Managing Risk in the NHS

Jeremy Lefroy Excerpts

Wednesday 17th July 2013 Commons Chamber

[Andy Burnham]

I always took action when anything was brought to me. When mortality data on Basildon hospital were published, I immediately ordered an in-depth review of all hospitals in England, which led to warnings on five of the trusts on the Keogh list. Those warnings were inherited by the hon. Gentleman’s Government, but Ministers allowed those trusts to carry on cutting staff, and the same was true for the hospital in the constituency of my hon. Friend the Member for Denton and Reddish (Andrew Gwynne), even though it was subject to a warning about patient care. I think that Government Members have to look at themselves before making claims.

On the duty of candour, the final recommendation that we need to see progress on relates to the regulation of health care assistants, which is long overdue. If the Secretary of State took these three sensible measures, he would provide support to staff and reassurance to the public, but they are not in themselves the answer to the structural challenge the NHS faces. That brings me to my final point on the longer-term solution. I have thought long and hard about what happened at Stafford hospital and why we hear recurrent echoes of the same elsewhere in the NHS, with older people lost on acute hospital wards, disorientated and dehydrated. I believe that the problem goes far deeper than any regulatory solution. Governments of all colours have underinvested in social care over many years, and in the end we get what we pay for: a malnourished, minimum wage system that dishes out care in 15-minute slots, which is barely time to make a cup of tea, let alone exchange a meaningful word.

Looking after someone else’s parents should be the highest calling that any young person can answer. However, if we are honest with ourselves, the effect of decisions taken here in this House over many years means that the signal we are currently sending is that it is the lowest calling that a young person can answer. Some 307,000 care staff in England—20% of the work force—are on zero-hours contracts. That is an appalling figure. This situation cannot carry on. Good care cannot be provided on a zero-hours, here-today-gone-tomorrow basis.

The collapse of decent social care in England means that too many elderly people are drifting unnecessarily towards hospital. Our hospitals are becoming increasingly full of very frail, very elderly people, and that is not sustainable in either human or financial terms. That is why I have proposed—

[Jeremy Lefroy (Stafford) (Con)]

I understand what the right hon. Gentleman is saying about the situation of care assistants—their low pay and so on—but in Stafford some of the highest-paid people in the organisation showed the least compassion. It is not all about money, although money may come into it. Compassion does not have any regard to income.

[Andy Burnham]

I agree with the hon. Gentleman, and I respect the way in which he continues to pursue the issues arising from what happened in his constituency. Yes, it is not all about money, but it is about the message we send to the people working in our care system. If somebody does not have certainty about the money that they will bring into the family home from one week to the next because they do not know how many hours they will be working, how can we expect them to pass on a sense of security to those they care for? We will not get the care that we all want for everybody’s parents if we carry on with a system that is working as it is. I lay the blame with no one Government; as I said, all Governments have brought this situation about.

That is why I have proposed the full integration of health and social care with one service looking after the whole person and all their needs, physical, mental and social. I hear the Government increasingly borrowing our ideas and our language, and I have no objection to that. However, here is my challenge to the Minister of State, who has been roused by that statement: he cannot speak the language of integration while legislating for fragmentation and competition. We are hearing reports from across the country of sensible collaboration between secondary, primary and social care being blocked by the competition provisions of the Health and Social Care Act 2012. Torbay, the beacon of integrated care, fears that any qualified provider may break up its celebrated model. That has led the Minister to suggest in the Health Service Journal that his integrated care pilot area might be offered exemptions from the Act’s competition provisions. Surely that is the clearest admission from the Government that the Act they passed is a barrier to the change that the NHS needs. Collaboration or competition? Integration or fragmentation? In the end, they have to make a choice; they cannot have it both ways. If the Minister is serious about this, the last offer I make is that we will work with him to fast-track repeal of the competition provisions of the Health and Social Care Act.

Today I have made some positive suggestions about a way forward for the NHS. It is now up to the Government to decide what they want to do. In the past few days, we have seen a glimpse of a Government prepared to run down the NHS, still the country’s best-loved institution, for their own political ends. If, from here on in, they intend to continue with that approach, they will be pursuing a very dangerous path. It will cement an impression in the country that some people have already formed—that the Secretary of State is running down the NHS to erode public confidence in it and to soften it up for privatisation. People suspect that that is the real agenda. Only today, we learned of six NHS trusts preparing for a major expansion in private work under privatisation freedoms given to them by this Government.

Nye Bevan said that there will be an NHS for

“as long as there are folk left with the faith to fight for it.”

I can tell all Government Members that they have not knocked the fight out of me, and I suspect there are millions out there ready to rally to the same cause. People rely on an NHS that puts patients before profit, and Labour will always defend that. This week the Government have revealed their hand and it is nasty. They should pull back or get ready for the fight of their lives.