Health and Social Care

Gary Streeter Excerpts

Monday 13th May 2013 Commons Chamber

[Mr Gary Streeter (South West Devon) (Con)]

It is a real joy to follow the hon. Member for Plymouth, Moor View (Alison Seabeck), my next-door neighbour—you are being extremely skilful in your selection of speakers today, Mr Deputy Speaker. I very much enjoyed her contribution; she spoke in her usual trenchant and passionate style. I also enjoyed hearing about the work that her late father was involved in, and I can say with some confidence that he would be extremely proud of her and all that she has done in her time as a Member of Parliament.

I liked the Queen’s Speech, but it was a little long for my liking. I was looking forward to the Queen sitting on the throne and saying, “My Government have decided to introduce no new laws this year, but to concentrate on implementing and overseeing well the policies that we have already passed and the laws that we have already put in place.” As we all know, coming to the House and taking legislation through involves a huge time commitment for Ministers, and there is a huge case to be made for Ministers to focus on implementing well the things that we have already decided. We have been radical in the past three years in this Parliament, so let us make sure that the policies now work in practice on the ground—let us set our Ministers free to do that. Interestingly, the key areas our constituents are most concerned about—getting the deficit down, getting the economy moving and cracking down on immigration—do not require any legislation at all. They simply require us to do well the things we have already decided.

I welcome the Queen’s Speech and, despite having said what I just said, the increased attention on immigration, which is what our constituents want. The reaction of my constituents to some of the tough measures we have introduced so far on immigration and on welfare changes is, “It’s about time. We have been waiting for this for many years.” So I support the broad direction of travel of the Government, and I have full confidence in the Health Secretary.

I want to make two points in a brief contribution about health issues, the first of which is about the challenge of urgent care. Our parliamentary system has many strengths, but one weakness is that every Government Member is inclined to say that everything we are doing is wonderful, while the Opposition are inclined to say that everything we are doing is rubbish. We all know that the truth lies somewhere in between. I support and pay tribute to the fact that we continue to pump fresh money into the health system year after year. The shadow Health Secretary is convinced that we are not meeting our commitment to increase health spending above inflation every year—I think we are, but of course there is a debate to be had. I do know that there are pressure points in the health system that need to be tackled, and urgent care is one of them.

[Andy Burnham]

The hon. Gentleman’s association with the detail seemed to be loose there; Andrew Dilnot wrote to the Government to say that health spending was lower in real terms in 2010-11 than it was when Labour left government. It is important to point out that the promise the hon. Gentleman stood on was for real-terms increases in every year of this Parliament and that that has not been honoured.

[Mr Streeter]

That is Andrew Dilnot’s opinion, but it is not mine—that is the point I am seeking to make. [Interruption.] The right hon. Gentleman’s speech was riddled with references to spending—more spending on health and on local councils—but is he not aware that this year the deficit in this country will still be, even after three years of austerity, £110 billion? If he comes to the Dispatch Box to make speeches about extra spending for health and local councils, he is obliged to tell us where that money will come from. At the moment, I can see no signs of it whatever.

[Andy Burnham]

rose—

[Mr Streeter]

I will not take any further interventions, but let us not hear any further speeches calling for extra spending unless we know where the money is coming from.

As I was saying, before I was so rudely interrupted, there are pressure points in the health system, and urgent care is one of them. This is about not only accident and emergency departments, but GP and out-of-hours services, community nursing, social care, ambulance services and hospital beds—there is pressure on all those points.

The hon. Member for Plymouth, Moor View and I are fortunate to go to Derriford hospital in Plymouth for briefings. I have been going slightly longer than she has—21 years—and I can tell the House that in good times and in bad times Derriford hospital is under pressure. It has a running capacity of about 95%, which means that when there are spikes, as there have been this winter, it can be running at 103% capacity, which puts the hard-working staff under enormous pressure. Even when the Labour Government were spending money as though it were going out of fashion, I have never gone to Derriford hospital and had the staff tell me, “It’s fine. There are no pressure points. Everything is working in our health service. It’s all working well and waiting lists are coming down.” That has not happened once in 21 years.

[Stephen Phillips (Sleaford and North Hykeham) (Con)]

Does my hon. Friend agree that perhaps one problem with the Queen’s Speech, and one of the issues with which neither Ministers nor shadow Ministers tend to grapple, is that there is a real problem in this country with demand? Unless and until we grapple with that, the national health service will always be under pressure.

[Mr Streeter]

I completely agree with my hon. and learned Friend, and I might come on to deal with that point in a moment.

The point I wanted to raise with Ministers is that the funding formula for emergency work needs to be reviewed. As I understand the system, the formula is based on the 2008-09 baseline, and any extra patients who come into an acute hospital over and above that baseline are paid at 30% of the tariff. It costs hospitals 100% to meet the needs of those people coming in, yet they are paid at 30%; the extra 70% is supposed to be spent by other health care agencies in providing alternative centres of treatment, which are intended to divert people away from acute hospitals. I am pretty well plugged into what is going on in my constituency, and I have not seen anything since 2008 that looks vaguely capable of diverting pressure away from Derriford hospital. The system of allocating 30% to the hospital and 70% elsewhere is simply not working. I ask our Ministers to look urgently at that formula and to find out why, if it is not working, we are still using it and to address that. I am not calling for extra money; I am calling for money to be diverted to the acute hospitals, because they are where the pressure points are. In my constituency, there have been no realistic options for treatment other than to go to Derriford hospital. So, such hospitals should be receiving not 30% but 100% of the tariff.

My hon. and learned Friend the Member for Sleaford and North Hykeham (Stephen Phillips) is absolutely right about demand growing exponentially. In 1979, if a man reached the age of 65, they could expect to live until they were 77. If a man reaches the age of 65 now, they can expect to live until they are 88, and of course that age is rising year on year, so the demand is going up.

One thing that we are noticing is that although the number of people admitted to the emergency department at Derriford hospital in the last 12 months has been stable, there is much higher acuteness—in other words, people are much sicker and therefore it requires a lot more effort to treat them. Please, nice Ministers on the Front Bench, may we have a look at that formula for the funding for people accessing acute hospitals on an emergency basis?

My final point, in the one minute of my time that remains, is that 20 years ago or so I made a speech in this House saying that the health service had lots of challenges, issues and problems, but that one of the things we did not need to touch was primary care as it was working fine. I cannot make that speech today. I will not hammer the Opposition again about the GP contract, but in the past few years constituents have been complaining to me in a way that they never did in the previous 15 years to say that accessing their GP is becoming extremely difficult. For someone—whether they are a mum with a young baby, or a senior citizen—to get a surgery appointment when they want it has become a serious issue in the past few years. Addressing that issue does not necessarily require legislation, but may I ask Ministers whether we can please put in place a system whereby GPs give the seven o’clock in the morning to seven o’clock at night, seven days a week service that this country so desperately deserves?