(9 years, 10 months ago)
Commons ChamberI am glad that my hon. Friend raised that point, as again it highlights the major difference between us and the Government. They were saying that we brought in private providers. Yes, that is true, but that was to bring down waiting lists for planned operations, such as hip and knee operations. As she has just rightly said, the Government are putting out to tender cancer services. That is a very different thing. The Government are presiding over a major increase in private ambulances providing blue light 999 services. That is a massively different policy from the one they inherited, which is why the points they have made simply do not hold water.
The right hon. Gentleman is making some emotional points here. Does he support the policies of his colleagues in Wales, and does he endorse the way in which they have dealt with the NHS in Wales?
I do get emotional about the NHS, because I believe in it, unlike the hon. Gentleman. That is fine, I do not mind—it does animate me. Let us have a look at Wales and, as I am about to come on to cancer care. In England, only 84% of patients receive treatment within 62 days. That is not good enough, and Wales has better figures on cancer care. The analysis of the four home nations’ health care systems found that there is good and bad in all of them and this Tory attack on the national health service in Wales has to stop.
I will move on to cancer and I will go back to the letter that I was quoting. It said:
“Thousands of patients are facing longer and even unacceptable waits to find out whether or not they have cancer, because services are under extreme pressure and referral targets are being missed.”
In 2014, 10,000 people in England had to wait longer than the recommended 62 days to start their cancer treatment. The number of patients waiting longer than six weeks for diagnostic tests has doubled in the past year—doubled, for cancer tests. That is simply not acceptable. We need to hear today what the Secretary of State is going to do about it and may I suggest that the very first thing he should do is stop the cuts to cancer care? A parliamentary question shows that expenditure on cancer services has fallen by £800 million in real terms since 2009-10; the information comes from his Department and I will send it to him. That is why the NHS has missed the cancer treatment target for two quarters running, the first time that it has ever done that.
The evidence is indisputable. The NHS has gone downhill on this Government’s watch and the question follows of what they are doing to bring GP, A and E and cancer services back up to national standards. That is what our motion and, more importantly, patients demand to know from the Secretary of State today, but they will also want to know why the NHS has gone from being a successful service four years ago to being at breaking point today. The front page of The Times on Monday offered us an answer. It quoted a senior Cabinet Minister who said:
“We’ve made three mistakes that I regret, the first being restructuring the NHS. The rest are minor.”
The Secretary of State is conveniently looking down and avoiding my eye at this point, but I am sure he has found out who that was. I am sure he knows. I know that he is avoiding looking at me, but is he prepared to tell us who it was or is he going to carry on with his head buried and avoiding—[Interruption.] He is blushing. I see that he has the good grace to do that, at least. It is an embarrassing comment, it really is, from a senior Cabinet Minister, but what use is it to people now, when people such as the hon. Member for St Ives (Andrew George) and I were pleading with the Government to stop the process, to admit that it was all a mistake? It is an embarrassing situation for the Secretary of State to deal with, but at least we have from the very top of this arrogant Government the first admission that their reorganisation was a major mistake.
The article goes on to quote an ally of the Chancellor, who says:
“George kicks himself for not having spotted it and stopped it.”
Not having spotted it? This was famously the reorganisation so big we could see it from space. Not spotted it? What planet was the Chancellor living on? The truth is that the Government could have and should have stopped the reorganisation for the simple reason that they were elected on a promise of no top-down reorganisation and did not have the permission of a single person in this land to carry it out. That is why Thursday 7 May 2015 will be their day of reckoning on the national health service.
If this private apology now is designed to bring people back on board, it will not work. Doctors and nurses lined up to plead with the Government to call the reorganisation off, but they ploughed on. In the words of Mark Porter, chairman of the British Medical Association:
“The damage done to the NHS has been profound and intense”.
Let me focus on just one example of that damage, staffing costs, as the Secretary of State was talking about them this week. The staff census shows very clearly that in the early years of this Parliament, when spending on back-office restructuring was at its peak, front-line nursing posts were cut by about 7,000. At the same time, the reorganisation threw nurse training into chaos. Training places were cut and have never recovered, down from 21,000 a year to 18,000 today.
The NHS has been recruiting more staff in the wake of the Francis report, but this is where the damage done by the reorganisation is hitting NHS trusts. They are being forced to recruit overseas or to turn to agency staff because there are simply not enough nurses coming through the training system.
I have been contacted by a whistleblower from a trust in Liverpool who says that it is now common for staff to receive text messages from agencies such as Pulse offering huge fees—up to £1,000—to work weekends in London or the north-east, with all travel and accommodation costs paid. That is now the norm, and it is happening on this Secretary of State’s watch. Some nurses are literally taking off one uniform on a Friday night and putting on another for the weekend. That is why the agency bill is out of control, and it is happening on his watch.
In 2013-14 the NHS spent £2.6 billion on agency staff. For foundation trusts that is a staggering 162% over what was planned. That helps to explain why trust deficits are mounting. Does not this mismanagement of the staffing budget explain why the Government are now reneging on their promise to pay nurses a meagre 1% pay rise? Is not that the real reason? I wonder how the Secretary of State thinks those nurses will feel when they read this week that senior mangers’ pay has increased by 13.8% on this Government’s watch, while their pay has gone up by only 5%. I am told that he has refused to meet the unions even to discuss it. It is not good enough. He should get to the negotiating table tomorrow and start treating the staff of our national health service with the respect they deserve.
First, let me just correct for the record what the right hon. Gentleman has said. The Prime Minister’s commitment was not just a continuation of the ring fence; he has committed to continue to increase funding in real terms for the NHS. If the right hon. Gentleman looks at the record of this Government, he will see that we have increased spending on the NHS by more, in real terms, than Labour’s promises at its conference. The point about promises is whether the people making them are credible. Which party will deliver the strong economy that can fund the NHS?
Will my right hon. Friend confirm that this Government have increased spending on the NHS in real terms by 3%? In Wales, where Labour is in control, there has been an 8% cut in real terms. How can we possibly trust a word Labour says on funding for the NHS?
That is the point. We get all sorts of rhetoric from Labour, but when we look at its record of running the NHS—whether its disastrous record in England previously, or its disastrous record in Wales today—we see the real face of Labour policies on the NHS, and no one should ever be allowed to forget it.
