(10 years, 5 months ago)
Commons ChamberMy hon. Friend makes a good point, and I see nods on both sides of the House. We have a tariff system and there are extra needs in more vulnerable and deprived areas. The nonsense in accident and emergency services is that hospitals are criticised and penalised for treating too many patients when we have seen how GP appointment systems are breaking down. That goes back to the recommendation in the Francis report that NHS provision should be looked at in the round and in its entirety. The trust special administrator just looks at the detailed finances and the assumptions that underpin the finances. That is wrong, and that is what we should concentrate on.
Does the hon. Lady agree that there is a serious problem with acute tariffs that have generally been cut by 4% in real terms every year, and have been for some time under this and the previous Government, compared with the tariffs for elective cases that seem to result in much more profitable work for hospitals? The more acute care a hospital provides, which is vital for the local population, the less likely it is to be financially sustainable.
I agree, and in the many meetings that north Staffordshire MPs have had with the University Hospital of North Staffordshire, the hon. Gentleman has made that point, as we all have frequently. We have also said that it is incumbent on us to relay that to the Government, because unless there is a shift and some recognition that the funding assumptions are flawed, no matter who is on the trust board of any new hospital, they will never be able to provide the necessary genuine health care.
(10 years, 7 months ago)
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I thank the hon. Gentleman for his intervention and I entirely agree with him. I would see the situation more as two hospitals coming together, but it is vital that the financial difficulties that UHNS is facing are sorted out. I particularly urge the Government to look at the private finance initiative cost, which is too great for that particular trust.
I am most grateful to the hon. Gentleman for giving way and I congratulate him on securing the debate. May I point something out for the record, so that when the Minister comes to reply he can, hopefully, give cast-iron assurances about the financial input that will be needed for this reconfiguration to take place, addressing the issue that UHNS has identified—that the additional expenditure needed for service configuration is in the order of £28 million or £29 million, whereas the trust special administrator has said that only £13 million would be needed? Also, the trust special administrator has proposed a cost improvement programme of 8.5%, whereas Monitor has said that anything above 4.5% is dangerous. We need a very clear, detailed calculation and input from the Government as to how these extra costs will be met, also taking on board the issue about PFI.
I thank the hon. Lady for her intervention and I entirely agree with that point. There is no point in Stafford’s merging with Stoke if the consequence is that we have a trust that will be financially failing in the future.
The administrators rightly place emphasis on the need for swift action, and I believe that the dissolution of MSFT in the autumn of this year should be possible—indeed, it should be possible even earlier. In fact, I would go further. MSFT has improved greatly in recent years following the huge failings brought to light through the vital work of Cure the NHS and documented in the Francis report. Its recently published hospital standardised mortality ratio figures were the best in the west midlands, but it is fragile and finds it difficult to recruit in some areas. We need the overall arrangements to take immediate effect, even in shadow form. In recent weeks I have detected less engagement than is necessary, because of the uncertainties of the administration process. That needs to stop.
This is all taxpayers’ money. It is our national health service. It is time to work together.
(11 years, 1 month ago)
Commons ChamberAs usual, my hon. Friend makes a powerful point—that this debate is not just about a relatively small district general hospital, because it will have ripple effects. We have a pretty efficient national health service, but it does run on tight margins, so that if we take one acute hospital out, it could have effects right across the whole region. Local clinical commissioning groups have a vital part to play, and I want to pay tribute to the good work they are doing in developing community services in Stafford.
The third element of co-operation comes from Monitor itself. Under the Health and Social Care Act 2012, Monitor now has responsibility for setting tariffs, including those for emergency and acute services. It would be rather strange if Monitor were to continue the programme introduced in 2009 of constant 4% year-on-year real cuts in tariffs, and then be forced to pick up the pieces of acute foundation trusts around the country that fall into deficit as a result of the tariff cuts it has made. Monitor has the chance to challenge the assumption that acute services can continue to squeeze out annual efficiencies—in some cases, and not just in Stafford—of up to 7% a year, while elective services enjoy a relative feast.
Monitor has the opportunity to ensure that the necessary changes to the provision of acute services are done in such a way that will allow acute services to continue to be provided locally. Monitor itself could become an excellent example of joined-up government, and in doing so carry out its legal requirement under section 62 of the Health and Social Care Act 2012 to promote the
“provision of health care services which…is economic, efficient and effective, and…maintains or improves the quality of the services.”
Finally, the national Government have a vital role to play in co-operation.
I am most apologetic about arriving late to this debate and not having the opportunity to hear the opening part of the hon. Gentleman’s speech. To find a long-term solution for health care in Mid Staffordshire and in North Staffordshire, it is vital that the Minister refers in his reply to the best way of ensuring that the emergency services and all the other services that people want can be retained. That can be achieved only if we have a proper collaboration between the University hospital of North Staffordshire, which must be at the front of—