National Health Service Funding

Debate between Justin Madders and Angela Eagle

Tuesday 22nd November 2016 Commons Chamber

[Justin Madders]

Our manifesto was very clear that we would put in £2.5 billion immediately, plus whatever was needed. Indeed, research by the House of Commons Library has shown that if health spending had continued at the levels maintained by the previous Labour Government, there would be an extra £5 billion a year by 2020.

The NHS has deteriorated on every headline performance measure since the Health Secretary took office. It now faces the biggest financial crisis in its history, with providers reporting a net deficit of almost £2.5 billion last year. That deficit was covered only by a series of one-off payments and accounting tricks that do not disguise the true picture of a service that is creaking at the seams, of a workforce stretched to the limit, and of a Health Secretary in denial about his own culpability for this shocking state of affairs. While he rightly paid tribute to the work of NHS staff, he must know that when morale is so low, his platitudes are just not enough.

[Ms Angela Eagle]

I asked my sister whether Liverpool had had any input into the Merseyside and Cheshire STP. Obviously my hon. Friend represents part of the area that it covers, so can he tell us whether Ellesmere Port has had any involvement in the development of that STP?

[Justin Madders]

Only last week Cheshire West and Chester Council, which covers the Ellesmere Port area, put forward a resolution indicating that it was not satisfied with its level of involvement in the STP. Indeed, I do not think any council in the Cheshire and Merseyside area is satisfied, including even the Conservative-controlled Cheshire East Council.

Faced with an unprecedented crisis, what did the Secretary of State have to say for himself when asked by the Health Committee about investment in the NHS over the next five years? He said:

“Whether you call it £4.5 billion or £10 billion does not matter.”

Well, it might not matter to him, but it matters to people up and down the country who are desperately worried about the future of their local health services. This is not loose change down the back of the sofa. We know the Secretary of State will not accept what the Chair of the Health Committee said about giving a

“false impression that the NHS was awash with cash”,

so perhaps he will listen instead to the head of the National Audit Office, who said yesterday:

“With more than two-thirds of trusts in deficit in 2015-16 and an increasing number of clinical commissioning groups unable to keep their spending within budget, we repeat our view that the financial problems are endemic and this is not sustainable.”

Perhaps he will listen to the Nuffield Trust, King’s Fund and the Health Foundation, which in a joint statement released this week said:

“The Department of Health’s budget will increase by just over £4 billion in real terms between 2015/16 and 2020/21. This is not enough to maintain standards of NHS care, meet rising demand from patients and deliver the transformation in services outlined in the NHS five year forward view.”

Ministers need to stop trying to hoodwink the public, patients and even their own Back Benchers about the extent of the crisis engulfing our health and social care sector. Every day we hear more about a service crumbling as six years of underinvestment and cuts in social care and public health come home to roost. At the weekend, we heard about the Yorkshire ambulance service piloting a new scheme that might involve heart attack victims waiting up to 40 minutes to get an ambulance. Only yesterday, there were claims from GPs that very young and elderly patients are dying because of worsening delays involving 999 calls. Indeed, the most recent ambulance figures were the worst on record, but what did we hear from the very top of the Government about the NHS this weekend? The only comment we heard was one reportedly attributed to one of the Prime Minister’s assistants that they were going to “fix” Simon Stevens, the chief executive of the NHS, because he had dared to contradict the Prime Minister over funding. I have a suggestion: instead of trying to fix him for telling the truth, why do they not try fixing the NHS instead?

It is time to be honest about where we are and the true nature of the STPs, which are now finally starting to emerge. Let me be clear that we are not opposed to the idea of a more localised strategic oversight of the NHS and the health sector, but it is becoming increasingly obvious that these plans are putting money ahead of everything else. As the British Medical Association set out yesterday:

“There is a real risk that these transformation plans will be used as a cover for delivering cuts, starving services of resources and patients of vital care.”

The few documents released so far reveal cuts to hospitals, services, beds and, in some cases, staff. As we have set out previously, we are deeply concerned by the lack of public, political and even clinical consultation, with two thirds of doctors not having been consulted on the plans and a third of them not even aware that the STPs exist. What a shambles!

It is also clear that without adequate resourcing, these plans will not lead to financial sustainability, and the only transformation that they will deliver will involve reduced services and longer waiting times. If the plans are as wonderful and transformative as Ministers claim, why will they not let us see them? The secrecy and the deliberate instruction not to release any of the information relating to the plans has only increased concern and cynicism among the public. That was, I believe, a serious error of judgment that the Government will come to regret.

We therefore call on the Government to publish immediately the plans that are not already in the public domain. We also ask them to ensure that there is a full consultation process before any of the changes are implemented. Consultation with the public does not mean presenting people with a completed plan and asking them whether they support it; it means involving them from day one, and the bigger the change, the better it is to start the consultation early. We are already playing catch-up, but genuine engagement can start now.

As we heard from my hon. Friends the Members for Wallasey (Ms Eagle), for Garston and Halewood (Maria Eagle) and for Wirral West (Margaret Greenwood), there are major concerns about the Cheshire and Merseyside STP. My hon. Friend the Member for Wallasey identified the three fatal flaws in the STP process: it is more about finances than patients; it is secretive; and it is run to deadlines that make consultation impossible. Every Member who talked about the Cheshire and Merseyside proposals rightly expressed concern about the devastating effect that they might have on local services. It seems that just about every council in the area has rejected them, or has said that it has not been involved. Indeed, there has been very little involvement with anyone.

My hon. Friend the Member for Garston and Halewood produced what I think was the runner-up in the competition for the worst use of management speak when she quoted the phrase

“The financial component has been a strong driver”.

That is the nub of it—this is all about money. Ministers must stop trying to pull the wool over our eyes and be realistic about the extent of the crisis that is engulfing our health and social care sector, because not one serious commentator or senior NHS manager believes that the sector will be financially sustainable without additional funding.

The Nuffield Trust, the Health Foundation, the King’s Fund, Unison, the Health Committee, the Association of Directors of Adult Social Services, the Local Government Association, NHS Providers, the British Medical Association, the Joseph Rowntree Foundation, the NHS Confederation and Age UK are all calling on the Government to act urgently to address the funding gap. I do not know whether that list was long enough for the Secretary of State—he does not appear to be too hot when it comes to numbers at the moment—but there were a dozen respected organisations there. Will he listen to them? Will he implore the Chancellor not to repeat the mistakes of his predecessor, and to ensure that the health and social care sector is given the funding that it needs? This is the last chance before the crisis overwhelms us. I commend the motion to the House.