Integrated Care

Jim Shannon Excerpts

Thursday 6th September 2018 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

It is a pleasure to speak on this matter. I commend the hon. Member for Totnes (Dr Wollaston) for setting the scene, and the hon. Member for Stockton South (Dr Williams) for making such a valuable contribution. I do not have the expertise of those two hon. Members—far from it—but I have a deep interest in the health service, and the treatment and service that is provided, which is why I am here. I thank the hon. Member for Totnes and all those who made a contribution to the Health and Social Care Committee’s seventh report, “Integrated care: organisations, partnerships and systems”.

We are ever-mindful of the anniversary of our own NHS. A lot of minds have looked back over the past 70 years, and we have all looked back over the years that we have been here, and we are thankful for the institution, which has been a beacon of the best of British by far. Just last weekend, I was present as my local council, Ards and North Down Borough Council, conferred the freedom of the borough on the NHS as a gesture of good will and a vote of thanks to those who work so hard in adverse conditions to provide care to those we love. As an active representative, I speak to those who work in the NHS and are recipients of NHS services every week. The hon. Member for Totnes made many telling comments, but one that I took from the very beginning of her contribution was that the purpose is to deliver a better service for patients. That really is the core of what we are about in the NHS, and at the core of the report’s recommendations.

Until recent years I had little cause to visit doctors or use the NHS but, as often happens, with age came complications, and diabetes was one of those. The doctor then said, “You need a wee tablet for your blood pressure. Well, you don’t really need one, but we’ll give you one anyway, just to keep you right.” Along with that, last year I was in hospital on three occasions for surgical operations. Not having been there for more than 40 years, suddenly finding that I was almost a regular visitor to the hospital gave me a really good idea of what our NHS is like today. I put on record my thanks to all those who made valuable contributions to those operations. I know it was down to the skills of the doctors and surgeons, but it was also down to people’s prayers.

We all know that the NHS is hanging on by a thread in many cases. It sometimes seems like that, but when I hung in the balance the NHS rose to the challenge. Sometimes we think that the NHS cannot deliver, but very often it does, and it delivers well. Any discussion about the NHS must begin with thanks to those who make it work against all the odds and who make what should be impossible possible. All of us here—myself in particular—say, “Thank you.”

I thank every person involved in the report, and I thank the Minister who is here to respond to it; I know he will do so very positively. As I began to read the report, the massive amount of work that went into it became abundantly clear. We need to bring on board the people with the vision for the NHS, as put forward in the report. I can see the vision for the NHS—I can read it on paper anyway, and then picture it. I understand the rationale behind the vision, but I also see the fear of secret privatisation, which people believe to be taking place. Some of the hon. Members who intervened referred to that.

We have all seen what happens when things move from public to private, and people fear a lack of services. That is easy to understand when talking about the loss of a rural bus link, but not when discussing whether a mother who is 72 years of age and has cancer will get treatment on the NHS. There is a fear among the general public that risk assessments will mean that we do not give such people a chance. I know that that is not the case, but we have to consider public opinion, and how people assess and see the situation. People see things quite simply at times. It is good to see things simply, because it makes it easy to follow through with the solution—those are my feelings anyway.

My feeling is that something has to change in the NHS. We all understand that bandages are not enough—it needs clinical surgery and massive intervention, some elements of which are in the recommendations. However, in order to be able to do that, we need to first prep the patients—the general public. We need to convince them that the proposed changes are for the better. We need to do a better job of preparing the public and explaining exactly what the plans are.

As the report was at pains to show, people do not fully understand how the NHS works. Information is not shared between emergency services and GPs in the detail and with the connections that it should be, and healthcare is provided from different sections who are not working together as well as they should. The integration referred to in the report can only work through partnerships that are truly trying to work together. When there is no understanding there is fear, and while people may not understand the current system, by and large they trust it. They trust that when they dial 999, an ambulance will arrive and bring them for care to their local emergency unit. When we tell them things are changing and we abbreviate terms using initials that save time but increase complexity, they fear that the very thing that they can trust no longer exists, because it is different from what it was five or 10 years ago, and they do not quite understand what is being said. That is why it is important to keep it simple. Of course, however we change the NHS, an ambulance will always be sent in response to a 999 call, but the simple fact is that people do not trust to that, so they will be unsure about what will unfold.

As a lay person, without the expertise that many on the Committee have—I bow to their knowledge and expertise—it is my humble opinion that we must do better in informing people how things are working now and how they can improve with changes, but understanding takes time and it is better to bring the public along, clarify uncertainties and address the issues at an early stage. Such corrective surgery has to take place, but the theatre must be prepped. People must be allowed to understand and that has to come with co-ordination and better working relationships with the press, as well as one-on-one discussions with patients when possible. It must happen with easy-to-understand information and it must happen before the changes are implemented.

I congratulate the hon. Members involved in preparing the report. I look forward to the Minister’s response, as well as the contribution of the shadow Minister.