National Health Service

Chloe Smith Excerpts

Wednesday 21st January 2015 Commons Chamber

[Alison McGovern]

My hon. Friend makes an excellent point, but I want to outline some of the specifics that might be entailed by that position. I want to talk about three elements of changing the NHS that I take to be very important. One of them is pretty parochial, but the other two are terribly important for our whole country.

The first concerns a walk-in centre in my constituency. Not everybody in the House will be an expert on the geography of Merseyside and, specifically, the Wirral, though I know that everybody will appreciate how important it is that they learn about it. In my part of the world, our local hospital is quite far from those of us in south Wirral. There was a hospital in south Wirral called Clatterbridge hospital, which I was born in. Its emergency facilities closed many years ago; I think that I was almost one of the last babies to be born there. Services were moved up to Arrowe Park on the border of the Birkenhead and Wirral West constituencies. I well remember, when I was young, how far away Arrowe Park felt and, when members of our family were ill, what a long distance it seemed when getting there.

Under the previous Labour Government, with my predecessor’s support, Eastham walk-in centre was opened in south Wirral, near the Cheshire border. That walk-in centre has been a rip-roaring success. It treats people effectively. They can turn up at hours that are convenient, such as out-of-work hours. It is open at the weekends and until 8 o’clock at night on a weekday. I declare an interest as a parent of a young child who always seems to manage to get herself unwell at the most inconvenient times. Eastham walk-in centre has been there for us, and my constituents value it greatly.

Under the reorganisation, the new clinical commissioning group took over. In Wirral, we had a bizarrely complex structure of three federated CCGs for a population of about 350,000. Having three CCGs in Wirral was total madness. Twenty-five million quid was wasted on a reorganisation that nobody wanted and nobody voted for. The first thing the CCG wanted to look at was urgent care, and it put our walk-in centre under threat of closure. This is an incredibly important facility to the people of south Wirral. It brings the NHS to their doorstep. It totally changed the availability of out-of-hours facilities for people in my constituency. The CCG, in its lack of wisdom, thought it was just fine to say, “We’re not sure we need that. We can re-provide those services at GP surgeries, never mind whether they are open at a convenient time.”

The CCG never went through with those proposals, and rightly so. Since then, however, there has been a constant threat and a worry in my mind about Eastham walk-in centre. I want to make it clear to the Minister that if there is any risk at all of that walk-in centre closing, he will receive representations from me pretty quickly, because it is an absolutely vital service. Unless we again conceive of the NHS as being there for patients and the public first and think about how to bring these facilities close to people, we will never get an efficient and effective service fit for the next generation. Walk-in centres are absolutely vital. It sends a chill down my spine to hear the shadow Secretary of State say that one in four has closed; if anything, we should be opening more.

Secondly, I want to talk about social care and older people. We all know that we have the benefit of an ageing population in our country. With an older population, we will have a more experienced and expert population. I take it to be a good thing that people’s grandparents and valued members of their family are living longer, but with that comes a responsibility to look after them properly.

I ask Ministers what has happened to the better care fund. What evidence is there that it has been used to find solutions that are really working? All I see on my patch is council cuts and then the consequences turning up at the door of the hospital. Older, more seriously ill people in our community are turning up at A and E, with the distress to them of being there, the consequential responsibility on staff and the worry for families as people lie on trolleys.

We need a much more radical approach. Integration is clearly the answer, but I would like us to go further: I want us to truly address the work force issues in social care. It is not good enough that poverty pay is endemic among those who look after the most senior members of our community. That is not acceptable; nor is the zero-hours culture. We once had that problem in child care, but as a country we took on the responsibility of changing the culture in the work force for the good of our children, and we must do the same for the benefit of our older people.

I will not speak for much longer, Mr Deputy Speaker, but I want to say something about mental health, which should be part of the strategic approach that we must take to change the NHS for the benefit of the next generation. Parity of esteem is of course correct and absolutely right. I take it that there is now cross-party consensus on that issue and that everyone in the House thinks that we should treat mental health as seriously as we do physical health, with no barriers to getting proper treatment. However, I want us to do something else: we need to recognise the interconnected nature of physical health and mental health. It is not just that we also need to treat mental health, but that if we sort out people’s mental health issues and conditions and empower them to live better and happier lives, they will have better physical health and will make better use of the NHS’s scarce resources.

[Chloe Smith (Norwich North) (Con)]

I warmly welcome the hon. Lady’s last point, but why did she not prevail on her Front-Bench colleagues to include it in the motion?

[Alison McGovern]

I have many conversations with my right hon. and hon. Friends on the Front Bench, but they do not always ask me for a full briefing before they draft their motions, as I am sure the hon. Lady appreciates.

I conclude by saying that with the appropriate use of walk-in centres, a radical approach to social care and real consideration of the interconnections between physical and mental health, the difference we can make to our NHS will be excellent.

