Health and Social Care
Ian Mearns Excerpts(11 years ago)
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Andy Burnham
Nuance, care and caution are precisely what we need in this debate; we do not need press statements written by Lynton Crosby which then turn up in the House as Bills. We want responsible government, ensuring that the NHS is not abused. We will support the Government as long as that is their intention, but if they are doing something more sinister and playing politics with these issues, they will not have our support.
We have had no answers on the NHS. Let me finally turn to public health. There was not much on which I agreed with the last Health Secretary, but he had my strong support when he spoke about tackling smoking. He said that he wanted tobacco companies to have “no business” in this country, and that introducing standardised packaging was an essential next step to ensure that young smokers were not recruited by the tobacco industry. [Interruption.] The Under-Secretary of State for Health, the hon. Member for Broxtowe (Anna Soubry), looks confused, but I think she advanced the same argument on the radio a couple of weeks ago, saying she was an advocate of standardised packaging. Then, we read in advance in our newspapers that the measure had been dropped—one of the “barnacles” on “the boat”, we were told, by the said Mr Crosby. This is the same Mr Crosby who has represented “big tobacco” since the 1980s, who masterminded the campaign against standardised packaging in Australia, and who was federal director of the Liberal party of Australia when it accepted millions of pounds in donations from the tobacco industry.
The Secretary of State said last week that a decision has not been made yet because the consultation has only just finished. It ended nine months ago. He can make a decision. I say to him again today, here is another positive offer from the Opposition: if he brings forward these proposals, they will have our full support and we will get them on the statute book.
Ian Mearns (Gateshead) (Lab)
My right hon. Friend may be interested to learn that the Prime Minister wrote to me about plain packaging before the Queen’s Speech was delivered to both Houses. He said in that letter that there were currently no proposals to introduce plain packaging.
Andy Burnham
The former Secretary of State said that it was full steam ahead and that is what they would do. This Secretary of State comes in and says nothing about the issue. Then, a right-wing Australian lobbyist arrives, and all of a sudden no one mentions it at all. Has the Secretary of State ever met Lynton Crosby and discussed this issue with him? I think we have a right to know. [Interruption.] He nods; I should be interested to know the substance—[Interruption.] He has not met him to discuss the issue. He looks very uncomfortable all of a sudden.
Ian Mearns (Gateshead) (Lab)
I am pleased to follow my hon. Friend the Member for City of Durham (Roberta Blackman-Woods) and in particular my hon. Friend the Member for Sheffield Central (Paul Blomfield), who made a very strong speech about the Government bottling the proposal for plain packaging for cigarettes.
The response to the Queen’s Speech from my constituency of Gateshead, the north-east and the whole country is: what a missed opportunity. Research by Sheffield Hallam university highlighted recently in The Times illuminated the impact of welfare reforms on local areas across the whole of Britain. The impact varies from place to place: the worst affected areas face financial losses that are twice the national average and four times those in the least affected areas, and—surprise, surprise—it is Britain’s regions and older industrial areas that are hit the hardest, whereas much of the south and south-east of England outside London escapes comparatively lightly. As a general rule, the more deprived the local authority, the greater the financial hit. Professor Steve Fothergill, who undertook the study, said that
“the Coalition government is presiding over national welfare reforms that will impact principally on individuals and communities outside its own political heartlands.”
So that is what they mean by, “We’re all in this together.”
What are the Government’s priorities? A local audit Bill, a water Bill, a deregulation Bill and, in terms of health, a chronic outbreak of Europhobia. Those are hardly the country’s priorities. Meanwhile the country and its people in regions such as mine continue to suffer.
New research in a book published this month, “The Body Economic: Why Austerity Kills” by the respected political economist David Stuckler and the physician and epidemiologist Sanjay Basu, shows conclusively that austerity policies are
“seriously bad for our health”.
They argue that in Greece, HIV infections have risen by more than 200% since 2011, as prevention budgets have been cut and intravenous drug use has grown amid 50% youth unemployment. Greece has also experienced its first malaria outbreak in decades, after budget cuts to mosquito spraying. David Stuckler has said:
“Austerity is having a devastating effect on health in Europe and North America. The harms we have found include HIV and malaria outbreaks, shortages of essential medicines, lost healthcare access, and an avoidable epidemic of alcohol abuse, depression and suicide, among others. Our politicians need to take into account the serious, and in some cases profound, health consequences of economic choices. But so far, Europe’s leaders have been in denial of the evidence that austerity is costing lives.”
Despite the clear evidence, the coalition is taking no action on minimum pricing of alcohol or on plain packaging of tobacco products. It has capitulated to manufacturers, lobbyists and self-interested advisers. In the face of the clear and unequivocal damage that this coalition’s policies are doing to the health of our nation, it has no appropriate response, despite the fact that we all know that prevention is better than cure. My hon. Friend the Member for Sheffield Central highlighted the number of people who annually die prematurely as a result of cigarette smoking. Over the weekend Wembley stadium was almost full for the FA cup final; imagine that number of people dying annually as a result of preventable disease induced by smoking.