There has been a lot of discussion about reorganisation. The right hon. Gentleman criticised reorganisation as if it were the last thing in the world that a Labour Government would do, but the previous Labour Government had nine reorganisations in just 13 years. Following the conference season, we know that Labour wants to have yet another one by effectively abolishing clinical commissioning groups in all but name and making GPs work for hospitals. There is widespread opposition to that policy across the NHS.
The right hon. Gentleman has repeatedly claimed that the reforms have cost £3 billion, but the audited accounts show that the reforms will save nearly £5 billion in this Parliament and £1.5 billion a year thereafter. These are the words of the National Audit Office—[Interruption.] He should listen to this, because this is about an independent audit that relates to a key part of his case. These are the words of the National Audit Office in its 2013 report:
“The estimated administration cost savings outweigh the costs of the reforms, and are contributing to the efficiency savings that the NHS needs to make.”
Will he publicly correct the record and accept what the National Audit Office has said, which is that the reforms saved money? The man who is never short of a word is suddenly silent. I have the National Audit Office report here, so he can see for himself. The reforms saved money.
If the right hon. Gentleman wants to talk about wasting money, I am happy to do so. The management pay bill doubled under Labour, compared with a 16% drop under this Government. The private finance initiative schemes left the NHS with £79 billion of debt. The IT fiasco wasted £12 billion. We will take no lectures on wasting money from the party that was so good at wasting it that it nearly bankrupted the country, let alone the NHS.
The Government argued that the current NHS reforms—their NHS reforms—would result in major savings to the NHS, making our system more “responsible, efficient and affordable.” I am sure that many Labour Members will agree that reforms under the Health and Social Care Act 2012 have failed to deliver a single one of these aims. The NHS is costing more and delivering less, the quality of care it provides has declined and hard-working staff, particularly GPs, nurses and staff in A and E, are bearing the brunt of the Government's misguided and irresponsible measures.
It seems that senior Cabinet Ministers may think the same as Opposition Members. As we have heard, The Times quoted one as having said:
“We’ve made three mistakes that I regret, the first being restructuring the NHS. The rest are minor.”
I think that it is about time Government Members owned up to their mistakes, and started to share their opinions openly with the House.
The reorganisation caused upheaval in every part of the NHS. Primary care trusts and strategic health authorities were abolished, and commissioning responsibility was transferred to NHS England as well as to clinical commissioning groups. The chair of a health and wellbeing board told me last Friday: “I am left more confused by the NHS England role than by anything I have seen over decades of involvement with the NHS.” More than 440 new organisations have been created, but all the evidence now shows that that has been done at a heavy economic and social cost. Some £3 billion has been wasted on altering the structure of the NHS rather than being spent on front-line patient care, and the reforms have consistently failed to be delivered within budget. In July last year, the National Audit Office stated that the cost of their implementation had been 15% more than originally expected.
Of course, we hear counter-claims from Ministers. When I tried to intervene on the Secretary of State, he would not take an intervention on the issue of management and reorganisation costs. It was interesting to hear what was said yesterday by Kieran Walshe, professor of health policy and management at Manchester business school, on Radio 4 about the savings claimed by the Secretary of State. He said that the Government had under-counted the costs of reorganisation, even to the extent of accepting nil returns from some strategic health authorities. Most tellingly, he said that the best way in which to test the facts was to talk to people in the NHS who had lived through the reorganisation. He said that he had not talked to anyone who thought that the reorganisation had made the NHS more efficient and more productive. He had not talked to anyone who thought that the trauma of total reorganisation and redesign was worth while. None of us understands why PCTs were replaced by CCGs, or why NHS England was created. He also said:
“I don’t think you will find anyone who thinks the new system costs less to run”.
We know that the financial difficulties of the NHS have worsened, not improved. For the first time, foundation trusts have found themselves in deficit, along with trusts that are not foundation trusts. Figures from Monitor showed that 86 out of 147 trusts were in the red, and that there had been a deficit of £167 million in the first quarter of 2014-2015. Alongside that, not surprisingly, we are seeing a decline in patient care. In all areas of the NHS, pressures are mounting and the quality of care is declining. The number of people waiting more than a week for an appointment with a GP is up. A survey of patients in Salford for our CCG showed that a third of the patients who responded had had to wait for days for an appointment, and one in seven Salford patients had had to wait for a week or more. That is better than the national picture, but it is not good enough. For the first time, the NHS has missed its cancer treatment target; and NHS workers have felt the need to go on strike—the largest strike of its kind in over 30 years. We have an NHS in crisis.
As we know, there are many challenges in addition to the damage that has been inflicted by the Health and Social Care Act 2012. We have heard about the mounting demographic pressure on health services. However, despite the increase in the number of people aged over 80, the Government have slashed local authorities’ budgets, causing them, in turn, to change eligibility for social care. I believe that that is one of the most serious failings. My city council in Salford has been subjected to savage cuts of £100 million, and—I mentioned this earlier, and I shall keep on mentioning it—1,000 people in Salford will either lose care packages or not qualify for care this year.
Does the hon. Lady think that members of the public should vote against any members of any political party who have imposed a cut on the NHS anywhere in the United Kingdom?
I am not going to answer hypothetical questions like that. I am talking about local authority budget cuts, and the parlous state in which social care will find itself after £3.7 billion has been taken away from it.
Constituents have told me about care staff working locally who have been allocated too little time to devote to the people in their care. That is a scandal. I have been told that a single care worker was sent out when two were needed to care safely. I have also been told about patients in nursing homes who have not been properly changed or helped to eat by care staff who are rushing to manage their work load. That is the reality, and it is not the way in which to create a sustainable health and social care system. I therefore wholeheartedly support Labour’s alternative plans. We must create an NHS with the time to care.
I agree with my right hon. Friend the Member for Leigh (Andy Burnham) that we must repeal the Health and Social Care Act 2012 before it causes any additional lasting damage to a health system of which people in this country are rightly proud, although they will not be for much longer. I shall be here on 21 November to vote for the private Member’s Bill. We must find ways of providing the resources to cope with the challenges that the NHS will face. As my right hon. Friend said, Labour has pledged to raise £2.5 billion for the NHS Time to Care fund, which will provide 20,000 new nurses, 8,000 more GPs, 5,000 new homecare workers and 3,000 more midwives. And do we need them? Yes we do.
We must also move towards an integrated model of health and social care. That integration in itself will not solve the financial problems the NHS faces, but moving to a model that allows for equal consideration of all a patient’s health and care needs can improve services and should reduce duplication. Above all, we must place patients and carers back where they belong, at the heart of a health and social care system that works for them and puts their needs before those of the providers and the ridiculous and convoluted commissioning structures that we have been arguing about in the debate today.
