Social Care Funding

Grahame Morris Excerpts

Monday 11th February 2013 Commons Chamber

[Mr Hunt]

I will certainly do that, and I am grateful for my hon. Friend’s comments. I would just say that it is in some of those areas with the highest proportion of older people that the impact of the current lottery in care provision is so dramatic and needs addressing so quickly. I therefore hope that her constituents will welcome the certainty in these proposals, but I will certainly look at and identify whether any particular issues are raised in rural areas.

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

The Minister has concentrated on the impact on the frail elderly, but does he recognise the other care crisis highlighted recently in a report published by four leading disability charities? What will these proposals do to assist in providing social care to working-age disabled people, who make up about a third of social care recipients? The shortfall we have estimated is about £1.2 billion—that is the gap between social care budgets and needs.

[Mr Hunt]

These proposals will go some way to addressing that problem. First, children who reach adulthood— the age of 18—with care costs will continue to receive the support they need without any qualification at all. Adults who become disabled during their working life will have a cap, but it will be a lower one. So we will be able to offer very important support to both those groups.

Oral Answers to Questions

Grahame Morris Excerpts

Tuesday 15th January 2013 Commons Chamber

[Mr Hunt]

I am happy to inform my hon. Friend that 25,000 people have benefited to date from the cancer drugs fund, which the previous Government failed to introduce. On top of that, 53,000 more people every year are being admitted for chemotherapy and 219,000 more cancer treatments are happening every year than happened in any year under the last Labour Government.

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

21. I have previously raised with the Secretary of State the opportunity cost—in terms of cost and effectiveness —of the proton beam therapy system. Given that expert opinion—in the form of the national radiotherapy advisory group—is divided, and given that the cost of the proton beam therapy system is 100 times more than other advanced radiotherapy systems that my region and others lack, why is he proposing to spend £125 million on it?

[Mr Hunt]

I recognise that the hon. Gentleman has a long-standing view on this matter. I am guided by clinical advice. Over the next two years, we will publish the cancer survival rates by multidisciplinary team across the country in all the major cancers for the very first time. That will give us a much better objective base from which we can work out what the most effective treatments are.

NHS Funding

Grahame Morris Excerpts

Wednesday 12th December 2012 Commons Chamber

[The Secretary of State for Health (Mr Jeremy Hunt)]

We have heard a lot of bluster and nonsense today. At its heart is an extremely uncomfortable truth for the Opposition: this Government are spending more on the NHS than Labour would have spent. That spend has moved away from consultancy and the back office to the front line, so the NHS is now performing better—I know that it is uncomfortable, but it is true—than it ever did under Labour. That means more treatment—[Interruption.] This might not be what Opposition Members want to hear, but they might as well listen. That means more treatment, more care and more lives saved. The previous Government talked the talk on the NHS, but it is this Government who have delivered an NHS of which we can be immensely proud.

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

Will the Secretary of State give way?

[Mr Hunt]

I will make a little progress before giving way.

--- Later in debate ---

[Mr Hunt]

Let me say very gently to the right hon. Gentleman that he can hardly come to this House criticising us for an alleged cut in NHS spending if his own plans would have led not to higher but to lower NHS spending. We are increasing spending by £12.5 billion, and he thinks that that is irresponsible.

[Grahame M. Morris]

Will the Secretary of State at least acknowledge that the previous Labour Government increased resources in the NHS from £30 billion when we took office to over £100 billion when we left office in 2010?

[Mr Hunt]

I accept that. We wanted to increase spending even further, and the right hon. Member for Leigh said that that was irresponsible.

--- Later in debate ---

[Stephen McPartland]

I understand that the hon. Lady has a specific issue in her constituency, and I would like to point out one in mine: anyone in my constituency who requires radiotherapy treatment has to travel to Hillingdon in London to have access to the linear accelerators, with the typical journey being more than 4,000 miles during the course of the treatment. I do not want to blame any particular Government or party, but the reality is that there are difficulties everywhere. I have a campaign, which I would love all hon. Members to join, to bring cancer care closer to people’s homes, and I want to have a radiotherapy unit based in my constituency. There are discrepancies and disparities all over the country, and it would be great if we could iron them out.

[Grahame M. Morris]

Does the hon. Gentleman agree that a good use, not only in Stevenage, but across the country, of some of the underspend that has been mentioned by hon. Members from across the House would be to buy advanced forms of radiotherapy equipment?

