a lot of cosmetic and minor operations. I would gently suggest, as a surgeon, that surgery is not a sport. Either the patient needs an operation clinically, in which case it should be provided by the NHS, or they do not, in which case they should not be able to buy it from the NHS. Under the principle of My Choice, hugely high thresholds are being set. In the case of some CCGs, a person has to have had two falls before they can have a cataract operation, or they have to be in pain, even in bed, to get their hip done. That is driving families to club together to address that. That is not right. If someone needs it, the NHS is meant to provide it free at the point of need, and if they do not, every single operation is a risk and should never be done to attract income for an NHS trust.

[Bill Grant (Ayr, Carrick and Cumnock) (Con)]

I value the hon. Lady’s comments about how money is being sucked out of the NHS. In Scotland, we have a particular issue with a large showpiece hospital in Edinburgh that should have been opened in 2012, seven years ago, that is sucking money from the NHS—millions of pounds annually over the past six or seven years. She may wish to comment on that.

[Dr Whitford]

Well, it has not been sucking money for the past six or seven years because it was only declared open in February. I totally agree that it is a huge setback that, due to a failure within the health board’s tendering process for the build, it did not recognise the need for the level of ventilation in an intensive care unit. I would gently suggest to the hon. Gentleman that I do not think he would have wanted our Cabinet Secretary to simply go ahead putting babies and children in an intensive care unit where the ventilation was not considered safe.

In Scotland, so far our funding for the NHS has doubled in the past 10 years and will actually increase further next year. But it is not just about funding; it is about structure. What is happening in NHS England is fragmentation. It is not just that NHS hospitals are competing with private companies; they are competing with each other, and that undermines collaboration. We need to have collaboration, with the patient at the centre. Anything that fragments or undermines that collaboration is weakening the quality and safety of care.