A health warning should be printed on this Government: “Warning: this Government’s policies will seriously harm you and others around you, and will detrimentally impact your mental health and that of your family and friends.” We have heard example after example. It was reported this week that, sadly, Stephanie Bottrill killed herself on 4 May. Already struggling financially, Stephanie faced the devastating prospect of the bedroom tax. In a suicide note left for her son, she said that
“the only people to blame are the government”.
Stephanie’s case is, of course, only the tip of the iceberg. Since this Government came to power the website Calum’s List has listed 33 cases where a coroner has recorded that an individual has been driven to suicide by welfare cuts.
On the evidence of this Queen’s Speech, the Government clearly do not understand or care about the human cost of what is happening. It is equally clear that they do not understand or care about the economic devastation that their policies have brought to significant sectors of our economy. Do they read the IMF reports on our economy? Do they even know how to contact the IMF to talk about them?
Having read the Queen’s Speech, it appears that the Government have no idea what to do. They seem like rabbits stuck in the headlights of their own rhetoric. The plans are more and more and more of the same: cuts followed by cuts followed by more cuts. With sectors and regions of our economy stuck in a spiral of decline, the country needs leadership, yet we have a vacuum of a Queen’s Speech. We need leadership to get us out of the problem, not dig us further into it, but instead we have a coalition strangled by indecision and political inertia. Where are the plans for growth? Where is the growth Bill, the national recovery Bill, or even the “We understand what the problem is” Bill? The Government seem to have no idea how to move things forward. There is not one substantial proposal in the speech.
It is not just me, my hon. Friends and the IMF who are saying that. Even the Chancellor’s new Governor of the Bank of England, Mark Carney, said only last month that Britain is an economy in crisis. He compared the UK with basket case countries in the eurozone. Speaking on the fringes of the IMF’s spring meeting in Washington, he said:
“The US is breaking out of the pack of crisis countries that includes the euro area, the UK and Japan.”
That pales into insignificance compared with the words of the IMF’s chief economist, Olivier Blanchard, who said last month that Britain was “playing with fire” by pressing ahead with austerity. We need change and we need action. The Queen’s Speech delivered neither.
Regional Pay (NHS)
Ian Mearns Excerpts(11 years, 6 months ago)
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Kerry McCarthy
There is some confusion. When I wrote to the Health Secretary to get some clarity—
Ian Mearns (Gateshead) (Lab)
On a point of order, Mr Speaker. I could not help but notice that the clock did not stop during that intervention. I see that a minute has been added on, but I think it should have been more than that.
Mr Speaker
Allowance will be made. I am grateful to the hon. Gentleman for his service. Perhaps we can now proceed with the debate in an orderly way.
John Pugh (Southport) (LD)
The submission made by 25 of my colleagues to the regional pay consortium—copies are still available, if people want them—has an excellent conclusion:
“Richard Disney, an expert on regional pay at Nottingham University, has said, ‘everyone thinks it’”—
regional pay—
“‘makes sense until they try to work it out.’ The Government is no different.”
Let us be brutal: this debate is not just about regional pay, but about a set of hospitals that are desperate to save money in any way they can by cutting their wage bill and that are stupid enough to think that how they treat their staff and human capital simply does not matter. This debate is not even just about getting the Government to intervene; it is also about exposing differences between the coalition parties and about the coalition trying, to an extent, to paper over the cracks, which is what the amendment endeavours to do.
We all know that the Secretary of State does not want to intervene and that he will wait, quite legitimately, for the pay reviews to report. He cannot do that much anyway, because the guys on the Opposition Benches created independent foundation trusts—they were conned into agreeing to them in 2003, I think—which has resulted in the current situation.
To be fair, some people believe that regional pay will revive economies in the regions, that pumping extra money into areas with high housing costs will not drive up house prices still further, that it will not reduce demand in the regions and that it is a great way of ensuring that everyone gets good quality public services. They are the sort of people who believe that it will allow us to create not only more private sector jobs, but more public sector jobs. That view was expressed by the hon. Member for Norwich North (Miss Smith) when we last debated this issue.
Ian Mearns
Would the hon. Gentleman care to speculate on how the quality of front-line care for our patients will improve by threatening tens of thousands of hospital workers and NHS front-line staff with a further reduction in their living standards?
John Pugh
Some proponents of regional pay argue that teachers would work harder, nurses would be more caring and skills shortages would disappear, and that we would not squander useless time on endless boundary, demarcation and wage disputes. Bizarrely, however, those same people usually believe that this principle and its effects are applicable only to lower paid jobs, not to the top jobs. In other words, the proposal applies only to the plebs.
A prejudiced northerner such as me might be tempted to call those people, “southerners,” but the truth is that they are only a tiny subset of southerners who are upwardly mobile, found in think-tanks, male and disproportionately London-based. Their arguments will change, but no evidence to the contrary will satisfy them, because they have a Tea party-like faith and simple creed that public services should and can be run as simple markets, that people respond only to financial incentives and, most preposterously of all, that nothing worthwhile is lost by turning our great public services into markets full of acquisitive agents. That is not so much market ideology as a form of market idolatry: an unreasoning faith in the omnipotence of idealised markets of the kind that we find only in economics textbooks. Regional pay—and market-facing pay—is part of that faith, and the principle of equal pay for equal work is not part of it. In all honesty, we have to say that we have such people in our midst, some of whom are in positions of power and influence, but equally we have many colleagues around us who have a better grip on reality and the complexities of life and who question such crackpot ideas as regional pay and where they might take us.
