Capita Contract (Coventry)

Karin Smyth Excerpts

Tuesday 8th November 2016 Commons Chamber

[Mr Geoffrey Robinson (Coventry North West) (Lab)]

I thank the Speaker for granting this debate. It is timely, because while the issue has been raised by local GP practices and their senior managers in Coventry, I am well aware, following a gracious call from the Minister’s office and given the presence of other hon. Friends, that the problem has a wider significance and that it has echoes in many other parts of England, at least. I thank Jane Moxon and others who came to see me—all very senior practice managers in Coventry. They alerted me what is evidently a growing problem throughout the country.

The Minister, who is aware of the situation emerging across the country, kindly asked whether she should address the wider issue, or concentrate on Coventry. The topic of the debate is the impact on patient care and the health service in Coventry of the privatisation of the thoroughly well-executed existing service for GPs in our area. The same thing is happening in other areas, however, and I will be very happy to give way to my hon. Friends. Sufficient time is available—not that I want to detain you unnecessarily, Madam Deputy Speaker, or the Minister or other Members, but if there is interest, I am sure that we can accommodate others, such as my hon. Friends the Members for Coventry South (Mr Cunningham) and for Coventry North East (Colleen Fletcher); all three Coventry Members are properly on parade this evening to take part in the debate.

The position was very simply summarised by the senior practice manager from Broomfield Park, Jane Moxon, when she came to see me. She acted as chair for the group, and still does. Warwick University is in the same position: students from the EU face the loss, absence or lateness of their patient records. Allesley Park hosted our meeting; Kevin Arnold is the practice manager there. They have all alerted me to the fact that GPs are simply unable to do their job without having their patients’ records to hand.

An excellent manual service was provided under the national health service, but the Government were taken in by the lure of apparent savings and the prospect of cutting 40% from a £1 billion bill, and they contracted the work out to Capita, of all people. Only last week, we saw what could happen in the absence of a properly thought-through privatisation programme. These contracts are gaily handed out to companies that do not have the skills, preparation or sheer commitment necessary to provide the service.

[Karin Smyth (Bristol South) (Lab)]

I am grateful to my hon. Friend for initiating this debate. I have been contacted by my GP practices in Bristol South about this issue. In a previous role, I worked in a commissioning group and I have employed GPs. The arrangements for doing that are very complex, requiring specialist local knowledge and a lot of experience. Does he agree that the decision to put the entire service out to a national tender was driven by a desire to make massive wholesale savings, and that the savings target completely ignored the service need locally? Does he also agree that we are in a very poor situation across the country? I hope that the Minister can address that point.

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[Mr Robinson]

I entirely agree with every single word my hon. Friend says. I would add, by way of a warning, that it is not a question of trying to punish the private sector by making it pay for this. Capita has to put the necessary resources into trying to correct the problem, and that must be its first priority. Something must give in the drive for profit, the drive to cut the costs of the services and the drive to improve the services. Those are irreconcilable objectives to start with, and in rectifying them the first thing that has to go is the drive for profit. Capita must realise that when it comes to put this right, it has to put the resources behind that. Compensation for GPs is important—I do not disagree with my hon. Friend for a minute on that—but I put it secondary to the provision of resources to get the contract right. I am sure that she would agree.

One other aspect of this shows an unacceptable, unpleasant and displeasing aspect of the privatisation process. It appears—I do not know this first hand—that Capita has turned to CitySprint to deliver these things. The effect of that is that we are employing drivers with no contracts, no sickness benefits and no breaks. This continual turning of the screw downwards is leading to a low-wage, low-productivity, low-output and impoverished economy. The workforce is suffering from that and it seems to be characteristic in many areas. For the public service to be involved in that process and almost to accelerate it, tightening that screw, is unacceptable.

This is another aspect of the commitment to negotiation and to the evaluation and validation process. The Government must learn to consider the quality of the service being provided and the quality of the means by which they intend to provide that service. CitySprint does not measure up to the standards we would expect from a good public sector contractor or employer.

To return to the main theme of tonight’s debate, what do we learn from this? The Government—principally the civil service, but Ministers, too—must learn to evaluate and validate the process of contracting out services. They cannot be driven by short-term savings, which are invariably illusory, but must consider the quality of the underlying contract. That is an art that must be learned, but I think it can be.

