National Health Service

Julian Huppert Excerpts

Wednesday 21st January 2015 Commons Chamber

[Alan Johnson (Kingston upon Hull West and Hessle) (Lab)]

Thank you, Madam Deputy Speaker. I will do my best to comply with your instructions.

As the Secretary of State was talking, my mind went back to the “responsible opposition” of the right hon. Member for South Cambridgeshire (Mr Lansley). I remember the efforts that went on for more than 40 years around Manchester to tackle the appalling level of infant mortality by reconfiguring maternity services. As the local newspapers said, that was stopped at every stage by politicians defending bricks and mortar. In the end, when that change went through, it was the Opposition who tried to reopen the issue. Before my noble Friend Lord Ara Darzi became a Minister, he did a very important review on London, where there were more single-handed GP practices than anywhere else in the country post-Shipman, and people attending A and E was a bigger problem than anywhere else. Lord Darzi put forward sensible proposals, which were agreed by clinicians and the NHS in London, but the right hon. Member for South Cambridgeshire opposed them. He issued an unfortunate press release about polyclinics—unfortunately, he spelt it “polly”, but it was not a clinic for parrots. I said to him, “Don’t adopt a policy that you can’t spell.” There are numerous examples of the previous Opposition doing that.

I bet I am not the only one in this House—I bet there are Members in all parts of the House—who rues the day when the right hon. Member for South Cambridgeshire got his hands on the NHS. His ideas for what to do, which culminated in the top-down reorganisation, were not new—I remember them from my first day as Health Secretary. He is not a bad man who hates the NHS, by the way. In many ways, he has great affection for the NHS, but he got things totally wrong. He slung across his draft Bill on what the NHS would look like after his top-down reorganisation. I read it that evening and it was horrendous.

The Government have done two things to erode confidence in politics in this country. The first is the Liberal Democrats’ conversion from opposing tuition fees to the extent that they wished to abolish them to supporting tuition fees to the extent that they agreed to treble them. The second is the Conservatives’ conversion from a pledge that there would be no top-down reorganisation of the NHS to the implementation of a top-down reorganisation so huge that, in the words of the previous NHS chief executive,

“you can see it from space”.

That is a vivid but not inaccurate description of a reorganisation that closed 170 organisations, created 240 new ones, made 10,000 staff redundant and re-employed 2,200 of them.

[Dr Julian Huppert (Cambridge) (LD)]

I will not highlight the right hon. Gentleman’s role in tripling tuition fees. The shadow Secretary of State said that, when he came into office—this is part of his defence— he got rid of the pro-privatisation agenda that he inherited. Who does the right hon. Member for Kingston upon Hull West and Hessle (Alan Johnson) believe the shadow Secretary of State was criticising in that comment?

--- Later in debate ---

[Dr Julian Huppert (Cambridge) (LD)]

It is a pleasure to follow the right hon. Member for Rother Valley (Kevin Barron). We have heard references to Nye Bevan and his amazing work in setting up the NHS. We should talk about Beveridge and his report, too. He was a good Liberal and he did that work during a coalition, albeit a somewhat different coalition that had come about for different reasons.

Let me start by looking at some issues that have arisen in my area of Cambridgeshire over the last month or so. There has been a number of winter challenges to be faced. Among them, I could talk about the ongoing problems with the ambulance service. The real problem that struck us was, I suspect, when the East Anglian ambulance service changed to the East of England ambulance service—and it has never recovered from that.

What has hit people most, I think, has been the problems at Addenbrooke’s hospital—a major incident took place, and a large number of operations had to be cancelled. I have spoken to the managers there and to many of the doctors and nurses. It seemed that there were two main reasons for the big problems. One was that Addenbrooke’s has been implementing the new e-hospital system—an exciting electronic records system that is the largest NHS IT project ever to be implemented. It is not as big as the one that was scrapped, but it was implemented. Although it will be a good thing when it is finally working, there have been many teething problems along the way and lessons that have to be learned. I suspect that other hospitals will want to learn from this: they should look carefully at the bad things, as well as the good things.

