Health Care (North Yorkshire and York)

Julian Smith Excerpts

Wednesday 1st December 2010 Westminster Hall

[Julian Sturdy (York Outer) (Con)]

It is a pleasure, Mr Leigh, to serve under your chairmanship. Naturally, I am grateful to those hon. Members attending this debate and to the Minister.

More than 800,000 people are fortunate enough to live in our beautiful part of the country, the North Yorkshire and York region. It is part of God’s own county, as some would say. Quality of local health care is of the utmost importance to many, if not all. Local health care provision is often viewed alongside other criteria such as employment and crime. It is a measure of the local community’s economic well-being and happiness—a word that seems to be floating around in many debates at the moment.

It is in our moral and economic interests to ensure the widest availability of health services, the shortest waiting lists and the most impressive health outcomes, and they should be implemented in each and every region. Ensuring such health care standards for all is truly one of the most essential roles of Government. Indeed, I am sure that all those Members here today will agree that health-related concerns crop up frequently in our constituency mail. That is certainly so in my constituency of York Outer.

When it comes to health, I often have nothing but sympathy with the majority of my constituents who are affected. Many of them feel betrayed by the system, weighed down by the bureaucracy, frustrated by the delays and ultimately let down by those supposedly in charge. In my experience, it is easy to comprehend such frustration. After all, our national health service is a national treasure. We champion it, and rightly so. However, when patients report negative experiences and local health funding concerns, our national treasure is in danger of being tarnished, to the detriment of health care users and service deliverers. That, in my view, should not be allowed to happen.

The health service has some of the most caring, compassionate and hard-working nurses and doctors in the world. That is certainly true in North Yorkshire and York. Our health care personnel carry out tremendous work, often in tough circumstances, and they do so out of a sense of public duty, kindness and compassion. I cannot commend these individuals highly enough. However, I am concerned about health care provision in North Yorkshire and York because of the representations that I have received from NHS employees and local patients.

The region faces some real health care difficulties. In truth, extremely serious concerns are growing about the capability and performance of the region’s primary care trust and related bodies. Local residents have good reason to believe that a huge range of treatments will be withdrawn, if they have not been withdrawn already. For example, I have received letters regarding the future of IVF treatments, counselling services, broken voluntary sector contracts and the withdrawal of pain relief injections. It also appears that about £2 million will be cut from GPs’ budgets for prescribing medications, and that some physio services are at risk.

[Julian Smith (Skipton and Ripon) (Con)]

I congratulate my hon. Friend on securing this debate. He might be about to discuss this, but my experience from my constituency is that North Yorkshire and York PCT’s way of dealing with voluntary organisations in the past few months has been a disgrace, breaching the voluntary compact between those organisations and the PCT. It has caused problems for those important parts of the big society that have been operating in North Yorkshire for so long.

[Julian Sturdy]

Absolutely. I agree entirely with my hon. Friend. The time limit given by the PCT to those voluntary organisations is despicable, and it has caused fear and concern in the sector. Not only that, if the organisations lose funding for six months, which might be seen as only a short period, the problem is that they might not start up again. That is my concern, and I will go on to discuss it in more detail.

Local residents have good reasons to believe that a huge range of treatments will be withdrawn, as I said. If the truth be told, the status quo is not only unacceptable but frightening, particularly for the most vulnerable members of our communities. Even describing the current situation as a postcode lottery is too generous. I fear that our patch is in danger of becoming an area of health deprivation.

Several different factors require deep consideration as we piece together this somewhat depressing picture. First, we must accept that the region has to some extent been underfunded in the past. Before 2008, the North Yorkshire and York PCT did not exist. Instead, four separate PCTs covered the area. Nevertheless, for the purposes of this debate, I have amalgamated funding data to show the PCT’s current funding allocation and the annual figures stretching back to 2003-04. For 2010-11, our region’s PCT received just over £1.1 billion, an allocation that places it in the lowly position of 140th out of 152 PCTs. From a starting point of 127th in 2003-04, it has dropped down the funding table each year. The current funding level is the lowest allocation per head of all Yorkshire and Humber PCTs.

PCT funding is currently allocated according to a complex funding formula, often referred to as the weighted capitation formula. In essence, the formula determines the target share of resources to which PCTs should theoretically be entitled, based on a broad range of criteria including population, the local cost of health care provision and the level of need and health inequality in the area. Unfortunately, most PCTs never receive an allocation equal to their deemed target share according to the formula. Rather, they move towards it over time, some faster than others.

Personally, I am slightly critical of the current formula. It often results in greater funding disparities between different regions, which provoke a profound sense of unfairness. Less deprived areas often seem to get a certain tag as well. For example, according to the formula, North Yorkshire and York does not have adequate need for additional resources, particularly compared to the needs of more urban areas such as Hull. I am not convinced that approaching regional health funding consideration with that mentality—judging whether areas are deprived enough—is a sufficiently robust methodology in current circumstances. We must look more deeply at the funding stream.

I agree that the funding shortfall has increased the strain on our local PCT and its ability to deliver the best possible health outcomes and equity access for local residents. I would appreciate the Minister’s comments on whether the coalition Government will review the funding formula at some future date. However, I also suggest that excusing our health care failings in our region on past funding alone would be somewhat naive. Over the past few years, North Yorkshire and York PCT has accumulated an overspend of some £17.9 million. Thus, despite the coalition’s welcome commitment to protect the wider health budget, services are being cut in our region to pay for the fiscal irresponsibility of the PCT. Moreover, the PCT seems to be intent on resolving this deficit immediately because the previous Government imposed a statutory obligation on all primary care trusts to break even by the beginning of 2011. Such a target-focused piece of bureaucracy has now resulted in the PCT cutting too many services too quickly, possibly leading to a diminished health care package for our local residents.

I have already listed some of the services that are under threat of withdrawal. My hon. Friend the Member for Skipton and Ripon (Julian Smith) has named the services in the voluntary sector as well. I shall expand on a few examples. First, there is the withdrawal of the pain relief injections. As Members from neighbouring constituencies know—my hon. Friend the Member for Selby and Ainsty (Nigel Adams) has campaigned with me on this—the PCT’s decision to restrict the provision of back pain relief injections has provoked a huge reaction from both patients and health care professionals alike.