NHS Outsourcing and Privatisation

Karen Lee Excerpts

Wednesday 23rd May 2018 Commons Chamber

[Jonathan Ashworth]

My hon. Friend makes the point well. I believe about 50 walk-in centres have closed and there are another 50 whose future has been reviewed.

[Karen Lee (Lincoln) (Lab)]

Lincoln’s walk-in centre was closed. A consultation was undertaken by the clinical commissioning group and 94% of those who responded did not want the centre to close. So what did the CCG do? It closed it.

[Jonathan Ashworth]

I thank my hon. Friend for her contribution. I know that she, as the relatively new Member for Lincoln, will be campaigning for the future of health provision in her constituency.

The response of the Prime Minister to those cancelled operations this winter was to shrug her shoulders and say, “Nothing is perfect,” but by the end of the winter reporting 185,000 patients, often elderly, vulnerable and in distress, had been left waiting in the back of an ambulance or treated in a corridor for more than 40 minutes. We do not have a crisis in our NHS just in winter; we have a crisis all year round. Since 2010, we have seen a reduction of about 16,000 beds, including more than 5,000 acute beds and nearly 6,000 mental health beds—that is almost 20% of them. Among equivalent wealthy countries, only Canada and Poland have fewer doctors per head, and only two countries have fewer beds per head.

A report today in The Guardian details how old and out of date the equipment is in hospitals because infrastructure budgets have been raided. According to the OECD, we are bottom of the league for the provision of CT and MRI scanners. Meanwhile, as my hon. Friend the Member for Worsley and Eccles South (Barbara Keeley) has pointed out, eight years of multi-billion cuts to social care provision have decimated the sector and have denied 400,000 people, often the elderly and the vulnerable, the support they would otherwise get.

Years of pay freeze, and failure to invest in and plan properly for the workforce, have meant vacancies for 100,000 staff, including vacancies for 40,000 nurses, 3,500 midwives and 11,000 doctors. In the past two years, we have lost more than 1,000 GPs. In our communities, we have seen district nurses cut by 45%. We have lost more than 2,000 health visitors in two years. We have lost nearly 700 school nurses. There are 5,862 fewer psychiatric nurses and 4,803 fewer community health nurses than in 2010, and the Prime Minister’s hostile environment has meant the Home Office has turned down visas for at least 400 staff.

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[Mr Hunt]

The hon. Gentleman makes a fair point, which would be echoed by many Government Members who represent rural constituencies. There is a balance to be struck between the benefits of specialist surgery, where greater volumes of a particular procedure are done, leading to better outcomes for patients, and the trade-off that we make with travel times. I know that that is something that the local NHS, in all parts of the UK, thinks through very carefully.

There is another myth we always get from the Labour party that I think it is very important to dispel: the narrative about the NHS being in total decline. Let us be clear about the pressures facing the NHS. We had to deal with the financial crisis of 2008, which left this country’s coffers empty. We have had to deal with the fact that over the last seven years, we have had half a million more over-75s. We had to deal with a crisis of care at Mid Staffs, which turned out to be a problem affecting many other parts of the NHS.

Yes, it is true that we are missing some important targets at the moment, but let us not forget the extraordinary things that have been achieved despite that pressure, such as for cancer. We inherited some of the lowest cancer survival rates in western Europe. In 2010, only 10% of patients got intensity-modulated radiotherapy; that figure is now 44%. We have two new proton beam therapy machines—at the Christie and University College London Hospitals—and there are 7,000 people alive today who would not be had we stayed with the cancer survival rates of 2010. Every day, 168 more people start cancer treatment than did in 2010. This is a huge step forward.

On mental health, previously we had no national talking therapy service for people with anxiety and depression; today, 1,500 more people are starting or benefiting from talking therapy services every single day, and we have huge plans to extend mental health provision to 1 million more people.

[Karen Lee]

Does the Secretary of State think it acceptable that ambulances were waiting outside Lincoln A&E for up to seven hours over the winter? Is that a mark of progress?

[Mr Hunt]

No, I do not think it acceptable at all, but I would ask the hon. Lady to bear it in mind that we have 2,000 more paramedics than we did in 2010 and that we have invested in a huge amount of capital equipment for the ambulance services. Of course we need to do more, but, when she talks about A&E, she should recognise the achievements of many hospitals, including her own. Every day across the NHS—even over this difficult winter—2,500 more people are seen within four hours than were in 2010.

