NHS Funding

Jim Shannon Excerpts

Wednesday 12th December 2012 Commons Chamber

[Jim Shannon (Strangford) (DUP)]

Thank you, Mr Deputy Speaker. I have no doubt that I will finish in time.

We are well aware of the pressures in every area to implement Government cuts and how difficult it is to do that. Whether we are in government or in opposition, we all have a job to do in sorting out that problem. In my opinion, there is no worse place to carry out cuts than the NHS. Sick people need treatments that are often expensive and doctors are working out treatment plans and thinking about how they can keep to their budget and provide top-class care. There are pressures on the doctors in the system and they are ever mindful of the budget that they have to work to.

Everyone inside and outside the Chamber is aware of the issues and of the value of the NHS. The debate is about how we can do things better. The Opposition tabled the motion and their concerns have been well rehearsed today.

In my constituency—many hon. Members have given similar examples—a young lady had been unwell for 10 years with ulcerative colitis. She was responsive to her treatment of infliximab, and yet the doctor had to take her off it because it was too expensive and other more serious cases needed the treatment. However, once she was off the treatment she worsened, had to go on the sick and received numerous warnings from her workplace about losing her job. Where would the money truly be saved in such a scenario—stay on the treatment, stay in work, or go off the treatment, go off work?

My mother had a saying—I am sure that many hon. Members will be able to relate to this—“Your health is your wealth.” It clearly is and those of us who are in good health are fortunate.

The right hon. Member for Cynon Valley (Ann Clwyd) is no longer in her place, but she made an excellent, compassionate speech. I think that she probably told the story of this debate in the examples she gave. I told her before she left the Chamber how important it was to have those comments on the record.

It must be remembered that in its review of independent NHS trust three-year plans up until 2014-15, Monitor, the NHS’s economic regulator, warned that cuts were unlikely to be matched by any let-up in the number of patients requiring care. There is an emphasis on preventive medicine and how best to use it. I am sure that the Minister will address how we can ensure that people who are getting older do not succumb to the many diseases and other problems. Sometimes, there is nothing gracious about growing old—it is a fact of life.

The Minister will talk about efficiency savings—they can achieve much—but when I consider the great job that the Northern Ireland Minister of Health, who happens to be a colleague of mine, has done on efficiency savings, I wonder whether the further cuts to Northern Ireland’s block grant will be applied to health again over the next few years. How much more can we save through efficiency? There is a limit—a ceiling—to what efficiency savings can do without affecting health. John Appleby, the chief economist of the King’s Fund think-tank, has said that the outlook for hospitals in 2013-14 and 2014-15 is particularly severe, with anticipated cuts of about 1% when the Government’s inflation forecast is 2.5%. That is a clear difference.

Some hospitals plan to partially offset the radical drop in NHS income by expanding their private patient work, aided, as their financial plans say, by moves to restrict NHS funding for certain surgical procedures. This is expected to fuel an increase in patients funding surgery privately. That greatly undermines what the NHS is about—its very thrust—namely care, no matter the condition, provided by national insurance contributions. As has been said, if we introduce a two-tier care system to operations, how long will it take until we find ourselves providing a system similar to America’s private health care system? How ironic it is that the Americans are attempting at this time to a design a system that is in line with our own NHS. Perhaps we can take some lessons from that.

I also want to comment on the problems that arise when we cut NHS funding. The number of MRSA cases in hospitals has increased. That is not through any particular fault of the staff—I am clear about that—but it is a problem that occurs whenever cost-cutting becomes the No. 1 priority for hospitals. We have to be careful.

We have already implemented cost-saving measures, such as carrying out certain treatments as day procedures followed by care at home, which, as well as being cost-effective, makes a lot of people feel more secure. However, it is essential that the patient is at the heart of any decision made and any strategy must incorporate that. There is a fine balance between cutting costs and cutting care. My fear is that the latest cuts, which will filter through to Northern Ireland through the block grant as a matter of course, will tip the balance for many people.

Many people in my office tell me that they were brought up to respect authority and that if a doctor tells them something, they accept their word. I come across other people who challenge their doctors and push them for the experimental treatment that they know is available, although at a cost, or for a referral to the mainland for innovative treatment. It saddens me that the results differ between those two types of people. In my opinion, it puts our health care professionals in the difficult position of choosing who deserves and who does not deserve the nth degree of care.

Recently in this Chamber I questioned the Secretary of State about the shocking use by doctors of so-called death lists—I am very careful about using that terminology—for elderly people, whereby they withhold certain treatments from those who they believe will die anyway. It is a dangerous precedent to set for the NHS when that can and does happen. If one puts oneself in the doctor’s shoes and realises that the Government are putting a great emphasis on cost, one can see that they are almost forcing that choice. That makes it a little more understandable, but no more acceptable.

As an MP, I have come across many constituents who have come to the mainland to have hospital operations and examinations. We are thankful that we are able to do that, but it involves a cost.

I am not the kind of person who believes that money grows on trees. I wish that it did. I have some trees in my garden, but I cannot find any money on them. We could spend, spend, spend, but I know that we must reduce the deficit. In my opinion, there are other ways of doing so, such as adopting the proposals put forward in the debate in May on the NHS and foreign nationals. To give a brief reminder of that debate, an article in The Daily Telegraph stated that official figures suggest that

“more than £40 million is owed to NHS hospitals by foreign patients who were not eligible for free care”.

It stated that a freedom of information request showed that

“the average unpaid debt for the provision of care to foreign nationals was £230,000 in the 35 trusts which responded.”

The article went on to note that the doctors’ trade magazine Pulse claimed:

“If this figure was the same across all 168 English acute trusts, the total debt would be almost £40 million”.

Perhaps in his response the Minister could give some detail about whether that money has been collected, and if not, when it will be.

In that debate, it was suggested that there should be a £1,000 threshold. Has that been implemented yet? Have those who owe the money been chased down? Has the six-month registration period for a GP been altered? In my opinion, by acting on such matters urgently, we can save money without cutting care. Does the Secretary of State agree that such angles must be pursued if we are to stop cutting services and still save money?

Time has got the better of me, so I will end by urging the Government to look at people and not simply at numbers. If everybody does their job more effectively, we can ensure that all people have top-class care, no matter where they live, without having to pay for it. The NHS is truly a jewel in the crown of this country. Many owe their lives to it and many depend upon it. Let us retain it and build upon it to ensure that in the years to come, it will still be the jewel in the crown that all in this nation cherish, love and depend upon.