(13 years, 5 months ago)
Commons ChamberAs my hon. Friend knows, much can contribute to that change of culture, not least making safety one of the central domains for measuring outcomes in the NHS. In addition, it must be personal to each member of staff in the NHS that they have that responsibility. We have too often seen cases in which people have been professionally responsible but have not acted in line with that responsibility. A central part of what we need to do is not about organisations and structures but about creating that sense of personal responsibility in professionals across the service to look after their patients and those for whom they care and to blow the whistle if there is harm or abuse; and we must protect and secure that whistleblowing when it happens.
The Secretary of State promised to reduce bureaucracy, but he has now spent more than £760 million on a botched reorganisation that gives us commissioning consortia, senates, a whole host of national quangos and PCTs being abolished to transfer their staff somewhere else. Is it not time he accepted that this is a botched reorganisation and withdrew the Bill?
Most of that was pure invention, including all the numbers. We are going to save money with these changes to the NHS. We are going to transfer resources from bureaucracy, management and administration into front-line care. Through clinical commissioning groups we are going to empower staff in the NHS, and abolishing two tiers of management in the NHS will save us, in total, a third in real terms out of administration costs.
(13 years, 7 months ago)
Commons ChamberI thank the hon. Lady for her question. With resources come responsibilities. I am pleased that the hon. Member for Hackney North and Stoke Newington (Ms Abbott) has welcomed the shift in public health. There is no doubt about it: local authorities have a long history of delivering public health improvements, and this will give them the opportunity to see again some of the improvements that were long awaited under the last Government.
20. What assessment he has made of progress in providing co-ordinated medical assessments for children with disabilities.
The Department for Education Green Paper, “Support and aspiration: a new approach to special educational needs and disability—a consultation”, was published in March and includes a proposal to develop a single new co-ordinated assessment for education, health and care plans by 2014. The consultation on the Green Paper continues until June 2011, and I hope that the hon. Lady will respond to it.
That was a very interesting answer, particularly as the Prime Minister told me on 30 March that this
“idea is rapidly becoming Government policy.”—[Official Report, 30 March 2011; Vol. 526, c. 340.]
Can the Minister tell us whether she intends to table an amendment to the Health and Social Care Bill to ensure that those crack teams of medical experts that the Prime Minister promised would be set up will be set up by GP consortia?
Families of children with disabilities and special needs will welcome the single, co-ordinated assessment. We have to see health and social care working more closely together, because those families bear a considerable burden of care. I would point the hon. Lady towards the consultation, and I suggest that she points her constituents towards it as well, as it is extremely important that we get their feedback.
(13 years, 8 months ago)
Commons ChamberIn the devastation that followed the second world war, this country had the courage and the vision to realise the dream of a health service available to all in times of need. If the Government’s plans go ahead, that dream will die. [Interruption.] Yes, it will. It is not simply that the reorganisation represents a broken promise, which it does, or that it is costly, although it is, but that it strikes at the very foundations of the NHS. Indeed, if it goes ahead, there will no longer be a national health service, but a vast postcode lottery, with treatment depending on where people live.
I am sorry—I have not got time. [Interruption.] Other Members are waiting to speak and I will not give way.
The market, not the patient will be king. That is being done under the cloak of localism—the Government’s current buzz word. Remove the cloak and we will see the realities: an NHS driven by the market, run by a vast, unelected and unaccountable bureaucracy, with accountability to Parliament greatly reduced.
The Government plan to give all commissioning to GPs. They conveniently ignore the fact that if GPs wanted to be managers, they would have taken MBAs rather than medical degrees. They will bring in other companies—mostly private—to do the managing.
I have said no. The hon. Lady was not even here for the beginning of the debate.
It is not sufficient for the Government to ensure that private companies determine our health care; they will also introduce EU competition law into the NHS. That means that the private health companies that are currently hovering over the NHS like a bunch of vultures will threaten legal action if services are not put out to tender. They will then cherry-pick the services in which they can make the most money—they do not want to do geriatric care, paediatrics or A and E. That will fatally wound and undermine local hospitals and some, no doubt, will go to the wall. It is no surprise that the Health and Social Care Bill includes detailed insolvency provisions.
Some hospitals will bring in more private patients to fill the gap, because the Bill lifts the cap on private patients. We will therefore have the absurd situation of private companies making decisions on health care, and of NHS staff and facilities being used not for those most in need, but for those with the ability to pay. There is a word for that and it is not often used in this House: it is quite simply immoral. It is also indefensible.
