NHS Services (Access)

Gary Streeter Excerpts

Wednesday 15th October 2014 Commons Chamber

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

Thank you, Madam Deputy Speaker. I love your husky voice.

In June, I spoke to a conference of orthopaedic surgeons from the south-west, including the NHS consultant who carried out my own hip replacement very successfully in 2012. They had asked me to speak about the future of the NHS and to be as bold and as honest as I could be. When we came to questions, I was amazed at how all the doctors said basically the same thing. It might be paraphrased thus: “When will you politicians realise that the NHS is creaking at the seams and come up with new, more radical policies and a brand-new model more suitable to the 21st century that is able to cope with the demands we now face?” They said they were grateful for the extra money this Government have put in and they recognised the competing pressures on the public purse, but they believed passionately that it was not just about money going in at the top. They wanted us to be more radical in addressing the problems now facing the NHS and, in particular, in finding new service delivery vehicles.

I explained that one of the weaknesses of modern-day politics is that as soon as anyone starts to grapple with innovation and change in the NHS, we hear the voices Opposition Members—we have just heard them—who immediately shriek privatisation, and the debate grinds to a halt, especially in the run-up to an election. I find it extremely disappointing that this has all happened again today. The audience of doctors recognised this depressing reality, but none the less urged us to be bolder in addressing the pressure under which they work day in, day out in an institution that was designed 70 years ago.

I listened to the shadow Secretary of State this evening and the complaint seems to be that doctors are now under an obligation, in their commissioning groups, to buy in the best services to provide the very best health care for our constituents. That is surely a good thing. The motion before us today is an example of this immature debate. It seeks to lay the blame for the pressure under which the NHS operates today on the reorganisation that took place earlier in this Parliament. That is an absurd claim. Let us look at some of the statistics.

Between 2009 and 2013, the number of general and acute in-patient admissions rose by more than 10%. In 2003, there were just over 77,000 hip operations. By 2013, these had increased by 43% to 110,000 hip operations, of which mine was one. In 2003, there were approximately 46,000 knee replacements. That number rose sharply by 71% by 2013 to more than 79,500 knee replacements. All this has to be funded. Total attendance at accident and emergency departments in 2013 was almost 22 million, representing an increase of 11% since 2003. There were around 9.1 million emergency calls in 2013, up from 4.9 million in 2003—an increase of 85% in just 10 years.

In Derriford hospital in Plymouth, every day 75% of the patients are over 65. In the 10 years between 2003 and 2013, the actual number of people over 75 who completed episodes of admitted patient care in NHS hospitals rose by 61%. Life expectancy in the UK is increasing significantly. One in three children born today is expected to celebrate their 100th birthday. The fact that people are living longer is a wonderful success story, but it is having a significant impact on the NHS. Average NHS spend on retired households is nearly double that for non-retired households.

As everybody in the country knows, the primary source of NHS pressure today is the demographic success we have seen in recent years of people living longer—more of us getting older and needing more health care. That is why we were right to ring-fence the health budget in 2010, which has resulted in an £12.7 billion extra pumped in in this Parliament. That is why it is right that the Prime Minister has committed the next Conservative Government to continuing to increase health spending over and above inflation every year for the next Parliament. I hope we will also be bold and find new models of delivering health care, still free at the point of use, to meet the demands of a growing and ageing population.

On the subject of new models and structures, I see signs that the new commissioning groups in my area are having a positive impact. My constituency is part of the West Devon clinical commissioning group, and my discussions with the GPs who serve on it give me great hope that they are beginning to improve the nature and scope of their commissioning, helping better to meet the health care needs of my constituents. It is right that doctors, not bureaucrats, be in charge of commissioning, and we were right to deconstruct the bloated PCTs. Our PCT in Plymouth was so cumbersome that I gave up attending the regular MP briefing meetings because I could not cope with the bureaucratic culture. I am glad it has been replaced by a more streamlined, doctor-led commissioning group. This is a step in the right direction. I do not suppose for a second that the reforms were perfect—nothing ever is that Governments do—but I can see progress in the commissioning of acute services.

I say one thing to my colleagues on the Front Bench: in the west country, it used to be extremely easy to recruit GPs, but it is getting tougher by the year. I hope in the winding-up speech to hear some reassurance that in places such as Devon—a splendid place to live and work—which are having difficulty recruiting GPs of the highest quality, steps and policies will be put in place to set this right over the next two years. Nevertheless, I support the reforms; the NHS is improving all the time.