(11 years, 1 month ago)
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Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
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My right hon. Friend predicts the final part of my speech. I hope the Minister will take the opportunity to put our fears to rest. Unfortunately, the information that I have received to date does not reassure me.
I compliment my hon. Friend on securing such a timely and important debate. I completely agree that one of the most worrying aspects is the potential changes to the funding of clinical commissioning groups. Easington would lose £62 a head. Does he agree that that could be seen as political gerrymandering, with the poorest areas deprived of funding and the wealthiest, such as east Hampshire, getting increases of as much as £164 a head? The areas with the best health outcomes will get the biggest increases in resources.
My hon. Friend has mentioned that in Health questions and in the Select Committee on Health, of which he is a doughty member who provides a lot of input. Someone from a poorer socio-economic background has a lower likelihood of reaching the age at which they would receive more funds under the allocation—it would probably never happen. This becomes a self-defeating, vicious circle of a lack of investment in people who might need it the most.
As I was saying, the proposals in a recent working paper issued by NHS England on the allocation and the indicative target allocation would have led to a per capita reduction in funding for CCGs throughout the north-east, and my constituents would have lost out. Meanwhile, CCGs in the south would have had a per capita increase; for example, those covered by Coastal West Sussex CCG would each gain £115, those in Hailsham £136, and those covered by South Eastern Hampshire CCG £164. That is clearly not a one-nation NHS. I received ministerial assurances that that formula was not ultimately used for 2013-14, but a response to a parliamentary question that I asked confirmed that
“No proposals or decisions regarding allocations for 2014-15 have yet been made.”—[Official Report, 22 October 2013; Vol. 569, c. 76W.]
The hon. Member for Stockton South (James Wharton), who is in the Chamber, told the Evening Gazette on 23 October that it was indeed “right” that NHS England was considering reducing health funding for his constituents and the north-east, but—
(13 years, 3 months ago)
Commons ChamberI am grateful to my hon. Friend for his point and for his kind words. My contention is that the problem with all these reforms is that they tend to unravel once there is an opportunity for not just Members of Parliament but health care professionals and the broader public properly to scrutinise them. Once people have the chance to consider the proposals in detail, there is an outcry such as that described by my hon. Friend.
I have tried to understand the thinking behind the Government’s changes and amendments. As I mentioned earlier, many of the changes fly in the face of the logic of the arguments originally made in Committee and when the Bill was first published. The obvious logical conundrum, if that is the term, can be seen in the fact that the original impact assessments, which were very comprehensive, said that it was essential to create a functioning market to gain the benefit of the reforms. A whole section of the impact study explained why “market exit” was fundamental to reforming the NHS. I heard what the Minister said earlier and I have read the Government’s amendments, but I am not quite convinced—perhaps I am a bit of a cynic—that this is a real concession. If we follow the Government’s logic, that makes the Bill as a package at best inconsistent and at worst it removes the possible benefits that Government Members may wish to promote in terms of the costs of any market system. Instead, we are subject to a strange system. The Secretary of State initially mentioned creating a level playing field to allow access for private health care firms as well as existing NHS and public providers. There are therefore some basic contradictions in the rationale behind some of the reforms, if there was any merit in the arguments initially.
Is my hon. Friend concerned, as I am, that 2% of PCT budgets—approximately £2 billion—is being used for this reorganisation? There is a direct effect on my community and the Redcar and Cleveland PCT, where almost £4 million has been taken from health inequality budgets, which could have been used on the front line.
I am making rather slow progress, but I did want to get on to health inequalities. My hon. Friend makes an excellent and important point. We touched on it briefly in the Bill Committee and it relates to new clause 6. I was concerned about the reports that in the allocations to PCTs and SHAs, the element set aside for addressing health inequalities had been reduced. That should concern us all, especially those who represent areas that suffer high levels of health inequality and deprivation.
It is a bit of an achievement that the Government could take the NHS at its most successful point and turn it around. Government Members have highlighted particular failings, but the NHS had a record number of doctors and nurses and a hospital building programme. There had been a transformation from waiting times of 18 months for routine operations such as knee and hip replacements or removal of cataracts to only a few weeks. The previous Government should be given some credit for that. The improvement was confirmed in patient satisfaction surveys and it is a great shame that the Government have decided not to commission the Department of Health to conduct such studies in the future. I suspect their motives in that regard.