[Stephen McPartland]

That would be fantastic use of the money, but Hillingdon already has eight linear accelerators and a cyber knife, which reduces the course of someone’s treatment from about 25 visits to eight. The key for my constituents is that the people accessing that service are generally elderly and they would have to access it by public transport, which they find very difficult, so they rely on friends and family. I want that treatment to be brought closer to their home, which goes back to my point about the patient’s experience.

Earlier in the debate, Mr Deputy Speaker called for a little bit of Christmas cheer, so I have great pleasure in being able to announce that earlier this morning, when it was minus 6°, I was outside my local hospital having my photograph taken and the Government were announcing £72 million of funding for infrastructure in the Lister hospital—the money is part of an ongoing investment programme worth more than £150 million. That is the third of 11 projects. We are having a huge accident and emergency department rebuilt, and a lot of people are going to be accessing it; and we are having new ward blocks, theatres and endoscopy units. A huge range of services are coming to the Lister hospital in Stevenage; it is fast becoming a centre of clinical excellence. I know that many hon. Members think I am quite lucky, and I am very proud and happy about what is happening.

That investment highlights one of the issues I want to raise. When we have these debates, we often find that the passions of hon. Members on both sides about small amounts and figures can create a sense of fear in the NHS that services are being delivered poorly day to day. In my constituency, for the past two years, construction has been going on and new services have been coming to my local hospital, with a range of users able to access them. That building will go on until 2014 to early 2015, and it is what we are calling phase 4. I refer to my radiotherapy campaign as phase 5—people are not aware of that, but we are keen to access the money for it. The hon. Member for Easington (Grahame M. Morris) suggested using the £1.6 billion underspend, and it will now be my target for where we get the funding.

In my constituency, the NHS is daily delivering better and better care; a legion of doctors, nurses and clinical staff, backed up by great administration staff, are providing a fantastic level of service and improving the NHS. I am proud of the NHS and of the staff in my constituency who work in the NHS, and I am delighted that we have had the opportunity to have this debate.

--- Later in debate ---

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

I rise to speak in favour of the motion tabled by my right hon. and hon. Friends on the Opposition Front Bench. The Deputy Speaker suggested that we might introduce a bit of Christmas cheer into the proceedings, and the hon. Member for Stevenage (Stephen McPartland) certainly painted a very rosy picture of investment in his constituency. I thought he made a very good speech, incidentally.

In case Ministers are making their Christmas lists, let me tell them that one of the first things that this Government did was cancel a new hospital that served part of my constituency in order to save £464 million. Restoring that funding might be a good use for some of the £3 billion underspend. It was not a private finance initiative scheme but a scheme that was approved by the Department of Health and the Treasury but stopped in the emergency Budget.

I want to concentrate on two specific issues that are directly linked to the motion and on the important question of trust in the Government’s pledge on the funding of our NHS. I believe that the Government are keeping the public in the dark about a range of issues relating to publicly funded contracts delivered by private sector organisations, including on cancer care.

On trust, none other than the Prime Minister broke yet another pre-election promise. Having said before the election that he would extend the Freedom of Information Act 2000 to all publicly funded organisations, he did not do so. As a result, the public cannot access information about private sector providers in the NHS. This does not apply just to the NHS. In his comments, the Prime Minister referred to other publicly funded organisations such as the Carbon Trust, the Energy Saving Trust, the Local Government Association, and traffic penalty tribunals. It is increasingly apparent that many of the large corporations that apparently enjoy cosy relations with this Tory-led Government are extremely anxious that the Prime Minister does not extend the Freedom of Information Act to them. Currently, it instead allows them to hide behind a cloak of commercial confidentiality as billions of pounds of taxpayers’ money are awarded to them in barely transparent contracts. The public are deliberately being kept in the dark, and I have no doubt that an expensive lobbying campaign is under way to ensure that the Prime Minister and the Tory party do not change their minds on this issue.

Meanwhile, private companies benefit by gaining intimate knowledge of public sector bodies through their own submissions of freedom of information requests. That information is then used to undercut or outbid the very same public sector bodies when contracts are tendered or put up for renewal. Members might ask what the relevance of this is in the NHS context, but as someone who worked in the NHS, who is passionate about it, and who has tremendous admiration for the people who deliver the service, I can say that it is a huge concern to me. The area that I worked in—the pathology service that carries out diagnostic tests—is under threat. This huge uncertainty continues, and we need to know precisely what the position is.