At the same time, these plans will undermine our ability to deal with long-term conditions. Progress has been made on conditions such as stroke through co-operation, not competition. It has been made through stroke networks, by sharing expertise and by reconfiguring services to get the best deal. All the expertise in primary care trusts on delivering those services will be swept away.
I have made my view clear, so the hon. Gentleman is wasting his time. The expertise will be swept away, and the plethora of GP commissioning consortia will have no strategic overview of these services.
There has always been a democratic deficit in the NHS, but the Bill will increase it vastly. It will give £75 billion to £80 billion to unaccountable consortia. It will remove from the Secretary of State the requirement to secure the provision of services. I say to Government Members: when the services go, do not come here to complain because the Secretary of State will not be responsible any more. The NHS commissioning board will be appointed by the Secretary of State and he will be able to dismiss its members at will. It will have no independence. Monitor will not have a single elected member.
The Bill does not give power to patients, and it does not empower health service staff. Kingsley Manning of Tribal summed it up cleverly as a Bill to denationalise the NHS. It is not supported by doctors, and it is not supported by patients. I say to the Liberal Democrats that if they go through the Lobby tonight in support of this reorganisation, people out there will not forget and they will not forgive.
(13 years, 9 months ago)
Commons ChamberI am pleased that the reconfiguration board is now studying a decision that the previous Government made to close my local hospital’s children’s ward. The Secretary of State is due to rule on that shortly.
A prime example of the authoritarian nature of primary care trusts can be seen in my constituency. Without proper consultation, we have seen our accident and emergency department closed and our children’s ward transferred to Blackburn. My constituency is seriously deprived, and the decisions made by managers in Manchester have had a disastrous effect on the health and well-being of thousands of my constituents, many being seriously ill children. The proposals before us will ensure that, for the first time, commissioners and all providers of NHS-funded services have to consult the local authority on the proposed substantial reconfiguration of designated services. In my eyes, that can only be a good thing.
I want to bring to the House’s notice a young man called Logan Cockroft, who lives in my constituency. He has cerebral palsy, and he cannot speak or walk. The only thing that Logan can do is smile. His parents live near Burnley general hospital; they moved there because of Logan’s illness. He made many visits to the hospital because of his illness, the nurses knew him, and he was happy to go there. Logan seemed intent on smothering himself with a pillow, so the nurses at Burnley hospital kept a close eye on him and put him close to the nurses’ station. The family were happy with the treatment that Logan received. Unfortunately, under their meeting patient needs programmes, the previous Government closed down our children’s ward. Logan now has to go to Blackburn. The nurses on the children’s ward in Blackburn do not know Logan. They do not know about Logan’s problems.
The Bill allows private providers to undercut the NHS. What would the hon. Gentleman’s reaction be if an NHS service in his constituency disappeared because it had been undercut by a private provider?
The service was removed by the hon. Lady’s Government, so I do not need to worry too much about private services.
As I said, Logan has those problems. When he is in Blackburn, his parents are extremely concerned about the care that he is receiving—not because the care is poor, but because staff there are seriously stretched. An attempt has been made to put the children’s ward in Burnley into the children’s ward in Blackburn, which was already overloaded, and the staff cannot manage. That cannot be right and it would not have happened if the PCT had contacted the people of Burnley, who have signed a 25,000-name petition against the move. Almost every GP is against the move, and the people of Burnley are unanimously against it. The move would not have happened under the new system that we are setting up.
The bureaucrats in Manchester tell me that the reconfiguration is not about money but about what is best for Burnley. I tell them that their unfounded interference will result in deaths. Nobody in my constituency wanted the A and E or children’s wards to close; they were a valued service. The Bill will strengthen democratic involvement by ensuring that the full council decides on whether to refer proposals to the NHS commissioning board or the Secretary of State. The people of Burnley had no say at all in what happened to our children’s ward. The Bill will strengthen the important function of scrutiny and recognise the new enhanced leadership of local authorities in health and social care.
It is about time—[Interruption.] I have been here only six months; if Labour Members cannot win, they start arguing, don’t they? But they never stand up and say anything fruitful.
