NHS (Government Spending)

Liz Kendall Excerpts

Wednesday 28th January 2015 Commons Chamber

[Liz Kendall (Leicester West) (Lab)]

It is a pleasure to close the debate. There have been some passionate speeches from Members on both sides of the House who are really standing up for care for their constituents. My hon. Friend the Member for Islington South and Finsbury (Emily Thornberry) talked about the excellent joined-up care provided by the Whittington hospital, which I was privileged to visit, and the excellent work of Islington council, which is still funding social care for people with moderate needs and ensuring that all its home care staff are paid the London living wage, including for travel time.

My hon. Friend the Member for Bishop Auckland (Helen Goodman) talked about the terrible problems with long ambulance service waits, and my hon. Friend the Member for Heywood and Middleton (Liz McInnes) talked about the difficulties with the Arriva patient transport service, a problem I have in my constituency, where there have been some appalling lapses in the quality of care.

My hon. Friend the Member for Barrow and Furness (John Woodcock) talked about the huge financial problems facing his trust, and made a powerful case for its uniqueness in terms of its geographical position and transport links, such that it needs to be looked at seriously in future. My hon. Friend the Member for Kingston upon Hull North (Diana Johnson) expressed concern about financial irregularities in her trust, which I hope we can get to the bottom of. My hon. Friend the Member for Easington (Grahame M. Morris) did not get much time to speak, but I agree with him that the NHS, perhaps more than football or cricket, is what makes us proud to be British.

Our NHS faces huge challenges: our ageing population; the increase in people living with long-term conditions; drugs and medical technologies advancing at incredible speed; and public expectations changing rapidly too. Meeting these demands, when the NHS faces the tightest financial settlement of its life, requires a Government who are laser focused on ensuring that all our services get the best results for patients and offer the best value for taxpayers’ money.

In practice, we know that this means that some services must be provided in specialist centres, so that patients get expert treatment 24/7. Others must be shifted out of hospital into the community and towards prevention, to help people stay living at home. All services—physical, mental and social, across hospitals and in the community—must be properly joined up and personalised, so that people have the right care, at the right time, in the right place. We also need bold action on public health to prevent long-term illnesses such as diabetes, obesity and heart disease from developing in the first place and to ensure that the NHS is sustainable in future.

In the light of those huge challenges, what did the Government do when they took office in 2010? They focused not on reforming front-line care, but on forcing through the biggest backroom reorganisation in the history of the NHS, wasting three years and £3 billion of taxpayers’ money. Ministers promised that they would cut bureaucracy, but instead they created 440 new organisations—not just NHS England, 221 clinical commissioning groups and 152 health and wellbeing boards, but four regional NHS England teams, 27 local area teams, 19 specialist commissioning units, Public Health England and Health Education England, and that is obviously alongside Monitor and the Care Quality Commission. It is a system so confusing that no one knows who is responsible or accountable for leading the changes that patients want and taxpayers need to ensure that the NHS is fit for the future.

Ministers promised that their reorganisation would save money, but £1.4 billion has been spent on redundancy payments alone, and more than 4,000 people who were made redundant have since been re-hired elsewhere in the system. They promised to cut the costs of management consultancy—indeed, the right hon. Member for South Cambridgeshire (Mr Lansley) specifically promised that those costs would be reduced by 46% by 2014. Instead, these costs have soared as hospitals and CCGs spend good money after bad to try to make sense of the new system. Last month, the British Medical Journal revealed that NHS spending on management consultancy has not been cut by 46%; it has increased by 100% to £640 million. That is enough to run three medium-sized hospitals or employ 20,000 extra nurses.

But the Government’s disastrous reorganisation does not even stop there. It is still going on. Primary care is being reorganised again because NHS England has finally realised that it cannot commission effective local GP services at a national level—just as Labour warned. Specialist commissioning is under review because NHS England has lost grip of the budget and realised that patients need specialist services that are joined up with local care—just as Labour warned. Support for GPs in their commissioning role is being reorganised too, with commissioning support units forced to merge and then—get this!—bid to be on a list of approved organisations, including private companies, that are allowed to sell their services back to the NHS. It is a Kafkaesque nightmare of incompetence and chaos written by the Conservatives and signed by the Liberal Democrats.

As if all this was not bad enough, Ministers have made the pressures on the NHS even worse by cutting the services that help to keep people out of hospital and living at home. They shut one in four walk-in centres, scrapped the 48-hour GP waiting target, and removed Labour’s incentives for evening and weekend surgery appointments, so more people are forced to turn to A and E. They slashed social care budgets by £3.5 billion, so fewer older and disabled people get vital help to stay living at home. They cut over 2,000 district and community nurses, who help elderly people get back home from hospital and prevent people with long-term illnesses from ending up there in the first place.

What is the result? More sick, elderly people in A and E, and more patients stuck in hospital, often for weeks or months at a time, when they could be cared for back at home. Over the past 12 months, delayed discharges from hospitals have cost the NHS £280 million. This could have paid for 6,500 nurses or a year of decent home care for 40,000 people. Where on earth is the sense in that? More patients are stuck in hospital, more people are forced to wait longer for treatment, and more planned operations are being cancelled. Patients are in distress, families are struggling, and staff are under intolerable pressure.

Patients, staff and taxpayers cannot afford another 99 days of this Government, let alone another five years. They need Labour’s long-term plan for investment and reform, with an extra £2.5 billion a year, on top of this Government’s plans, to get the doctors, nurses, midwives and home care workers we need. We will join up physical, mental and social care services from home to hospital, with one team and one point of contact, to get families the support they need. We will introduce a year of care budget to create a powerful incentive for better home and community services, to keep people out of hospital, and to tackle the scandal of 15-minute home care visits. We will give more power and control to patients, with new rights to swifter cancer tests, better GP access, talking therapies and care at home. We will end the zero-hours contracts that exploit social care workers, so that elderly people finally know who is coming through their front door every morning and staff can properly plan their lives.

At the next election there will be a real choice on the NHS. It will be a choice between care going backwards, services fragmented and money wasted under the Conservatives, or Labour’s plans to fully integrate services to get the best results for patients and the best value for taxpayers’ money. It will be a choice between the Conservatives, whose Prime Minister has broken his promise to protect the NHS and thrown the system into chaos, or Labour, who will make the real investment and reforms the NHS needs to meet the challenges of the future. It will be a choice between the Conservatives’ unfunded plans to cut taxes for the wealthiest and make even deeper cuts to social care, or Labour’s fully funded proposals and 10-year plan to ensure that the NHS is sustainable for the future. I commend the motion to the House.