Virgin Care, Circle, Serco, Care UK and any other private sector companies awarded a public contract to provide hospital, community or even specialist diagnostic cancer services are not subject to the FOI Act. We have no idea how these companies went about winning those lucrative, taxpayer-funded contracts. Under current arrangements, the best that may be hoped for in terms of any rudimentary accountability is achieved through a Commons Select Committee inquiry of the type conducted by the Public Accounts Committee chaired by my right hon. Friend the Member for Barking (Margaret Hodge). However worthy this process, it is by its very nature very limited in scope, and such inquiries can only ever touch the tip of the iceberg.

This is a national scandal that has prompted me to table early-day motion 773, which has attracted quite a wide range of support, mostly from Labour Members. It calls for the FOI Act to be extended to private sector bidders for public service contracts, particularly in organisations such as the NHS.

My concern is that this has overtones of the Government’s response to Leveson, in so far as I do not believe that the Government want their corporate friends to be accountable to Parliament, even though our public services are being awarded to those companies in ever greater numbers. We should follow the public pound and ensure that we know who is getting it, and how and why they are spending it.

The Secretary of State has said that there will be no large expenditure projects that are not fully thought out and properly costed. That brings me to my second point. Responses to FOI requests from my hon. Friend the Member for Leicester West (Liz Kendall) have made it clear that the Secretary of State is presiding over cuts to essential cancer networks, yet we know that he is planning to spend £250 million of taxpayers’ money on two proton machines, even though, according to the Department of Health’s own report, there is little evidence that they provide any benefit. There are no clinical trial data and no randomised control trials, which are the gold standard by which the National Institute for Health and Clinical Excellence judges the effectiveness of clinical therapies. Indeed, the new chair designate of NICE appeared before the Health Select Committee earlier this week and said exactly that.

The economic justification for purchasing those two machines has been based on informal discussions with the manufacturers who make them. If the machines are to be viable for the two hospitals that are to have them, they will need to treat 1,350 patients a year at a cost of £40,000 per patient. However, according to the Department of Health’s own dataset, the highest number of patients ever treated with proton therapy in one year is 79.

I would like to draw the House’s attention to the situation in Germany, which has invested more than most in proton therapy. Today, two of the three proton machines in that country are being mothballed. In Kiel, €250 million was spent last year on a machine, but it is now being dismantled and put into storage because of a lack of demand.

[Ian Lavery (Wansbeck) (Lab)]

Can my hon. Friend explain to the House what a proton machine actually is?

[Grahame M. Morris]

Probably not, in the very limited time available, but I can tell my hon. Friend that proton therapy is a form of advanced cancer treatment.

My argument is that the money the Department is proposing to spend on those incredibly expensive machines would be far better spent on advanced radiotherapy machines such as the stereotactic body radiation therapy machines that the hon. Member for Stevenage mentioned. There are other forms of therapy that are far more cost- effective. I might add that we in the northern region have no access to such therapies. Indeed, whole regions of the country do not.

The one remaining proton machine in Germany is at the university of Heidelberg, and it treats a maximum of 1,200 patients each year. The German Radio-oncology Society has said—[Interruption.] I hope that the Minister will listen to this. The society has said that

“for the vast majority of cancers there is no proof that proton therapy is more beneficial than other forms of innovative radiotherapy that are one hundred times less expensive”.

This proton debacle highlights the perversity with which the Government are running the NHS budget, and these questions lie at the very heart of whether we can trust Conservative promises on the NHS.

The Prime Minister tells the public that by April next year every cancer patient who needs innovative radiotherapy will get it, while at the same time the Secretary of State for Health starves dozens of hospitals and cancer networks of vital money needed to buy innovative radiotherapy equipment. We now know that money is being redirected into those two highly dubious projects. The Secretary of State needs to cancel those projects now and redirect the money into radiotherapy machines that will help tens of thousands of people in my constituency and across the country. This has the potential to be a monumental scandal and a waste of public money. I urge hon. Members who share my concern to sign early-day motion 773, to lobby the Health Secretary and ask him to reconsider his spending priorities in relation to cancer therapies, and to support the motion on the Order Paper.

