NHS Funding (Ageing)

Edward Leigh Excerpts

Tuesday 25th March 2014 Westminster Hall

[Mr Gareth Thomas (Harrow West) (Lab/Co-op)]

It is a pleasure to serve under your chairmanship, Sir Edward, and to follow the hon. Member for Suffolk Coastal (Dr Coffey). I apologise to the House and in particular to the Front-Bench spokesmen for the fact that, because of a long-standing commitment, I shall have to read their responses to the debate in Hansard.

I want to raise a concern similar to the one raised by the hon. Member for Suffolk Coastal, about the funding formula, although there are constituency differences. Many health professionals in my constituency are concerned that Harrow does not receive an appropriate share of NHS funding and that that is already affecting elderly people there, and may affect many others. The context is that both the key hospital serving my constituency, Northwick Park hospital, and its parent trust, the North West London hospitals NHS trust, have been in a challenging financial position for many years.

In 2010-11, the trust made a tiny operating surplus; in 2011-12, it had an operating deficit of some £7.5 million; and in 2012-13, the operating deficit had increased to £20.5 million, approximately. Figures in papers submitted to the NHS Trust Development Authority’s recent board meeting suggest that the trust is again heading for a sizeable deficit this financial year, of about £20 million. Although final 2013-14 accounts are clearly not yet available for Harrow’s clinical commissioning group, the prediction, from NHS England information, is for an end-of-year deficit of £10.4 million. Indeed, Harrow clinical commissioning group is one of only four in London where there is significant concern about financial performance.

By setting out that information, I do not mean to criticise the trust management, the clinical commissioning group or their staffs. I have been treated at Northwick Park hospital several times, and I think the staff and management do a first-class job. I know the chair and many of those who serve on the board of the Harrow clinical commissioning group, and they, too, do a first-class job in extremely difficult circumstances. Those circumstances are made difficult by the amount of funding that Harrow receives from the NHS.

To humanise the consequences of those statistics on the financial situation that Northwick Park hospital and Harrow clinical commissioning group face, I should make it clear that there are increasing concerns about cancelled operations and longer waiting times in the A and E department at Northwick Park. Given the cuts to local government funding, there are fears that Harrow council’s social care budgets, which are already hard hit, will be cut further by an estimated £70 million over the next three years. The concern is that the NHS in Harrow will come under even greater pressure to meet the needs of elderly people in our area because of an inevitable lack of access to social care.

Additionally, the popular Alexandra Avenue polyclinic, which was open from 8 am to 8 pm for 365 days a year and provided an excellent walk-in service, has for some time been closed to patients without an appointment for all but a short period on Saturdays and Sundays. Again, the service was heavily used by elderly people, as well as by many others in my constituency. The closure of large parts of the Alexandra Avenue polyclinic’s service is particularly galling because health professionals in Harrow accept that the polyclinic was making a difference by helping to improve health care opportunities and access to health care for elderly people and many others in my constituency. That is the context of my participation in this debate, and I am concerned about whether the funding formula properly reflects the needs of the NHS and my constituents.

The hon. Member for Suffolk Coastal set out some of the funding formula issues, and I will present them in a slightly different way; that is perhaps a reflection not only of our different political parties but of the different nature of the seats we represent. The Minister and the shadow Minister, my hon. Friend the Member for Copeland (Mr Reed), will be far more aware of the debate on changes to the funding formula than I am. Like the hon. Member for Suffolk Coastal, I understand that a weighted capitation formula based on population, the local cost of providing health services, the level of health care need and health inequality is used to determine allocations to each clinical commissioning group. I also understand, as she set out, that the Advisory Committee on Resource Allocation was charged with developing a revised funding formula based on the standardised mortality ratio for those aged under 75—the so-called fair shares formula.

After substantial consultation—the hon. Lady made this point—the board of NHS England decided not to adopt the fair shares formula, and clinical commissioning group allocations were initially uprated based on their estimated share of previous primary care trust allocations. In December 2013, the board of NHS England decided on CCG funding allocations for 2014-15 and 2015-16. I understand that, again, the board decided to reject proposals for a faster move towards CCG allocation targets. I do not intend to make a party political speech, but I gently insert the point that perhaps the board might have felt differently if it had had access to the £3 billion that has been spent on reorganising the NHS, about which Opposition Members are somewhat sceptical.

The hon. Lady alluded to distances from target figures for 2014-15 and 2015-16. The figures indicate that Harrow’s allocation was almost 10% away from the target for 2014-15 and almost 9% away from the target for 2015-16. The total estimated funding shortfall for Harrow is some £23.4 million over the next two financial years. That information was provided to me by statisticians from the House of Commons Library based on estimates using the closing target allocations per head and our estimated CCG population.

I recognise that, as the Minister will presumably point out, the figure is not completely settled and that there may be movement given how far Harrow clinical commissioning group is from receiving its target allocation, but I hope that I can persuade the Minister today to scrutinise the Harrow figures. I hope he will ask his officials to talk to Harrow clinical commissioning group to see whether there is more information that might justify a further funding increase for the NHS in Harrow, to close the funding gap that has been identified.

A little like the hon. Member for Suffolk Coastal, I have tried not to be party political in this debate, although she will understand that I think I have managed it better than she did. In that spirit, I hope the Minister will take seriously my concerns about the NHS in Harrow and will ensure that his officials talk to those who do an excellent job working for Harrow clinical commissioning group.

[Sir Edward Leigh (in the Chair)]

When the Minister replies, I have no doubt that he will refer to Harrow’s ageing population.

--- Later in debate ---

[Mr Jamie Reed (Copeland) (Lab)]

It is a pleasure, Sir Edward, to speak under your chairmanship again, although I am afraid I am not a brother knight.

[Sir Edward Leigh (in the Chair)]

Give it time.

[Mr Reed]

I am even more afraid that it is a fraternity I will never be invited to join.

I thank the hon. Member for Suffolk Coastal (Dr Coffey) for securing this timely debate and for her opening remarks. Particular thanks should go to Government Whips for drafting so much of it. As she knows, the last Labour Government took a malnourished, failing NHS with an annual budget of approximately £30 billion and left it with a budget of more than £110 billion. The Conservative party voted against every increase in that budget. The same Labour Government oversaw the biggest ever hospital building programme in this country. It recruited tens of thousands more doctors and nurses. It inherited an NHS in which Bruce Keogh said people were dying waiting for treatment, and left a service with the lowest waiting times and the highest patient satisfaction rates in its history. Of course, there was much more to do.

I warn the hon. Lady against complacency. If she wants to see a health economy that has been plunged into crisis as a result of the Government’s policies, she should come to Cumbria where a crisis is unfolding, patients are paying the price and the Secretary of State is entirely disinterested in what is happening.

It is incredible to hear that NHS England does whatever it is told by the Labour party. That is extraordinary—this must be the most powerful Opposition of all time. Government Members should consider whether they are in office but not in power. A canard seems to be being established whereby the NHS England board have become the new reds under the bed. That fascinating argument will be rolled out between now and the next election.