--- Later in debate ---

[Chloe Smith (Norwich North) (Con)]

It is instructive, as always, to follow the hon. Member for Dudley North (Ian Austin), and I thank him for his exposition of the positions set out around the Chamber this afternoon. I also welcome the comments of my hon. Friend the Member for Wycombe (Steve Baker) in picking up on the needs of areas that might not normally be viewed as deprived, but that need attention none the less. Norwich is one such city, because it contains wards and areas of serious deprivation. I have argued on behalf of GP surgeries that serve those wards, and there is a genuine question about the way our national structures and funding serve those areas.

[Steve Baker]

Is it not odd how people who are obsessed with inequalities take levels of aggregation that hide the real suffering of individuals and families?

[Chloe Smith]

My hon. Friend makes a wise point.

Tomorrow, I am visiting a walk-in centre and the hospital that serves my constituents. When I am there, I shall be explaining, as I have several times in the House recently, my support for the NHS in Norwich and across Britain, my thanks for what the staff are doing and my understanding of what the patients, my constituents, need from the NHS.

I want to make three points in the debate. My first point is that, as many hon. Members have said this afternoon, the NHS is under unprecedented demand. It does it no disservice to acknowledge that and bring it into the debate. I for one welcome the decisions that allow for increased numbers of doctors and nurses in urgent care—that is true in the Norfolk and Norwich University Hospitals Trust; for an increased number of operations to be carried out each year—that is true everywhere in the country; and for increased hours at GP surgeries. I recently learned to my pleasure that Norwich doctors will apply for the next round of the access fund. They have not done that before and it is very welcome. The Government have made the fund available and it could be of great benefit to patients in my area.

I am also grateful to the Government for the decisions made early—earlier than ever before—that have allowed for winter pressures to be dealt with. Again, that directly benefits the area of Norfolk that contains the Norfolk and Norwich hospital. I am particularly pleased that the use of that funding will be planned jointly with local authorities through the system resilience group. That is incredibly important. I will turn to that kind of joined-up working in my final remarks.

Let me make a point about the motion. We have heard wise contributions from Back Benchers on both sides of the Chamber. For example, my hon. Friend the Member for Stafford (Jeremy Lefroy) rightly asked us not to use the name of his area as a shorthand. He is right that we ought to look much deeper. As a further example, the hon. Member for Wirral South (Alison McGovern) rightly spoke eloquently about mental health. Unfortunately she is not in the Chamber, but I am sure she will be back before the winding-up speeches. I intervened on her to ask why the motion does not refer in its own right to mental health; it is a great shame that it does not. The motion is 10 lines of overblown and fly-blown rhetoric. It asks for an NHS that is “fit for the future”, but makes no mention of mental health being equal to physical health, which I believe strongly. Mental health and physical health should be equal in word and deed, and in budgets. Indeed, I have been discussing that with the Minister recently through parliamentary questions.

The truth is that the motion is rather sad and inadequate. It betrays even the usual standards of political football that are played on Opposition days. The right hon. Member for Leigh (Andy Burnham) said in his opening speech that it is time for honesty. To that end, we would like to know whether his party leader believes in “weaponising” the NHS. To that end, we would like an end to the shabby leaflets on the NHS that go around the country.

I would have liked mental health, which is an important topic, to replace the waste of words in the motion. The motion is a pathetic reuse of the tired and crumbling money-making policy—the mansion tax—that not even all Opposition Members agree with.

[Liz Kendall (Leicester West) (Lab)]

Will the hon. Lady give way?

[Chloe Smith]

Perhaps the hon. Lady will explain whether the mansion tax will be spent once or 20 times over, like Labour’s bonus tax.

[Liz Kendall]

Why is the NHS as a whole not one of the hon. Lady’s Government’s five priorities?

[Chloe Smith]

The hon. Lady will have heard the Secretary of State speak eloquently on the topic of the Government’s priorities. The point I was about to make is that economic competence allows us to run an NHS securely and strongly for the future. It is the Conservative party and this Government who are demonstrating such economic competence, thus allowing the NHS to be a priority for the future.

My final point is much more important than this political to-ing and fro-ing. My hon. Friend the Member for Blackpool North and Cleveleys (Paul Maynard) made a sensible point about the good that can come from local commissioning and joined-up working. I would add a third point, to make a kind of trinity. The third important thing we all want to see in our local health services is the making of decisions in good time. For example, the walk-in centre in Norwich has recently had to move. As I mentioned, I will be there tomorrow discussing this further with staff and patients. There was no need for the decision to relocate to be made at the last minute. It is a source of great frustration to patients locally that the decision was not confronted earlier on. It was there in black and white in the centre’s rental lease contract, so it was not too hard to spot.

Patients look to health officials—both locally and, where it applies, nationally—to make sensible decisions on time, and for those decisions to be made locally, wherever possible, and in a joined-up way, as my hon. Friend the Member for Blackpool North and Cleveleys rightly said. I would like the walk-in centre to look to its future by assessing its relationship with accident and emergency, GPs, physical health, mental health and all types of provider, including the voluntary sector, which has not been mentioned in the debate so far. I would particularly like decisions about the walk-in centre to be made in good time. There can be no forgiving decisions taken right up to the wire, which fail to deal with the real world as it stands in terms of rental contracts and, most importantly, fail to serve patients best.