National Health Service Funding

Craig Whittaker Excerpts

Tuesday 22nd November 2016 Commons Chamber

[Craig Whittaker (Calder Valley) (Con)]

Our national health service is, and always has been, valued and cherished by my constituents who rightly expect an excellent standard of care to be provided free at the point of use when they need treatment. We are all deeply committed to the future of the NHS, but to ensure that it can continue to provide the quality of care that our constituents expect, it cannot stand still. It needs to continue to transform the way in which it delivers services so that more resources lead directly to better care for patients.

Both the total NHS budget and the amount of NHS spending as a proportion of total Government spending have increased in every single year since 2010. Spending is now 10.1% higher per head in real terms than in 2010, and that increase has brought our health spending as a proportion of GDP broadly in line with that of our western European neighbours. In order to achieve best value from its resources and to deliver £22 billion of efficiency savings—those are savings that the NHS identified as achievable in its five year forward view—it is necessary to reconfigure the way in which health and social care services are delivered at a local level. That is a huge issue, and until we amalgamate social care budgets with health budgets to deliver a truly health-driven service with proper health-led care in the community, we will struggle with this for many years. I mention that not to cause controversy, but to highlight the difficult decisions ahead. Too often those decisions and the long-term sustainability of our local services are hindered by ideology, local politics and empire protections over budgets.

A few weeks ago, the West Yorkshire and Harrogate STP was published, setting out the vision, ambitions and priorities for the future of health and care in the region. This built on the significant work that was completed locally by both the Calderdale and the Greater Huddersfield clinical commissioning groups, which have been working together to address the significant challenges facing the health economy across our whole area. The decision to proceed with the development of a full business case was met with considerable concern from some members of the public who have been vociferous in their opposition to what they perceive to be a complete withdrawal of urgent care treatment at Huddersfield royal infirmary. Although the process has been challenging, to say the least, I would argue that it has been absolutely essential. What is certain is that the current model through which health services in Calderdale and Huddersfield are delivered is not sustainable in the long term, and that changes are needed to ensure that we have a local health service that continues to provide excellent care.

Amid some of the sensational media headlines from the local press and the comments of some of my opponents at the last general election, it can be easy to forget that these proposals are being put forward not by politicians or by the Government, but by our senior local clinicians and doctors—the very people who understand how our local health services can best be delivered in the long term. They have taken an independent view about how the additional resources that the Government are making available can directly lead to better care for patients locally, and we have to trust their judgment. However, if we are to receive the support of our constituents for transforming the way in which we deliver their care, we must vastly improve the way in which we communicate any proposed changes and not keep scaremongering about cuts and reduced services, especially when the annual NHS budget spend is increasing in real terms.

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[Craig Whittaker]

Does my hon. Friend agree that one lever for discouraging bed-blocking would be to join up some of the budgets around health and social care?

[John Howell]

I do, and that is precisely what the organisations in Oxfordshire have been trying to achieve.

The second point I would make relates to how we produce better-serving hospitals. In my own area, the Townlands Memorial Hospital, which is in Henley but which serves the whole of south Oxfordshire, has recently gone through a major reprovision. It now has an increased number of facilities serving the population of the area, but the beds are not in the hospital. Although limited in number, they are in an adjoining care home, whose opening I happened to attend with the Duke of Gloucester only the other day. It is good to see the issues at the hospital finally resolved.

That is the way forward for local hospitals: better treatment for people in their home through a system of what has come to be called ambulatory care. Such a system prevents the problems I mentioned, with patients suffering when they stay in hospital for a long time. This view comes not from politicians but from clinicians both local and national. The national clinicians I would point to are those in the Royal College of Physicians, who are fully behind this process. This method costs more in the first instance but provides better value for money and increases better patient outcomes.

The third area I want to discuss is what can happen when we integrate the staff providing care who are employed by the county council and those who are employed by the NHS. This allows us to ensure that the pay and service requirements of both groups of people, who are doing exactly the same job, can be harmonised in a much more positive way. That sets out a good scope for efficiency in the operation of social care within the NHS model. I agree with my hon. Friend the Member for Calder Valley (Craig Whittaker), in that I would like to see them fully integrated, but until then I have set out a very good method of being able to operate in those circumstances and to co-operate in order to achieve the outcomes that I have mentioned.

Sustainability and transformation plans focus on organisations working together and are the best hope of improving health and social care services in the long term. That is not my view but that expressed by the King’s Fund when it looked at the plans. I fully agree with its assessment of the situation and of these plans, which are working towards achieving the same outcomes.