Health and Care Services

Jim Cunningham Excerpts

Wednesday 3rd July 2013 Commons Chamber

[Grahame M. Morris]

That is an excellent point, and my hon. Friend the Member for Worsley and Eccles South mentioned evidence presented to the Health Committee that showed that £2.7 billion of expenditure or allocations has been removed from local government budgets and social care. That has had a huge impact on the service and resulted in changes to eligibility and thresholds, and charges for transport and other things.

[Mr Jim Cunningham (Coventry South) (Lab)]

I apologise to my hon. Friend for arriving a minute after the start of his speech. The hon. Member for Bradford East (Mr Ward) raised an interesting point about social care, particularly in relation to local authorities. Given the one-third cut, plus the 10% cut, in those budgets, I see a major problem for local authorities in buying care for elderly people. Indeed, it has been a major problem over the past two or three years.

[Grahame M. Morris]

That is an excellent point. I am sure that Members across the Chamber will have experience of that. On Friday gone, we had a crisis meeting of the county MPs and senior politicians in my local authority area of County Durham to determine how to cope with a further tranche of cuts. The situation is becoming serious. It is said that the allocations have been ring-fenced, but the local authorities’ discretionary spend is all being absorbed into social care and expenditure for children and the elderly, and there is very little room for manoeuvre.

--- Later in debate ---

[Mr Jim Cunningham]

Does my hon. Friend agree that, unless something realistic is done about the health service, we could find ourselves back in a pre-1997 situation, with a shortage of beds and with people sleeping on trolleys?

[Grahame M. Morris]

I am grateful to my hon. Friend for that intervention. There is certainly a crisis in emergency care. The causes of that are multi-faceted, and I certainly do not agree with the Secretary of State’s analysis that it is simply the result of the change in the GP contract in 2006. Some of his comments to that effect have caused great offence to the medical profession. We are in crisis in many respects, including in the area of recruitment. It has been pointed out in recent evidence to the Select Committee that the NHS is not recruiting enough people into emergency care, or enough GPs. We are storing up bigger problems for the future if we do not have the necessary cohorts of trainees going through medical school.

A new approach is needed if we are to meet today’s challenge of the rising demand for health care in an ageing society. We will certainly need more co-operation, not more competition. We will need to see the integration of health and social care services, not more fragmentation, and we will need more whole-person care. In many respects, the Government’s reforms will make that harder, with markets fragmenting services and an open-tendering free-for-all meaning more providers dealing with smaller elements of a person’s care, without the necessary overall co-ordination.

We know about joint budgets. We have seen the Government transfer resources from the NHS to social care. However, what we need is a single budget. I should like to see a national health and care service, a co-ordinated service that focuses on an individual’s physical, mental and social care needs from home to hospital. We need a new focus on prevention: people who are at risk of being admitted to hospital should be identified and supported in their homes. The Select Committee has been looking into the policies and interventions that have enabled that to be done in other countries. We need to end costly migrations from home to hospital, and from there to expensive care homes where, in many cases, the individual must bear a huge financial burden. That is good for neither the taxpayer nor the individual. The integration of services will allow significant savings to be made. Investment in early intervention will limit more costly hospital admissions, as well as helping people to lead healthier lives.

There is a real choice. While the coalition Government are pushing for a free market in health care, Labour is calling for the full integration of health and care services. While the coalition talks of choice, it is delivering fragmentation. In contrast, Labour supports co-operation between doctors, nurses, social workers and therapists, all working together with a single point of contact.

There are huge risks, and the first news stories about them are beginning to surface. If we do not deal with the present situation, the need for fees may arise, and we may end up with a two-tier system. Top-up payments for treatment may be required, especially as more private companies enter the market. We may even see the re-emergence of an insurance-based free-market private health care system. I believe that we should remain true to the founding principle of the NHS: that it should be a health service funded from general taxation and provided free at the point of use. Ministers may shake their heads, but they should remember their last promise, that there would be no more top-down reorganisations.

The NHS, whose 65th birthday we celebrate this weekend, is Labour’s greatest achievement. We created it, we protected it, and we saved it after years of Tory neglect and under-investment. We must continue to protect and transform our most cherished public service, so that we can meet the challenges that we face in the future.