(12 years, 9 months ago)
Commons ChamberMy hon. Friend makes a valuable point from a sedentary position. The driving force behind the arrangement and the key criterion for Circle is the need to turn the hospital around, with regard to its quality and standard of care and its finances. The challenge for Circle is to eliminate completely the £39 million historical deficit over the 10-year period and put the day-to-day running costs of the hospital on a firm footing. I am confident that, within the framework of the agreement, that offers the best change to turn the hospital around.
I congratulate my hon. Friend on exploiting the position presented by the Opposition. Given that this is a one-off, as he has said, what is the future for the other 20 hospitals that are in a desperate financial state? Is this a blueprint for the future and can we look forward to other partnership arrangements coming forward?
I am grateful to my hon. Friend for the opportunity to put on the record the way forward for those 20 hospitals. This is not a blueprint or model to be used by other hospitals. It is on the statute book, as the hon. Member for Leicester West (Liz Kendall) knows. Where there are problems with the 20 hospitals that are seeking foundation trust status, the SHAs, departmental officials and the trusts themselves are looking at them. They have all published TFAs in the past six weeks or so with their intention for the way forward. I think that I am right in saying that for all of them there is a variety of options that range from a stand-alone FT bid to a possible merger or acquisition with another FT or trust. There are no TFAs for a franchise arrangement. As I have said before, this is a first and, as of now, unique model.
(12 years, 10 months ago)
Commons ChamberMy right hon. Friend makes an incredibly important point. Make no mistake: if the Bill passes, the NHS will never be the same again. The Bill will unpick the fabric of a public national health care system—a planned system—and turn it into a free-for-all, as he says. Indeed, it is unbelievable to see a letter in The Guardian today from senior Liberal Democrats—many of whom made the same argument a few weeks ago as my right hon. Friend—now saying that, because of a few tweaks to the Secretary of State’s powers, the time has come to abandon all their concerns about the provisions. That is a ridiculous statement to make. If they still have concerns about competition and privatisation, they should have the courage of their convictions and stand up against the Bill, instead of writing sanctimonious letters to The Guardian.
Grip has been lost; the NHS is drifting. However, the Government cannot say that they were not warned. Sir David Nicholson, the chief executive of the NHS, told the Public Accounts Committee that the reorganisation had increased the scale of the financial challenge:
“I’ll not sit here and tell you that the risks have not gone up. They have. The risks of delivering the totality of…the efficiency savings that we need over the next four years have gone up because of the big changes that are going on in the NHS as a whole.”
This has been a lost year in the NHS—a crucial year, when it needed to face up to the financial challenge—but things are not getting better. We face months of further uncertainty, as the Secretary of State battles on with his complicated and unwanted Bill. Four-hundred and ninety pages, 70-page letters to peers, amendments made on the hoof: it is a total mess. The NHS deserves better than this. Even the man the Secretary of State brought in to run his new NHS Commissioning Board describes his Bill as “completely unintelligible,” and went on to say:
“It is going to be messy as we go through a very complex transitional programme.”
And this from the Secretary of State’s friends.
The harsh truth is that the Secretary of State has comprehensively failed to build the consensus he needs behind his Bill. GPs do not want it; nurses do not want it; midwives do not want it; patients do not want it. I say to the Prime Minister and the Health Secretary today: stop digging in. Drop this Bill. If they do, my offer still stands, as our motion makes clear. We will work with the Secretary of State to reform NHS commissioning, giving GPs and other clinicians a bigger role. That can be achieved without legislation and a major structural upheaval of the entire NHS. It can be done through existing legal structures, giving immediate stability and saving millions.
We make our offer again today, as it is time for all politicians to put the NHS first. It is slipping backwards, and the warning signs are there for all to see. Waiting lists and waiting times are getting longer, with a 48% rise in the last year in the numbers of patients waiting more than 18 weeks. When patients are waiting longer, it is unforgivable that £2 billion to £3 billion has been set aside to pay for the costs of reorganisation. It is also unforgivable that £850 million is being spent on making people redundant who will end up being re-employed elsewhere in the system, in the new clinical commissioning groups.
We are witnessing a return to the bad old days of waiting longer or paying to go private. This is just a glimpse of the future. If the Bill passes, the NHS will never be the same again. We have all seen the adverts on television for the health lottery. Is this the right hon. Gentleman’s early marketing and his new brand name for our NHS?
Does the right hon. Gentleman not accept that one of the severe problems that the national health service is facing came about on his watch, when primary care trusts were allowed to build up huge deficits without making the economies and efficiencies that should have been made at that time, rather than on this Government’s watch?
I have never said that the NHS was perfect, or that there were no challenges during our time in government. But let me tell the hon. Gentleman what happened when the NHS was facing those deficits in 2006 and 2007. We took a grip at the centre and we brought those trusts back into financial balance, through hard work. There was a turnaround team in the Department, and we made sure that those difficulties were tackled at root. I do not see the same grip in the national health service right now. I see drift and lack of focus, and I see huge distraction as a result of this unwanted Bill.
The second reason the House should reject the motion is that it fails to pay tribute to the hard-working staff of the NHS. I participated in many debates such as this when I was shadow Secretary of State and I thought that they provided an incredibly good opportunity for Members to raise issues relating to their own constituencies. I hope that that happens in this debate, as it is important. Every one of us has in our constituencies thousands of committed and hard-working NHS staff who want to know that we recognise it. I do not see any of that in the motion.