[Karin Smyth]

My hon. Friend is being generous with his time. I do not know whether he is aware that the Public Accounts Committee recently held an evidence session on the contract awarded to UnitingCare in Cambridgeshire. Many of the issues he has rightly outlined about the scoping of such contracts and expertise within the NHS were highlighted, particularly as regards whether the expertise was there to do the sort of detailed and specialist work he mentions. Should that expertise be built back into the NHS, so that it can conduct those contracts in the spirit of good public service as opposed to yet more taxpayers’ money being spent on expensive external consultants?

[Mr Robinson]

We are ranging wide of the debate, but again I have to say that I entirely agree with my hon. Friend, and I saw something about that Public Accounts Committee hearing. That is absolutely right; the problem is getting these lessons learned by the Government. I do not know what it is; it is as if there is an institutional or cultural inhibition leading to resistance to doing the technical job properly. People can be brought in to do it, but—I think that this was my hon. Friend’s point—there is a wealth of knowledge and expertise about the health service in the NHS that needs to be released and employed. Being able to do that is the art of management.

That is my plea. Yes, we want to bash Capita tonight, but more than bashing Capita and hitting out at incompetence and inexperience in the civil service, the real point of tonight is to tell Capita it is in disgrace and needs to get this right. It is obviously a nationwide—an England-wide—problem and it is not just restricted to Coventry. Capita’s overriding No. 1 objective is to put it right. That is our message tonight: “Get your finger out, put it right. Put the resources into putting this whole problem right and do not go for the short-term solution.”

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[Nicola Blackwood]

The hon. Lady is absolutely right to raise the impact on GP services in recent weeks and months, and I will move on to that point later.

Capita has piloted a new way to move medical records. I think that is the pilot in west Yorkshire to which the hon. Member for Stretford and Urmston referred, but it was not a pilot for the overall Capita project. Capita assures me that ultimately it will be more reliable and secure by tracking the end-to-end movement of every record. It is piloting that approach in west Yorkshire and plans to be ready to roll it out nationally in March 2017. I am aware that some GPs were left short of basic supplies as a result, including syringes, and that they have had to source those from other suppliers at their own expense. NHS England tells me that it has reimbursed practices for any costs incurred from having to buy local supplies of needles and syringes.

I know that many of the hon. Members’ GP constituents have experienced frustration with Capita’s contact centre. I share those frustrations. Capita assures me that the contact centre has improved the way it responds to urgent queries by investing in more staff, improved processes and enhanced training. Capita is confident that these measures will deliver a quality service to customers. We will monitor its progress closely, including through meetings.

[Karin Smyth]

I am listening carefully to the Minister, and it is obviously reassuring to know that Capita, NHS England and the Minister are having these conversations at a national level. In those discussions, has any consideration been given to my point about the loss of local, specialist knowledge and expertise? Is any consideration being given to putting back some of those local arrangements, given the importance of primary care to the entire system?

[Nicola Blackwood]

I shall come a little later to the problems with the existing system that meant it needed to be replaced. However, the hon. Lady’s point about the value of institutional knowledge, especially among NHS workers and personnel in other roles, is very important. They have been engaged in a lot of consultation processes as we try to put this issue right with NHS England and Capita. If the hon. Lady writes to me, I will be happy to give her more detail.

I also expect Capita to address issues with the courier service. I am aware of several steps that have been taken to ensure that all practices receive regular collections and deliveries. Both NHS England and Capita have taken steps to demonstrate that they are committed to restoring their reputation and re-establishing a quality service, and I am encouraged to see them working in partnership to do so. That said, I recognise that GPs, and ophthalmologists in particular, have suffered financial detriment as a result of late processing of payments. NHS England is working with Capita to explore what can be done to support affected stakeholders, and I have made it clear to Capita that I expect it to consider compensation as an option.

Some have suggested that the old model for provision of primary care support should be reinstated, but we must remember that it relied on localised services that did not connect with one another, with much duplication across processes. The quality of these services varied greatly—in some areas, it was outstanding; in others, it was quite poor. That was simply unsustainable. Furthermore, the system was unable to generate useful management information and so, honestly, issues such as the ones that we now face would be very unlikely to have surfaced. They would have gone unreported.

A new model, with efficient and modernised processes, is the right approach to deliver to our primary care providers the service that they deserve. The Department and I will continue to closely scrutinise Capita and NHS England as they work to resolve current problems and build a quality service that is sustainable. I acknowledge fully that there is a long way to go before the service can be considered acceptable and that Capita has much to do to earn the trust of practitioners and patients.

This is clearly a live issue. I want to be clear today: I am listening. The issue is at the top of my priority list and will remain there until I am satisfied that an efficient and effective service is being delivered that meets the needs of patients and providers.

Question put and agreed to.