NHS Services (Access)

Debate between Dan Poulter and Lilian Greenwood

Wednesday 15th October 2014 Commons Chamber

[The Parliamentary Under-Secretary of State for Health (Dr Daniel Poulter)]

It is a pleasure to conclude this debate and to speak to the contributions of hon. Friends and hon. Members. It is a pity that when we have NHS debates, they sometimes become unnecessarily tribal and partisan. Some Labour Members often seek to talk down the local NHS rather than to stand up for their hard-working NHS staff who deliver high-quality services on the ground.

I want to talk about some of the successes this Government have delivered for our NHS and then I shall address some of the points raised in the debate. We know that even in these difficult economic times, this Government have protected our NHS budget with £12.7 billion more during this Parliament. That was something that the shadow Secretary of State, the right hon. Member for Leigh (Andy Burnham) called “irresponsible”, but it is not irresponsible to make sure that we continue to support and protect the NHS front line. We have stripped out over £5 billion-worth of bureaucracy and reinvested that money into front-line patient care. That has been audited by the National Audit Office, but the hon. Member for Leicester West (Liz Kendall) did not choose to highlight that point in her remarks. It has been confirmed and we know it is true.

I make no apology for the fact that we as a Government have focused ruthlessly on having a more efficient health service that frees up as much money as possible for front-line patient care. We have reduced the number of administrative staff by around 20,000, increased front-line clinical staff by over 12,500 and set up a cancer drugs fund that has helped 55,000 people who would not have received cancer drugs to receive them. There has been an unrelenting focus on promoting a more joined-up approach to care, to help deliver more care in the community for people with long-term medical conditions, particularly the frail elderly.

Let me deal with some of the comments and contributions to the debate. I would like to reassure my hon. Friend the Member for Morecambe and Lunesdale (David Morris) that the hospital in his constituency is, of course, not going to close and that any local scaremongering by the Labour party is wrong and misplaced. I would also like to reassure the hon. Member for North Durham (Mr Jones), who raised concerns about the north-east ambulance service, that the service has generally been performing well. In 2013-14, it met all its national targets. I urge the hon. Gentleman to write to me if he has any further concerns on behalf of local patients.

We heard strong contributions from my hon. Friend the Member for Norwich North (Chloe Smith), who made important remarks about the services delivered at the Norfolk and Norwich hospital, and I look forward to accepting her invitation to visit that hospital once again in the near future, and from my hon. Friend the Member for Bosworth (David Tredinnick) who made one of his regular pleas for more alternative medicine in the NHS. Importantly, he talked about the benefits of clinically driven commissioning. Under this Government, we have put doctors and nurses in charge of our NHS to make sure that services are delivered at local level. Patient services are run by doctors and nurses, not by bureaucrats, which has been a tremendous step forward. My hon. Friend the Member for St Ives (Andrew George) made a considered contribution about the previous Government’s record on encouraging private sector providers in the NHS—a point to which I shall return.

[Lilian Greenwood]

What does the Minister think about what happened to the clinical commissioning group in North Staffordshire, which decided not to allow people with mild to moderate hearing loss to have hearing aids, even though that was clearly not the view of the local health scrutiny committees or local patients? Is that not precisely putting in jeopardy preventive services, which would keep people in work and keep them active in the community rather than being isolated? It is stopping those people from participating.

[Dr Poulter]

If the hon. Lady has concerns about local commissioning decisions, she should take them up with local commissioners. Time forbids me from going into the rationing of services by the previous Labour Government. It is important that clinical services are now designed and delivered by front-line health care professionals, and if she is concerned about them, I am sure she will take that up with her local CCG.

The right hon. Member for Leigh (Andy Burnham) referred to a work force crisis in GP training. It is clear that under this Government 1,000 more GPs are now in training and working in the NHS than in 2010 when we came into government. If it is not accepted that that is good start, we have committed to training an extra 5,000 because we want more people working in general practice.

We have ensured that 1.3 million more people are being treated in A and E compared with the number in 2009-10. We have halved the time that people must wait to be assessed, and every day we are treating nearly 2,000 more people within the four-hour target compared with the number in 2010.

Competition was introduced into the NHS not by the Health and Social Care Act 2012 but by the previous Labour Government, of whom the right hon. Member for Leigh was a Minister. The Labour Government opened the door to private sector providers when they opened the first independent sector treatment centres in 2003. The Labour Government gave £250 million to private companies and independent sector treatment centres, regardless of whether they delivered that care. Labour was more concerned about giving money to the private centres than about ensuring that quality care was delivered. Labour paid independent private sector providers 11% more to provide the same care as NHS providers. That is Labour’s record on the private sector in the NHS—a record that shows that it is more committed to the private sector than any previous Conservative Government.