The other problem is the shortage of care wards, with delayed transfers of care. That has been a problem for a long time. Addenbrooke’s opened some new wards, but more are needed. I have been campaigning for some time to reopen some wards at Brookfields hospital, also in Cambridge, and I spoke about that in this place last year. I am delighted that, as of 9 February, these wards will be opened at Brookfields hospital. That is very encouraging. It is interesting to note that, in 2007, there were proposals to close down the entire hospital; I am delighted that we are opening up more wards instead.

We are trying to solve the problem for the long term through a new older people’s contract. This is the second-largest tender ever put out for the NHS, as it includes all the older people’s services in the county. I am delighted that the contract was won by the NHS—unlike the largest contract. The acute hospitals, the mental health services and the community work sector will all be working together to solve the problems we are having with things such as delayed transfers of care. That is the long-term fix for older people’s services in Cambridgeshire, and I hope it will be a model for other parts of the country to have a look at.

We have seen the news about Circle pulling out of the Hinchingbrooke hospital. This has been discussed in this place, and it is a shame that the shadow Secretary of State is not in his place, as it is always fascinating to hear him argue that he was in favour of the NHS bid led by Serco. I do not count Serco as part of the NHS, and I do not think that any Opposition Member would wish to do so.

[Andrew Gwynne]

Will the hon. Gentleman give way?

[Dr Huppert]

I will give way once on this issue.

[Andrew Gwynne]

I fear that the hon. Gentleman is, yet again, seeking to rewrite history. He will know that when my right hon. Friend the Member for Leigh (Andy Burnham) became Secretary of State, he changed the “any willing provider” policy to “NHS preferred provider”. That allowed Cambridge University Hospitals NHS Foundation Trust to become a partner of one of the three bidders. It was, of course, the Government whom the hon. Gentleman supports who signed the contract 18 months after the general election.

[Dr Huppert]

The hon. Gentleman ought to get his facts right. The Cambridge university trust put in a bid—it was the sixth last to do so—but then withdrew because the cost of the tendering process under the right hon. Member for Leigh was far too high. It did not have a partnership with Serco. The hon. Gentleman should check the facts and check the record. The trust was driven out by the tendering. The hon. Gentleman should also know that the bid to which I suspect he was referring was led by Serco. What he is saying, in essence, is that the current shadow Secretary of State had to undo the damage that had been done by previous Secretaries of State. That is a bit of Labour misery that I imagine Labour Members can sort out between them.

We know the history, and we know the problems that led to it: the Government had to decide between three private sector-led bids for Hinchingbrooke. What we must do now is work out what to do next, and I think we need to ensure that Hinchingbrooke stays in the public sector. Trying to remove it from the public sector in order to deal with the PFI problems, which was the original idea, simply has not worked. It must stay fully within the NHS.

Last year, before any of this happened, I led a debate about health in Cambridgeshire. I dealt with a number of issues, and I will not go into all the details now, but I spoke about health funding and, in particular, about mental health. I gave a number of detailed examples of some of the many challenges that we have faced and still face. For instance, huge cuts were made five or six years ago. During that debate, I called for a substantial amount of extra money, not just for Cambridgeshire—although I shall say something about that shortly—but for mental health throughout the country. Members in all parts of the House have made some excellent speeches about mental health, but it is not talked about enough. I find it regrettable that the motion does not mention it, and I suspect that a number of Members on both sides of the House do as well. Let us hope that we receive that extra money for mental health.

Cambridgeshire, however, suffers from a number of specific problems. We have been a test bed for experimentation for many years. We had the Hinchingbrooke experiment— the largest tender that the NHS has ever seen. We saw huge numbers of PFI projects not just at Hinchingbrooke, but at Peterborough. Paying off the NHS costs is still taking 18% of Peterborough hospital’s budget. That is only a small proportion of the 138 PFI projects that we saw under the last Government, the costs of which will amount to £11.7 billion over the next Parliament. That money could be used far more productively.