I pity the Minister, who is probably aware—I looked this up—that house prices, wages and the cost of living in his Suffolk constituency are very similar to those in many parts of the south-west. He certainly will not welcome telling hordes of his constituents that they are a tad overpaid.
Mr Wright
The hon. Gentleman makes a pertinent point. I am about to come to the financial condition of my trust, which I imagine is true of other trusts.
A total of £40 million needs to be cut from the trust’s budget in the three-year period from 2011-12 to 2013-14—so much for real-terms increases in NHS budgets, as put forward by the Secretary of State at the Dispatch Box. Given that pay costs represent over 68% of the trust’s total income, it seems inevitable, given the financial pressures that the Government are putting the trust under, that there will be a need to cut pay costs still further, whether through redundancies, recruitment freezes or changes to terms and conditions.
The change on sickness enhancement pay is the first of many, and I suggest to the Minister that we must see it as the thin end of the wedge. The proposal on sickness enhancement pay will go through, and then, as the hon. Member for St Austell and Newquay (Stephen Gilbert) said, there will be changes to or cancellations of increments for staff, cuts in overtime, and further pay freezes for lower and middle-paid staff, leading to less money in the local economy. The actions of North Tees and Hartlepool NHS Foundation Trust on sickness enhancement pay simply amount to regional pay through the back door.
As a result, we will see a steady deterioration in pay and other terms and conditions for NHS workers in my constituency relative to other areas and other trusts, even within the north-east. I do not want a race to the bottom with regard to health care in my area. I am concerned that recruitment and retention of staff in North Tees and Hartlepool NHS foundation trust will become an issue because pay will be higher elsewhere, even within the region. Staff may want to move elsewhere, or may not want to work in the trust in the first place, which will lead to a deterioration in quality health provision.
Ian Mearns
I have an additional concern. Eroding morale within the NHS and hospital trusts to such an extent that staff turnover increases, will lead to an inherent increase in costs due to the additional training required when new people replace those who have left, at a lower rate.
Mr Wright
My hon. Friend makes an important point. As the shadow Secretary of State will know from when he was in office, we have had debates, concerns and anxieties about the future of health and hospital services in Hartlepool and north of the Tees for many years. That has not helped staff morale, recruitment or retention. I think that this is the thin end of the wedge, and regional pay through the back door will make matters in my area even worse.
In his response, will the Minister comment on what is happening at North Tees and Hartlepool NHS Foundation Trust and explain why, if NHS spending is increasing in real terms, it has to find £40 million of savings? Why is regional pay being pushed in through the back door? Does he think that the ideas put forward by the trust are good, and what impact will that have on recruitment, retention, morale, and ultimately health care provision in the NHS in areas such as mine?
I will conclude with a broader point about the economic rationale—or rather, the lack of it—behind regional pay. If the national economy’s major problems are caused by a lack of demand, an erosion in the confidence of consumers, households and businesses, and structural imbalances in regional economies—in the north-east especially, relative to London and the south-east—I cannot emphasise enough that it seems economically ludicrous to contemplate policies that widen the regional imbalance, restrict demand still further, and result in further private sector austerity in regions such as mine. That is precisely what Lord Heseltine argued against in his review on growth published last week. We must ensure balance between the regional economies, so that the great potential of areas such as mine can be fulfilled. Regional pay in the NHS, or elsewhere, is not the way to do that.
The 5,500 people employed by the North Tees and Hartlepool NHS Foundation Trust live in my area and contribute to the sub-regional economy. They buy things such as cars; they might add a conservatory to their house. That will all stop as a result of regional pay, which will strip out money from the north-east economy to the tune of £0.5 billion a year, according to the TUC. That will result in reduced economic activity in the private sector, and increased private sector unemployment in an area that already has the highest unemployment and the lowest wages anywhere in the country. That is economic madness. We cannot say, “Public sector work over here, private sector enterprise over there”. Modern economies simply do not work like that.
If the Government wish to rebalance the economy geographically—as I think they should—regional pay and a race to the bottom is not the way to do it. The national health service needs a national pay agreement. I strongly support health care provision and health care workers in my area, and on that basis I support the motion.
Breast Implants
Ian Mearns Excerpts(12 years, 4 months ago)
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Mr Lansley
I refer the hon. Gentleman to what I said in my statement: if women are entitled to NHS treatment in those sorts of circumstances, they should come to the NHS and we will provide the standard of care that I outlined.
Ian Mearns (Gateshead) (Lab)
The Secretary of State has demonstrated his obvious concern for the women affected by this situation. Does he accept that they are gravely concerned about the difference of opinion that is emerging between Governments in the countries where these implants have been used, in particular, the difference between our Government’s advice and that of the country where the implants were manufactured, France? Will he also reflect on whether companies in the private sector that are giving either cosmetic or other treatments of this nature to women are properly insured, so that even if they go out of business the insurer will cover women for future treatments should something go wrong?
