NHS Funding

Joan Ruddock Excerpts

Wednesday 12th December 2012 Commons Chamber

[Mr Hunt]

Some politicians walk into the same trap not once but twice. Let me give the right hon. Gentleman the sentence that comes straight after that, which he did not want to quote. It says that

“it might also be fair to say that real-terms expenditure had changed little over this period.”

That is what Andrew Dilnot is saying, which is why the motion is so completely bogus.

[Dame Joan Ruddock (Lewisham, Deptford) (Lab)]

I am no statistician, but my understanding of that English is that things have not changed much. However, the Secretary of State has consistently said that he and the Government have pledged to implement an increase. There is nothing in that letter to suggest that any increase has occurred.

[Mr Hunt]

The right hon. Lady’s party has been saying that spending has been cut, and it had the foolishness to call an Opposition day debate on the basis of a letter from Andrew Dilnot that states that, broadly speaking, spending has remained unchanged. That is why, at its heart, the motion is bogus.

The sad fact is that this is not the debate that the Opposition planned to have, two years into this Parliament. The right hon. Gentleman dreamed of coming to the House to remonstrate about an NHS that was on its knees and that was not delivering for the public. He wanted to argue about waiting times, but they have gone down, with fewer people waiting a long time for an operation than at any time under Labour. He wanted to argue about treatments, but there are more people getting new hips and knees and many other treatments than under Labour. [Interruption.] Opposition Members should listen to this. He wanted to argue about cancer, but 23,000 people are now getting drugs under the cancer drugs fund that Labour refused to set up.

Today, the right hon. Gentleman has tabled a motion criticising the decisions taken by the coalition and my right hon. Friend the Member for South Cambridgeshire (Mr Lansley) on NHS spending in our first two years in office. This is also about how we spend the money, as many of my hon. Friends have said. What are the decisions that the right hon. Gentleman is criticising? They are precisely the decisions that mean that the NHS is now performing at record levels, and vastly better than at any time under Labour.

Let us look at those decisions. There was the decision to reduce the number of managers by 7,000 and transfer resources to the front line. There was also the decision to cancel Labour’s disastrous attempt to embrace the technology revolution that cost billions and set the NHS back by years. Then there was the decision to end the wasteful consultancy spend, which has now been cut by 39%. [Interruption.] The right hon. Gentleman needs to listen to this. There was the decision to stop the scandal of unsustainable private finance initiative projects that left the NHS with a £73 billion debt and £1.6 billion-worth of repayments every year. [Interruption.]

--- Later in debate ---

[Dame Joan Ruddock (Lewisham, Deptford) (Lab)]

Today’s debate centres on the Prime Minister’s broken promise to protect the NHS, which was expressed as a commitment to increase spending on the NHS year on year. That is not the only promise that he made. In opposition, he spoke passionately about retaining essential local services and named my local hospital, Lewisham, as one of the 29 hospitals that he would personally defend. Today we can offer him and the Secretary of State for Health that opportunity. The bottom line for NHS spending has to be the provision of safe, quality health care that meets the needs of the local population and is free at the point of need. Nothing is more important to the vast majority of our people.

The four tests that the Government have set for any local reorganisation proposals are: that they should have the support of local GPs; that they should have strong public and patient engagement; that they should be backed by sound clinical evidence; and that they should provide support for patient choice. Not one of those criteria has been met by the current proposals for Lewisham hospital by the trust special administrator.

[Mr Graham Stuart]

The right hon. Lady is speaking movingly about local services. Does she welcome, as I do, the £12.5 billion increase proposed for the NHS budget during this Parliament? Does she disagree with the right hon. Member for Leigh (Andy Burnham), who believes that such increases are irresponsible?

[Dame Joan Ruddock]

If the hon. Gentleman will be patient, he will discover that I find it impossible to see the increase. What I see on the ground are cuts, cuts, cuts. That is what I want to speak about today.

As I was saying, not one of those criteria is met by the trust special administrator’s proposals for Lewisham hospital. The TSA was appointed in July by the Secretary of State for Health to sort out the considerable financial problems of the neighbouring South London Healthcare NHS Trust. His remit required him to find tens of millions of pounds of savings from the services provided by the trust’s hospitals in Woolwich, Farnborough and Sidcup. That could not be done, so the TSA’s response was to grab a successful, solvent and highly regarded hospital, Lewisham, and propose to destroy it to raise money from the sale of two thirds of the site currently occupied by the hospital, a fact that was not even mentioned in the consultation document.

