NHS Funding

Liz Kendall Excerpts

Wednesday 12th December 2012 Commons Chamber

[Liz Kendall (Leicester West) (Lab)]

During this debate, Ministers and the few Government Members who have spoken have either denied that the Government have broken their promise to increase NHS spending or have claimed that it does not matter, as if the Prime Minister’s clear, direct and personal pledge to voters can easily be swept to one side. They—perhaps with the exception of the hon. Member for Southport (John Pugh)—have also skated over or ignored the waste, confusion and utter distraction of their back-room NHS upheaval.

In contrast, Opposition Members have talked about the harsh reality of the double whammy of cuts and reorganisation on their constituencies. My hon. Friend the Member for Lewisham East (Heidi Alexander), my right hon. Friends the Members for Lewisham, Deptford (Dame Joan Ruddock) and for Rother Valley (Mr Barron), my hon. Friends the Members for Corby (Andy Sawford), for Bolton West (Julie Hilling) and for Easington (Grahame M. Morris), and the hon. Member for Strangford (Jim Shannon) spoke powerfully about their concern that changes to local services are being driven by money alone, not by improving patient care. I also pay tribute to my right hon. Friend the Member for Cynon Valley (Ann Clwyd), who spoke with bravery and compassion about the unacceptable standards of care in parts of the country, which must be tackled.

Perhaps the most worrying example of the combination of cuts and reorganisation that the Government are forcing through involves what is happening to cancer networks. Those groups of local specialists were set up more than a decade ago under Labour’s 2000 cancer plan to help tackle one of Britain’s biggest killers. It is widely acknowledged that cancer networks have played a central role in improving mortality rates, cancer survival rates and equality of cancer care, and they have done that on small budgets with few staff, offering good value for taxpayers’ money. Crucially, the specialist local skills of cancer networks are vital to making even greater improvements that cancer patients need and deserve in the future.

Ministers have repeatedly promised to protect budgets for cancer networks. On 31 January last year, the then Health Secretary told the House that

“cancer networks funding is guaranteed during the course of 2011-12.”—[Official Report, 31 January 2011; Vol. 522, c. 612.]

On 27 November this year in a debate on the NHS mandate, the new Health Secretary told the House:

“Cancer networks are here to stay and their budget has been protected.”—[Official Report, 27 November 2012; Vol. 554, c. 127.]

Those promises have been broken.

In response to a freedom of information survey from Labour, cancer networks report budget cuts of 13% in 2011-12 alone—[Interruption.] The Secretary of State shakes his head but he can look through all the figures, including individual examples, if he wants to see those cuts. In total, budgets have been slashed by 26%—by a quarter—since the Government came to power.

The Government’s national cancer director, Professor Mike Richards, at least has the honesty to say that

“cancer networks will have a smaller proportion of the budget in future.”

I understand that the Health Minister in the House of Lords, Earl Howe, has also been forced by an urgent question to admit that less money will be available to cancer networks.

[Mr Jeremy Hunt]

Will the hon. Lady give way?

[Liz Kendall]

I will, of course, give way to the Secretary of State.

[Mr Hunt]

First, these networks are brilliant. They are a good thing and they have done a huge amount. The Government support them and we are expanding them. That is why instead of just having cancer, cardiac and stroke networks, we will also have networks for dementia and maternity. The budget for those networks is going up by 27%.

[Liz Kendall]

The budget for cancer networks has been cut by a quarter. The Secretary of State is not expanding those networks but merging them and diluting their specialist expertise, as I will show. The cuts and the Government’s NHS upheaval mean that cancer networks have lost one fifth of their staff, withdrawn or scaled back current work, and put future projects on hold—[Interruption.] The Secretary of State is still denying that so let me tell him what the networks actually say.