Mr Lansley
On the hon. Gentleman’s final point, I refer him to what I said earlier about how we might deal with that in the future. On the point about other countries, I have spoken to Commissioner Dalli and I have spoken to my French counterpart twice. What I want to be clear about is that the French authorities did recommend routine removal of implants, but from any individual woman’s point of view we are, in effect, recommending that the same thing should happen: any individual woman should see the clinician responsible, should be examined—by imaging, if necessary—and should consider, in the light of that and in a clinical decision with her adviser, what is right for her. That will be true in France and in Britain. I wish to emphasise that we have not seen, on advice, scientific evidence that justifies the recommendation of the routine removal of these implants. We are not saying to women that we think they should have them removed; we are saying that women should have access to imaging. Clearly, women with symptoms, or women for whom evidence of rupture or leakage has been provided through imaging, may well choose to have the implants removed, and we would support that.
Congenital Cardiac Services for Children
Ian Mearns Excerpts(12 years, 10 months ago)
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Nic Dakin (Scunthorpe) (Lab)
It is a pleasure to follow the Minister, who was very careful in setting out how he is attempting to ensure that this process proceeds in an appropriate way. I was pleased by his comments about the consultation being genuine and about the review being flexible, open-minded and not limited to a particular set or number of outcomes. His contribution was very reassuring and I thank him for that.
I would like to use as my reference point a lady who attended a meeting in Scunthorpe, at the Wortley House hotel, for people who have used the Leeds children’s heart unit’s services in recent years. Her use of the service goes back to when it was in Killingbeck hospital a long time ago before it moved to Leeds General infirmary in 1997. At that point, as has been pointed out, all children’s services were located in one area to great positive effect for the children of the Yorkshire and the Humber region. What she said to the people from Leeds at that consultation was that she really did not mind where the heart surgery locations were, but that she wanted the very best to be delivered for children in need so that they could access the best and most excellent services. She went on to say that her experience of the Leeds service was such as to give her assurance that it would meet those needs. She was particularly concerned that proper outreach services should remain in any future configuration. Her daughter was expecting another child and was already engaged, in relation to her pregnancy, with service support through Leeds, which was going to make it less likely that there would be significant cardiac problems that could not be dealt with at the appropriate time and with appropriate effectiveness.
In the Scunthorpe area, we tend to be on the periphery of things, so we always have to travel, in this case to Leeds. The weather conditions at the end of last year made it difficult to travel to and from Scunthorpe, and a two-hour journey with unwell youngsters would have led to great concern.
We need to make sure that there are proper outreach services to give support in future and, as my hon. Friend the Member for Leeds East (Mr Mudie) said earlier, we must recognise that people should have equality of access to excellence wherever they are in the country. That is important for my constituents.
Ian Mearns (Gateshead) (Lab)
Does my hon. Friend agree that it seems a little unfortunate that the options in the consultation would not include the continuation of services at both Leeds and the Freeman hospital in Newcastle? That was deeply upsetting for parents in the communities that both hospitals serve. There is real concern that the excellent heart and lung transplant service at the Freeman hospital could be jeopardised.
Southern Cross Healthcare
Ian Mearns Excerpts(12 years, 11 months ago)
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Paul Burstow
I understand the desire of all hon. Members for urgent action and a rapid resolution that secures the interests of residents, but I did not hear the hon. Lady suggest what those changes to regulation should be. When she cares to offer such suggestions, we can look at them.
Ian Mearns (Gateshead) (Lab)
I am grateful for the Minister’s reassurances, but I am afraid that they ring a little hollow, because I was aware of a great many shortcomings in the level and quality of care in Southern Cross homes in Gateshead before its financial crisis became a matter of public record. It seems that the CQC is looking at homes on an individual basis, and that it is not drawing a national pattern of the rotten care ethos within the whole of that organisation. When will the Minister address this as a national problem?
Paul Burstow
I am doing that, and shall certainly make it my business to look up past correspondence from the hon. Gentleman raising those concerns, so that we ensure that they are properly addressed.
Public Health Observatories
Ian Mearns Excerpts(13 years ago)
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Grahame M. Morris
I am grateful to my hon. Friend for mentioning that important and contemporary report. I completely agree with Sir Michael Marmot’s findings— and Marmite is also very good for public health. Building on the work of Professor Townsend and Sir Douglas Black, Sir Michael Marmot states as one of his recommendations:
“Action taken to reduce health inequalities will benefit society in many ways. It will have economic benefits in reducing losses from illness associated with health inequalities. These currently account for productivity losses, reduced tax revenue, higher welfare payments and increased treatment costs.”
I mentioned the economic benefits of insulating houses. It would be a real step forward if the Marmot report’s six principal recommendations were incorporated and linked to quality standards in the public health outcomes framework that the National Institute for Health and Clinical Excellence is working on.
Ian Mearns (Gateshead) (Lab)
My hon. Friend mentioned the Black report, the Townsend report and the Marmot report, and I wonder whether Government officials and Ministers might in due course come to regard the Marmot review a little like Marmite—either loving it or hating it—in respect of its findings, because it is clear that the need to monitor what is going on in public health across the regions of England, such as the north-east, is vital for future policy developments.
Grahame M. Morris
Absolutely. That is a critical issue. In some respects, the Government have taken their eye off the ball. I will develop that point a little later and would like the Minister to respond to it.
