NHS Reorganisation

Diane Abbott Excerpts

Wednesday 17th November 2010 Commons Chamber

[Ms Diane Abbott (Hackney North and Stoke Newington) (Lab)]

This is a period of great challenge for the national health service, and it would be whoever was in government. However, Government Members accused us of not having a care for staff and patients. In fact, it is precisely because we are concerned about staff and patients that we are using this debate to point to all that is problematic—and potentially even disastrous—about the Secretary of State’s proposed NHS reorganisation.

In exploring the gap between what those in government said while in opposition and what they are saying now, we can do no better than refer to a speech that the present Prime Minister gave to the King’s Fund in 2006, in which he set out the five key components of his approach to the NHS—components that, to my knowledge, he has not altered. His first component was that he wanted to guarantee the NHS the money that it needs. Who believes that now? Certainly not the Institute for Fiscal Studies, which has noted that not since the 1950s—from April 1951 to March 1956, to be precise—has there been such a small increase in NHS funding; and not the chief executive of the Royal College of Nursing, who said:

“A huge range of services and jobs are earmarked for cuts against this urban myth that the NHS is being protected. The evidence is quite clear…this is simply not the case”.

Hon. Members, who, as the weeks turn to months, will see the cuts in their own constituencies, will not believe it either.

My hon. Friend the Member for Sheffield Central (Paul Blomfield) talked about what is happening to children’s hospitals. What has not been factored in is the cost of reorganisation, which experts have said will be £3 billion. Ministers have said that their estimate is £1.7 billion, but when asked about the number of redundancies they cannot answer. We know that the cost—

[Mr Baron]

Will the hon. Lady give way?

[Ms Abbott]

No, I must get on.

The cost of redundancies, when they are factored in, will be hundreds of thousands of pounds. We believe that the figure of £1.7 billion will be overshot, and bring greater financial pressure on the NHS.

The second point that the Prime Minister made in 2006 was that he wanted to end the damage caused by pointless and disruptive reorganisation of the NHS. He said:

“We will not mess around with existing local and regional structures”.

So the Secretary of State’s big idea for the NHS was a pointless and disruptive reorganisation.

What do the people who work in the NHS think about that? The Royal College of General Practitioners says:

“our members are not convinced that the scale of the changes proposed is justifiable, especially in the context of cost reductions”.

The British Medical Association

“questions whether a less disruptive, more cost-effective process could have achieved the aims of reducing bureaucracy”.

The Royal College of Midwives says that it is

“very disappointed that despite pre-election promises to end…top-down reorganisation…the White Paper focuses far more on structures than it does on care delivery.”

The reorganisation is high-cost, high-risk and contrary to everything that was said by those who are now Ministers in the run-up to the election. They have accused us of being confused and incoherent, but it is their reorganisation that is confused and incoherent. Every professional body echoes that thought.

The Prime Minister said that he wanted to

“work with the grain of the Government’s reforms…So we will go further in increasing the power and independence of GPs and PCTs”.

He has gone so far that he has left GPs behind, and only one in four believe that the reorganisation will improve patient care. As for PCTs, contrary to the Government’s promises when in Opposition, they have abolished them.

What was the Prime Minister’s fourth point about his main driving aims for the NHS? He said that he wanted to

“take the politics out of the management of the NHS”.

There could not be a more political reorganisation. It is driven by ideology and a belief in free market ideology. As the chair of the BMA, Hamish Meldrum, said:

“If the Government is truly committed to reducing waste and inefficiency, their proposals for NHS reform should focus less on competition and more on a co-operative approach on delivering health care.”

Finally in his 2006 speech the Prime Minister said that his main commitment on the NHS was

“fair funding to the NHS…We will end political meddling…removing the scope for fiddling”.

We will see how much the scope for fiddling is removed when money is moved from the NHS budget to local authorities for social care.

My hon. Friends the Members for West Lancashire (Rosie Cooper), for Kingston upon Hull North (Diana Johnson) and for Bolton South East (Yasmin Qureshi) all expanded on what is problematic about the reorganisation. The Secretary of State began by posing as the friend of patients and those who work in the NHS. I will not take lectures from him on that. My mother came to this country as a pupil nurse from Jamaica in the 1950s. She was part of that generation of West Indian women who helped to build the national health service. Government Members cannot talk to us about the people who work in the NHS. As for patients, are Ministers listening to the patient groups—people who represent children, people who represent the elderly, and people who represent those with mental health problems—about their concern about what the reorganisation will mean for them?

This reorganisation is ill thought out and, at a time of tremendous financial stress in the national health service, ill timed. We believe that Government Members have been lulled into a false sense of security about what is to come. They believe that although students might be marching and the Church might be in uproar, the NHS is safe. I put it to them that, as the weeks turn to months and we move through the winter, and as we begin to see winter bed pressures, the consequences of this ill-thought-out, unnecessary, top-down reorganisation will reverberate not only in this Chamber but in the surgeries of Government Members and of all Members of this House. I am proud to support the motion.