The Secretary of State and his Ministers will know that I have had cause to write to them, to e-mail them and even to meet them on numerous occasions to discuss the absolutely appalling second-rate NHS treatment that patients in my constituency are receiving. They are receiving such treatment from an NHS that is run entirely by the Labour party, which is enacting precisely the policies that Opposition Members wish to enact here. Those patients include Mariana Robinson, whom the Secretary of State was good enough to meet recently. She has waited months for diagnostic treatment for an illness that could well be cancer; she does not know what it is. She wants to be treated in England by the coalition-run national health service.
Those patients also include Mr Christmas in Abergavenny, a war veteran who is in his 80s. He had constant chronic pain in his tooth that was keeping him awake at night, but he was told that, despite his age and his war service, he would have to wait nine months for any form of treatment. In the end, he was forced to use his meagre savings to go private. Ann Wilkinson also wants to be treated in England. She has stated very publicly that she has cancer, but there is no cancer drugs fund in Wales and she wants to have access to Avastin. I believe that she will shortly present a petition in Parliament and in the Welsh Assembly demanding the same high standards in Wales that this coalition Government are already delivering in England.
Some Opposition Members, including the hon. Member for North Durham (Mr Jones), wanted to quote statistics.
The hon. Gentleman mentions access to cancer services. He might have heard me say earlier that the NHS here is missing its national cancer target, with more people waiting longer than 62 days. In England, only 84% of patients start to receive treatment within 62 days. Does he acknowledge that 90% of patients in Wales start their treatment within 62 days?
When they have been diagnosed. The right hon. Gentleman has failed to point out that while only 2% of patients wait more than six weeks for diagnostic treatment in England, 33% of patients do so in Wales. That is absolutely disgraceful. If a situation in which 2% of patients are waiting more than six weeks is bad, what on earth are we to make of a situation in which 33%—one in three, or so—are waiting that long? I hope the hon. Gentleman would agree that that is a disgraceful situation.
The hon. Member for North Durham talked about ambulance response times and gave the House some interesting examples. However, the recent Nuffield report demonstrated that the worst ambulance response times in the United Kingdom were in Wales. We have accident and emergency targets, for those in Wales who are lucky enough make it into a hospital, but those targets have not been met since 2009. We have waiting list targets of 26 weeks, as opposed to the 18-week targets that apply in England. One in seven of the population in Wales is on a waiting list. That is what lies in store for people if they vote Labour at the next general election.
It was interesting that the hon. Member for Worsley and Eccles South (Barbara Keeley) was unwilling to say what she thought voters should do about people who wanted to cut NHS budgets. Despite all the Opposition rhetoric, this coalition Government have kept their promise and continued to fund the NHS. In real terms, we have increased its budget, whereas Labour—where it is in office—has cut NHS funding in real terms by about 8%. It cannot escape any of the blame for this. We heard about reorganisations earlier, and we have had several in Wales. We went from having five health boards to having 22 and then back to having seven. Not only has Labour been in power constantly, either completely or as the dominant party, ever since the Welsh Assembly was set up in 1999, but it has rammed those health boards full of Labour party supporters, failed parliamentary candidates, ex-Assembly Members, local councillors and the like. In one case, Labour put in a former general secretary of the TUC, who, I am guessing, is probably not a supporter of the Conservative party. Labour has politicised the health boards and it must therefore take complete responsibility for the shambles that has led to so many people wanting to be treated not in Wales but in England, by the coalition-run NHS.
No more damning example of all this can be given than the recent antics with the OECD, which is trying to carry out a comparison on NHS systems across the whole of the United Kingdom. The coalition Government are keen for that study to go ahead and are delighted with the opportunity to have themselves compared with Wales, and they should be; they have every reason to look forward to that. But of course the reaction in the Welsh Assembly has been one of absolute horror. I am told by very reliable sources that the Welsh Assembly Government cancelled the visit by OECD officials because they were so desperate to try to ensure that no report comes out before the general election. Of course, people watching this debate do not have to take the word of anyone in this room; they simply have to Google “Wales NHS waiting lists” or something similar to see story after story about people who have been badly treated by the NHS in Wales and want to be treated by the NHS run by the Under-Secretary of State for Health, my hon. Friend the Member for Central Suffolk and North Ipswich (Dr Poulter), who is sitting on the Front Bench.
I could suggest much that would improve things. Ideally, I would like to see the power taken away from the Welsh Assembly, because it has simply made such a mess, but that is never going to happen. If Opposition Members are confident that they could do a good job with the NHS, they should support the OECD report, and get their colleagues in Wales to get behind it and bring it out as quickly as possible. They should allow funding to follow patients, so that where a patient from Wales wants to be treated in England, that should be able to happen, with the money simply deducted from the Welsh Assembly block grant. Of course, the same should apply vice versa; any patients from England who want to be treated in Wales should be allowed to have that chance—I do not see many doing that.
One of the more irritating bits of propaganda coming out of the Labour party is that it says that lots of people from England are being treated in Wales. That is true, as historically there have been people with Welsh GPs who have to be treated in Wales even though they live in England. However, these people have set up an action group called Action4OurCare and are trying to take legal action on this. These are normal patients, not party activists, who want to be treated by the coalition-run NHS.
About the only good thing that comes from all this is that Labour apparently wants to make the NHS one of the main planks of its election campaign. I say bring it on, because I cannot wait to debate the NHS with Labour party members all over the United Kingdom. I will ask them about Wales and the cuts to the budget, the lack of a cancer drugs fund, the long hospital waiting lists and the fact that its ambulance response times are the worst in the United Kingdom. I shall remind them that people are already voting with their feet—they are voting to get out of the Labour-run NHS in Wales and get into the coalition-run NHS in England. They will shortly have the opportunity to vote not with their feet but in the ballot, and I very much look forward to seeing them have the opportunity to do so.
It is a pleasure to close today’s debate and to follow my hon. Friend the Member for Luton South (Gavin Shuker), who spoke very powerfully. In fact, hon. Members on both sides of the House have spoken with great passion and commitment about the NHS and the vital role it plays in their constituents’ lives and in their families’ lives. Many hon. Members, including the hon. Members for South West Devon (Mr Streeter), for Bosworth (David Tredinnick) and for Morecambe and Lunesdale (David Morris), have rightly praised NHS staff for working tirelessly to deliver good quality services despite all the challenges they face.