(13 years, 1 month ago)
Commons ChamberIf the hon. Lady had read on, she would have found that £700 million of the £1 billion is to be found not through cuts in services, but through efficiency savings, for example through the use of telecare, which significantly reduces costs, and investment in reablement services, which save resources and help people to get back on their feet. That is all in the report that she is waving around. When it comes to investment, the Government have already made clear their commitment through the spending review, and are investing, by the end of this Parliament in 2014-15, an additional £2 billion—something that her party did not do when in government.
The extra money being given to adult social care should be good news, but in Harrow, the council, which is Labour-run, has applied the £2.1 million additional funding to redundancies in general areas, rather than passing it on to the weak and the vulnerable. Will my hon. Friend take action to ensure that the new money provided by the Government reaches the people who need it?
I am absolutely determined to make sure that the additional resources that the NHS is transferring to social care deliver real benefits for people who need social care services, protect services, and allow local authorities to make the right decisions about how they continue to support not just investment in prevention, but those most in need.
(13 years, 5 months ago)
Commons ChamberMy hon. Friend will know that through the plans set out in the Health and Social Care Bill the commissioning of those services will be the responsibility respectively of the NHS commissioning board and local authorities. Through local authorities, and as part of our public health responsibilities, we will be looking to promote good sexual health and high-quality support for people who need assistance with reproduction.
My right hon. Friend has referred to the ring-fencing of the money that is going to be given to local authorities. Will he advise the House how long he expects that ring-fencing to last? Is it until such time as local authorities can be trusted to spend the money on public health?
(13 years, 8 months ago)
Commons ChamberMy hon. Friend makes a very important point, and that was not all that happened. On the money available to primary care trusts for what is termed the healthy living programme, there is no correlation between how much trusts spend relative to health deprivation, so in places with the poorest health outcomes trusts on average do not spend any more on discretionary health improvement activity. That is why our proposed health premium is so important. The places with the poorest health outcomes will clearly have the money they need to undertake specifically preventive work to raise health outcomes.
I warmly welcome the proposals to transfer public health to local authorities and, indeed, the ring-fencing, but will my right hon. Friend clarify how we will enforce the spending of that money on public health, so that there are no blurred edges and local authorities cannot fund their other services from within that ring-fencing?
I bow to my hon. Friend in his understanding of local government. My experience and understanding of local government is such that I know that the people involved are very concerned about improving health in their communities, and these resources will be available for that. Those people will not only be accountable to the people who elect them but accountable through the incentive mechanism of the health premium for the delivery of improving outcomes in the reduction of health inequalities. They will have an in-built incentive in the funding system to use those resources to deliver the outcomes that are collectively agreed, co-produced with local government. If they do not do so—if they spend the money elsewhere—they will not see the increase in resources that would otherwise flow.
(14 years, 1 month ago)
Commons ChamberAh! That was one of the Opposition Whips’ handout questions, wasn’t it? I will tell the hon. Gentleman that actually, patients are more likely to get their treatment more quickly. Let me give him an example. Patients with rheumatoid arthritis need rapid treatment, but they were losing out and suffering as a consequence of the 18-week target, because hospitals were hitting 18 weeks, but not providing the care needed by those patients in the light of their conditions. We must focus on what is in the best interests of patients, not on what is in the best interests of political grandstanding.
The Secretary of State’s announcement will be warmly welcomed in my constituency. On Friday, I went to see a group practice of 12 GPs who are totally frustrated by the local PCT. They are concerned that when the reforms are introduced, they will also be frustrated by the GP consortiums. Will my right hon. Friend give me some assurances on how the GP consortiums will be formed? What will happen if some GPs disagree with how a consortium is set up?
I can tell my hon. Friend that I am looking to GPs in a locality to create GP commissioning consortiums that represent an area. They must decide on the geography of that and make proposals. It will not be possible for GPs simply to say, “This is nothing to do with us,” because in future, we must expect GPs, who are senior professionals in public service and paid appropriately, to be responsible not only for the care of the individual patient in front of them, but collectively for the quality of care provided to their population at large.
(14 years, 2 months ago)
Westminster HallWestminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
The hon. Gentleman is tempting me to go down a path that it would be unwise to go down at this stage. The reason I say that, and why I will not be tempted, is that as he is probably aware, my right hon. Friend the Secretary of State and my ministerial colleagues are doing a considerable amount of work putting together and fleshing out our vision for the NHS, not only for the next five years but thereafter—a vision that puts patients at the heart of the NHS and that is driven by the needs and improved care standards of patients. It would be inappropriate and wrong of me to succumb to temptation and to start to unveil, in this august debate, what my right hon. Friend the Secretary of State will announce in due course. The only good news that I can give the hon. Gentleman is that he will not have long to wait before all these mysteries are explained to him, and I am confident that he will be reassured and pleased by what my right hon. Friend the Secretary of State has to say.
One of the key issues for Northwick Park hospital is how it deals with both Brent and Harrow primary care trusts. Both are in desperate financial straits, as I think hon. Members would agree. My concern is how that will be manipulated for Northwick Park and St Mark’s hospital trust in the future.
My hon. Friend raises an interesting point. It is true, as I hope I have explained, that there have been challenges for the North West London Hospitals NHS Trust with regard to its finances in recent years. However, as I explained—I will go into more detail on this later—measures are being put in place to seek to minimise the problems. I can assure my hon. Friend that when it comes to dealing with PCTs, trusts and the finances, I do not recognise the word “manipulate” as being in the lexicon. Everything is done to ensure that the maximum amount of money is made available to PCTs and trusts, to ensure that we protect front-line services, and to provide the best health care possible for my hon. Friend’s constituents and those of all hon. Members throughout the country.