As my hon. Friend pointed out, there is a clear and present danger of a reversal of health inequalities, which would be exacerbated by decisions taken elsewhere across Government. It is such an important issue, and one that I have long campaigned on. As someone who has worked in the health service and served on a local authority, I feel very passionately about it.
Remarkably, we are now considering proposals that risk losing our greatest weapon in tackling public health inequalities: evidence-based health intelligence. More recently, as my hon. Friends have noted, the Marmot review has restated the link between socio-economic factors and health, which are known as the wider determinants of health. One of the more serious threats to the future of public health intelligence is its future funding under the new arrangements proposed by the Government. In my view, the Secretary of State has shown little interest in the functioning of public health intelligence under these proposed structures.
Public health policies must take account of local circumstances as health inequalities remain stark, particularly in areas such as my constituency. For example, smoking-related deaths vary greatly across different parts of the country. Public health intelligence must drive public health practice. I appreciate that public health observatories self-generate revenue, alongside their Department of Health grant and moneys from primary care trusts and strategic health authorities. They also have opportunities to gain commissions from universities and charitable organisations, but it would be extremely risky to proceed down the Government’s proposed route without the certainty of their core Department of Health funding, which I understand is to be reduced by 30% this year.
Staff and people associated with the service have reported to me that valued employees are already being laid off at the north-west public health observatory, which is based at Liverpool John Moores university, and there is a similar situation at the north-east public health observatory. Local authorities commission the majority of public health services from a ring-fenced budget. What assurances can the Minister give me on safeguarding through this hiatus—this period of transition—and for the long term under the new arrangements?
I also thank David Kidney, the former Member for Stafford, who is now head of policy at the Chartered Institute of Environmental Health, for his assistance in preparing for this debate. The institute has stated its view that Public Health England must be established with a degree of independence, a point I made earlier, and with the ability to oversee arrangements for collecting, analysing and disseminating valuable data for public health services.
In short, it is now time for Ministers to provide concrete assurances that the role of public health intelligence, the collection of the evidence base and, in particular, public health observatories will be safeguarded for the future.
NHS (Public Satisfaction)
Ian Mearns Excerpts(13 years, 1 month ago)
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Mr David Anderson (Blaydon) (Lab)
I congratulate my hon. Friend the Member for Leyton and Wanstead (John Cryer) on getting this debate. Like the hon. Member for Banbury (Tony Baldry), I stand here as the son of a nurse, though she stopped work before the NHS was created. Through her lifetime she saw the improvements in the NHS. I also stand as a man whose niece is fighting for her life in intensive care in the Royal Victoria Infirmary, Newcastle. She is a young girl of 40 years old. I call her a girl because from the day she was born she has been hit by muscular dystrophy. She has needed the NHS from the first minute of her life. It has been there for every moment, as it was for one of my sisters, who sadly died at 53 of the same disease. The NHS was always there for them, never perfect, but second to none when compared with health services around the world. Those of us fortunate to have better health have always been prepared to pay to ensure that those who need help were able to get it.
Due to my experience with muscular dystrophy, I have the privilege of being the chairman of the all-party parliamentary group on the subject. That group has shown what we as parliamentarians can do together. We have come together, across the parties, and made huge improvements in the past few years in ensuring that specialist commissioning groups have worked with the all-party group here and with PCTs on the ground, making real improvements in the lives of people suffering from muscular dystrophy. We had a meeting about a month ago in this House. People came from across the country and across the political spectrum, and there were also professionals in the health service. They were all concerned about the direction of travel on which the Government are bent. Their concerns are: will they still be able to access the things they need? Will specialised commissioning groups still be able to work together to deliver the services they want? They have genuine concerns that the all-party group will take forward with the Minister as the debate continues.
This debate is about satisfaction. Why is satisfaction up? There are a number of reasons. Although I have some issues with the hon. Member for Banbury, I agree with him in that I have campaigned against the private finance initiative since before the previous Government took office, since the early 1990s, when the idea was first floated by the former Secretary of State for Health and now Lord Chancellor and Secretary of State for Justice, the right hon. and learned Member for Rushcliffe (Mr Clarke). I opposed it back then, and I have thought it the wrong direction for my Government to take over the past 13 years. The truth is that my Government had to do something.
The hon. Member for Banbury hit the nail on the head when he said that spending on health was 3% of GDP in the 1980s. We know it was 3% because people were being looked after in Victorian hospitals. As my hon. Friend the Member for North Durham (Mr Jones) regularly says, in his area people were being looked after in an old workhouse. That was not good enough for the Labour party, and it was not good enough for the people of this country. That is why we decided that over the period we would increase investment in the NHS, and we increased it by 300%. The people of this country went along with that, including when we put 1% on national insurance contributions. People supported that move because they believed in the service that the NHS delivered. We should never forget that.
During discussions on developing a more capital-intensive NHS, into which a lot of money went, we saw real moves on staff harmonisation, recognising the roles of staff and increasing the responsibilities of people at different levels in the health service. A huge amount of work went into that. While that was happening, other work was being done on improving public health across the board.
