National Health Service

Hugh Bayley Excerpts

Wednesday 21st January 2015 Commons Chamber

[Mr Hunt]

I will, and that is what this is about—putting patients first. That is why we need important reforms such as ensuring that every vulnerable older patient has a named accountable doctor—I will mention that later in my remarks—and why we must remove barriers between the health and social care systems.

[Sir Hugh Bayley (York Central) (Lab)]

It has been well known in the NHS for decades that an ageing population means that more needs to be spent in real terms each year on the NHS than in the year before. In 2010, when the Government came to power, 8.2% of our gross national income was spent on the NHS, but that has now fallen to 7.9%. How can that possibly be an increase in the Conservative party’s commitment to the NHS?

[Mr Hunt]

Because the only way we could return the economy to growth was by tackling the deficit left by the Labour party—the worst deficit in the developed world. Labour left us with that problem; we have sorted it out and are turning the country round. If the hon. Gentleman wants to increase spending on the NHS, as I do, the only way to do that is through a strong economy, which is what the Government are delivering.

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[Dr Huppert]

The hon. Gentleman ought to get his facts right. The Cambridge university trust put in a bid—it was the sixth last to do so—but then withdrew because the cost of the tendering process under the right hon. Member for Leigh was far too high. It did not have a partnership with Serco. The hon. Gentleman should check the facts and check the record. The trust was driven out by the tendering. The hon. Gentleman should also know that the bid to which I suspect he was referring was led by Serco. What he is saying, in essence, is that the current shadow Secretary of State had to undo the damage that had been done by previous Secretaries of State. That is a bit of Labour misery that I imagine Labour Members can sort out between them.

We know the history, and we know the problems that led to it: the Government had to decide between three private sector-led bids for Hinchingbrooke. What we must do now is work out what to do next, and I think we need to ensure that Hinchingbrooke stays in the public sector. Trying to remove it from the public sector in order to deal with the PFI problems, which was the original idea, simply has not worked. It must stay fully within the NHS.

Last year, before any of this happened, I led a debate about health in Cambridgeshire. I dealt with a number of issues, and I will not go into all the details now, but I spoke about health funding and, in particular, about mental health. I gave a number of detailed examples of some of the many challenges that we have faced and still face. For instance, huge cuts were made five or six years ago. During that debate, I called for a substantial amount of extra money, not just for Cambridgeshire—although I shall say something about that shortly—but for mental health throughout the country. Members in all parts of the House have made some excellent speeches about mental health, but it is not talked about enough. I find it regrettable that the motion does not mention it, and I suspect that a number of Members on both sides of the House do as well. Let us hope that we receive that extra money for mental health.

Cambridgeshire, however, suffers from a number of specific problems. We have been a test bed for experimentation for many years. We had the Hinchingbrooke experiment— the largest tender that the NHS has ever seen. We saw huge numbers of PFI projects not just at Hinchingbrooke, but at Peterborough. Paying off the NHS costs is still taking 18% of Peterborough hospital’s budget. That is only a small proportion of the 138 PFI projects that we saw under the last Government, the costs of which will amount to £11.7 billion over the next Parliament. That money could be used far more productively.

We have been hit hard by that, but we also receive very low funding. We inherited a formula from the last Government, and the process of changing it has been too slow under the present Government.

[Sir Hugh Bayley]

rose—

[Dr Huppert]

The hon. Gentleman can intervene if he wants to talk about why PFI is a great thing, but otherwise I will move on.

The Government have been too slow to move to the new formula, which properly takes account of ageing populations. We know that the elderly cost more in terms of health care. Cambridgeshire receives £961 per head, whereas West Norfolk, for example, receives £1,255. That is a huge difference. I asked for extra money during the debate that I mentioned, and I am delighted that we have managed to secure an extra £20 million as a result of the recent allocation. That will provide much more funding for mental health, on top of the extra £1.5 million that has been provided this year and the extra £2.2 million that will be provided for IAPT—improving access to psychological therapies—next year. That will make a big difference, and will reverse some of the challenges that we face.

We need that extra cash, but we still need more in Cambridgeshire and throughout the country. Simon Stevens called for an extra £8 billion by 2020, after savings and efficiencies had been taken into account. He said that an extra £8 billion, in real terms, was needed if the NHS was to keep going. I think that that is important, and we as a party think that it is the right thing to do. One of the problems with the motion is that it does not deliver what Simon Stevens has said is needed for the NHS. I am not all that keen to support the provision of less than a third of what is needed to keep the NHS going, especially after hearing from the shadow Secretary of State that, despite what the motion says, the money is not all for the NHS but constitutes the entire offer for the NHS and social care, which also needs its own funding. We need that £8 billion.

I voted against the Health and Social Care Act 2012 as I did not agree with much of it. There are some issues, such as parity of esteem, that are very good and that I hope will never be repealed. I also disagree, however, with many of the things that the Labour party did to bring in the private sector in some damaging ways, with people being paid for things that never happened.

