National Health Service Debate
Full Debate: Read Full DebateChris Skidmore
Main Page: Chris Skidmore (Conservative - Kingswood)Department Debates - View all Chris Skidmore's debates with the Department of Health and Social Care
(12 years, 10 months ago)
Commons ChamberMy hon. Friend makes a very important point. That was precisely why I said it was irresponsible for the Conservatives to promise increases to the NHS in the way that they did, on a much-reduced public spending envelope. That has led to precisely the consequences that she describes. Indeed, that hidden cut to adult social care has been quantified at £2 billion.
I remember well Conservative party claims before the election about death taxes, but what about the dementia taxes that the Conservatives have loaded on to vulnerable older people up and down this country, who are now paying more out of their own pockets to pay for the care that they desperately need? That is the effect of cutting adult social care and cutting council budgets in that way.
We today the nail the position once and for all. The real position is worse than the one I described because of spiralling inflation, which in effect means even deeper real-terms cuts for the NHS this year and in all the years that follow.
The right hon. Gentleman mentions that the £2 billion transfer from the NHS social care budget is not ring-fenced, but I am sure he is aware that ring-fencing can have the perverse effect of ensuring that local authorities do not spend existing budgets. Will he clarify his position? Is ring-fencing a good idea or not?
I disagree with the hon. Gentleman. I said that it was irresponsible to pledge the money for the health service in the way that the then Opposition did in the run-up to the election precisely because I realised that more would be needed for adult social care. However, if the NHS is to transfer money to local government for adult social care, we must be certain that it will pay for that and not for weekly bin collections or for whatever else he thinks is more important than supporting older, vulnerable people with the costs of care. He makes my point that that money should have been ring-fenced, so that adult social care could have been protected.
The hon. Gentleman nods, but I am afraid that that was not the Secretary of State’s policy.
I shall give way in a moment.
If we thought that the Conservative party’s promises on funding were bad enough, the sheer audacity of its claims on hospital closures is breathtaking. Before the last election, the right hon. Gentleman toured the country promising the earth to every Conservative candidate he met. I recall seeing his commitments—I have them here—pile up in the Ashcroft-funded glossy leaflets that landed on my desk in the Department of Health. He said that he would reopen the accident and emergency department in Burnley; he said that he would save and A and E in Hartlepool, but, scandalously, only if the town elected a Conservative MP; and I well remember the day he visited his hon. Friend—although, after this week, I doubt that the Government Front Bench team still consider him a friend—the hon. Member for Bury North (Mr Nuttall) and promised the people of Bury in the leaflets I have here:
“Vote Conservative and if there is a Conservative government the maternity department will be kept open.”
It could not be clearer. However, the maternity department at Fairfield hospital is scheduled to close next March. It is disgraceful. However, the Prime Minister’s most shameful politicking came in north London. I lost count of the number of times he promised to save the A and E department at Chase Farm hospital.
On a point of order, Mr Speaker. Is it in order for the right hon. Gentleman to name my hon. Friend the Member for Bury North (Mr Nuttall) without telling him?
It is remarkable that we are having this debate today. As the Secretary of State has said, the Opposition’s motion is a remarkable own goal, especially as it has been confirmed that the Government will be increasing funds in real terms by 0.4% over the course of this Parliament. The shadow Secretary of State is shaking his head, but that will mean an extra £12.5 billion, which he has opposed today. It also remarkable that we have had confirmation from him of his comments in The Guardian on 16 June 2010, when he stated:
“It is irresponsible to increase NHS spending in real terms within the overall financial envelope”.
He agreed with that and I am delighted that he has put that on the record now that he has a second bite of the cherry, as the shadow Secretary of State for Health. He had an opportunity to make amends, and I thought he would, but unfortunately he has not. He also stated in the New Statesman on 22 July 2010:
“They’re not ring-fencing it. They’re increasing it.”
He was talking about the NHS budget and the fact that the Government were increasing it.
We have heard from the Secretary of State today that if there is an underspend, it has come entirely from the central departmental budgets. What is wrong with that? Does the shadow Secretary of State disagree that we might have cut down on costs such as the £115,759 he spent on a personal chauffeur during his time as Secretary of State? Does he oppose an underspend, given that during his time at the Department it spent £3.65 million on almost 26,000 first-class rail tickets? We have slashed that cost by more than 70%. Does he deny that he and the Department spent £1.7 million on luxury hotels during his time there? What is wrong with cutting such spending? What is wrong with the fact that Ministers are no longer using hotels such as the Hotel President Wilson in Geneva as they did in 2008 when the bill was £548.87 a night? If we are making those cuts to the central budget, I quite welcome our doing so.
