NHS Funding

Kevin Barron Excerpts

Wednesday 12th December 2012 Commons Chamber

[Mr Kevin Barron (Rother Valley) (Lab)]

I am sorry that the Secretary of State is leaving because, before going on to discuss what is happening in my local health community and local hospital, I want to pick up on a couple of the things that have been said. First, I am pleased that this very dry motion has been tabled because I hope that it will concentrate our minds on what is happening in the national health service and, in particular, to spending.

The Secretary of State said that spending is related to budgets. He did not respond to the point posed by my right hon. Friend the Member for Leigh (Andy Burnham) that in 2010-11, there was a £1.9 billion underspend in the national health service budget. No use was made of the budget exchange scheme, so none of that money was moved into the following financial year. We can assume that £1.9 billion went back to the Treasury.

In the following year, 2011-12, the underspend was £1.4 billion, and £316 million was carried over into 2012-13. An underspend in the region of £3 billion from the first two years of this Government—including the year they won the general election—has gone back to the Treasury. Those are the facts; I do not know if any Front Bench Member wishes to dispute them.

[The Minister of State, Department of Health (Norman Lamb)]

Does the right hon. Gentleman also acknowledge that the average underspend in the last four years of the Labour Government was £1.9 billion?

[Mr Barron]

I recognise that there has been underspend, but I take this debate, and the debate we had running up to the general election, a bit more seriously. The chairman of the UK Statistics Authority said that there had been an underspend, and what we have just heard is not true. As my right hon. Friend the Member for Leigh (Andy Burnham) said, the Conservative party manifesto stated:

“We will increase health spending in real terms every year.”

[Mr Graham Stuart]

Will the right hon. Gentleman give way?

[Mr Barron]

I will give way in a few minutes. When the Conservative party was in opposition, the current Prime Minister said in 2009:

“With the Conservatives there will no more of the tiresome, meddlesome, top-down re-structures that have dominated the last decade of the NHS.”

I want to keep reminding hon. Members of that because, as my right hon. Friend the Member for Leigh pointed out, we may be able to take £20 billion out of a budget over four years—that is a big ask and has never been done anywhere in the public or private sector—but to do it while we are also having mass reorganisation is creating chaos in the health service. I will refer to what is happening in my local health service in a few minutes.

In 2007 the right hon. Member for South Cambridgeshire (Mr Lansley) was shadow Secretary of State for Health, although he has now moved to Leader of the House. He said that the NHS needed

“no more top-down reorganisations.”

Indeed, in terms of expenditure the coalition agreement stated:

“We will guarantee that health spending increases in real terms, in each year of the Parliament, while recognising the impact this decision will have on other departments.”

It also stated:

“We will stop the top-down re-organisations of the NHS”

so we can take that with a pinch of salt as well.

[Mr Graham Stuart]

rose—

[Mr Barron]

I will give way to the hon. Gentleman before I move on to what is happening to the NHS in the real world.

[Mr Stuart]

Like my right hon. Friend the Member for Charnwood (Mr Dorrell), the right hon. Member for Rother Valley (Mr Barron) is a former distinguished Chairman of the Health Committee. My right hon. Friend rightly said that spending on the NHS is broadly flat, and that the most important question we should be debating, rather than scoring points over 0.1% of spend, is how to use the money most effectively. Does the right hon. Gentleman agree with that, and that we must look at the allocation of spend around the country? I represent a rural area and it does not seem as if funds are fairly allocated now.

[Mr Barron]

The issue of allocation has been looked at by many Select Committees, including by the Health Committee when I chaired it in the last Parliament. We did not find the level of unfairness that people, particularly those from rural areas, used to say there was. We looked for it but we did not find it.

Let us look at what is happening in the real world. My local Rotherham hospital foundation trust is not a bad hospital trust in any way and scores quite well in many areas. It received foundation trust status a number of years ago, and when this Government took office, it is fair to say that the efficiency factor was there already. On 16 March 2011 the trust announced that more than 60 jobs were to be axed at Rotherham general hospital, and confirmed a potential reduction of 62 posts in medical and surgical areas. Earlier this year on 6 March 2012, the local BBC announced that more than 70 NHS staff were facing the threat of redundancy, and the trust is seeking to save about £4 million. On 26 October 2012, an internal report given to the local media stated that the trust now intends to cut 750 jobs—about 20% of its work force—by 2015.