We have been hit hard by that, but we also receive very low funding. We inherited a formula from the last Government, and the process of changing it has been too slow under the present Government.

[Sir Hugh Bayley]

rose—

[Dr Huppert]

The hon. Gentleman can intervene if he wants to talk about why PFI is a great thing, but otherwise I will move on.

The Government have been too slow to move to the new formula, which properly takes account of ageing populations. We know that the elderly cost more in terms of health care. Cambridgeshire receives £961 per head, whereas West Norfolk, for example, receives £1,255. That is a huge difference. I asked for extra money during the debate that I mentioned, and I am delighted that we have managed to secure an extra £20 million as a result of the recent allocation. That will provide much more funding for mental health, on top of the extra £1.5 million that has been provided this year and the extra £2.2 million that will be provided for IAPT—improving access to psychological therapies—next year. That will make a big difference, and will reverse some of the challenges that we face.

We need that extra cash, but we still need more in Cambridgeshire and throughout the country. Simon Stevens called for an extra £8 billion by 2020, after savings and efficiencies had been taken into account. He said that an extra £8 billion, in real terms, was needed if the NHS was to keep going. I think that that is important, and we as a party think that it is the right thing to do. One of the problems with the motion is that it does not deliver what Simon Stevens has said is needed for the NHS. I am not all that keen to support the provision of less than a third of what is needed to keep the NHS going, especially after hearing from the shadow Secretary of State that, despite what the motion says, the money is not all for the NHS but constitutes the entire offer for the NHS and social care, which also needs its own funding. We need that £8 billion.

I voted against the Health and Social Care Act 2012 as I did not agree with much of it. There are some issues, such as parity of esteem, that are very good and that I hope will never be repealed. I also disagree, however, with many of the things that the Labour party did to bring in the private sector in some damaging ways, with people being paid for things that never happened.

The fact is, as was mentioned by the hon. Member for Brighton, Pavilion (Caroline Lucas), under the previous Government medical spending on private provision went from £1.1 billion a year in 1997 to £7.5 billion in 2009-10. That is a vast increase. I have no problem with people who say that they support that and that it was the right thing to do, but to suggest that that large increase was excellent for the NHS while the fact that it has continued at essentially the same rate under this Government is a disaster for the NHS strikes me as a rather bizarre claim.

I have criticisms of this Government, the previous Government and the one before that. I want the NHS to spend more of its time focusing on patients or, even better, avoiding the need for people to be patients in the first place. That needs a trained, motivated and well-paid staff—I think they should get the money from the independent review. It needs a focus on prevention and public health and proper funding—that is, the £8 billion by 2020.

[Paul Burstow]

On that point, does my hon. Friend agree that the better care fund, which is now being launched in April, is a key way in which we can deliver the joined-up care that he is talking about and that we need to have an ambition that by 2018 all CCG budgets, primary care budgets and social care budgets are in that pot?

[Dr Huppert]

My right hon. Friend is right, of course, and I pay tribute to him for the work he has done on this and on many other health measures. We must ensure that that integration happens so things work together and that is why token amounts such as a couple of billion pounds from the Conservatives, who need to go a lot further, and the £2.5 billion across health and social care from Labour—and by the way, please correct me if I am wrong, but according to The Guardian that is from 2017 onwards —will not go far enough. We need integration through the better care fund and we need that £8 billion. That is the proper funding that is needed.

Finally, we in this House ought to have a proper debate about how to fix problems and cut back on the amount of partisan bickering that happens in this place. That does not do us proud. We are all prone to it, including me. It is much better to talk about what we can do to promote health, whether it is physical or mental.

[Several hon. Members]

rose—