Labour seems to think that quality problems in the NHS started in 2010. I should point out that because of what we have done to deal with the problems of Mid Staffs, which happened on Labour’s watch, including through the new Care Quality Commission regime, 2.1 million more patients every year benefit from good or outstanding hospitals than did five years ago. A couple of weeks ago for the first time the majority of hospitals in the NHS were good or outstanding, which is a huge step forward and a huge tribute to NHS staff. That might be just one reason the Commonwealth Fund last year said that the NHS was the best healthcare system in the world. When Labour was in office, it was not even the best in Europe.

There is another reason to oppose the motion. It has nothing to do with health policy, but is a much bigger point of principle. After more than five years in this role, the one thing I have learned is that good policy can be made only through frank and open discussion between Ministers and officials. It will not surprise the House to know that Ministers are human, we make multiple mistakes—not me of course—and it is critical that the Secretary of State in charge of the largest health system in the world can get honest, high-quality advice, but the motion would fundamentally undermine that.

This is not a party political point. Many Labour Members have benefitted from such advice, and all of us would want Ministers of any party in power to benefit from such advice, regardless of whether we support the Government, yet the motion asks us to release not just that written advice from officials, which would have an enormous chilling effect, but notes of confidential discussions between Ministers and officials. In short, as my right hon. Friend the Member for Aylesbury (Mr Lidington) said only last week, it would undermine the safe space within which Ministers and civil servants consider all the options and weigh up the best approach. Officials must be able to give advice to Ministers in confidence. The candour of all involved would be seriously affected if there were any fear of those discussions being disclosed.

No Government of any party have ever operated in an environment where advice is sought one week and made public the next. Let us look back to what Andy Burnham said in 2007 when he as a Minister was asked to release information. His words were:

“Putting the risk register in the public domain would be likely to reduce the detail and utility of its contents. This would inhibit the free and frank exchange of views about significant risks and their management, and inhibit the provision of advice to Ministers.”—[Official Report, 23 March 2007; Vol. 458, c. 1191.]

Far from increasing the accountability of the Executive to the legislature, releasing such information would risk weakening it, as more and more discussions would end up taking place informally with no minutes taken at all.

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[Karen Lee (Lincoln) (Lab)]

After eight years of the Government’s austerity agenda, the NHS is on its knees. People in Lincoln commonly wait hours for an ambulance, including those having a heart attack. If a Health Minister happens to be in Lincoln any time soon, they might want to ask about that, because call-to-balloon times for PCI have increased. I am not scaremongering—that is the truth. I am sorry, but I will not pretend that—pardon the pun—everything is rosy.

Although the austerity experiment has been discredited by various economists, we have not seen a halt or a reversal of the underfunding and privatisation of our NHS. With the NHS approaching its 70th birthday, the Government are not providing it with the funding and resourcing it desperately needs. Despite the Government telling us that they are putting record amounts of money into the NHS, compared with countries such as Germany and France, we spend a considerably smaller percentage of our GDP on healthcare.

The latest King’s Fund research confirmed the bleak picture of the policies of the past eight years. The NHS has among the lowest levels of doctors, nurses and beds in the western world. This is not scaremongering; it is the reality of the past eight years’ effect on the health service. I am sorry if people do not like hearing it, but it is the truth. The question should not be why the NHS does not perform better compared with other countries, but rather how the NHS copes under immense pressure when it is so under-resourced. Remember, this is at a time when the Government are prioritising tax cuts for the wealthy and for large corporations.

Deregulation under the Health and Social Care Act 2012 is a stain on this country’s long respect and support for our NHS. There is no role for the private sector if the NHS is fully resourced. Outsourcing has led to nearly two thirds of clinical contracts being won by non-NHS providers. The NHS should not be a cash cow available to the highest bidder. The financial pressures on the NHS have forced some firms to leave the market, while others search for short-term cheap fixes to deliver contracts, which ultimately impacts on patient care.

It is clear that the Government have a not very well hidden agenda: slash, trash and privatise. Underfunding, with little sign of change over the past eight years, only raises the question: do the Government actually want a nationally run service that provides free healthcare to all, free at the point of service? My constituents, after the closure of our walk-in centre—against the wishes of 94% of people who said they wanted it to stay open—are not convinced. The sustainability and transformation partnerships, wholly owned subsidiaries and accountable care organisations are all a ploy for their ideological goal: the backdoor privatisation of our service.

I have seen that at first hand from the hospital floor as a nurse. Instead of just words of praise for those working in the health service—praising nurses sounds really cheap, you know, as if Conservative Members can take some sort of credit for it; it is their hard work, not yours—why not provide them with the resources to do their job properly? Rewards come with actions, not just words.