[Mr Deputy Speaker (Mr Nigel Evans)]

I call Jim Shannon. I am not putting the clock on him, but he must resume his seat by 4.44 pm.

Winterbourne View

Grahame Morris Excerpts

Monday 10th December 2012 Commons Chamber

[Norman Lamb]

I agree absolutely. One of the great scandals of this whole saga has been the extent to which local authorities and primary care trusts let people down. The father of a patient at Winterbourne View told me how the concerns he raised were ignored, how he watched as his son became more zombie-like because of the use of antipsychotic drugs and how he felt guilty himself—how shocking that a parent ends up feeling guilty through no fault of his own. He was powerless to do anything. It is shocking that public authorities let people down in that way. That is why I say that everyone in the system has to step up to the plate and recognise the need for a complete change of culture to recognise that everyone with learning disabilities has exactly the same rights as the rest of us.

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

I thank the Minister for his statement and hope that he will reflect on some of the questions posed by my hon. Friend the Member for Leicester West (Liz Kendall), who made a powerful case for private providers being subject to freedom of information requests—I draw his attention to early-day motion 773, which embodies that principle.

On the failings that brought about this terrible tragedy, the Care Quality Commission was overly concentrating on process rather than its main job of ensuring that the required standards were met and looking at quality and risk profiles. There was a big disconnect between the perceptions of carers and families and the views of the CQC. Fundamentally, unless we address the lack of resources, will we not see a series of these disasters in the future?

[Norman Lamb]

In the aftermath of Southern Cross, we have seen the need for much greater transparency in these large corporate bodies to ensure that we know exactly what their financial structures are like and where the risk exists. The hon. Gentleman mentioned funding. The great scandal is that we are spending vast sums of public money putting people at risk and into inappropriate care settings. Visiting places such as Tower Hamlets, we discover that the right care package for individuals—most often, supported living in their own community—is much cheaper and gives them a quality of life they never experienced in these institutions. This is not about money, therefore, but about the system stepping up to the plate and ensuring that individuals are respected in their own right.

NHS Commissioning Board (Mandate)

Grahame Morris Excerpts

Tuesday 13th November 2012 Commons Chamber

[Mr Hunt]

I am more than happy to do that, because when it comes to conditions such as dementia there is no one right solution, and doctors’ surgeries and hospitals will have different approaches in different parts of the country. We want everyone to take ownership of the problem. I hope that what is happening in Crawley will be noticed by other parts of the country, so that we can spread best practice everywhere. That is the point—we want to allow innovation to happen in a way that has never happened before.

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

This is a hugely significant occasion. It is the one opportunity that Parliament will have to call the Secretary of State to account for the priorities that he sets for the NHS Commissioning Board, so may I refer him to his pledge to improve cancer outcomes? Given that he made a pledge to the House on 23 October to make available to anybody who required it innovative radiotherapy, how does that square with giving back to the Treasury £3,000 million that could otherwise be used to buy advanced and innovative radiotherapy equipment?

[Mr Hunt]

Let me remind the hon. Gentleman, as I reminded the right hon. Member for Leigh, that for the four years that preceded this Government, there were underspends, including when the right hon. Gentleman was Health Secretary, and in three of those four years the underspend was higher than it was in our first year in office. But we do want innovative cancer treatments to be available. That is why we introduced, among other things, the cancer drugs fund, which was not introduced by his Government and which has transformed the lives of thousands of cancer sufferers.

Winterbourne View

Grahame Morris Excerpts

Tuesday 30th October 2012 Commons Chamber

[Norman Lamb]

I tend to the view that we have had too many changes of regulator over a number of years, and that continuity would be a good thing. An assessment of the CQC earlier this year indicated that it was on the right track. I have met the new chief executive and am reassured by the plans he has in place. It is seductive to believe always that it is an attractive proposition to abolish an organisation and set up a new one, but is there any more chance that a new organisation will be better? Let us therefore make the CQC work properly.

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

I welcome the Minister’s response—he is sincere in his desire to address these issues. Does he recognise the important role of whistleblowers? Does he have any information on concerns raised by whistleblowers in respect of the alternative provision before Winterbourne View patients were transferred?