Oral Answers to Questions

Debate between Dan Poulter and Lilian Greenwood

Tuesday 27th November 2012 Commons Chamber

[Dr Poulter]

I thank my hon. Friend for that question. This point has been raised before and although it sounds like a good idea in principle, the problem is that different aspects of care in different wards—for example, an older people’s ward compared with a ward that looks after younger people—will have differences in the intensity of nursing. Therefore, a mandated ratio would be difficult to implement. A ratio may be counter-productive to making sure that we can give more intensive nursing cover where it is needed, and could even encourage a race to the bottom.

[Lilian Greenwood (Nottingham South) (Lab)]

T8. A recent Schizophrenia Commission report highlighted catastrophic failings in the care of people with severe mental illness. We know that suicide rates rise during times of economic hardship and that record numbers of people are being detained under the Mental Health Act. The Government have said that mental health should have parity with physical health, so why has funding for mental health services been cut for the first time in a decade?

Kettering General Hospital

Debate between Dan Poulter and Lilian Greenwood

Friday 9th November 2012 Commons Chamber

[Lilian Greenwood (Nottingham South) (Lab)]

Will the Minister give way?

[Dr Poulter]

It is interesting to find a Member from Nottingham, who I hoped would be in her constituency on a Friday looking after her constituents, taking such an active interest in this debate. However, I am happy to give way once on this issue.

[Lilian Greenwood]

I am attending this debate because I was here earlier to deal with a private Member’s Bill on behalf of the shadow transport team. Whatever the Minister says, is it not a fact that in the official documents, the “best” option is downgrading Kettering general hospital’s accident and emergency, maternity, children’s and acute services, and cutting a significant number of beds? How can he say that those services are safe?

[Dr Poulter]

The hon. Lady is turning this into a political debate, which is exactly what the Labour candidate in the Corby by-election has done. That is completely wrong and what she says is not true—it is scaremongering. There are no official documents at the moment because there is no consultation of that nature at the moment. There is no NHS consultation. Perhaps she should focus more on Nottingham, which is where her constituency is. I am sure her constituents would rather she were on the train back to hold a constituency surgery, which is what I will be doing after this debate, rather than making silly, ill-founded and mistaken political points about matters that bear no resemblance to her constituents’ concerns. I hope she will draw a lesson from this. I know she has been put up to making that point, but this is not the time.

The hon. Lady’s point was ill-founded. There is no consultation active in Kettering at the moment. There were some leaked documents about a range of options, which incorrectly set a number of hares running. The Labour candidate in the Corby by-election has already retracted his position. My hon. Friend has held the debate today because of that scaremongering, and because he is such a strong advocate for the needs of his patients in Kettering and his hospital. He wants to reassure them that Kettering hospital has a viable future.

[Lilian Greenwood]

Will the Minister give way?

[Dr Poulter]

I will not give way again. This is an Adjournment debate, not a general debate on the Floor of the House. The hon. Lady did not contact me before the debate to say that she would make a point—no Labour Member did. This is not a time to raise those points. The debate is about reassuring my hon. Friend that Kettering hospital has a viable future, which it does. That is confirmed clearly by Healthier Together, which has also confirmed that no active consultation is taking place; that, at the moment, we have only potential options appraisals; that A and E and maternity are safe; and that Kettering hospital has a viable future. I hope that the hon. Lady will put as much dedication into standing up for her hospital services in Nottingham as she has to making cheap party political points in a debate about a different part of the country.

I should now like to address some of the points, questions and legitimate concerns that have been raised, mostly as a result of the outrageous scaremongering by the Labour party. The Healthier Together programme has been put together, but, as I have said, there is no formal consultation at the moment. I am sure the concerns my hon. Friend so eloquently raised will be fed into it, and that the debate, and the comments of the Prime Minister and Health Ministers, will be part of it.

We recognise, as my hon. Friend has outlined, the importance of proper public engagement throughout any consultation process—as and when it comes. He will be aware that there has already been significant public and stakeholder engagement on how services in the midlands might need to look in future. As he rightly said, there are new demographic challenges—more people are moving into that part of the country—and the process of engagement must continue. If a formal consultation is opened in future, it is important that it meets the clear clinical tests for service reconfiguration. However, I should repeat that no formal consultation has been opened and it would be incorrect to allow any further Labour party scaremongering on that point.