The fact is, as was mentioned by the hon. Member for Brighton, Pavilion (Caroline Lucas), under the previous Government medical spending on private provision went from £1.1 billion a year in 1997 to £7.5 billion in 2009-10. That is a vast increase. I have no problem with people who say that they support that and that it was the right thing to do, but to suggest that that large increase was excellent for the NHS while the fact that it has continued at essentially the same rate under this Government is a disaster for the NHS strikes me as a rather bizarre claim.

I have criticisms of this Government, the previous Government and the one before that. I want the NHS to spend more of its time focusing on patients or, even better, avoiding the need for people to be patients in the first place. That needs a trained, motivated and well-paid staff—I think they should get the money from the independent review. It needs a focus on prevention and public health and proper funding—that is, the £8 billion by 2020.

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[Sir Hugh Bayley (York Central) (Lab)]

NHS services in the vale of York are provided by well-qualified and hard-working staff and this year they received £367 million to provide their services. Nevertheless, services in my city of York are in crisis as a direct result of coalition Government policy.

The A and E service at York hospital has broken down over the past two months. In December, 71 operations were cancelled at the last minute so the beds could be freed up for emergency admissions from A and E. Between 1 and 11 January this year—11 days—84 operations were cancelled for the same reason. When my right hon. Friend the Member for Holborn and St Pancras (Frank Dobson) was Secretary of State for Health, he created the walk-in centre in York, which he visited with me, and it reduced pressure on A and E. He created NHS Direct, which reduced pressure on A and E. The walk-in centre was closed two or three years ago and NHS Direct has now been closed, so it is not surprising that we face these extra pressures with hundreds of thousands of extra presentations at A and E each year.

The pressures in A and E mean that when ambulances arrive with acutely ill patients they often have to wait a long time before they can pass the patient over to the A and E service. That inevitably has a knock-on effect on ambulance response times. A freedom of information request made last week by the trade union Unite found out that Yorkshire ambulance service failed to meet its national target of responding to 75% of emergencies within eight minutes in 11 of the 12 months leading up to October of last year.

The problems within mental health services are even worse. Last year, the Care Quality Commission highlighted major failings and, following an especially serious incident at Bootham Park hospital, the acute mental health hospital in York, in which a patient died, I wrote to the Secretary of State in April 2014 in support of the local clinical commissioning group and Leeds and York Partnership NHS Foundation Trust, the provider of mental health services in York, to press for urgent plans to replace the 250-year-old Bootham Park hospital. It is a fine grade I listed building, but because of its listed status English Heritage prevents the health trust from removing ligature points or installing anti-barricade doors and makes it impossible to provide clear lines of sight from nursing stations to the patients’ bedrooms.

The CQC’s concerns are not just about adult mental health services. The child and adolescent mental health unit in York, Lime Trees, was constructed more recently. It is a mixed unit for girls and boys, but it does not have sufficient bathrooms to preserve dignity with two genders within the unit. It also has inadequate space for clinical meetings, therapy sessions and family visits, and it only has limited space for the young people themselves to relax and, because of its deficiencies the more acutely ill young people have to be sent away, often to the other side of the Pennines, in order to get treatment. That does not make sense. We have heard from my right hon. Friend the Member for Kingston upon Hull West and Hessle (Alan Johnson) and others today about the pressures on families when acutely mentally ill young people are moved away.

I got a letter back from the Minister of State saying that NHS Property Services was working with local commissioners

“to look at a comprehensive estate strategy for York.”

That was eight months ago, and I say to the Minister—I hope his Parliamentary Private Secretary will tap him on the shoulder now—that I would like him in his response today to say what progress has been made in those eight months in providing a capital package to replace Bootham Park hospital in York. It is urgently needed and he has had a long time to consider it.

Just last week the CQC, in a new report, made further criticism of the Leeds and York mental health trust. Most worryingly of all, it revealed that York receives much poorer services than Leeds, despite the same trust providing services to both places. The local paper in York had a headline story describing it as “A Tale of Two Cities.” The trust chief executive Chris Butler has told me that the reason for the disparity in services is simply because the CCG in Leeds is better resourced than the CCG in the Vale of York and therefore it receives more money per capita for the population served from Leeds than for that served from York. It is simply unacceptable for access to care to depend on a postcode lottery.

Two things have brought about this crisis. First, there has been a squeeze in funding in the NHS. As I pointed out when the Secretary of State was speaking, the NHS budget has fallen from 8.2% of our GDP in 2009-10 to 7.9% in 2013-14, and the situation is getting worse as we will see when the figures for this year are revealed. To put that fall in perspective, the difference between 8.2% and 7.9% of GDP is some £5 billion a year. That is the amount by which this coalition Government have cut the NHS budget.

The Government must address not only the overall level of funding, but the way the funding is split between different health authorities. Within the former North Yorkshire primary care trust area, where all patients used to get the same level of treatment, funding in the Vale of York is just £1,062 per person as against £1,270 in Scarborough and Ryedale. I went with colleagues from neighbouring constituencies to see the Secretary of State to say that parity of funding should be restored, but nothing has happened. This is a Government who talk the talk but do not walk the walk on the NHS.

[Several hon. Members]

rose—