NHS Sustainability and Transformation Plans

Debate between George Howarth and Margaret Greenwood

Wednesday 14th September 2016 Commons Chamber

[Margaret Greenwood (Wirral West) (Lab)]

To understand the significance of the Government’s creation of the sustainability and transformation plans, we need to be aware of what has gone before and consider the extent of the financial crisis. In 2012, the coalition Government passed the Health and Social Care Act, paving the way for the privatisation of the national health service and removing the duty of the Secretary of State to provide and secure a comprehensive health service in England. I believe the STPs are a key part of the Government’s plan to drive through privatisation.

[Mr George Howarth (Knowsley) (Lab)]

Does my hon. Friend agree that the concern in our part of the world is that the word “sustainability” is all about financial sustainability, not the sustainability of services?

[Margaret Greenwood]

My right hon. Friend has hit the nail on the head.

Monday’s Liverpool Echo leaked some of the detail of Merseyside and Cheshire’s STP, reporting an anticipated £1 billion deficit by 2021. The STP talks about a

“need to reduce demand, reduce unwarranted variation and reduce cost.”

Those are all very nice ambitions, but the idea of trying to reduce demand just to plug a £1 billion funding gap is, frankly, the wrong way to deal with planning a sensible health service. The STP also says that there is an “appetite” for hospital reconfiguration—an appetite among whom, one might ask—as the existing set-up is unaffordable. It says there will be a requirement for

“our hospitals to be reconfigured, consolidated with less sites and clinicians and consultants working increasingly in new emerging networks.”

There is a problem with commas in the document, so who knows what it means. In other words, there will be cuts to staff and cuts to hospitals.

Merseyside Fire and Rescue Service

Debate between George Howarth and Margaret Greenwood

Tuesday 26th January 2016 Westminster Hall

[Margaret Greenwood]

I thank my hon. Friend for that really important point, because of course someone might say that five is a small number—of course, every life matters—but when we see a trend such as that one it is significant. We also have to consider the wider trauma that is suffered, because of course one person who dies in a fire may have many relatives and children, and so the trauma is not just restricted to that one person. This is a very serious situation.

In addition to the increased risks to the public that we are seeing, we must also bear in mind what these cuts mean to the fire crews themselves. When a firefighter is committed to an incident wearing breathing apparatus, the length of time that they spend dealing with that incident and the activity that they undertake will have a bearing on the length of time they will need to recover away from the area of danger before they can be recommitted. Each time a firefighter wears breathing apparatus at an incident, the potential risk that they face increases, because of the amount of time they are exposed to hazards and the physical efforts of repeated use of breathing apparatus.

The speed at which other fire appliances arrive to provide additional crew in breathing apparatus is crucial to reducing the risk to firefighters and to providing an effective firefighting response. Dan Stephens, the chief fire officer of Merseyside fire and rescue service, has given his view of the impacts of the cuts so far. He says, “The reduction of appliance numbers resulting from the cuts to the Merseyside fire and rescue authority budget have increased response times for the first and subsequent appliances to life-risk incidents. The reduction in appliances has also impacted on the number of crews that can be released for risk-critical training and exercises on any given shift. The organisational capacity to undertake community safety interventions such as home fire safety checks has also been significantly reduced.” It is important that we take notice of the chief fire officer’s analysis of the situation that the cuts have given rise to.

[Mr George Howarth (Knowsley) (Lab)]

I am very grateful to my hon. Friend both for her good fortune in securing this debate and for the powerful way in which she is making her case. Does she agree that given the weight of the problem that she has described, it would be appropriate for the Government to treat the fire and rescue service in the same way that they have treated the police, which is to say there should be no further cuts to the fire and rescue service?

[Margaret Greenwood]

I thank my right hon. Friend for that excellent point, and I absolutely agree with it.

As though all that has happened from 2011-12 to 2015-16 was not enough, there are more cuts to come. The future funding settlement announced as part of the local government funding settlement at the end of last year—on 17 December—has left Merseyside fire and rescue service facing a 41.3% cash reduction in the revenue support grant, which is the grant from central Government, over the period from 2016-17 to 2019-20. That equates to approximately a 50% reduction in real terms. Once business rates are added, Merseyside fire and rescue service will see a cut in cash terms of 16%, or between 22% and 25% in real terms if we take inflation into account. Of course, we have to remember that that those cuts are on top of the cuts that the service has already suffered, meaning total cuts of £11 million over the four years. The cuts that are coming our way are likely to lead to the loss of another 10 fire engines, taking the number down from 28 to 18, and the loss of another four or more fire stations.

The overall impact of the cuts delivered and planned for by the coalition Government and the current Government, between April 2011 and March 2020, will be a 41% reduction in the number of firefighters—a loss of about 400—a 46% reduction in the number of support, fire prevention and management staff, to just under 200, and a 21% cut in control staff, bringing their number down from 42 to 33. We can also expect to see the number of fire engines reduced from 42 to 18—a 43% cut.

--- Later in debate ---

[Margaret Greenwood]

I agree with my hon. Friend’s excellent point.

