NHS Funding Bill

Dean Russell Excerpts

2nd reading & 2nd reading: House of Commons
Monday 27th January 2020 Commons Chamber

[Matt Hancock]

I am very glad that my hon. Friend has raised this matter, because I was concerned to read the reports in the newspapers and have had a briefing this morning. There is work on a new contract to replace the old one, and I very much hope that that is settled and agreed as soon as possible.

[Dean Russell (Watford) (Con)]

First, I thank my right hon. Friend the Secretary of State for visiting Watford during the election, when he came to Watford General Hospital with me and very kindly met the chief executive. As part of that, he assured me that we would get £400 million of investment from the Government for West Herts trust, primarily to secure a new Watford General Hospital, one of six new hospitals—and many more—over the next few years. Given press speculation about the money being a loan and not funding from the Government, will he reassure my Watford constituents that that is not the case?

[Matt Hancock]

Yes, that is exactly right. I enjoyed visiting Watford at the invitation of my hon. Friend. It is fantastic that Watford will get a new hospital. Watford General Hospital needs to be rebuilt and it will be rebuilt with a grant from the Government. The money will go to Watford general—to the trust—as he mentions. It will not be a loan; it will be a grant. I know that there has been some speculation about that. I do not know where it came from, but it is not true. The money will come as a grant.

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[Dean Russell (Watford) (Con)]

I would like to talk a little bit about the future of the NHS. Quite rightly, we have talked a lot about funding, bricks and mortar, nurses and porters, which is fabulous, but we also need to look at where we are heading over the next 10, 20 or 30 years. I think that technology has a big role to play, so I am pleased that the Health Secretary has a great legacy in the digital world. That brings great power to the direction in which the NHS is headed.

Look at how the world has changed. It is no longer just about infrastructure; although that is key, the data we use and how we consume it are also important. We have heard brilliant speeches today about prevention, but prevention is not just about leaflets telling people not to shake hands if they have a cold or the flu; it is about understanding what is happening in the world around us and connecting the dots of data on patient health. Many people in the Chamber probably wear a watch that tracks how many steps they take. Sadly, I never quite hit my target, but the truth is that we are constantly gathering data on what we do and where we go—health statistics. The beauty of this in relation to the NHS in the coming years is that if we overcome the fear of creepiness versus convenience when it comes to data, we can start to think about how data can offer a powerful way to prevent illness, to connect the dots between patients and see trends, to analyse. If we no longer see such data as scary or as a threat to privacy in the way we heard about in the earlier debate about Huawei, we can think about what it might mean in terms of prevention.

There are many opportunities in the future, but there is also a risk of jumping in with innovation that costs a lot of money but gets us nowhere. About 10 years back, in my business capacity, I was involved in a review of every single NHS website in England and Wales. Hon. Members might think that 10 years ago there were perhaps 20 or 30. In fact, there were 4,121 NHS websites. I did a financial calculation as part of that review. This was all in the Health Service Journal. Sadly, my name was not against it, but now it will be—in Hansard. I remember sitting up late doing the analysis, and checking it over and over again. What I found was that the Labour Government back then were spending between £87 million and £121 million a year just to keep those sites live; although, to be fair, it was about innovation. We can look at the way the digital economy is driven and the way the digital world has shifted, but we have to ensure that we are not wasting money. We need to look at outcomes and impact, and how we can use them to prevent, but we also need to look at how we can prevent future illness and issues.

The use of technology in today’s world is going to be a core part of the way we are investing, and of the future of the NHS. We cannot ignore the conversation about demystifying people’s fears around providing their own health data. People are currently very happy to give away their own information by clicking on an ad to buy something at a discount, but they are very fearful of giving their data away for health reasons or sharing it with their GP. Over the next few years, there has to be a really big demystifisation, if there is such a word—that is one for Hansard to work out.

[Matt Western (Warwick and Leamington) (Lab)]

I welcome the hon. Member to his place. He is making an important point. I think most of us recognise the crucial opportunity for the UK given that the NHS has a massive pool of data over many decades, but does he share my concern about the future ownership of that data in any free trade deal?

[Dean Russell]

The key part is understanding the single patient view—how we best use it, and where that data is held and stored. I am very confident that privacy and the risk described by the hon. Gentleman will be very high on the Government’s agenda. I am in no doubt about that.