The Arden cancer network in Coventry and Warwickshire says that it has lost its vital chemotherapy nurse. The Peninsula cancer network in Devon and Cornwall says it has had to turn down £150,000 from Macmillan Cancer Support to fund a programme for cancer survivors because its future is so uncertain. Essex cancer network says that posts have been removed, its staff are in a redeployment pool, and that it will have

“no presence in Essex from April 1st next year.”

Instead of supporting those vital local experts, as well as specialists in heart and stroke networks, the Government are merging them into 12 generic clinical networks that cover bigger geographical regions and far more health conditions. No one is against sharing the skills and experience of cancer and cardiac networks. However, as Maggie Wilcox, a former palliative care nurse, breast cancer patient, president of Independent Cancer Patients’ Voice and the layperson on the recent review by the Department of Health into breast screening said,

“subsuming cancer networks into generic clinical networks could be disastrous for cancer patients…you cannot be both a specialist and a generalist.”

That is especially important in an area as complex and fast-developing as cancer. Staff will not be able to make the same depth or scale of improvements if they are forced to cover a large area and more conditions with fewer members of staff.

The Secretary of State ploughs on regardless, denying that there is a problem and telling BBC Radio 5 Live that it is too early to know what will happen. How utterly complacent and out of touch. Networks are already disappearing. Their staff have left or are looking for jobs because their future is in such disarray. With their reckless NHS reorganisation, the Government have wasted not just taxpayers’ money but the knowledge and expertise of specialist staff, and patients are paying the price.

[Mr Hunt]

With respect to the hon. Lady, we have increased the budget for strategic networks by 27%. What would have happened to that budget if we had a lower NHS budget, as her party’s Front Benchers have been arguing for?

[Liz Kendall]

I do not think the Secretary of State understands that in a really complex and fast-developing area such as cancer, we need to know about individual, specific issues and concerns. If there are fewer staff covering bigger areas and more health conditions, we will not get specialist expertise.

If the Secretary of State does not believe me, perhaps he would like to comment on what Dr Mick Peake, the clinical lead for NHS cancer improvement and the national cancer intelligence network, has said. He has stated:

“With the shift towards GPs commissioning, the need for this expert…clinical advice will become ever more crucial…I am worried that in the process of reorganisation of the networks…we will lose many expert and very committed individuals, and that this could impact on the quality of commissioning and cancer services in the future.”

What will be the impact on patients, who are what the network is supposed to be about? Let us take prevention. Who has championed prevention by increasing the uptake of screening programmes? Cancer networks. Who trains GPs to spot the signs of cancer so that patients get earlier diagnosis? Cancer networks. Who has helped patients get their tests and scans done in days, not months, and slashed waits for cancer specialists to two weeks? Who has helped hospitals compare their performance, use the best drugs and treatments and transform patient information and support, and who has been central to setting up the new national cancer outcomes database, which the Government rightly say will help reduce cancer variations and drive improvements in future? Cancer networks. So why is the Secretary of State diluting—[Interruption.] Oh, now he switches to talk about the cancer drugs fund, because he knows that by stripping away vital local expertise, he is putting care at risk.

When the Secretary of State tells Radio 5 Live that he does not know why Labour is flogging this issue, calls cancer networks a mere pilot and says that his upheaval will be in patients’ best interests, cancer specialists, patients and Opposition Members know that he is wrong. We know that he cannot sustain the progress on cancer and make even more improvements in future when he is ripping away the foundations of better cancer care. As Earl Howe has just told Members of the Lords, it is “perfectly correct” that the share of the pot that cancer networks will be able to get will be smaller next year than it is this year. I rest my case.

The Prime Minister said that he would increase spending on the NHS, but NHS spending is lower in real terms today than it was when Labour left office—broken promise No. 1. Health Ministers repeatedly claim that they have protected cancer network budgets—broken promise No. 2. No top-down NHS reorganisation, mental health a priority and social care budgets protected—broken promises three, four and five. The list goes on. The Prime Minister claims that his priority can be summed up in three letters—NHS. That very same organisation is responding with its own three letters—SOS. I commend the motion to the House.