NHS

Grahame Morris Excerpts

Wednesday 5th February 2014 Commons Chamber

[Andy Burnham]

No, it was your law, your Government’s law, the Health and Social Care Act 2012—the same law against which his own care Minister, the hon. Member for North Norfolk (Norman Lamb), has recently been speaking out. He recently told the King’s Fund:

“I have a problem with the OFT being involved in all of these procurement issues… I think that’s got to change… In my view I think it should be scrapped in the future… That might happen at some future date… we’ve got to look at the barriers and address them and sort them out.”

Is that just his view, or the view of the whole Government? [Interruption.] He voted to let the OFT into the NHS. Why is he now changing his tune?

The former care Minister, the right hon. Member for Sutton and Cheam (Paul Burstow), said the same:

“The one area I have my concerns about is the way”—

the 2012 Act—

“opened up the role of the OFT.”

Yes, but did we not tell him that two years ago when he voted for the Act and when his hon. Friend the Member for St Ives (Andrew George), who is sitting next to him, joined us in the Lobby to oppose it? This is exactly what we warned them about. We warned them that it would let the market run riot through the NHS, but they would not listen, and that is why we are where we are today.

It is not just Ministers who are saying it; the comments by the chair of the Care Quality Commission at the weekend show the utter confusion in Government policy on competition in the NHS:

“We need more competition…more entrants into the market from private-sector companies”.

Will the Secretary of State clarify? Is that a statement of official Government policy? Is it his policy to get more private sector companies and more competition into the NHS? Is that what he wants? If that happens, it will mean more enforced competition leading to the fragmentation of care, and it will load extra costs on to the NHS at the worst possible time.

[Grahame M. Morris (Easington) (Lab)]

My right hon. Friend is making some positive points about the privatisation of the NHS, but does he share my concern that Monitor’s board is packed with executives who have come from private health sector companies?

--- Later in debate ---

[Grahame M. Morris (Easington) (Lab)]

Given the heated exchanges we have just had, I want to make it clear that I am speaking in support of the Opposition motion.

Given the extent of the crisis that is being faced by accident and emergency departments around the country, one would be forgiven for thinking that this Government must have inherited an NHS on the brink of collapse. In fact, the opposite is true. I know we have stopped doing the patient satisfaction surveys, but at the time that was discontinued, patient satisfaction was at an all-time high and we must not forget that the national health service had been transformed by the Labour party. I worked in the health service and I remember what it was like in the 18 years when the Tories were running it. The NHS that the Labour party inherited in 1997 was transformed. The budget for the NHS was £30 billion then, but when we left the NHS in good health in 2010, the budget was over £100 billion. The 18 years of Tory neglect had been thoroughly addressed with new hospital buildings. Every single A and E department was replaced.

What have we seen since? We have seen an unwanted top-down reorganisation, which nobody wanted and nobody voted for, coupled with under-investment, and the slashing of alternative services has placed a huge burden on our A and E services. By referring to alternative services I am talking, for instance, about walk-in treatment centres, including my own excellent Healthworks in Paradise lane, Easington Colliery. It is under enormous pressure yet offers a fantastic service with out-of-hours and weekend opening, but we are not sure whether that will continue because of pressures that the clinical commissioning group is facing. By almost any standard, it is clear that the performances of accident and emergency departments are struggling under the current Government. It is clear that patients are waiting longer to be seen and that the numbers of delayed discharges and emergency admissions are up—I think the Secretary of State admitted that. The number of cancelled operations is certainly up.

[Nicholas Soames (Mid Sussex) (Con)]

I am following carefully what the hon. Gentleman is saying; he is making some very good points. Does he acknowledge that 45% of the health service budget is spent on 5% of the population—namely, those vulnerable people with multiple chronic illnesses? Getting that right must be the key to the future. What does he think the solution is?

--- Later in debate ---

[Grahame M. Morris]

I am grateful to the right hon. Gentleman for that intervention, because his point is germane to my argument. I shall develop that subject in the few minutes I have left when I talk about the consequences of what is happening in social care. I certainly feel that some of the policies that his Government have supported have contributed to the crisis. For example, the top-down reorganisation has had a damaging effect on A and E performance. I will address that point in a moment.