I wonder that the hon. Gentleman is not more worried about issues such as those I raised earlier. The real cuts being experienced in my constituency are in NHS walk-in centres and in the active management of long-term conditions. That is a real downgrading of patient care. I am surprised that he is bringing up these expenses; I think he should focus on what is happening in the NHS.
I entirely agree that we need to integrate better social care in the NHS, and part of the reason why we have £2 billion going into social care is to tackle that problem. It is interesting that the hon. Lady does not deny that those spends have happened and that she does not apologise for the fact that the previous Government made those spends. Personally, I think they are a disgrace. Obviously, Opposition Members do not have a problem with spending £600 on a hotel in Switzerland, but I do. I say to the shadow Secretary of State, “Don’t build a greenhouse and then throw stones out of it.” Let us remember that it was the Labour party that gave us an NHS IT system at a cost of £12.7 billion—450% more than the original cost. It was the Labour party that gave us private finance initiative deals that were so badly drafted that they were worth £11.4 billion but cost £65 billion to pay off. What did the shadow Secretary of State say when he was the Secretary of State?
I am grateful to the hon. Gentleman for giving way and I hope that my intervention allows him to cool his jets a little. One cannot make a case about this by arguing about minutiae. Will he accept that for many of us the reality of the NHS is what we see at Central Middlesex hospital, where somebody turns up on a Monday to be told that the accident and emergency department closed on the previous Friday and has now been rebranded without there having been any democratic input? If one has any complaints about that, however, one should not even bother trying to find a person to speak to. That is the reality. The NHS is over-commercialised and is losing touch with its roots.
The hon. Gentleman will regret his comments. We have to pay back £65 billion on PFI deals that were originally signed for £11 billion—that ain’t minutiae. Many constituents are concerned about the waste that took place under the previous Government.
In 1997, there were 23,400 managers. That has gone up to 42,500. We are making a genuine attempt to tackle the problem. I could go on, but I will put the party politics aside.
Would the hon. Gentleman care to comment on the National Audit Office report in relation to savings that could be made from NHS procurement? Does he think that fragmenting the NHS will assist that or hinder it?
We are spending £1 billion more than we should on procurement because of the lack of consistency across the NHS, delivered principally by the previous Government. That is one area in which we could make vital savings. The NHS needs to change. Your boss, the Leader of the Opposition, said:
“To protect the NHS is to change it”
and we need to do so. The reforms that we are bringing in are essential if we are to deliver savings and also to ensure that the NHS survives when our ageing population means there will be twice as many 85-year-olds by 2030.
We need to reform the NHS and we do so in the spirit of what Tony Blair and new Labour put forward. Julian Le Grand, Tony Blair’s key adviser, said that the reforms were
“evolutionary, not revolutionary: a logical, sensible extension of those put in place by Tony Blair”.
When I asked him in the Health Committee whether this is what Blair would have done, he said: “Absolutely. Blair ‘would have tried’ to get these reforms through, but I imagine the left of his party may have prevented him from doing so.”
How does the hon. Gentleman square his enthusiasm for all these reforms with the Prime Minister’s statement that there would be no top-down reforms of the NHS?
We are introducing these reforms principally so that we put power back in the hands of GPs and, above all, patients. We are making these reforms because we have to. The status quo cannot remain—[Interruption.] If the right hon. Lady wants the NHS to continue as it is, fine. If the NHS is to be free at the point of delivery, it needs clinician-led commissioning. That is what we are going to achieve.
I agree with much of what my hon. Friend says. Does he agree that on such an important subject as the NHS, the people we represent and who sent us here would expect us to be thinking about how we can improve the NHS for patients and for the people who work in it, rather than engaging in this ridiculous tit-for-tat party political scrap that we are seeing this afternoon?
I entirely agree. A constituent, a lady who sadly lost her foot through a rare cancer, came to my surgery recently. She is allowed only one type of plastic foot from the NHS and the PCT. She wants what is called an Echelon foot which will allow her to walk up a hill—she is a hill walker—but under the current model she cannot get that alternative foot. By bringing in any qualified provider, we will allow patients and clinicians the freedom to choose for the first time—a choice that was denied under the “any preferred provider” model that the shadow Secretary of State still clings to vainly. We need to ensure that our NHS operates for the 21st century and I hope the reforms will deliver that.
To sum up, I will oppose the motion. It is juvenile—the text could have been written by Adrian Mole. This is about getting away from the politics of debate in the Chamber and giving the NHS back to the professionals and the patients. It is not our NHS; it is their NHS, and we need to ensure that we achieve that aim.