The hon. Member for Southport (John Pugh) raised the issue of productivity. It is strange how he defined productivity. I would be interested to read the report from the NAO on defining it, and I am glad that he has brought it to my attention. Productivity used to be measured in the health service by recording when an episode concluded. An episode could be concluded when someone died. A hospital where more people died was more successful in terms of productivity than one where somebody kept coming back and that episode was not concluded. That is a perverse way to look at productivity. The real measure of productivity is that there are twice as many people alive at 85 and over than there were 20 years ago. Should we not celebrate that? Is that not a productivity increase of which we can all be proud? That is the result of the work done.
I am not going to pretend the NHS is perfect. We know it is not perfect; every one of us as constituency MPs will have dealt with issues.
Ian Mearns (Gateshead) (Lab)
It is not a question of not thinking that it is perfect, but one of wanting constantly to improve it. The hon. Member for Southport (John Pugh) offered a view, with which I concur, that an individual’s experience of the NHS is different from their broad view, based on what they read in the press. The personal experience of the vast majority of people is either positive or very positive. The broad view is less so, which is hardly surprising, since the vast majority of editors of news journals in this country do not regard good news as news at all. It is also true that many people have a positive view of services they perceive to be under threat. Take the example of a local school. There is always a more positive view if it is under threat. The problem in this country is that millions of people, sadly, believe the NHS to be under threat.
Mr Anderson
I thank my hon. Friend and neighbour: I will discuss that with him later.
As a constituency MP, I have had three cases over the past six years of supporting people making complaints against the NHS. We took them as far as we could, trying to raise resolutions. However, none of those people opposed the NHS as an organisation; it was the specific treatment they had received that they were complaining about. There have actually been hugely improved outcomes, as I know from talking to thousands of ordinary folk across the constituency. How happy they are that we built—thankfully, before this Government got in—a new health and leisure centre in Gateshead. Unlike the Building Schools for the Future money, that was not stopped. We got it built before 7 May last year: thank God for that. The real people who matter—the public—are concerned about where we are going.
We should be thankful for the people who work in the NHS. I get really frustrated and annoyed when I hear coalition Members and the Secretary of State, who seems to take real pleasure in denigrating trade unionists, as if trade unionists were removed from this. The vast majority of trade unionists who represent health workers are hands-on professionals. They are not sitting in an office all day; they are at the coal face. They are not just talking about representing people; they are doing it, day in, day out. It is a disgrace that a party pretending to be the party of the big society should denigrate the people who are part of the largest voluntary group in the country. They stand up for people day in and day out. At the same time as standing up for their colleagues, they work in the service, they represent the service and they fight for the people they take care of. Their voice is important; their voice is informed and should not be ignored.
What do we see? We see Ministers refusing to listen to groups within the health service. I just picked up a report of the Second Reading, when I referred to one of those groups, the King’s Fund. Others include the Ministers’ own colleague, the hon. Member for Totnes (Dr Wollaston); the British Medical Association, denigrated here by the hon. Member for Banbury; the Royal College of Physicians; the Royal College of Nursing and the head of Arthritis Care. Every one of those has been ignored by the Government, on the basis of “We know best.”
Most Conservative Members have had a degree of education way beyond mine. However, in this debate, the words of my hon. Friend the Member for Bolsover (Mr Skinner) should be heeded, when he said that a lot of them have been “educated beyond their intelligence”. If this debate does not show that, nothing else does. The truth is that constantly over the past 13 years, health professionals have said to us, “Let us get on with the job.” The promise the Conservative party gave in opposition was that it would do exactly that; it would let them get on with the job, because there has been far too much meddling in the health service. I agree with that but, now, instead of letting them get on with the job, the Government are turning the health service upside down. Not only will it not work, it will make it much worse. It is a disgrace that it is happening.
Health (CSR)
Ian Mearns Excerpts(13 years, 6 months ago)
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Ian Mearns (Gateshead) (Lab)
Thank you for your indulgence, Mr Gale, in allowing me to speak this afternoon. I apologise; I was in the main Chamber earlier for the debate on policy for growth. I also thank my hon. Friend the Member for Easington (Grahame M. Morris) for securing the debate. To look at us, one would not believe that we are often mistaken for each other. I do not see how that comes about, but I understand that it does—it is something to do with the accent, I believe.
Despite pledges that the NHS would be ring-fenced from Government cuts, according to press reports, dozens of accident and emergency and maternity units have been earmarked for closure or merger. Let me highlight a few: Newark hospital in Nottinghamshire will have its A and E services downgraded, and emergency admissions will stop being taken from April 2011. At the Queen Elizabeth II hospital in Welwyn Garden City, A and E services will be downgraded and the consultant-led maternity unit could be closed. There will also be a downgrading of A and E services at Rochdale infirmary. The Conservative’s election manifesto promised a moratorium on the forced closure of A and E units and maternity wards, so what happened to that pledge?
The situation proves that the settlement provided for health by the comprehensive spending review is not sufficient to meet the pledges made by the coalition parties. As my hon. Friend said earlier, the Prime Minister’s promise in January, and the coalition agreement pledge to
“guarantee that health spending increases in real terms in each year of the Parliament”,
will not be met.
Ian Mearns
The settlement agreed by the coalition will leave the NHS unable to meet growing cost pressures, and that will reduce its purchasing power each and every year. The Government seem to be in denial—that has just been shown by the Minister’s sedentary comment.