[Norman Lamb]

The role of whistleblowers is central. Importantly, the Government have funded a whistleblowing helpline, which is available to any worker in the care sector—it covers all care homes. It is important that any worker at any stage feels they can raise their concerns with the relevant authorities so that they are properly investigated. What happened with the whistleblower at Winterbourne View was not acceptable, because their concerns were not taken up effectively.

Oral Answers to Questions

Grahame Morris Excerpts

Tuesday 23rd October 2012 Commons Chamber

[Mr Hunt]

I absolutely agree with my hon. Friend. Indeed, last week we announced that waiting times are at near-record lows. The number of hospital-acquired infections continues to go down and mixed-sex wards have been virtually eliminated. I am very pleased that my hon. Friend has an urgent care centre, and am sure that Mrs Bone will appreciate it even more than he does.

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

Does the Secretary of State recognise that the Office for National Statistics survey shows that the mortality rate in north-east England is 12% higher than that in the rest of the UK? Does he recognise the need to invest in more advanced radiotherapy equipment, bearing in mind that 70 of the 212 systems will need to be replaced by 2015?

[Mr Hunt]

I would not necessarily expect the hon. Gentleman to follow announcements that are made at the Conservative party conference, but we did make the big announcement that access to radiotherapy will be transformed, making it available to everyone for whom it is clinically necessary and cost-effective. Improving mortality rates is extremely important. As I have set out, one of my key priorities is to transform the NHS so that we have the best mortality rates in Europe. I hope that that is welcome news for his constituents.

Oral Answers to Questions

Grahame Morris Excerpts

Tuesday 17th July 2012 Commons Chamber

[Mr Lansley]

Yes; I am grateful to my hon. Friend. When we came into office, something like 209,000 people had waited over 18 weeks. We have reduced that figure to 160,000. The number waiting over a year was nearly 19,000, and we have brought that down to below 5,000. I remind Opposition Members that in Wales the target for the number waiting more than 26 weeks has not been met—the figure stands at 6%, whereas in England it is 2.2%.

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

In regard to improving cancer outcomes, will the Secretary of State consider using some of the underspend in the cancer drugs fund to allow improved access to advanced radiotherapy?

[Mr Lansley]

I am grateful to the hon. Gentleman for that question, because it allows me to confirm that the annual report states that the NHS has met all the cancer waiting time standards, and that we in England have provided for 12,500 patients to have access, through the cancer drugs fund, to cancer drugs that they would not otherwise have been able to have. It is a matter of regret that a similar cancer drugs fund is not available for exceptional treatments in Wales.

National Health Service

Grahame Morris Excerpts

Monday 16th July 2012 Commons Chamber

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

Thank you for calling me early, Mr Deputy Speaker. I am delighted to be able to participate in this important debate just before the recess.

I refer hon. Members to part of the Opposition motion:

“That this House regrets the growing gap between Ministers’ statements and what is happening in the NHS; notes mounting evidence of rationing of treatments and services by cost, despite Ministers’ claims to have prevented it”.

I would like to highlight one specific example. The Minister, who is not paying attention at the moment, may wish to make note of the issue, because it matters to cancer patients in my area and across the country. I am talking about the lack of access to advanced radiotherapy.

By way of background, I should say that the national cancer action team told NHS commissioners that radiotherapy is involved in 40% of cases in which cancer is cured. Furthermore, radiotherapy by itself now cures 16% of cancer patients. By contrast, cancer drugs are the main cure of only 2% of cancer patients. We can draw the conclusion that I hope the Department of Health and Ministers would accept: radiotherapy cures far more cancer patients than drugs. They should issue instructions to commissioners to reflect that and make money available for radiotherapy.

The current allocations are inadequate and arguably paltry. The radiotherapy budget for the current year is just £350 million, while the cancer drug budget is close to £1.5 billion. Within that sits the Government’s flagship cancer drugs fund, which, according to information that I have received, was underspent by £150 million. Despite that underspend, an additional £200 million is going into the cancer drugs fund. My concern is that that money is not for cancer patients but for cancer drug companies.

The whole idea is becoming discredited—so much so that, as has been reported in the newspapers, even Mr Clive Stone, the Prime Minister’s constituent who originally inspired the fund, has asked for less money to be put into the fund. Why? He now needs advanced radiotherapy for his cancer and there is no money available for him.