However, we have also heard countless examples of what the Alzheimer’s Society, the Multiple Sclerosis Society, the Royal College of Nursing, the Royal College of Midwives, the Royal College of General Practitioners, the Royal College of Physicians, the Royal College of Paediatrics and Child Health, the British Medical Association and many others said in their letter to The Independent last week. It stated that
“Signs of a system buckling...are everywhere…The NHS and our social care services are at breaking point and things cannot go on like this.”
We heard from my hon. Friends the Members for Corby (Andy Sawford) and for Worsley and Eccles South (Barbara Keeley) about how more and more people are struggling to get an appointment with their GP, with one in four waiting at least a week and thousands waiting more than two weeks.
Hon. Members, including my hon. Friend the Member for Nottingham South (Lilian Greenwood), spoke about how the huge cuts to local council care budgets mean half a million fewer older and disabled people, some of the most vulnerable people in society, are getting vital services, such as home care visits or home adaptations. This is leaving their families struggling to cope and to pick up the pieces.
Fewer services in the community mean that increasing numbers of frail, elderly people end up ringing 999, going to A and E and getting stuck in hospital when they do not need to be there, causing them and their families distress and costing the taxpayer far more. Ambulance services are under huge pressure, as my hon. Friend the Member for North Durham (Mr Jones) said. Hospital A and Es have now failed to meet the Government’s lower four-hour waiting target for 63 weeks in a row. A and E performance over the summer has been worse even than at the height of last winter. Delayed discharges from hospital are at a record high and cost more than £250 million in the last 12 months alone—money that could have paid for a year’s home care for 37,000 older or disabled people. Where on earth is the sense in that?
Rising emergency admissions and delayed hospital discharges mean planned operations are going backwards, too. More than 3 million people are now on the waiting list. The 18-week maximum wait target has been missed for the last two months in a row, and the NHS has missed the 62-day wait for vital cancer treatment—
I will not. [Interruption.] If the hon. Gentleman is going to talk about Wales, 90% of patients get their treatment within that target, compared with 84% here, so let me save him some time and bother.
The Government’s failure to keep people out of hospital and keep waiting lists under control, means the NHS is facing a looming financial crisis, too. Two-thirds of all acute hospitals are already in deficit to the tune of £500 million. They predict they will end the year £1 billion in the red, piling on the pressure for even greater service cuts and worse standards of care in future.
The tragedy is that it did not have to be this way. After 13 years of investment and reform, the previous Labour Government left the NHS with the highest ever patient satisfaction rates and the lowest ever patient treatment waits. But we were not complacent. We understood that the NHS had to face up to even bigger challenges: our ageing population, the increase in long-term conditions and huge medical advances, at a time when there is far less money around. For that reason, we had a plan in every region to reform front-line services, through Lord Ara Darzi’s NHS next stage review, by delivering some services in specialist centres so that patients got expert treatment 24/7 and by shifting other services out of hospitals and into the community. It was a move towards prevention joined up with social care to help people stay living at home. Instead of going ahead with our reforms, however, the Government scrapped them and forced through the biggest backroom reorganisation in the history of the NHS, wasting three years of time, effort and energy, and £3 billion of taxpayers’ money that should have gone on patient care.
The Health Secretary told the House today, and said on the “Today” programme, that the Government had saved £1 billion.
(10 years, 2 months ago)
Commons ChamberWhat is happening in north-west London is going to make patient care better. It involves the seven-day opening of GP surgeries, over 800 more professionals being employed in out-of-hospital care, and brand new hospitals. That is a huge step forward, and the hon. Gentleman is fighting a lone battle in trying to persuade his constituents that it is a step backwards.
This Government recognise the pressure that the NHS is under, as I was telling the shadow Health Secretary. The fact that the population is ageing means that the NHS now needs to perform 850,000 more operations every year than when he was in office, which we are doing. That means that some patients are not receiving their treatment as quickly as we would like, so NHS England is this week announcing programmes to address that, ensuring that we maintain performance while supporting the patients waiting longest for their treatment, something that did not happen when he was in office. We will not allow a return to the bad old days when patients lingered for years on waiting lists because once they had missed their 18-week target, there was no incentive for trusts to treat them.
A and Es, too, are facing pressure and are seeing over 40,000 more patients on average every week than in 2009-10. NHS staff are working incredibly hard to see and treat these patients within four hours, and it is a tribute to them that the median wait for an initial assessment is only 30 minutes under this Government, down from 77 minutes under the last Government. However, as we did last year, we will continue to support trusts to do even better both by improving their internal processes and working with local health economies to reduce the need for emergency admissions. This will be led by NHS England, Monitor and the NHS Trust Development Authority.
We have heard some comments from Opposition Members about waiting times. My right hon. Friend will be aware that fewer than 2% of patients in England wait for more than six weeks for diagnostic treatment, but is he aware that the figure is 42% of patients in the Labour-run NHS in Wales?
I am aware of those shocking figures, and I am also aware that the Royal College of Surgeons says that 152 people died on waiting lists in Wales at just two hospitals because they did not get their treatment in time. I gently suggest to the shadow Health Secretary that the Labour party might want to fix what is going on in Wales if it is really serious about patient care, because how Labour is running the NHS in Wales is an absolute disgrace.
Order. The shadow Secretary of State is clearly not going to give way at the moment.
The Prime Minister set his own test for his reorganisation: its effect on waiting times. This month, waiting times hit a six-year high. Almost 3 million people are now on the waiting list for treatment, up by half a million since 2010, but that is not all.
On a point of order, Mr Speaker. The shadow Health Secretary does not seem to want to give way to anybody from Wales. Is there any reason for that, and could it be a case of discrimination of some sort?
I am always interested in the ingenious interventions of the hon. Gentleman, but that is not a matter for the Chair and I will not speculate on it or in response to the hon. Member for Swansea West (Geraint Davies). We will return to the shadow Secretary of State.
Interestingly, health is not even covered in the Queen’s Speech, but we are debating it so I will say a few words about it. The good news is that my granddaughter has just been accepted by Liverpool university to study midwifery, so that is some compassion coming back into the health service. The bad news is that on Friday I had a meeting with GP commissioners who came to see me because they are teetering on the edge. I am talking about the Northumberland commissioners who are running the doctors consortium. They had a budget, worked to it and were doing all right until the Government came along and clawed money back. I would not mind if the Minister tried to say why the Government clawed money back from them; I would be interested to know that.