Kieran Walshe, professor of health policy and management at Manchester business school, who has already been cited in the debate, puts the figure for reorganisation at up to £3 billion, but there is nothing to say that it will not cost significantly more. We do not yet see where the money will come from.
One of the last reorganisations under the Labour Government involved reducing the number of primary care trusts from 303 to 150. In oral evidence to the Health Committee, Sir David Nicholson, the chief executive of the NHS, stated that it generated
“significant management cost savings and gains at that time. If you look at productivity in the NHS in 2006-07, by 2007-08 you see productivity improved.”
If streamlining and reducing commissioning bodies has saved significant amounts in the past and created efficiencies, why does it appear that the Government now want to create more commissioning bodies? Some say that up to 500 general practice consortiums would be required, but it could be more than that.
The GP involvement in the process is questionable. My local experience in Gateshead as deputy leader of the council with the adult social care portfolio was that it was often difficult to engage GPs in the process of partnership working—they are very busy people. In addition, it takes time for any organisation to become an effective negotiator in commissioning relationships with acute care providers, and to develop health provision plans and purchasing capacity. Why is the coalition placing those additional pressures on the NHS at a time when it is cutting its spending power?
Press reports—the Minister refers to these as rubbish—give fairly extensive lists of hospitals facing A and E closures, maternity closures and cutbacks. Let me quote an example:
“Despite pledges that the NHS would be ring-fenced from government cuts, dozens of A&E and maternity units have been earmarked for closure or mergers.”
Those are the words of not some revolutionary incitement periodical, but The Sunday Telegraph. I do not think that many of the people on yesterday’s demonstration about the proposed hikes to tuition fees were hawking The Sunday Telegraph as some kind of revolutionary organ with which they could incite the crowd to further action.
The Sunday Telegraph refers to:
“More than 30 maternity and casualty units facing the axe”,
and provides us with a significant list of examples from all over the country. It also tells us that, as a result of the spending review, the NHS faces a bed-blocking crisis. It states that the permanent closures and downgrading of services agreed since May affect many hospitals.
Ian Mearns
There is a long list. However, according to The Sunday Telegraph:
“Maternity units in Tiverton, Okehampton and Honiton, Devon: plan to downgrade services so they will not offer any midwife care overnight. Solihull Hospital: maternity unit was shut as a temporary measure just before the election. It re-opened in July as a midwife-led unit. Proposals to make the closure permanent due to be published within weeks”—
I could go on. For Hartlepool, in my region, we are told that there is a “proposal to close A&E” and that that will be
“replaced with minor injuries unit, and direct admissions for emergency medical cases.”
Of course, that comes on the back of the announcement a couple of months ago of the cancellation of the replacement North Tees hospital.
Ian Mearns
This is a very recent Sunday Telegraph report. I am glad to hear what the Minister says, but it is not the real issue for the area—that is the replacement North Tees hospital. As the Minister told us in a previous debate in this very Chamber, a brand new hospital worth £450 million, with brand spanking new service facilities, will be sacrificed for the grand sum of £11 million a year over the life of the hospital.
The Sunday Telegraph goes on to state:
“Hexham, North Tyneside and Wansbeck hospitals in Northumberland: Casualty units would no longer take ambulance cases if a new hospital is built near Cramlington.”
The Hexham hospital provides A and E services for people in a large constituency. I would not like to be dragged backwards by my hair between that constituency and Cramlington, because it is an awfully long way. There is a great deal more in the article.
The health service in my constituency is unrecognisably better than the one that we inherited in 1997. I would like to place on record my personal thanks to the staff of the neurosurgery unit at Newcastle General hospital, without whose efforts I would not be standing here today, because I had neurosurgery on my spine about 22 months ago. The Queen Elizabeth hospital in my constituency is now a very well regarded resource for the region and has a regional surgical support unit. Our other primary care facilities include the successful Gateshead smoking cessation service, which has reduced the prevalence of smoking—[Interruption.] I am not having a go at the Minister; I really mean that. However, the service is important to my constituents. We have reduced smoking rates in my constituency with its help from some 35% just over 10 years ago to about 21%. That is vital to the life expectancy of many thousands of my constituents. There is great concern, worry and uncertainty about what the future holds for such services as a result of the Government’s decisions.
The spending review will force deep cuts in patient care as the Government focus on a wholesale NHS reorganisation that will negate many, if not all, of the efficiency savings. I have real concern about commissioning, in that we will see GP practices coming together and then outsourcing to some fairly significant global players. Those players will take over the services on a local basis—they are out there, ready and waiting. It is not in the interests of patient care for money to go out of the public sector as profit for those companies.
Hospital Services (North-East)
Ian Mearns Excerpts(13 years, 9 months ago)
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Grahame M. Morris
Okay, thanks. The cost difference is very marginal, when we factor in things such as NHS inflation and so on. The Minister has already given some clarification, but my point is that by not continuing with the proposed new hospital the cost of delivering health care may in fact—
Ian Mearns (Gateshead) (Lab)
I have to say that the figures that the Minister has just given in his intervention on my hon. Friend seem to make the Government’s position even worse than I thought it was. What we are actually talking about is a margin of difference of £11,000—based on the figures that he has just given us here in Westminster Hall—across the 35-year operating programme. Now, I am not sure if that is actually correct. I wonder if it is a bit like the lists given out by the Secretary of State for Education; the figures and the numbers keep altering on us. But based on the figures that the Minister has just given us, we are talking about £11,000, and that is the cost of not having a brand spanking new state-of-the-art hospital to serve five constituencies: my own constituency; the constituencies of my hon. Friends the Members for Stockton North, for Hartlepool and for Sedgefield (Phil Wilson), and the constituency of the hon. Member for Stockton South (James Wharton).