The NHS trust said that it needed a smaller hospital with substantially fewer beds and a smaller work force to save £50 million over the next four years. The internal report—aptly named, “Creating Certainty in an Uncertain World”—said that it was necessary to save £50 million from the £220 million budget before 2015 to meet Government targets. That was confirmed by the trust in a press release.

On 5 November 2012, the chief executive of the trust said that it would show staff the plans and invite them to come back with alternative views on how things might be done differently. The trust stated:

“We’ve made it very clear that there may have to be redundancies, but to be honest with you until we have gone through the process, I don’t know how many we will be able to lose through natural turnover and how many will have to be made redundant.”

What type of planning is there in any of this when we have such a situation in a district general hospital on which about 80% of my constituents rely if they have to go into secondary care?

On 20 November 2012, the chief executive announced his retirement. On 3 December 2012, the hospital announced that staff will be informed about the decision to postpone the formal consultation launch into work force restructuring. It went on:

“We realise this an anxious time for all members of staff, but it is imperative that we do what is right for the Trust, our staff and our patients. This means that we need to take more time to ensure our workforce proposal is exactly what the Trust requires and we anticipate the launch to take place later in the month.”

On 7 December 2012—last Friday—a headline in the local newspaper stated that the trust had recently engaged the services of a director of transformation on a time-limited basis. The acting chief executive said:

“It is important that the trust acts quickly to take the action required to safeguard the future clinical and financial sustainability of the Trust. This appointment, which was made after a competitive process, is required to provide additional expertise and impetus to the changes we need to make, whilst allowing others to remain focused on delivering the healthcare services that the people of Rotherham need and deserve.”

I do not stand here and support the way the NHS has been structured now or in the past, and I have been critical about many areas of that. I agree with the chief executive of the NHS, David Nicholson, who said at the NHS confederation conference this year:

“We need to change the model of care to one which supports patients and focuses more on preventing ill health from happening in the first place...and move away from the default position of getting someone into a hospital bed.”

At the same conference the then Health Secretary said that closure decisions were not an issue for national politicians, and my right hon. Friend the Member for Leigh said that the current Health Secretary said very much the same thing—“It’s nothing to do with me, guv.”

Let me say to the Minister, and other hon. Members who have made relevant interventions, that if changes and reconfigurations inside the national health service are getting better care to more patients, that is fine. However, the chaos in my local health service is about cutting back and saving money. I have played an active role in health care in my constituency over many years and, as far as I know, there has been no debate with local Members of Parliament, patients, patient groups, local doctors or people engaged in health provision in Rotherham. There have been no discussions whatever about reconfiguring the district general hospital to improve the position of patients and of the people of Rotherham and the surrounding area. Instead there is a drive to save money, which is creating chaos in my local health service.

[Norman Lamb]

Does that not demonstrate a complete failure at local level to address the real problems that we are trying to grapple with? There is therefore a case for a changed system whereby a health and wellbeing board brings all the parts of the system together to debate such issues.

[Mr Barron]

The events of the past two months suggest to me that the people in whom the Minister has faith to reorganise health care in Rotherham do not know what they are doing. They have brought in new systems and produced a report inside the hospital, which I understand was given to the trade unions. It ended up on the front page of a local newspaper and was countered by a press release by the hospital itself. Where is the debate about improving health care for my constituents and others? It is absent.

I say to the Minister that it was wholly wrong for the previous and current Secretaries of State—he is not the Secretary of State himself, but we never know, he may be one day—to say “These are not matters for Ministers”. I have not been consulted about them. The three local MPs had an appointment with the chief executive of the trust about two weeks ago, but it was cancelled because he had announced his retirement the week before. That is not acceptable.

The hard reality on the ground is that no matter what we would like to happen in health care, trusts are charging into cutting budgets. They are cutting jobs, because that is where the major expenditure is in health care, and that is creating the chaos that I have described. It is not acceptable. My constituents pay their taxes to pay for health care—it does not come out of the budget down here in Westminster—and they deserve better than what they are getting at the moment.