We know what is happening in the health service and we know why there is no Bill. Since this Government came to power we have seen creeping privatisation; no corner of the health service is untouchable as far as privatisation is concerned. Sometimes I just wonder what is going to happen in the next few years—God forbid if the Tories get elected again, with this lot here in charge. Are we going to be paying for our health service? Are charges going to be put on the health service? That is a good question to ask to see whether we can get a denial from the Government—
Sit down, you will have your Welsh question in a minute. It would be good if the Minister could deny that he has any intention of charging for any services in the health service in the future, because they are creeping in little by little. As for the nurses—the people who run the health service and do all the work—their miserable wage rises are absolutely disgraceful and this Government should be ashamed of taking even that 1% away from them; they should get more but the Government are not even going to give them the 1%.
Let us get back to the reality. This Queen’s Speech was the dullest one I have seen in my 27 years in this place, and I think everyone would agree on that. I sat down and I said to myself, “How can I liven it up? What if it was my Queen’s Speech? What if I jumped on the bike of my hon. Friend the Member for Bolsover (Mr Skinner)—although it has been pinched—and got into Buckingham palace to ask them to take my speech to the House of the Commons instead of the one they were going to read out?” My first Bill would be on the national minimum wage—I would put a Bill through to increase it to £10 an hour. My second Bill would be on a shorter working week—32 hours without loss of pay. My third Bill would call for full employment with no redundancies. There would be a repeal of all anti-union laws, and the reintroduction of collective bargaining. My next Bill would restore health and safety for workers. The health and safety budget has been cut by 35%, so we need a Bill to put that right for working people.
My fifth Bill would bring an end to privatisation. There would be no more privatisation of the trains or the buses—[Interruption.] Never mind about the increases and the costs; this is my Queen’s Speech, not Labour’s. There would be no more asset stripping of public facilities. Bill No. 6 would be to get rid of Trident, which would make me popular, especially with the Scottish nationalists.
My seventh Bill would put the buses and trains back into public ownership. It would try to stop the privatisation of the east coast main line, but I very much doubt that we can stop it now, as this Government are hell bent on getting rid of it before they go out of power. But we will restore it to public ownership—at least I hope we will; I hope that our Ministers are listening, and that we will restore it.
My eighth Bill would bring education back under local democratic control. We have heard in the statement today how out of control things are. Local authorities are wavering. Their spending has been cut, and they have very little say over the academies or the free schools. Anything could happen in the education service now, because we no longer have that local watch, so we need to bring it back.
My ninth Bill would be about the national health service. I want free public health care for all. That would be a big Bill and it would cost a lot of money, but we need to stop this creeping privatisation. I would get that money from one place: I would go to the City and tell all those spivs and bankers, “Your bonuses are stopped, because of all the money you have spivved off the working people of this country.” It is the working people who have had to pay for the austerity measures. I would tax those people and get the money for the Bills in my Queen’s Speech.
Living in and representing a constituency on the border has given me a unique insight into the different systems that have now grown up in the NHS in Wales and the NHS in England. One thing has become absolutely clear—not just to me but to any independent organisation that has looked into this—and it is that the standards of care being delivered by this coalition Government are far higher in England than they are in Wales, where the NHS is run by members of the Labour party.
The reality is that, judged on virtually any single indicator that one would care to look at, standards of treatment are better in England than they are in Wales. The waiting times for cancer have not been met in Wales since 2008; the four-hour accident and emergency target has not been met in Wales since 2009; the ambulance response times targets have not been met in Wales for 21 months; and in Wales the funding for the NHS from Labour, which claims to be the party of the NHS, has been cut by 8% while NHS funding has been ring-fenced in England.
That has led to all sorts of situations. For example, an Opposition Member talked earlier about cancer in England. In England, of those people being diagnosed with cancer less than 2% have to wait longer than six weeks for their diagnosis, while in Wales 42% of people being diagnosed with cancer have to wait longer than six weeks to receive a diagnosis. The treatment times are also different; in Wales, people wait around 26 weeks, whereas in England the wait is just 16 weeks.
Behind these dreadful statistics are a range of human stories. I was grateful to the Secretary of State for Health for allowing me to meet him with a constituent of mine, Mariana Robinson. She had been trying unsuccessfully to get treated in Wales for months and there was absolutely no interest in helping her. She wanted to be treated in England; she was one of many people who would rather be treated by this coalition Government in England than by the NHS in Wales. Finally, after a great deal of correspondence and after receiving advice from the Secretary of State in London, the NHS in Wales has finally relented in this instance, and Mariana will now be treated in Bristol. I am grateful to the Secretary of State for his help.
Even this afternoon, while I was waiting to speak, I had yet two more e-mails from people who are totally dissatisfied with the treatment they are receiving in Wales at the moment and who would be prefer to be treated in England. I was contacted by an 88-year-old veteran who had served in the Korean war in the Fleet Air Arm of the Royal Navy. He is in constant pain at the moment and unable to sleep because of a problem with wisdom teeth. He has been told that he will have to wait nine months for treatment in Wales. I do not believe that such a thing would be allowed to happen in England, but he has been told that he cannot seek any treatment in England; he has no right to transfer his health care to a place where it can be provided more efficiently.
Labour Members talked about the privatisation of the NHS. The Conservative party will never privatise the NHS; we have always believed that treatment should be free at the point of service. It is members of Labour in Wales who are responsible for supporting private health care, because they are putting patients in Wales in a situation where the only chance they have of being treated is to go and seek private health care. The 88-year-old veteran of the Korean war was told that if he wanted to have something done about the constant pain he is suffering, he would have to go private.
I was also contacted today by a lady, the retired head teacher of a school in my constituency, who found a lump in her breast. She expected to be seen by someone almost immediately, as she would have been in England, but she was told that the first appointment she will have will be some time in late August.
That is the reality of what is happening in Wales under a Labour-run NHS, and the Leader of the Opposition has said that we should “take lessons”—this is to quote him—from how the NHS is being run in Wales and try to implement them in England. My message today is to warn everyone, particularly Government Members, not to let these people be in charge of the NHS, because what we will end up with in England is longer waiting lists, slower ambulance response times, people not being diagnosed properly and no cancer drugs. Apparently, 150 people in Wales have died while waiting for heart treatment. It is an absolutely disgraceful situation.