We have already mentioned the increased response times that are so critical when it comes to saving life. Independent consultants Greenstreet Berman suggest that by 2020, should the cuts go ahead, slower response times nationally will mean up to 41 additional deaths at dwelling fires, up to 91 additional deaths at road traffic collisions, up to 57 additional deaths at water incidents and 212 additional deaths at special service incidents. A significant increase in loss of life is predicted, so we must consider too what cuts in staffing on that scale will mean for those left working in the service. Anyone working in an environment that involves teamwork knows full well that the loss of 40% of staff would put pressure on those remaining.

As well as considering the impact on the service’s ability to respond to fires, we must also bear in mind the other essential work that the fire service carries out. In 2015, the Government published the latest edition of the national risk register of civil emergencies, which is the unclassified version of the national risk assessment. The register covers a range of civil emergencies that threaten serious damage to our welfare, the environment and security. A striking number of those threats are matters dealt with by the fire and rescue service, for example terrorist attacks, coastal and inland flooding, storms and gales, low temperatures and heavy snow, heatwaves and severe wild fires, pandemic influenza and other disease outbreaks, major industrial and transport accidents, and public disorder, such as during the civil disturbances of 2011. We must remember that a Government’s first duty is to protect its citizens, and the coalition failed in that duty in 2011, with the riots that took place in London. I happened to be in London at the time, and it was very frightening to be there.

Firefighters in Merseyside continually plan, prepare and train for those kinds of emergencies. Some of the risks posed by such events have increased in recent years, and with climate change many of the risks are likely to increase in the foreseeable future. The Government’s own analysis of flooding incidents responded to by fire and rescue services across England in 2014-15 shows a 15% decrease in the number of such incidents, but I think that we would all agree that this winter we have seen just how important fire and rescue services are in flood incidents, and we have all powerfully been made aware of how unpredictable extreme weather events can be. Merseyside fire and rescue service has supported every major flood event over the past 10 years.

We have to remember too the risk of terrorism. Terrorist incidents are, of course, by their nature unpredictable, but Merseyside fire and rescue must be able to respond to them. For example, it provided a terrorist firearms attack team for the NATO summit in Cardiff.

Other events are highly uncertain and difficult to quantify, and it is impossible to plan for multiple events. Everyone assumes that the fire and rescue service is prepared, equipped and staffed to meet every challenge. The Government’s planning for such risks assumes that sufficient firefighters are available to tackle the emergencies, and that the fire and rescue service in Merseyside is resilient in the face of such threats.

I want to talk a little about the drop in the number of fire incidents. Some have tried to argue that the drop justifies the reduced spending on fire and rescue services. That might have once been the case, but after receiving deep cuts in 2011, Merseyside fire and rescue service should not face any more. The latest round of cuts will adversely affect the service’s ability to carry out crucial fire prevention work in the community, which is particularly important when one considers the age profile of the local population, as in my constituency, for example. Older people suffering from memory loss, mobility issues, sight and hearing loss, and dementia increase the risk of domestic fires. The prevention work carried out by Merseyside fire and rescue service is as important today as it has ever been.

The increase in the number of road traffic incidents, to which the fire service across England has had to respond, should also be borne in mind. The coalition’s cuts to Merseyside fire and rescue service have damaged the service’s ability to respond to fire and a range of other incidents, many of them life-threatening. The cuts announced before Christmas will make matters far worse. The loss of 41% of firefighters, 46% of support, prevention, protection and management staff, and 21% of control staff will put an inacceptable strain on the remaining staff and affect response times. Cuts on that scale could also lead to loss of life.

I have looked but have been unable to find mention in the Conservative party manifesto that the Government intended to make dramatic cuts to essential life-saving services. I welcome a correction from the Minister if I am wrong. I very much doubt that the public will support this level of cuts or that they would be forgiving of such detriment to the service over time.

[Mr George Howarth]

My hon. Friend will be aware that Dan Stephens, the chief fire officer, said today that he believes that there is no capacity to absorb any further cuts. He also said that the situation is exacerbated by our low tax base and that

“the cuts we have sustained to date”

mean that the

“bulk of future savings”

will have

“to come from response”.

Is that not the case in a nutshell? My hon. Friend has described all the consequences—that more people will be at risk, more firefighters will be at risk, more people will lose their lives, more people will be injured and more properties will be destroyed or badly damaged.

[Margaret Greenwood]

My right hon. Friend makes an excellent point. Increasing response times is not an option if we take risk management seriously.

In the spending review, on 25 November, the Chancellor made great play of the fact that there would be no cuts in the police budget and that there would be real-terms protection for police funding. He said:

“The police protect us, and we are going to protect the police.”—[Official Report, 25 November 2015; Vol. 602, c. 1373.]

On closer inspection, the pledge does not look quite as watertight as it did when it was first made, but the U-turn does prompt the question: why are the Government not going to protect firefighters? Moving the responsibility for the fire service from the Department for Communities and Local Government to the Home Office offers the Minister an opportunity to pause, reconsider and drop the cuts, and I urge him to do so.