NHS Funding (York and North Yorkshire)

Julian Smith Excerpts

Wednesday 7th January 2015 Westminster Hall

[Julian Sturdy]

I entirely agree with my hon. Friend. Given the rurality of the whole of North Yorkshire, which I mentioned at the start of my speech, we know that providing health care services is difficult and expensive. That is part of the argument for why the funding formula must be adjusted. At the same time, it must be more cost-effective to deliver services in people’s homes and offer more accessibility. Nevertheless, as my hon. Friend will know from the situation in her constituency, it is important that we also keep small hospitals open and accessible. I know that that is an important issue in the constituency of my hon. Friend the Member for Skipton and Ripon. This debate is all about ensuring that we have a fair formula so that we can deliver those services.

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

On that point, when we are here in London it is difficult for people fully to comprehend the distances involved for both patients and their families in North Yorkshire. The local provision from the hospital in Ripon and Castleberg hospital in Settle in my constituency is valued really highly by families and patients alike.

[Julian Sturdy]

My hon. Friend is absolutely right that that is fundamental to a fair health care system and to fair health care for all. Through this debate I want to show how important that is for our area. We need a fair funding system that can deliver health care across not only York and North Yorkshire but the whole country. We must ensure that areas such as York and North Yorkshire do not suffer while others benefit. That is why we must get the funding formula revised.

Returning to IVF, the treatment now offered by Vale of York CCG does not help those who have been denied access to treatment, as have many people in my constituency over many years. They have either paid thousands of pounds privately or are now past the eligible age criteria for access to IVF. Despite that welcome news from the CCG, people living in our area had no access at all to IVF treatment for some time.

Alongside certain procedures that have been denied to many of my constituents, another area that has really felt the strain is A and E, which has hit the headlines in the past 24 hours. I wholeheartedly welcome the Government’s £700 million increase to the NHS budget to deal with well-known winter pressures. That shows the Government’s foresight: they knew that the issue was looming and so put that money in. Nevertheless, altering the funding formula would also help areas that are constrained by their budgets, because A and E funding ultimately comes through CCGs.

Finally, I want to turn to the controversial issue of clinical exceptionality and the impact that it has had on several of my constituents. Where a treatment is not routinely commissioned by the local health authority, clinicians must submit individual funding requests on behalf of their patients, which are then decided by a special panel. In order to achieve funding, the GP is required to prove that their patient is clinically exceptional from the referenced population. Or, to put it more plainly, they must be suffering more than other sufferers of the same condition.

That is, just as it sounds, an extremely difficult task for already busy GPs. It also results in an extremely tragic situation wherein a small group of people who suffer with a rare condition slip through the net and do not receive the treatment that their doctors feel that they need. Their condition is too rare for the particular treatment to be routinely commissioned, but not rare enough to prove that they are clinically exceptional and therefore eligible for individual funding.

One young constituent of mine suffers with severe gastroparesis, as well as diabetes. His devastating condition effectively prohibits his stomach from doing the job that it is supposed to do. As a result, he feels almost permanently nauseous and vomits up to 30 times a day. His clinicians believe that the most effective treatment for him is to have a gastro-pacemaker fitted at a cost of £25,000. That may seem like a lot of money, but as my constituent is unable to work and his mother has had to leave work to care for him, the cost to the state is far greater each year. The alternative treatments that he currently receives, such as morphine, also come at great cost to his health and well-being.

I have been working for some time on behalf of my constituent and alongside his clinicians to try to obtain the necessary funding for the treatment he so badly needs. The most frustrating thing for him is to know that other patients under the same clinicians, who do not suffer as badly as he does, are being accepted for funding because they live in areas that do much better out of the existing formula than York. Sadly, I fear that the lack of funding in our area is causing the individual funding request panel to interpret the rules of clinical exceptionality much more rigidly than our neighbours in, for example, Leeds.

My nine-year-old constituent Ben Foy, of Strensall, has also been a victim of the deeply unsatisfactory situation. Ben suffers with narcolepsy and cataplexy after having the swine flu vaccine, and he is known to fall asleep suddenly up to 20 times a day. Along with Ben’s family and clinicians, I have tried numerous times to obtain funding for sodium oxybate to treat his condition, but we were repeatedly told that we had fallen short of proving his clinical exceptionality.

To sum up, as it stands the funding formula is clearly causing a disparity in how health care is delivered across Yorkshire, as well as across the country. It is imperative that we move toward a funding formula that gives much greater weight to age and that recognises rurality and its associated higher cost of health care provision, while scaling back on the amount given for deprivation. We cannot continue to have, as was previously the case with PCTs, CCGs in the deprived areas of Yorkshire and the Humber receiving substantially more per capita and consistently under-spending their allocation, at the expense of CCGs in areas such as mine. Time and again, we are seeing patients being refused or pushed away from treatment because of the funding formula.

Ultimately, I accept that it is a difficult decision for the Government, the Department of Health and the Secretary of State. Along with colleagues, I have met the Secretary of State and Ministers numerous times to discuss the issue. As I say, I know that it is a difficult decision, but I fundamentally feel that we have protected the NHS budget during the past five years and we have seen more money go into the NHS over that time, which is the right thing to have done, but now we must ensure that we have a funding formula that backs that investment up and can deliver a fair health care system for all.