Grahame M. Morris
There seems to be some confusion here with the figures. However, in my mind, perhaps in the minds of other Labour Members and certainly in the minds of the good people of Easington, it only shows what a bad decision it was. I do not believe that it is being made for the stated financial reasons, but instead seems to form part of some type of idelologicallybased course of action taken by the coalition Government.
It is clear now that the saving of £464 million—the figure that was widely quoted to the media at the time of the hospital’s cancellation—is completely misleading. At some point, I hope that we will also get to the bottom of the true costs to the taxpayer of cancelling and pulling the plug on this new hospital development, which, as my hon. Friend the Member for Hartlepool has indicated, has been in the planning since 2005.
On 2 May 2010, in an interview with Andrew Marr, the right hon. Member for Witney (Mr Cameron) talked passionately about how a responsible society should protect the vulnerable. This is what he said:
“The test of a good society is you look after the elderly, the frail, the vulnerable, the poorest in our society. And that test is even more important in difficult times, when difficult decisions have to be taken, than it is in better times.”
I am sure that many of my colleagues knew at the time, as I did, that that statement lacked substance.
Easington is one of the most deprived areas in the United Kingdom. Health inequalities still play a large role in Easington; there is shorter life expectancy and poorer quality of life. Life expectancy in Easington is a full two years lower than the national average. The proposed new hospital was part of a clinically led strategic reorganisation of health provision for one of the poorest areas in Britain, which would have gone some way to tackling some of the worst health outcomes in the country.
The latest figures that I have been able to access are the 2007 statistics on standardised mortality rates per 100,000 population. They show clearly that death from illness that is amenable to health care—that is, deaths that would have been preventable with health interventions—accounted for 256 deaths per 100,000 of the population in the Easington local authority area, compared to an average of only 195 across the rest of England and Wales. For all causes, the figure for Easington is 713, compared to 582 for England and Wales. For coronary heart disease, the figure is 112 per 100,000 in Easington compared to 90 per 100,000 across the rest of England and Wales. For cancer, the figure for Easington is 219 per 100,000 compared to 175 nationally.
Diana R. Johnson
I apologise to my hon. Friend the Member for Gateshead for not mentioning him; I know that he takes a particular interest in the issue.
I hope that the Minister will explain the rationale for the decision that was made about the hospital, and whether the cost-benefit analysis included the savings that would come about from a healthier population with better access to health services. I am sure that he will explain it. My hon. Friend the Member for Easington also mentioned health inequalities. It is important to ensure that patients and communities have access to high-quality in-patient facilities when they need them.
My hon. Friend the Member for Sedgefield argued compellingly on business grounds that the hospital could help lead the regeneration of the area. He described the hospital as an anchor tenant that could attract up to 12,500 private sector jobs, a telling point for an area of the country that wants to attract private sector business and stand on its own two feet. He made a compelling case. My hon. Friend also said how good the care that he and his family had received from the local NHS was.
Ian Mearns
It is important that the Minister has now clarified that the figure is not £11,000, as he stated earlier, but £11 million. I am sorry, but the difference between the figures that he gave was in fact £11,000, and I hope that the record will show that. That said, we now know that the figure is £11 million over 35 years, or £314,000 a year, the lack of which will deprive the people in those five constituencies of a brand spanking new hospital facility that could add significant value over that period to detract from the additional cost.
Diana R. Johnson
My hon. Friend makes an important point about the cost over 35 years.
My hon. Friend the Member for Stockton North, who I understand is a former non-executive director of the North Tees and Hartlepool NHS Foundation Trust, spoke clearly about the need for a new hospital. I know that he also tabled early-day motion 273, which attracted a great deal of support, to request a review of the coalition decision about the hospital. He, too, made an important case about health inequalities and why the hospital is needed. He also pointed out that structural upheaval in the NHS at a time when we are facing such financial problems is a recipe for chaos. What is the future for the people represented by him and our hon. Friends? Again, I look to the Minister to explain the coalition Government’s thinking about what will happen to the needs of communities in the north-east.
I do not wish to rehearse the history of this £464 million hospital project—my right hon. Friend the former Secretary of State made it clear that it was a top priority for the NHS, and agreed in March this year that it should go ahead—but it had been in planning for a long time. It was not just signed off close to a general election. As we have heard, the coalition Government decided to cancel the hospital project within the first few weeks of taking up their position in Government. It is clear that the Treasury and other Departments reviewed every significant spending decision made between 1 January and the general election on 6 May. The proposal for the new hospital scheme, which received Government approval only in March, was considered properly during that review, but there are questions about why that particular hospital project was cancelled and others were allowed to proceed when my right hon. Friend had made it clear that the hospital was a top priority for the NHS.