The cancer drugs fund cannot be used to fund advanced radiotherapy, and that is a real concern. I have no doubt that during the winding-up speeches we will be told that the Government are putting in an extra £150 million into new radiotherapy treatments over the next four years. The Minister of State, the hon. Member for Sutton and Cheam (Paul Burstow), keeps telling us that, but when I ask him where the first and second year allocations—£13 million and £22 million—are being spent, he tells us that he does not know.

I thought I would try to help out the Minister, so I sent freedom of information requests to every strategic health authority asking how much of the money they had received and how their PCTs had spent it. I have good news for the Minister, who is not in his place. It is that he is not the only one who is in the dark when it comes to that £13 million and £22 million; the SHAs do not know either. I have the replies with me. I was going to read them out, but unfortunately I do not have time.

The stark truth is that under this Government no new money is going into providing the latest radiotherapy technologies for the NHS. In March last year, the Secretary of State commended some of the new facilities, including the new CyberKnife system at St Bartholomew’s hospital in London. Members, some of whom have also been to see the system, are concerned that charities are having to be used to raise money to buy that vital equipment. When I raised that issue in this Chamber, the Minister disputed that, but I have furnished him with a list of areas where it is happening. The Minister should accept his responsibility, get a grip on the situation and ensure that cancer patients needing advanced radiotherapy have access to the service that they need. I support the motion.

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[The Secretary of State for Health (Mr Andrew Lansley)]

I was rather disappointed by the speech of the hon. Member for Denton and Reddish (Andrew Gwynne). Like the motion, the hon. Gentleman failed to say anything about NHS staff, or to reflect the admiration and respect we have for them. The motion and his speech were just another occasion for Labour to use the NHS as a political football, fuelled by nothing but distortions, inaccuracies and myths.

I always welcome such debates, because they give hon. Members an opportunity to raise constituency issues. Many did—I will respond to the points they made—but the right hon. Member for Leigh (Andy Burnham), the shadow Secretary of State, did not. When the Conservative Opposition raised debates on the NHS before the election, as we often did, we had an alternative policy to express and arguments to put forward. Like the motion, his speech was empty of argument and of fact, and he and the Labour party are empty of policy.

The right hon. Gentleman told us only that he wants to abolish the Health and Social Care Act 2012. If that happened, there would be no clinical commissioning in the NHS. In fact, nobody would be responsible for commissioning. He would abolish local authorities’ responsibilities for public health in their area, which they are embracing and acting on. He would abolish health and wellbeing boards, which are integrating health and social care more effectively. He would abolish the duties in the legislation for NHS bodies to act to reduce health inequalities, which rose under a Labour Government.

Let me address some of the points—

[Grahame M. Morris]

Will the Secretary of State give way?

[Mr Lansley]

No. I will address the points made in hon. Members’ speeches, including the hon. Gentleman’s. He was the first Back-Bencher to speak in the debate. He talked about more support for radiotherapy. He must recognise that we committed to £150 million additional support for radiotherapy in the cancer outcomes strategy. That will be available. He mentioned CyberKnife, which is a brand name for stereotactic beam therapy. That form of therapy is available in the NHS and will continue to be available. He neglected to mention that I announced during the past few months new plans for the establishment of two major centres for proton beam therapy in this country, which will mean that patients no longer have to go abroad to access it.

[Grahame M. Morris]

Will the Secretary of State give way?

[Mr Lansley]

No.

My right hon. Friend the Member for Charnwood (Mr Dorrell) made an important point on the Nicholson challenge, which a number of Opposition Members mentioned. At least one or two of them had the good grace to recognise that David Nicholson’s proposals were set out in May 2009, under, and endorsed by, a Labour Government. Labour Members now want nothing to do with the consequences of meeting that financial challenge. They fail to recognise, as my right hon. Friend said, that the challenge was against the background of an expectation that a Labour Government would not increase the NHS budget, and that the challenge would have to be achieved within three years. The Conservative Government have increased the budget for the NHS. Over the course of this Parliament, it will go up by £12.5 billion, which represents a 1.8% increase in real terms. The right hon. Member for Leigh and his party were against that.

No Opposition Member recognised in the debate the simple fact that, in the first year of this Parliament, £4.3 billion of efficiency savings were achieved, and performance improved, across the NHS. That was not even in the time frame for the Nicholson challenge. We have now had one year of the challenge. The target was £5.9 billion of efficiency savings, and we achieved, across the NHS, £5.8 billion. Things are on track, which completely refutes the shadow Secretary of State’s argument that we cannot have reform and deliver on the financial challenge at the same time. Actually, we can do both, and in addition improve performance in the NHS.