It is worth bearing in mind that part of the reason for the concerns about services in my hon. Friend’s part of the world is the massive private finance initiative debt signed off by the previous Government to Milton Keynes hospital, which has struggled ever since the PFI was signed. That has led to significant pressures on Milton Keynes and other hospitals in the region. As we know, some services are specialist centres. It might be worth reflecting, before any further cheap political points are made, that one reason why there was a discussion about a consultation on services was the big PFI legacy of debt, which is stopping the delivery of high-quality front-line care. That is a direct legacy of the previous Government signing off bad PFI deals in health care. It is worth reflecting on that before any more scaremongering takes place.

When reconfiguration of health care takes place, the previous Government—and this Government—have laid down some key tests of what makes a good reconfiguration. It has to be led locally by local commissioners and decision makers, and my hon. Friend made that point very clearly. Any significant proposed changes to services would be subject to four reconfiguration tests set out by the previous Secretary of State for Health. They are local support for the changes from GP commissioners and clinical leaderships; robust arrangements for public and patient engagement, including local authorities; greater clarity about the clinical evidence basis underpinning proposals; and the need to take into account the development and support of patient choice.

In my hon. Friend’s region there are considerable distances between the hospitals involved and, if at some point in the future a consultation opened up, those greater travelling distances between hospitals would be taken into account as it may impinge on patient choice. I hope that restating those configuration tests is helpful. If there is concern that those tests have not been met, an independent review can be carried out by the independent reconfiguration panel, at the discretion of the Secretary of State. I hope that my hon. Friend finds that reassuring. I reiterate that at the moment there is no consultation formally on the table in Kettering, and its accident and emergency and maternity services are safe.

There are other significant challenges facing Kettering hospital and the local NHS, as my hon. Friend outlined. They are the same as those faced by the NHS everywhere— ensuring that we have services that are fit for purpose for the future to better look after the many older people—people are living longer—and the need to provide more dignity in elderly care. Part of that is having local bread-and-butter services. My hon. Friend rightly made the point that some health care services have to be regionalised, such as specialist trauma centres. The clinical evidence is that such centres save lives and, in my part of the world, we have one in Addenbrooke’s. Dedicated centres for stroke care also improve care for patients and the quality of outcomes for people with stroke, so that they can resume their daily activities much more quickly. Those day-to-day, bread-and-butter health care services that are so important, such as maternity and accident and emergency—and the cardiac services that Kettering is rightly proud of—are needed at a local level, and I am sure that any test of reconfiguration would confirm that they should remain accessible locally. We are very aware that many parts of the country are not urban. Many people face the challenges of rural life and the distances to travel between centres. Whenever services are redesigned in the future, it is important that those bread-and-butter services are available for local patients.

I reiterate the fact that there is no formal consultation proposal, and there is no place for scaremongering in these debates. I am sure that the future of Kettering hospital is a vibrant and successful one. I know that my hon. Friend has strongly advocated the dedication of local staff and I hope that he will take my reassurance back to them—so that they do not listen to the scaremongering—that Kettering hospital will still have a viable A and E and viable maternity services, and a very strong future.

Question put and agreed to.

Oral Answers to Questions

Debate between Dan Poulter and Lilian Greenwood

Tuesday 23rd October 2012 Commons Chamber

[Dr Poulter]

My hon. Friend makes an excellent point. It was the previous Government who, through the “Agenda for Change”, gave flexibility to NHS trusts to allow some employers to pay a 30% premium in areas with workplace shortages.

[Lilian Greenwood (Nottingham South) (Lab)]

17. At a time when NHS budgets are under exceptional pressure, my constituents simply do not understand why the Government are so intent on pushing trusts to divert money away from patient care and into wasteful local pay bargaining. Is there not a risk that Nottingham’s excellent NHS hospitals and community services will be unable to recruit and retain the best staff if regional pay results in cuts to their salary scales? The Government are supportive of the idea, endorsed by the previous Government, that local pay flexibility allows additional rewards to be paid to staff in areas with workplace shortages, as my hon. Friend the Member for Banbury (Sir Tony Baldry) just made clear. The Government are supporting the unions, employers and employees, as the NHS Staff Council, in coming together to try to agree how we need to modify the “Agenda for Change” and other agreements to ensure that they remain fit for their purpose of protecting employees.