I have talked to Government Members about a suggestion that I made in relation to the Government of Wales Bill, which is to let these people put their money where their mouth is. If they think they are doing a good job with the NHS in Wales, they should allow patients in Wales and England to opt to go wherever they want to for treatment. At the moment, we have two totally separate NHS systems, so patients in Wales do not have the right to access treatment in England and, of course, patients in England could not go to Wales. A lot of patients in Wales want to be treated in England. I do not believe there are any patients in England who would want to be treated by the Labour-run NHS, but perhaps there are some out there who fancy waiting longer to be diagnosed and then waiting longer again to get the treatment that they have a right to expect.
Let us see Opposition Members supporting a change to legislation that would allow patients in England to be treated in Wales, with the money required being added to the block grant given by the Government to the Welsh Assembly every year, and patients in Wales who want to be treated in England having the right to access that treatment in England, with the money required being deducted from the block grant that is handed over to the Labour party in Wales every single year. And let us see the direction of movement, because I know that an enormous number of people will immediately opt for the lower waiting times, the better diagnosis and the wider access to drugs that are available to people in England.
Does the hon. Gentleman accept that there are only 3 million people in Wales, and that when we compare Wales with a lot of the English regions and hospitals we do just as well? In London, we obviously have international centres of excellence. In Wales, we spend more cash per head. There is a sparser population and more nurses per 1,000 people, and we have better results on cancer than elsewhere, so there is a mixed picture. He is being completely political and undermining the morale of people working in the health service in his constituency; it is disgraceful.
It is not a mixed picture at all and we should be very clear about that. People wait longer for treatment in Wales than they do in England. People wait longer to be diagnosed in Wales than they do in England. People wait longer for an ambulance in Wales than they do in England. Money for the NHS is being cut in Wales and it is being ring-fenced in England, because the NHS will be a priority.
The real disgrace is that Labour Members have always prided themselves on being the party of the NHS and have gone out of their way to do so. Because they have that reputation, they know that in Wales, and possibly in England too if they ever end up running things, they can get away with making cuts and with cosying up to the unions because they feel that people will trust them.
I say to anyone independent and impartial who wants to know what it would be like for NHS patients if Labour Members ever get into government, they should look at what is happening in Wales right now.
I will give way to the hon. Gentleman even though he did not extend that courtesy to me or to anyone else from Wales.
Of course, people only needed to see the NHS at its highest satisfaction levels in 2010 to know what Labour in Westminster would do. I will correct the record on cancer waits, because of course Wales has a better record on cancer waits than England does: 92% of people in Wales are seen within 62 days, as opposed to 86% of people on this side of Offa’s Dyke.
That is a fairly minor difference—[Interruption.] Oh yes. However, what the hon. Gentleman has forgotten to say, of course, is that those people in Wales will have waited far longer for the diagnosis of cancer than people in England. That is why he is not being entirely straight in putting his facts across. When he is winding up, I challenge him to say whether he thinks what is going on in Wales at the moment is good and something that Labour Members would like to aim for. Is what is going on in Wales what they aspire to?
I urge anyone in the Opposition to look at The Guardian, which recently did an exposé of the NHS systems around the UK and showed that people in Wales have the longest waiting times of anyone in the United Kingdom, and that is the vision for the NHS that Labour Members want to impose on the people of England. I advise people in England to look at the figures before they decide to vote for Labour Members.
I ask the hon. Member for Denton and Reddish (Andrew Gwynne) if he would be prepared to allow patients in Wales to be treated in England, and patients in England to be treated in Wales if they wish to do so. I doubt very much whether he would support such a thing.
I am grateful to the hon. Gentleman for giving way again. He is obviously not aware that the number of English patients being treated in Welsh hospitals has increased by 10% since 2010.
I am well aware of that, but the hon. Gentleman might not be aware that those patients have no choice. [Interruption.] He is laughing, but he does not understand how the system works. There are many patients on the English side of the border who are treated in Wales, but they have no choice about that. They have set up a pressure group, Action for our Health—he can look it up on one of his smart phones—because they are so disgusted with the service that they are getting in Wales that they want to be treated in England. The point is that they do not have a choice, and I believe that they should. Those English patients are very angry about the fact that they are treated in Wales and not given the choice.
When the Secretary of State was talking about some of the things that have gone wrong in the NHS, I heard an Opposition Member shout, “He hates the NHS.” My right hon. Friend does not hate the NHS, but he does believe in putting patient choice and patient voice first. He believes in standing up for patients against vested interests, wherever they may be. I fully support him in that and commend him for what he has done. My only criticism of Ministers in this Government is that they have improved services in England so much that I have an enormous mailbag of letters from people who want to access the services that they have put on offer. If anyone wants to find out what would happen if Labour ran the NHS in England, they should look at the facts and figures for Wales.
(10 years, 5 months ago)
Commons ChamberI agree strongly with the sentiment expressed by the hon. Member for Stafford (Jeremy Lefroy) that no community should be subjected to the tender mercies of the trust special administrator regime. It is brutal, harsh, unfair, unreasonable and impervious to local knowledge or opinion.
Following the way in which most reports are presented, I shall start with my executive summary—my understanding of what happened in the South London Healthcare NHS Trust. The right hon. Member for Banbury (Sir Tony Baldry) was wrong. The special administrator was not appointed to Lewisham hospital. That is the very heart of the matter. He was appointed to the South London Healthcare NHS Trust, which is the adjoining trust, then comprising the Queen Elizabeth hospital in Woolwich, the Princess Royal university hospital in Orpington and Queen Mary’s hospital in Sidcup. He then decided to take a well-functioning, well-respected, well-performing and financially sound institution, in the shape of Lewisham hospital, and use it to deal with problems elsewhere.
In an Adjournment debate 18 months ago when the issue first occurred, I used the simile that it was like the administrator for Comet advising that the best thing to do, in the interests of Comet, was to close down Currys. That is exactly what the trust special administrator did.
If the hon. Gentleman believes that it is important that local people are listened to, would he care to comment on the decision by Labour’s Health Minister in Wales, Mark Drakeford, to shut down or downgrade Withybush hospital in west Wales?
The short answer is no, I do not wish to comment.
