National Health Service (Amended Duties and Powers) Bill
Debate between Clive Efford and Dan Poulter(10 years ago)
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Dr Poulter
I am just a doctor who still works in the health service and I practise medicine for free. Of course, we could go into the fact that I am the only Front Bencher present who has front-line experience of looking after patients. Professional politicians on the Opposition Benches are outlining a case that is incoherent with their record in government. We could also talk about the huge union funding that goes towards many Labour policies, but time would forbid us from doing so and I am sure that the Deputy Speaker would not want me to digress from the subject of this debate.
Let us come on to what the Health and Social Care Act actually did. First, it stripped out an entire layer of management from what was at the time an overly bureaucratic NHS. This is an important point that hon. Members would do well to listen to. The reforms will save our NHS £5.5 billion in this Parliament alone, and £1.5 billion every following year. That money is being put back into front-line patient care. In addition, as I notified the House in an answer to a recent written question, spending on administration as a proportion of the total NHS budget has fallen under this Government from 4.3% in 2010-11 to 2.9% in 2013. More money is going into front-line patient care because we have stripped out bureaucracy and administration and freed up that money to look after patients.
Between 2010 and July 2014, the number of infrastructure and administration support staff in the NHS has reduced by 10.3%, which is about 21,000. That includes a 17.7% decrease in managers and senior managers combined. Savings from reducing bureaucracy in this manner are being ploughed back into front-line patient care. For instance, we now employ 8,000 more doctors and 5,600 more nurses on our wards than in May 2010, and our NHS can do nearly 1 million more operations every year.
Clive Efford
The hon. Gentleman is taking us through a very detailed list of bureaucratic costs. Obviously, the Government are paying close attention to that, but why is it that when I asked them about the cost of overseeing the tendering process—the cost of lawyers, accountants and other advisers—they said that they do not collect that information?
Dr Poulter
I will come on later to the costs that the hon. Gentleman’s Bill would directly create. The point is that we should be proud—the Labour party should be supporting the Government—that we are reducing administration and bureaucratic costs, because that money is now being spent on patients. Why cannot Labour for once accept that a good thing has happened and that more money is now going into front-line patient care?
The second effect of the 2012 Act is that it empowered local doctors and nurses, as those closest to and most able to determine the needs of their patients, to design and lead the delivery of services around the needs of those patients. Thirdly, the Act placed great importance on and sought to drive increased integration across our NHS, a point clearly articulated by my hon. Friend the Member for Bosworth (David Tredinnick). Commissioners had duties placed on them by the Act to consider how services could be provided in a more integrated way, and we have since built on the Act by supporting a number of integration pioneer sites, which will trail-blaze new ideas to bring care closer together, particularly for frail elderly people and people with complex care needs. They will be leaders of change—a change we have to see in the health system, if we want to offer the very best quality of care to patients.
We are also supporting the health and care system through the £5.3 billion better care fund, with commissioners working in partnership with local authorities to deliver more integrated person-centred care. Offering seven-day services and delivering care that is centred on patients’ needs will encourage organisations to act earlier to prevent people from reaching crisis point. That is the sort of clinical leadership that the Act has fostered. It will refocus the point of care towards more proactive community-based care, for the benefit of so many patients.
Dr Poulter
The Government’s health care reforms ensured that, as under the last Labour Government, day-to-day decisions of care delivery became the responsibility of clinically led NHS commissioners. It is for the local NHS to decide which providers, whether from the public, private or voluntary sectors, can best meet the needs of their patients and deliver high-quality care.
Dr Poulter
I will give way one more time in a moment, and then that really will, I am afraid, be the lot, because I know that Mr Deputy Speaker would like me to come to a conclusion.
Dr Poulter
Thank you, Mr Deputy Speaker.
I have mentioned the benefit to patients many times in my speech, because that is, after all, what I care about as a doctor and what I care about as a Health Minister, and what I hope all hon. Members care about; I know that the hon. Member for Huddersfield (Mr Sheerman) does so.
Additionally, and contrary to claims made by some, TTIP will not prevent any future Government from changing the legal framework for the provision of NHS services. Neither will it prevent the termination of the private provision of such a service in accordance with the law or contracts entered into, as is already the case today. The reassurances that we and the European Commission offered were sufficient for the right hon. Member for Wentworth and Dearne (John Healey), a previous shadow Health Secretary, when he stated:
“On the NHS....my direct discussions with the EU’s chief negotiator have helped produce an EU promise to fully protect our health service including, as the chief negotiator says in a letter to me, so that: ‘any ISDS provisions in TTIP could have no impact on the UK’s sovereign right to make changes to the NHS.”
If it was good enough for the right hon. Gentleman—
Dr Poulter
I will give way to the hon. Member for Eltham and then I will conclude.
Clive Efford
That really will not wash. The Minister is saying that we must trust the Government and that they will not allow TTIP to apply to the national health service. The Bill says that this House will be sovereign; this House will decide whether TTIP applies to our national health service. Does he support that?
Dr Poulter
I was simply quoting the reassurances that his right hon. Friend had given to all hon. Members, which was that
“any ISDS provisions in TTIP could have no impact on the UK’s sovereign right to make changes to the NHS”.
If TTIP is good enough for the right hon. Member for Wentworth and Dearne , it should be good enough for everyone in the Labour party.