[Andy Sawford (Corby) (Lab/Co-op)]

My right hon. Friend will be aware that my constituents have similar concerns about the future of their local hospital in Kettering, despite assurances that changes are being driven by the best clinical advice and guidance and by clinical outcomes. Contrary to the unrecognisable picture described by those on the Government Benches, we know that the cuts in Kettering hospital’s services, which will affect my constituents in Corby and east Northamptonshire, are a result of a £48 million deficit that is a direct result of the Government’s policies. Does my right hon. Friend share my concern that this is about those cuts in funding rather than the clinical outcomes?

[Dame Joan Ruddock]

I thank my hon. Friend for his intervention. If all hon. Members are honest in providing a record of what is happening on the ground, we will see that the reality is, indeed, cuts and reductions in services.

It is a case of not only how much money we spend on the NHS, but how wisely we can spend it, and there may be agreement throughout the House on that. [Interruption.] I say to the hon. Member for Beverley and Holderness (Mr Stuart) that just four years ago, Lewisham hospital gained a new wing through a successful and affordable private finance initiative contract. Just two years ago, a state of the art new birthing centre was opened, and only in April of this year the £12 million refurbishment of the A and E department was completed.

Now, however, the trust special administrator proposes to close both the full A and E service and the full maternity service at Lewisham hospital. The consequence of closing the A and E department and replacing it with an urgent care centre means the closure of the intensive care unit, the coronary care unit and the acute medical and elderly medical services. Every year, more than 13,000 people benefit from those acute services, 4,500 babies are born in the maternity unit, and more than 120,000 people use the A and E department.

The proposals are, to be frank, catastrophic—they will remove vital services from a growing population of more than 270,000 people. This is an accountant’s solution to a problem that does not even exist in Lewisham itself. Not a single constituent, patient, GP or hospital specialist has come to me in support of the plans.

My colleagues, Lewisham hospital trust and I are not opposed to change aimed at greater efficiencies and higher standards. Indeed, that was the Labour Government’s policy and philosophy for the NHS all along. We know that closures of small hospitals have led to safer services. We know that paramedic services and blue-light ambulances taking people to highly specialised centres save lives every day. We also know that the NHS could be more efficient, but there is no evidence that the needs of Lewisham people for A and E or maternity services can be safely met elsewhere in south-east London. All other existing provision is full to capacity, and travel from most of Lewisham to Woolwich is highly problematic.

The TSA report is full of assertions and aspirations that are completely divorced from the realities of people’s lives in a borough that contains some of the most deprived wards in the UK. If the proposals were to go ahead, the 750,000 residents in the boroughs of Lewisham, Greenwich and Bromley would be dependent on a single A and E department. As the report says, hospitals are part of a bigger NHS family, which is why the Secretary of State must look at London as a whole. It cannot be just or sensible to try to find enormous financial savings to rescue one health trust by destroying another.

The public have had just 30 days to respond to the extraordinary proposals in what is a deeply flawed consultation process, but such is the anger that more than 32,000 people, including more than 100 local GPs, had added their names to a petition started by my hon. Friend the Member for Lewisham East (Heidi Alexander) by the time we presented it to No. 10 last Friday.

Last week the trust board of Lewisham hospital issued its response. It supports in principle the merger of Lewisham with Queen Elizabeth hospital in Woolwich, and I must say that that is worth considering, but the trust says:

“We are concerned that the financial modelling completed by the TSA team at pace will include errors that will work against financial viability of the proposed Lewisham Healthcare NHS Trust and Queen Elizabeth hospital reorganisation.”

That would simply repeat the history of the hospitals in the South London Healthcare NHS Trust that have had continuing financial problems.

The trust board goes on to say:

“The TSA process has made it impossible to have the engagement and involvement that proposals such as these would normally warrant, and our clinicians do not feel they have been listened to in this process.”

The rest of its submission to the TSA is entirely damning. It says:

“We do not believe there is a convincing case for the major change of services proposed in Lewisham. The TSA has overlooked the significant role that LHT provides in the broader provision of services to local people. The TSA recommendations will result in worse, rather than better, care for the people of Lewisham. We believe a health and equalities impact assessment would show this but has not yet been completed—a significant weakness of the TSA Report.”

When the Secretary of State comes to view the TSA’s report, whatever form it takes, I urge him also to review all of the evidence that has been presented by local people, local experts, local consultants, GPs and the hospital trust itself. As the local Save Lewisham Hospital campaign says, this is not a difficult decision for the Government—it is potentially a deadly one. I urge him to give the most careful consideration to what is being said. The criticisms are damning and we have absolutely no faith in the proposals that the TSA will put before him.