Other hon. Members have spoken today, in interventions on my right hon. Friend the Member for Leigh (Andy Burnham), about patients being ferried to hospitals in police cars. That has certainly happened in County Durham, and it must be a cause for concern. The A and E crisis can largely be placed at the Government’s door, because they have not faced up to some of the problems. It has rightly been pointed out that the number of admissions had risen by 633,000, not least because of demographic changes involving more older people and people with core morbidities and multiple conditions. That is placing a huge amount of extra pressure on A and E departments, but that pressure is being compounded by damaging cuts to local authority budgets.

My own local authority, Durham county council, is experiencing cuts of £222 million between 2011 and 2017. I know that Ministers will say that social care is ring-fenced and that £3.8 billion is being transferred to the home care fund, to be made available to clinical commissioning groups and local authorities, but what that means in real terms for the people living in Easington is that EDPIP—the East Durham Positive Inclusion Partnership—which supports frail elderly people and young people in vulnerable families, is closing down because of a lack of funding from the local authority. Similarly, East Durham Community Transport, which provides transport to take the frail elderly—including my mother, incidentally—to day centres and elsewhere, has been severely curtailed.

The Government have been warned by experts that cutting the staggering £1.8 billion from council social care budgets in the first three years of this Government would have a knock-on effect for the NHS, particularly in accident and emergency departments. That point has been made in expert witnesses’ evidence to the Health Select Committee, on which I have the honour to serve. Because of the cuts to social care, fewer older people are getting adequate support in the community, and are therefore visiting A and E departments instead. The impact of that is twofold. First, it means that those with care needs are not getting the treatment they need. Secondly, it means that our A and E departments are being put under great strain. Directly and indirectly, the Government have ignored warnings that by slashing social care they would make it difficult to discharge patients with care needs because it would be unsafe to send them home.

[Barbara Keeley]

Perhaps it would be pertinent at this point to mention the comments of Sir Bruce Keogh to the Health Committee’s inquiry into urgent and emergency medicine. When I asked him if the cuts in social care bothered him, he said:

“Yes, it does bother us and I think it bothers everybody. We are trying to maintain a stable and improving service in the NHS at a time that our colleagues in social care are taking a massive hit to their baseline.”

--- Later in debate ---

[Grahame M. Morris]

I am grateful to my hon. Friend for that intervention, and I hope that her point will not be lost on Ministers. That is a significant factor.

The lack of adequate support in the community and in the home has stored up problems in the NHS, and I am convinced that they will be exacerbated by what is now happening. I know that we have done some good work on the Care Bill—there is good intent there—but I have real concerns about whether the resources necessary to make social care really work will be provided. We have seen attendances at hospital A and Es continuing to rise.

[Norman Lamb]

We have had this discussion on the Care Bill. The hon. Gentleman talks about the need for additional resource, but in Committee there was no indication from the Opposition that they would make a commitment to provide extra resources. Is he now saying that they would do so?

[Grahame M. Morris]

I cannot thank the Minister for that intervention. We have had many exchanges during the passage of the Care Bill, but that decision is above my pay grade. It would be for those on our Front Bench to determine the level of such resources. The purpose of this debate is to consider the A and E crisis. I would like to think that that commitment could be made, however, and if the Minister is asking me personally whether I support it, the answer is that I do. I believe we should also support free end-of-life care, which I know the Minister and many others on the Government Front Bench support. However, I must make some progress with my speech.

The lack of adequate support in the community has had an impact. It has contributed to increased attendances at A and E departments. I hope that Members will not have forgotten that, two years ago, the Prime Minister said:

“I refuse to go back to the days when people had to wait for hours on end to be seen in A&E”.

Well, I am afraid that we have gone back to those days. Sadly, by removing the social care needed for many elderly people to avoid unnecessary trips to hospital and to return home when their stay should be over, the Prime Minister is bringing back those days. I urge hon. Members to support the Opposition motion today.