The right hon. Member for Greenwich and Woolwich (Mr Raynsford) completely contradicted the hon. Member for Eltham (Clive Efford) on the South London Healthcare NHS trust. The latter said he was against changes at Queen Mary’s, Sidcup, but the former said that I did not get on with the changes soon enough. The hon. Member for Denton and Reddish complains from the Opposition Front Bench that I did not have a moratorium, but the right hon. Member for Greenwich and Woolwich complains because I did have one.

Let me be clear about this: I did introduce a moratorium, and the four tests. Reconfigurations that meet the four tests should go ahead, because they will improve clinical outcomes for patients, meet the needs of the people of that area, deliver on the intentions of local commissioners, and be in line with the views of the local public. If they meet the four tests, they should go ahead; if they do not, as my hon. Friend the Member for Redditch (Karen Lumley) made clear in respect of Worcestershire, they should not go ahead. That much is clear.

My hon. Friend the Member for Pudsey (Stuart Andrew) made good points on how clinical commissioning is bringing improvements in musculoskeletal services. He also rightly made it clear, as the right hon. Member for Leigh did not, that Wales does not meet anything like the same standards as England and is cutting its NHS budget by 8.4%. We are increasing resources for the NHS in England and improving it. It is expected that, by the end of this Parliament, expenditure per head for the NHS in Wales will be below that of England. That is what we get from a Labour Government.

Let me reiterate to the hon. Member for Ealing, Southall (Mr Sharma) and my hon. Friend the Member for Ealing Central and Acton (Angie Bray) a point I made a moment ago. The hon. Member for Ealing, Southall should admit that the plans being looked at in north-west London are entirely the same ones considered under a Labour Government before the election. I will insist that the plans are subjected to the four tests I have described. If they meet those four tests, they can go ahead; if not, they will not. I advise him to continue making speeches in the House, but also to ask the general practitioners and clinical commissioners in Ealing what they think is in the best interests of their patients—his constituents. That is a good basis to start with.

My hon. Friend the Member for St Ives (Andrew George), the right hon. Member for Holborn and St Pancras (Frank Dobson), and a number of other hon. Members, asked about the south-west pay consortium. When I went to the NHS pay review body just a couple of months or so ago, I made it very clear that the Government believe we should do everything we can to support NHS employers to have the flexibilities in the pay framework that are necessary for them to recruit, retain and motivate staff.

Care and Support

Grahame Morris Excerpts

Wednesday 11th July 2012 Commons Chamber

[Mr Lansley]

The statement I have made is a Government statement. We are working closely with our colleagues across Government to secure these proposals. I know that my hon. Friend understands these things very well. He will know that if there are significant public expenditure implications beyond the current spending review period, they must be dealt with in the context of a spending review. All Government Members are committed to deficit reduction. Understanding where, within those constraints, our priorities lie is the essence of a spending review.

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

This is a much more important issue than Lords reform. It is important to millions of people in this country and I am happy to have the opportunity to discuss it. There is clearly a huge shortfall and a crisis of funding in social care. The Secretary of State is not hoodwinking anybody by suggesting anything other than that. What has changed since he walked away from the cross-party talks led by my right hon. Friend the Member for Kirkcaldy and Cowdenbeath (Mr Brown)? The Secretary of State dressed up the proposal made before the general election as a “death tax”, yet he has come back with a proposal that is broadly similar.

[Mr Lansley]

I am not attempting to hoodwink anybody. I have made the point very clearly that in this financial year the Association of Directors of Adult Social Services is making total savings of £891 million, of which only 13%, some £113 million, is being achieved through reductions in services. We are investing in and supporting such services. In 2012-13, £930 million of extra funding will go to local authorities through formula grant to support social care. The NHS is transferring £622 million and we are doubling last year’s figure so that £300 million will be available through the NHS for re-ablement. Those are major additions to the support for care.

On the other point that the hon. Gentleman made, even the right hon. Member for Leigh did not try to return to the debate that we had before the election, and rightly so. The right hon. Gentleman eschewed party political point scoring; the hon. Member for Easington (Grahame M. Morris) did not. I think he should have done.