Lewisham was stitched up from day one. In 40 years as a public representative I have rarely come across anything so disreputable, so devious, so mendacious, so dishonest and so duplicitous as the process that was employed regarding south London health care. It started on 13 January 2012 when the then Secretary of State, the right hon. Member for South Cambridgeshire (Mr Lansley), now Leader of the House, laid an order before the House entitled the South London Healthcare National Health Service Trust (Appointment of Trust Special Administrator) Order 2012, alongside an explanatory memorandum that included the case for applying the regime for unsustainable NHS providers—the first time it had been done. There was also an additional order that extended the consultation period for the trust special administrator. As I say, it was called the South London Healthcare National Health Service Trust. When the administrator got on with his work and produced a report, it was entitled, “The Trust Special Administrator’s Report on South London Healthcare NHS trust and the NHS in South East London”. Parliament did not authorise an inquiry into the NHS in south-east London, but, by that cover, they attempted to shut down a perfectly well-functioning district general hospital in Lewisham because it was administratively more convenient.
On 16 July, Mr Matthew Kershaw was appointed as the trust administrator. I had numerous dealings with Mr Kershaw. Personally, I found him to be a perfectly reasonably, sane and sensible person, but he was commissioned by the Department to do a job. His priority, quite plainly and self-evidently, was not to decide what was in the best interests of the people of south-east London, but to do the bidding of Richmond House.
I start by acknowledging the receipt of a petition handed to me yesterday, containing 159,000 signatures collected by members of 38 Degrees, expressing their concerns about the matter we are debating today. I know that a great many Members will have received e-mails about that and will have their own opinions, and I want to discuss the issues.
Will the right hon. Gentleman refresh my memory? Is that the same pressure group that a few years ago was saying that the NHS was going to be privatised, which is completely untrue, and which a couple of months ago was saying that it was about to be silenced by some Bill the Government were pushing through yet is now very noisily campaigning once again? Surely this cannot be the same completely unreliable group of left-wingers with links to the Labour party, can it?
That was a lot of accusations and I will leave 38 Degrees to answer for itself. All I wanted to do was formally announce that it had given me this petition because, out of conscience, I thought that was the right thing to do. I want now to share my concerns about, and view of, new clause 16.
First, however, I want to reflect on what the shadow Secretary of State, the right hon. Member for Leigh (Andy Burnham), said. He made the point, on which I think there is consensus, that we should not reach the stage at which a trust special administration process is embarked on, and that we need to take every possible step to avoid that. That means that we must learn the lessons from the successful reconfigurations and reorganisations. Unfortunately, there are too few successful reconfigurations that do not lead to people mounting the barricades to oppose the change. The right hon. Gentleman referred to the example of stroke services, but such successes are few and far between. Part of the reason for that is that, historically, the NHS has not been good at engaging with its population in a way that brings them with it and gives them a feeling of being jointly involved in the process. People need to feel part of a shared endeavour and that their health services are fit for their community. That is what we need to instil in the process if we are to avoid the need to use the power that the Government are proposing.
Indeed. My hon. Friend makes his point very well and I bow to his superior judgment.
I am also concerned about a point that was raised earlier. As everyone knows, I have absolutely no clinical or medical background, and it has always come as a surprise to me that I have spent so much of my time in the Chamber talking about these subjects. In business, there is a fairly simple calculation that assesses the solvency of a business; the strict definition is if someone is not able to meet their liabilities or knows that they are not able to do so in the short term, they are considered insolvent. They then go into administration and the processes kick in.
We are talking about a very different picture here in which a judgement has to be made about institutions that may or may not be considered unfit to continue. Under those circumstances—however much I accept that there are good intentions and not the devious plots that are being suggested—it means that much is left open to doubt. Therefore, it is with a very heavy heart that I will be on the other side when we go into the Lobby—when I have worked out which side that is. But I do so based on my 10 years of experience of what has been a very difficult exercise in my constituency.
I listened with great interest to my hon. Friend the Member for Enfield North (Nick de Bois) but I will be supporting the Government 100% tonight because I have great confidence in what the Government have achieved with the NHS. I say that because I have seen the alternative; I have seen what has happened to the NHS when it is run by Labour, because that is the problem that I and many of my constituents face at the moment in Wales.
My right hon. Friend the Member for Sutton and Cheam (Paul Burstow) came forward earlier with a petition from the left-wing pressure group 38 Degrees. Health campaigners have been talking today about the amount of salt that we take but one has to take dangerously large pinches of salt with anything that comes out of that organisation. These people purport to be happy-go-lucky students. They are always on first name terms; Ben and Fred and Rebecca and Sarah and the rest of it. The reality is that it is a hard-nosed left-wing Labour-supporting organisation with links to some very wealthy upper middle-class socialists, despite the pretence that it likes to give out.
It is 38 Degrees who were coming out with all sorts of hysterical scare stories a few years ago about how the Government were going to privatise the NHS. It took out adverts in newspapers, scaring people witless that that was going to happen. Of course the organisation has forgotten all about it now because there was never any intention to do that. We will never privatise the NHS because we believe in public services in this party. A couple of months ago, 38 Degrees came out with more scare stories about how it was going to be gagged because of another piece of legislation that the Government were putting through to bring about fairness in elections. It said that we would never hear from it again, and yet here we are a few months later with yet another host of terrible stories, scaring members of the public quite unnecessarily. I do not think that we have to take any lessons from 38 Degrees, nor hear any more about their petition.
I am backing the Government tonight because I know that the Secretary of State has done an enormous amount to drive up standards in the NHS even as they fall in Wales. It is this Secretary of State who has presided over falls in waiting lists to 18 weeks in England. People are lucky in Wales if they can get to the target of 36 weeks. There has been an increase in funding when it has been cut in Wales and there is much better access to cancer drugs in England than we have in Wales.
New clause 16 refers to the need to confer with members of neighbouring boards. We have health boards, not trusts, in Wales. I hope the Secretary of State will confer with the boards in Wales about these changes. The only criticism that I have of the Government is that they have been so successful in improving the NHS in England that large numbers of people now contact me every single day, in Wales and in my constituency, asking for the right to be treated by the NHS run by the coalition Government and not by the NHS run by the socialists in Wales.
I ask the Minister and Opposition members to look at an article in the Western Mail today by a woman called Marianna Robinson who has spoken about the difficulty she has had in trying to get treatment and how desperately she wants to be treated in Bristol. There is a place for her in Bristol but she is not allowed to have it. I ask Ministers, and perhaps Opposition Members, to think about what we are doing here. I would like to see patients in Wales who wish to be treated in England being allowed to go to England and get treatment, with the money then being taken off the block grant to the Welsh Assembly. If Opposition Members—
Order. I think I need to help the hon. Gentleman. As he knows, we are dealing with the new clause. I do not want the history of the Welsh health service, which is certainly not what Members are here to listen to. I know he wants to get back to the new clause, which is where we will carry on. He should also look to the Chair now when he speaks.