It is about time that measures were put in place to strengthen the role of local authorities and the involvement of democratically elected representatives. That is how there will be representation. We will have somebody to listen to us who has been democratically elected. I have met no one in Burnley who found anybody in the primary care trust or the palatial offices of the strategic health authority in Manchester to speak to about the closure of the children’s ward. Now the people’s voices will be heard.
I am particularly pleased that the Government recognise that district councils have an important role to play in shaping our local hospitals. I hope that the proposed health and wellbeing boards take into account the recommendations of local hospitals and listen to patients. I trust GPs in Burnley to make the right call about our hospital. I only wish that these measures had been in place before the previous Administration reduced services at Burnley general hospital to the point of non-existence.
I welcome these radical changes. Local democratic legitimacy in decision making about our hospitals is desperately needed. It is time that we gave power back to the people.
(14 years ago)
Commons ChamberThe treatment centres, which the hon. Gentleman mentions, helped contribute to bringing waiting times down to 18 weeks and helped to say to the British public, “Whatever treatment you need in hospital, you will not have to wait more than 18 weeks for it.” That was a consistent universal promise that we were able to make to patients as a guarantee for the future. That has now been ripped up, and we can see the result as waiting times and waiting lists lengthen. As I said at the start of my speech, my fear is that during this period of Tory leadership, we will see the NHS going backwards.
As for the hon. Member for St Ives (Andrew George), I understand his problem. He is a Liberal Democrat and I have to say that this health policy bears very little of the Liberal Democrat imprint. The one part of the Liberal health manifesto that they managed to get into the coalition agreement was this:
“We will ensure there is a stronger voice for patients locally through… elected individuals on the boards of their local primary care trust”.
Within two months, of course, that was not even worth the coalition agreement paper it was written on.
Does my right hon. Friend agree that there is something else that the Government are not telling us—namely, the huge cost of getting rid of primary care trusts and strategic health authorities in respect of redundancy and getting out of broken contracts? Does he, like me, speculate that many of the people affected will end up working for GP consortiums or private health care firms—a huge cost to the public purse that delivers not one iota of front-line care?
Quite so. Estimates of the cost of the reorganisation are up to £3 billion, but we have not had any cost announcements from this Government, who will not tell us how much is going to be spent on reorganisation rather than on patient care. At a time when finances are tight, this is precisely the wrong prescription for the NHS over the next few years.
It is no wonder that GPs have grave doubts—they trained as family doctors, not as accountants or procurement managers, and they are committed to treating patients, not doing deals over contracts. However, they will be forced to commission services, whether they like it or not; they will make rationing decisions, not just referral decisions for their patients; and they will have to take on the deficits or inbuilt funding shortfalls in their PCT areas. GPs spend an average of eight or nine minutes with each patient. If they plan, negotiate, manage and monitor commissioning contracts in future, they will have no time left to see patients. If they continue to be family doctors, commissioning will be done for them, not by them; it will be done in their name by many of the same PCT managers who presently do the job or by commercial companies that have already started hard-selling their services to GPs. The other day I picked up “The Essential Guide to GP Commissioning” helpfully published by United Health—one of the biggest US-based health care companies in the world.
(14 years, 4 months ago)
Commons ChamberThe hon. Lady makes an important point, but perhaps she will be a little cautious with her question, not least because the previous Government made a lot of promises to carers in respect of the amounts of money that were to be invested, only for carers to find that on the ground the money was not delivering changes in services. So this Government are determined to ensure that we not only make promises but deliver on them. That is the commitment that this Government have made.
15. What percentage of patients at Warrington Hospital were treated within 18 weeks of referral in the last 12 months for which figures are available.
At the Warrington and Halton Hospitals NHS Foundation Trust, in the 12 months up to April 2010, 93.2% of patients admitted to hospital for treatment and 97.8% of patients whose treatment did not require admission to hospital waited 18 weeks or less from referral.
I am grateful to the Minister for that reply. What percentage of patients does the Minister now believe will be treated within 18 weeks, and which people exactly does he think deserve to wait longer than that?
May I reassure the hon. Lady that in my lexicon no one “deserves” to wait longer. What I want, and my right hon. and hon. Friends want, is a first-class health service that makes decisions based on clinical reasoning and gives treatment swiftly and relevantly to those who need it. My right hon. Friend the Secretary of State has made some changes to some of the targets to ensure that clinicians and clinical decisions dominate, not political decisions by politicians and bureaucrats.