Future of the NHS

Debate between Graham Stringer and Matt Vickers

Monday 31st January 2022 Westminster Hall

[Matt Vickers]

This is a debate that we have in every election campaign, and other than the issues around dentistry, which I am sure we will come to, the NHS remains free at the point of use. I will fight the corner to keep it that way, and I am sure that the hon. Gentleman will do so as well.

[Graham Stringer (Blackley and Broughton) (Lab)]

I think everybody in this room would agree with the principle that the NHS was founded on—care that is free at the point of use—but the NHS has had many structural forms since its inception immediately after the second world war. My concern is that its current form and the proposals that the Government are bringing forward further centralise the NHS, and waste further money on bureaucracy, mimicking the private sector and creating an artificial market. Does the hon. Gentleman agree that that is a waste of money, and that the NHS should be decentralised in order to provide better services to local communities?

[Matt Vickers]

I am sure we are going to hear about the ways in which these structural reforms will take place with that very aim in mind. I am going to try to get through my speech, because I am sure that Members would prefer for everybody to get in and to hear from the Minister, who is wiser on this issue than I am.

In my view, the Health and Care Bill does not represent an attempt to create a “pay for play” system—quite the opposite. While I am sure the Minister will go into detail about this point in his response, my understanding is that the Bill is largely the work of the NHS itself, inspired by NHS England’s own desire to restructure its organisational system to be more efficient and effective. It builds on the NHS’s own long-term plan, as set out in 2019, and the NHS people plan, which was published in 2020. Many of my conversations with leaders from my local NHS trust suggest that the answers to improving health outcomes require multi-agency working and empowerment of local health agencies, and my understanding is that the reforms and structural changes in the Bill set out to do exactly that.

One point on which I strongly agree with the petitioners is the need to drive value for money within our NHS, reducing management costs and excessive use of consultants, so that the huge increases in funding for the NHS can actually reach the frontline, not just fund more fruitless layers of bureaucracy. I am hopeful that the Minister will update us on what is being done to drive efficiency in that regard. Another point that I fundamentally agree with is the petitioners’ view that private finance initiative contracts have no place in our NHS. I know all too well the debilitating effect they have on the ability of the NHS to administer care across our country. Nationally, PFI contracts cost our NHS £1 billion a year and restrict numerous hospitals across the breadth of Great Britain.

I have seen at first hand how PFIs have damaged our local services in the Tees Valley. South Tees Hospitals NHS Foundation Trust, in particular, has been plagued by a dodgy new Labour PFI contract. The James Cook University Hospital was completed in 2003, but its PFI contract does not run out until 2034, and will cost over £1.5 billion. The trust currently has to meet annual payments of £57 million a year—more than £1 million every week. Of course, hospital upgrades and rebuilds are expensive, but that trust is paying £17.5 million over and above what an equivalent Treasury-funded hospital would cost annually. Shockingly, that is enough to pay for more than 530 nurses. It is ludicrous.

Even if there were not an extra 530 nurses at South Tees, there is so much the hospital could do with this money, such as investing in its building, equipment and staff to help improve health outcomes and inequalities. Excessive costs from historic PFI contracts are listed as the largest single contributory factor to the hospital’s troublesome financial position. At time when retention is a huge issue for our NHS, this money would be crucial to making a substantial difference to the working lives of our NHS heroes. I am glad that in 2018 a Conservative Government decided that PFI contracts would be phased out. However, hospitals up and down the country are now stuck dealing with a Labour legacy that has damaged our NHS, our people and our ability to tackle health inequalities across this country.