NHS Reorganisation

Debate between Jim Cunningham and Faisal Rashid

Wednesday 12th December 2018 Westminster Hall

[Faisal Rashid (Warrington South) (Lab)]

I beg to move,

That this House has considered NHS reorganisation.

It is an honour to serve under your chairmanship, Mr Gapes. It is my pleasure to open this debate on our NHS as we near the end of the year marking its 70th birthday. In debating its reorganisation, we should not lose sight of what a great credit the NHS and its staff are to our country. Its foundation represents arguably the greatest achievement of this House. It is for precisely that reason that its reorganisation matters so greatly.

Let me set the context. Eight years of cuts and the biggest financial squeeze in its history have pushed the NHS to the brink. On all key performance measures, it is struggling to keep up with demand—A&E performance hit a record low this year, more than 4 million people are stuck on a waiting list, and cancer targets are repeatedly missed. In a speech last year, the chief executive of NHS England warned:

“On the current funding outlook, the NHS waiting list will rise to 5 million people by 2021. That is an extra 1 million people on the waiting list. One in 10 of us waiting for an operation. The highest number ever.”

As the NHS is pressurised to do more with less, it is imperative that Parliament properly scrutinises the ongoing process of its reorganisation. We should not allow the Government’s shambolic handling of the Brexit negotiations to distract us from reforms that are critical to the livelihoods of millions in this country.

I acknowledge that this subject is wide-ranging and complex, so I intend to focus on a few key issues: clinical commissioning groups; sustainability and transformation plans and partnerships; integrated care partnerships; health and social care integration; and healthcare infrastructure.

Let me start with the Health and Social Care Act 2012 and CCGs. Six years on from the coalition Government’s top-down reorganisation of the NHS, it is clear that that initiative has been as much of a disaster as Labour warned it would be. My hon. Friend the Member for Ellesmere Port and Neston (Justin Madders) rightly described those reforms as having put in place

“a siloed, market-based approach that created statutory barriers to integration.”—[Official Report, 6 September 2018; Vol. 646, c. 176WH.]

The 2012 Act removed regional health planning by abolishing strategic health authorities and creating a complex and fragmented system of clinical commissioning groups. Strategic health authorities helped co-ordinate the provision of healthcare across an area. Subsequent NHS reorganisations have often felt like partial attempts to reverse the damage done by the 2012 Act. It is therefore unsurprising that little effort has been made to keep the public informed of those changes.

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

I congratulate my hon. Friend on securing the debate. He touches on the reorganisation way back in 2012. Clinical commissioning groups were created, but they are not accountable to the public—we have problems trying to find out what their budgets are and so forth. We have the same problem with NHS England, which is another very difficult organisation to deal with. As a result of all this reorganisation, we have organisations that are not really accountable to the public, and the public do not get their voices heard.

My hon. Friend touched on staff salaries. If we worked it out, we would probably find that they have had an 8% real-terms cut in wages over the past seven or eight years, on top of which they have to pay car parking charges for the privilege of serving the public. Does he agree that that cannot be right?

Budget Resolutions

Debate between Jim Cunningham and Faisal Rashid

Wednesday 31st October 2018 Commons Chamber

[Faisal Rashid (Warrington South) (Lab)]

Does my hon. Friend agree that it is utterly shameful that the Budget aims to claw back £700 million from the self-employed by reforming off-payroll working, yet only £400 million from the tech giants, which have avoided an astonishing £5 billion-worth of tax over the last five years?

[Mr Cunningham]

I agree, but I point out to my hon. Friend that between 4 million and 5 million people earn poverty wages in this country, which demonstrates that work does not pay under this Government.

To turn back to education, the bonus averages out at £10,000 per primary school and £50,000 per secondary school—around £50 per pupil. If we think about that, the Government took £4.5 billion out of education, then put £1.5 billion back, so they still owe over £3 billion. Analysis suggests that schools in Coventry have faced almost a £300 cut to funding per pupil since 2014, so a £50 one-off payment per pupil is a drop in the ocean—barely enough to buy two new textbooks. Schools do not need small change or “little extras”; they need funding to rehire special educational needs senior assistants, to re-offer dropped subjects and to fund teacher pay increases fully.

As hon. Members all know, Coventry will be the city of culture and while I welcome the £8.5 million for that, the Government still have not given us the same amount of money that they gave Hull—in fact, it is nearly half. The city centre will benefit hugely, and it will also benefit from cuts to business rates for smaller businesses. However, as I said, the £8.5 million is below the £14 million that was given to Hull for 2017. I will work closely with my colleagues in Coventry City Council. Coventry must receive its fair share of funding to help to make the most of the city of culture opportunity.