My point is that we should look at how we can break down the barriers so that we are not generating fear through people having a lot of concerns about where their data is going to go. We do need safeguards, but we also need to look at technology as the way forward so that we can, for example, reduce cancer risks because we spot the ailments earlier. That is really powerful. We used to swallow tablets to get better; now we can use them in the Chamber and elsewhere, to check out apps and find out more about improving our own health.

I am very fortunate that Watford is getting a new hospital at Watford General in the coming months and years, but as part of that project we need to look at where we head next, what that means, how we can use technology and how we can provide freedom for everybody to have ownership over their single patient view, and take those ideas forward.

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[Craig Mackinlay (South Thanet) (Con)]

I am delighted to see you in your place, Mr Deputy Speaker; it is the first time we have been in the Chamber together since you were elected—congratulations to you.

I am pleased to support the Second Reading of the Bill, which displaces any doubt that the Conservatives’ commitment to the NHS is absolute. It will be cast in legislation, and the budget will rise way into the future. The Bill reflects what we have: an ageing population; even more advanced, very expensive machines, which one has only to go round a modern hospital to see; procedures that were not even thought about just a generation ago; and pharmaceutical products that are advancing and by their very nature expensive. In the future, the NHS will be even more important. As we advance into an age of gene and DNA mapping, insurance providers will know the conditions that we are likely to have in 40 to 50 years’ time—we may not want to hear about some of them. The NHS will be much more at the heart of everyone’s healthcare.

However, I have concerns about throwing money out unless there is proper administration and great care about looking after it. I fear that NHS trusts may simply reach out again for the locum hotline and that the money will not be spent where it ought to be on the frontline. In South Thanet, we have an issue with GP numbers—just one GP per 2,500 of population. That is among the worst figures in the country: the average is one per 1,600. It is little wonder that our A&E departments find themselves under stress. The GPs issue is complex: it is about retention, early retirements and morale. We have tried to implement an international recruitment scheme, but it has not gone as well as many of us would have hoped.

I am particularly worried about procurement. A couple of years ago, I launched an extensive freedom of information request aimed at NHS trusts and clinical commissioning groups, police and fire authorities, and even universities, across the entire country. I published the results with The TaxPayers’ Alliance in January 2018. I asked a simple question: how much did they pay for a ream—500 sheets—of 80 gsm photocopy paper, which every institution uses by the pallet load? Any one of us could probably go to the high street and pick up a ream for £2.50. The average NHS trust procures 25,000 reams a year.

I found that the highest price paid by a CCG was Wokingham CCG at £5 a ream; the lowest price—very well done—was paid by Haringey CCG at £1.62. The lowest price paid per ream by an NHS trust was £1.40, by Colchester Hospital University NHS Foundation Trust; the highest was £4.65 by Portsmouth Hospitals NHS Trust. That was a simple issue to ask questions about, and one wonders what else is being procured badly. How much are trusts paying per kilowatt-hour for electricity? What do they pay for their telecommunications, their medicines and everything else?

[Dean Russell]

One of the big challenges as we move into the digital economy is the procurement of advertising, especially social media advertising. Facebook, Google and so on all take huge amounts but in small pockets across the country—not just from NHS trusts, but from all aspects of Government and businesses as well. I would love that issue to be looked at.

[Craig Mackinlay]

My hon. Friend makes a good point. How much do trusts spend on recruitment consultants? There is a whole panoply of expenditure on other things that the NHS, as a very big procurer, could get at competitive, keen prices.

My hon. Friend the Member for North Dorset (Simon Hoare) made a good point about the cost of medicines and repeat prescriptions. That has to be a major issue: across the country, £20 billion a year—nearly one sixth of the NHS budget—is spent on medicines, many of which are on free, repeat prescription. My wife, a pharmacist in the community, far too often sees bags full of expensive drugs come back to the pharmacy after the demise of a loved one. They have to be thrown away, and the money is completely wasted. We need to ask some difficult questions about the NHS. Let us not try to throw more money at it in the hope of a better outcome, because we need to be rather more clever. Great as it is—it has become a national institution, greatly loved—the NHS does not always do things perfectly.