NHS and Social Care Funding

Jim Cunningham Excerpts

Wednesday 11th January 2017 Commons Chamber

[Dr Wollaston]

I am afraid that that intervention is exactly not the kind of debate we want to be having. Let us look to the future. We are in a different part of the electoral cycle. I accept the hon. Lady’s comments—I was still an NHS clinician when that happened and, like many of those working in health or social care, I looked at the yah-boo debate in this place and thought that surely there had to be a better way—but I ask her to put them aside and to look to the future rather than backwards, otherwise we will not get anywhere. I think our constituents want us, as politicians, to recognise the scale of the challenge and to get to grips with it.

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

Looking to the future, does the hon. Lady not agree that there should be a new funding settlement for the NHS and social care budgets that brings both together? At the moment, there have been cuts of £4.6 billion.

[Dr Wollaston]

That is exactly what I am hoping. We must end the silos of health and social care. We should stop thinking about money as a social care pound or a health pound, and instead think about a patient pound and a taxpayer pound, and how we get the very best from that.

That brings me on to a point I would like to raise directly with the Secretary of State. There is an example of where this has happened: in my constituency, Torbay and South Devon NHS Foundation Trust has formed an ICO—an integrated care organisation. Across health and care, passionate people recognised the benefits and sweated blood to get the organisation off the ground. Torbay’s integration is talked about not just nationally but internationally as a recognised way of doing this better. I regret to say, however, that because of the scale of the financial pressure on the ICO, we are now hearing that next year the NHS will be pulling out of the risk-sharing agreement.

That is totally unacceptable. I hope the Secretary of State will meet me to discuss the pressures facing the ICO, which has achieved exactly what we are talking about in this debate. It is able to pool finances better through risk sharing and to work together to get people out of hospital who do not need to be there more rapidly than happens in other areas. It can put people from social care into hospitals to see how we can speed up that process. Unfortunately, if that risk-share falls apart, one of the key pillars of how we want to improve the flow through hospitals and out the other end will break down. Part of the reason, as I understand it, is that unless the control totals are met the funding it hopes to use to improve the facilities in the A&E department will be at risk. The challenge for Torbay is not how it works together to get people out of hospital; it is the facilities at the front door, and it could do so much to improve the facilities. We have the odd paradox whereby we could end up improving A&E infrastructure but worsening the ability of the system to respond at the point where we are trying to get people cared for in the community.

A certain degree of financial challenge can have the effect of bringing health and social care organisations to work more closely together because they know it makes sense, but when unrealistic targets are set it can go the other way. It can start to mean that people have to retreat to protect their budget silos. I hope that the Secretary of State will look closely at what is happening and meet me to discuss whether we cannot just get this back on track for next year. I am confident that the local authority and the NHS staff across the CCG and the provider trust will continue to work together—they have an extraordinary tradition of doing so—but there are threats, which I hope can be addressed. This is about the entire flow from the front door right the way through to getting people cared for back at home.

More widely, we now have more than 1 million people in communities who are unable to receive the care they need. Mears, the prime provider in my area, is in special measures. These are financial issues. Yes, there is much that the NHS can do that is not about money—we know there is a lot of variation that cannot be explained by financial challenge and demographic changes alone—but finance and the workforce inevitably are the key challenges we have to face, and we have to work together across all political parties to resolve them.

In closing, I would like to raise with the Secretary of State the front page of today’s Times, which is extraordinarily disappointing. This is the second time a major national newspaper has reported briefing against the chief executive of the NHS, Simon Stevens. I invite the Secretary of State or the Minister closing the debate unequivocally to support the chief executive of the NHS. When the chief executive appears before the Health Committee and I, as the Chair of the Committee, ask him to respond to questions, I expect him to be truthful and transparent in his answers. He should be commended for doing so and not find himself the subject of negative briefings. I therefore invite the Minister unequivocally to support him and ask for this to stop.