I shall simply say this, Mr Deputy Speaker. I will vote in the Lobbies with the Government tonight. Many people in Wales would like the opportunity to vote with their feet and be treated by the national health service which is run by this coalition Government, and I hope that we shall get around to addressing that at a later stage.
(10 years, 5 months ago)
Commons ChamberI am sure that my colleagues in the Welsh Assembly want to do everything they can to improve care and support. Today we are discussing the care sector in England, and I hope that the hon. Gentleman will give his support to what we are proposing.
I am really sorry, but I want to make a bit more progress. I have a lot of new clauses to get through, and Back Benchers have also tabled new clauses and amendments.
We also know that many care workers do not even get the minimum wage at the end of the week, because they are not paid for their travel time, among other things. Her Majesty’s Revenue and Customs recently undertook an evaluation of minimum wage enforcement in the social care sector. It found that a staggering half of all care providers had failed to pay the minimum wage to at least one of their employees, yet despite Ministers’ insistence that such people will be named and shamed, not a single provider in the care sector has so far been identified.
We need to look at all those employment issues, which I think have a fundamental impact on the quality of care. If the Bill is to promote well-being, shift services towards prevention and improve standards, we must get to grips with those issues; otherwise, it will not work. New clause 17 would require the Secretary of State to conduct an overall review of the economic and financial factors affecting employment, publish the results and consult on the findings.
(11 years, 5 months ago)
Commons ChamberUrgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
Each Urgent Question requires a Government Minister to give a response on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
Does the Secretary of State agree that the vast majority of people in the UK will welcome these long-overdue proposals? Will he explain what he will do to ensure that those who are denied treatment because they are here illegally and not entitled to it cannot simply slip over the border to Wales or Scotland, which, unfortunately, are in the throes of an NHS run by socialist Governments?
We will work closely with the devolved authorities to ensure we have a co-ordinated response to the problem, but I agree that today’s announcement will be welcomed by the vast majority of people in the country, who will be astonished that the Labour party, even now, seeks to minimise the problem.
(11 years, 7 months ago)
Commons Chamber2. What recent steps he has taken to reduce hospital waiting times in England.
Latest figures for October 2012 show that 70,000 fewer patients are waiting longer than 18 weeks than at the last election. The Government’s mandate to the NHS Commissioning Board makes timely access to services a priority.
Those figures compare extremely well with those in Wales, where most patients are waiting for 26 weeks, and many for 36 weeks. Would the Minister be willing to share some advice on how to get waiting lists down with his counterparts in Wales, and perhaps discuss with them why patients wait so much less time in the Conservative NHS in England than in the socialist NHS in Wales?
My hon. Friend is right to highlight key differences between the NHS in England and in Wales. The Labour-run Assembly in Wales is cutting funding by around 8%, which will—of course—impact on the quality of care available to patients and other front-line services. At the same time, in England we are ensuring that we continue to invest, with £12.5 billion in the NHS during the lifetime of this Parliament. I would be happy to point that out to colleagues in Wales and the Welsh Assembly, and to make the point that it is the Conservatives and the coalition Government who deliver better patient care through investing in the NHS.
(12 years, 1 month ago)
Commons ChamberI think that the hon. Lady knows that the figure is in the order of £1.2 billion to £1.3 billion. She also knows that, during this Parliament, we will deliver, as a result of the changes, reductions in bureaucracy and administration costs across the NHS, which cumulatively will be of the order of £5.5 billion.
Is the Minister also aware that the National Audit Office report shows without doubt that deep and damaging cuts are taking place within the national health service, but that they are all happening in Wales? Does he agree that the last thing we need is to see that repeated in England by allowing these people control of our NHS?
My hon. Friend is right. There is only one part of the United Kingdom where the health service is being run by a Labour Government—in Wales, and that is the only part of the United Kingdom where the Government are deliberately cutting the budget of the NHS. We should not be surprised. The right hon. Member for Leigh (Andy Burnham), the shadow Secretary of State, at the time of the last election and afterwards, told people that they should cut the budgets, and Labour in Wales did it.
(12 years, 2 months ago)
Commons ChamberAs I said to the hon. Gentleman, as part of the responsibility deal we are considering an ambitious programme of removing 5 billion calories a day from the diet in England. A range of programmes, such as behaviour change programmes and the reduction of saturated fats and sugars in foods by the industry, will make that happen. All those issues will be considered as part of how we can deliver that ambitious programme.
22. I congratulate the Secretary of State on yet another initiative that has helped to ensure that patients in England have a better standard of health service than their counterparts in Wales. What is his message to Welsh Members of Parliament who call on him to stop various reforms and expect him to impose the second-class standards of health service that we see in Wales thanks to the Welsh Assembly?
With reference purely, of course, to the public health responsibility deal.
(12 years, 6 months ago)
Commons ChamberNo, the hon. Gentleman is wrong. As he, or certainly the right hon. Member for Leigh (Andy Burnham), will know, the risk register is an ongoing document—discussions between Ministers and civil servants on the formulation, implementation and transition of policies—and it would be wrong, in my opinion, for it to be published. That is why my right hon. Friend the Secretary of State appealed to the tribunal following the decision of the Information Commissioner, in line with the precedent adopted by Secretaries of State in the Labour Government in both the Department of Health and the Treasury.
Does the Minister agree that the risk of not reorganising would be the longer waiting lists, longer waits for ambulances and lower access to life-prolonging drugs that we currently see in socialist-dominated Wales under the Assembly?
(13 years, 7 months ago)
Commons ChamberOf course, it was the last Government who agreed the arrangements with GPs. It was the last Government who, in 2007, undertook a flu review when central procurement of flu vaccine was recommended, but did nothing about it. The public health responsibility is distinct from the commissioning responsibility for health care of patients. We will look at, and we have still to make a decision about, how we procure flu vaccine in future years. We may do it through central procurement or through continuing GP procurement; but either way, we will make sure that we improve on the system we inherited.
T6. Can the Minister tell us how much money is spent each year on disposable surgical instruments, and whether any thought has been given to greater use of properly sterilised reusable instruments?
The straightforward answer to my hon. Friend’s question is, £18 million per annum. The decision to use single-use instruments as opposed to reusable ones is based on many complex clinical factors. For this reason, these decisions are left for the determination of local trusts on the basis of safety, quality and value for money.