NHS Funding (North-East and Teesside)

Ian Lavery Excerpts

Tuesday 5th November 2013 Westminster Hall

[Tom Blenkinsop]

Yes, the police, and particularly the police and crime commissioner for Cleveland, have raised that with me in private meetings on first responder calls. They have funding worries about what will happen if such practices continually recur.

The NEAS letter shows that there will be more cuts, more private ambulances and possibly a less responsive service. It is not me saying that, but the chief operating officer of the North East Ambulance Service. The figures are stark. In 2008-09, 865 call-outs were attended by private ambulances in our region, costing £86,000. In 2009-10, some 1,816 call-outs were attended by private ambulances, costing £151,000. In 2010-11, however, 6,429 call-outs were attended by private ambulances, costing £477,000, which is a huge jump. In 2011-12, there were 9,000 call-outs attended by private ambulances, costing £639,000. In 2012-13, 13,524 call-outs were attended by private ambulances, costing £754,000. So since 2010, there has been a fivefold increase in private ambulance costs in the north-east, with the funds going to private contract firms. It is obvious that from 2010 onwards, there has been an explosion of private ambulance usage by the trust, costing a huge amount of taxpayers’ funds. The chief executive states:

“These arrangements do not allow us to enhance our own workforce plan because the money for the additional activity will not be available next year to fund the extra salaries, overheads and vehicles we need to meet the extra demand.”

A third issue of particular concern to my constituents is that both the NHS trusts that serve them—the South Tees Hospitals NHS Foundation Trust, and the Tees, Esk and Wear Valleys NHS Foundation Trust—have found themselves under investigation by Monitor in the past 12 months. Since May 2010, the South Tees trust has failed on seven occasions to meet its referral-to-treatment target, most recently between March and August. That has resulted in the Monitor investigation, because the trust has failed to ensure that 90% of patients commence treatment within 18 weeks of referral. Furthermore, there has been an increase in reported “never” events at the trust, and an increase in the incidence of clostridium difficile.

Despite the seriousness of those issues, Health Ministers have taken no action. My constituents would at the very least expect Ministers to have had conversations with Monitor and the trust on the issue, and on what support the Department of Health can provide, yet the Under-Secretary of State for Health, the hon. Member for Battersea (Jane Ellison), confirmed to me in a written answer that

“No such discussions have taken place with Ministers.”—[Official Report, 22 October 2013; Vol. 569, c. 83W.]

Will the Minister please assure me that he will closely monitor the situation and have discussions with both Monitor and the South Tees trust on how the Department can provide support, including additional funding if necessary?

My final point is on allocations to the north-east’s clinical commissioning groups.

A recent working paper issued by NHS England on allocation and indicative target allocation outlines proposals that will reduce per-capita funding for CCGs across the north-east. People in Sunderland will each face a £146 cut, people in south Tyneside a £124 cut, people in Gateshead a £104 cut, and people in my constituency a £60 cut.

[Ian Lavery (Wansbeck) (Lab)]

Is it not perverse that deprivation and health inequality indicators are not part of the overall calculation, as regards the funding allocation for the north-east? That will potentially result in the north-east losing up to £230 million of NHS funding per annum.

[Tom Blenkinsop]

Yes, the cumulative effect of all the funding allocations in different areas is very worrying. If those allocations are all reduced, my genuine worry for my constituents, and for constituents across the north-east, is that all the hard work and financial effort in Teesside in the past 15 years to reduce cardiac risk, bad outcomes for cancer, and other problems will be undermined, and we will not build on the momentum gathered over the past 15 years.

--- Later in debate ---

[Dr Poulter]

No, I will not give way. I have said things clearly for the record, without any political smoke.

As a Government, when we had control of the funding formula, we clearly put in a weighting for deprivation and for some of the poorest communities. I am proud that we did so, but it is now for an independent body to look at the case and at the independent advice that it has been given. I would find it extraordinary, however, if it were not to factor deprivation into its decision making, although there are other factors that it will want to put into the equation, such as the fact that older people are the greatest users of health care, so places with lots of older people also need to be recognised. A number of factors will be taken into consideration, and deprivation will be one of them. I have been reassuring about that, and I will not allow the Labour party or any hon. Member to make mischief with something that the Government have stood by.

[Ian Lavery]

Will the Minister give way?

[Dr Poulter]

No, I will not give way any more. I have clarified the point considerably, and the hon. Gentleman would do well to listen. I will not allow the Labour party to make political mischief, when my party has made it clear that we value the deprivation weighting. In fact, if we look at the public health allocations to every local authority, they have been generous. As I hope to reassure hon. Members, we can see that the health care funding allocations to the north-east have also increased under this Government, so the assertion that funding to the north-east is being reduced is clearly not the case.

The Government have increased the NHS budget, which the shadow Secretary of State described as “irresponsible”. At the same time, the Labour-led Welsh Assembly Government have cut the budget by more than 8%; in England, however, we have ensured that we have increased the health care budget in real terms. In the north-east specifically, CCGs have received an above-real-terms increase in funding for 2013-14 of 2.3%, compared with the primary care trusts’ funding for the equivalent set of services last year. Opposition Members should be pleased about increases in funding for the north-east, because if the Opposition spokesman were Secretary of State at the moment, he would have considered that irresponsible.

[Ian Lavery]

If the proposals in the consultation document had been implemented this year, can the Minister confirm that the north-east would have lost out to the tune of a little more than £228 million?

[Dr Poulter]

The hon. Gentleman is right in saying that had the Government followed the advice of the Advisory Committee on Resource Allocation in the past, we would potentially have cut the budget for the north-east. I can reassure him that we maintained the resource allocation budget, and the north-east has received an increase in real terms. Those are the facts. He may want to create political smoke, but there is none. We preserved and increased funding to the north-east for patients in Opposition Members’ constituencies and in those of my hon. Friends.