National Health Service

Lord Austin of Dudley Excerpts

Wednesday 21st January 2015 Commons Chamber

[Alison McGovern (Wirral South) (Lab)]

It is a pleasure to follow the hon. Member for Stevenage (Stephen McPartland). I listened carefully to his speech. He has very good taste in one respect—the football team that he supports. Although he praised the NHS staff—of course, the NHS staff I represent and speak to work incredibly hard; I pay tribute to them—in almost everything else he said, he could not recognise the glaring fact of the reorganisation being the root cause of some of the problems that we are seeing, and he was wrong in his assessment of the shadow Secretary of State’s contribution. The NHS is an extraordinarily important issue to us all. Opposition Members show great passion, as the hon. Gentleman did, and we would all pay tribute to the hard work of NHS staff. There is no difference between us on that point.

I commend the speech by my right hon. Friend the Member for Kingston upon Hull West and Hessle (Alan Johnson), who is not in his place at this moment. I was particularly moved by his recounting of the experience of his constituents—teenage girls suffering from mental health conditions. It is what the House of Commons should be there for, to allow us to hear his constituents’ voices in that way. I would hope that, in our debates on mental health, we can do much more to bring those problems in our system to the fore.

I want to talk about what I see as three possible solutions to the current difficulties and crises in the NHS.

[Ian Austin (Dudley North) (Lab)]

Vote Labour, vote Labour, vote Labour.

[Alison McGovern]

My hon. Friend makes an excellent point, but I want to outline some of the specifics that might be entailed by that position. I want to talk about three elements of changing the NHS that I take to be very important. One of them is pretty parochial, but the other two are terribly important for our whole country.

The first concerns a walk-in centre in my constituency. Not everybody in the House will be an expert on the geography of Merseyside and, specifically, the Wirral, though I know that everybody will appreciate how important it is that they learn about it. In my part of the world, our local hospital is quite far from those of us in south Wirral. There was a hospital in south Wirral called Clatterbridge hospital, which I was born in. Its emergency facilities closed many years ago; I think that I was almost one of the last babies to be born there. Services were moved up to Arrowe Park on the border of the Birkenhead and Wirral West constituencies. I well remember, when I was young, how far away Arrowe Park felt and, when members of our family were ill, what a long distance it seemed when getting there.

Under the previous Labour Government, with my predecessor’s support, Eastham walk-in centre was opened in south Wirral, near the Cheshire border. That walk-in centre has been a rip-roaring success. It treats people effectively. They can turn up at hours that are convenient, such as out-of-work hours. It is open at the weekends and until 8 o’clock at night on a weekday. I declare an interest as a parent of a young child who always seems to manage to get herself unwell at the most inconvenient times. Eastham walk-in centre has been there for us, and my constituents value it greatly.

Under the reorganisation, the new clinical commissioning group took over. In Wirral, we had a bizarrely complex structure of three federated CCGs for a population of about 350,000. Having three CCGs in Wirral was total madness. Twenty-five million quid was wasted on a reorganisation that nobody wanted and nobody voted for. The first thing the CCG wanted to look at was urgent care, and it put our walk-in centre under threat of closure. This is an incredibly important facility to the people of south Wirral. It brings the NHS to their doorstep. It totally changed the availability of out-of-hours facilities for people in my constituency. The CCG, in its lack of wisdom, thought it was just fine to say, “We’re not sure we need that. We can re-provide those services at GP surgeries, never mind whether they are open at a convenient time.”

The CCG never went through with those proposals, and rightly so. Since then, however, there has been a constant threat and a worry in my mind about Eastham walk-in centre. I want to make it clear to the Minister that if there is any risk at all of that walk-in centre closing, he will receive representations from me pretty quickly, because it is an absolutely vital service. Unless we again conceive of the NHS as being there for patients and the public first and think about how to bring these facilities close to people, we will never get an efficient and effective service fit for the next generation. Walk-in centres are absolutely vital. It sends a chill down my spine to hear the shadow Secretary of State say that one in four has closed; if anything, we should be opening more.

Secondly, I want to talk about social care and older people. We all know that we have the benefit of an ageing population in our country. With an older population, we will have a more experienced and expert population. I take it to be a good thing that people’s grandparents and valued members of their family are living longer, but with that comes a responsibility to look after them properly.

I ask Ministers what has happened to the better care fund. What evidence is there that it has been used to find solutions that are really working? All I see on my patch is council cuts and then the consequences turning up at the door of the hospital. Older, more seriously ill people in our community are turning up at A and E, with the distress to them of being there, the consequential responsibility on staff and the worry for families as people lie on trolleys.

We need a much more radical approach. Integration is clearly the answer, but I would like us to go further: I want us to truly address the work force issues in social care. It is not good enough that poverty pay is endemic among those who look after the most senior members of our community. That is not acceptable; nor is the zero-hours culture. We once had that problem in child care, but as a country we took on the responsibility of changing the culture in the work force for the good of our children, and we must do the same for the benefit of our older people.

I will not speak for much longer, Mr Deputy Speaker, but I want to say something about mental health, which should be part of the strategic approach that we must take to change the NHS for the benefit of the next generation. Parity of esteem is of course correct and absolutely right. I take it that there is now cross-party consensus on that issue and that everyone in the House thinks that we should treat mental health as seriously as we do physical health, with no barriers to getting proper treatment. However, I want us to do something else: we need to recognise the interconnected nature of physical health and mental health. It is not just that we also need to treat mental health, but that if we sort out people’s mental health issues and conditions and empower them to live better and happier lives, they will have better physical health and will make better use of the NHS’s scarce resources.

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[Mr Simon Burns (Chelmsford) (Con)]

It is a pleasure to follow the right hon. Member for Manchester, Gorton (Sir Gerald Kaufman), although he would not expect me to agree with everything he has just said.

I listened to the right hon. Member for Kingston upon Hull West and Hessle (Alan Johnson) with considerable interest. One thing that struck a chord with me was when, at the beginning of his speech, he said, basically, that the NHS should not be a political football. I could not agree more. It does a great disservice to the people who work so hard—the doctors, nurses and ancillary staff—to provide health care for the citizens of this country, to see it turned into a party political football. Let me explain what I mean by a political football.

The Opposition have, of course, a democratic right to hold the Government of the day to account for their stewardship of the health service, as they do on education or anything else. Of course, every individual Member of Parliament, regardless of party, has a right to fight for the interests of their constituents with regard to health care if they feel that it is failing their constituents.

[Ian Austin]

Will the right hon. Gentleman give way?

[Mr Burns]

No, I will not, because I only have eight minutes.

What I decry, however, is when, in the generality, the health service is used to attack a political party, whether the Government or whatever, simply to try to score cheap party political points. That does a grave disservice to the NHS. As the right hon. Member for Manchester, Gorton said, people in this country love the health service. They believe in it, free at the point of use for all those who are eligible to use it. I, like I imagine millions and millions of taxpayers, have no objection to paying our taxes to have a free health service. To appropriate the four freedoms of Franklin Roosevelt, there is a fifth freedom: the freedom from fear of a medical bill dropping on one’s mat and financially ruining one’s family.

Where I see the greatest and, to my mind, the most disgraceful attack is in the accusation, which is not new—it was being made in 1979, and, I suspect, before then, but fortunately I am a bit too young to remember exactly—that the Conservative party wants to privatise the health service. We do not and we never have done. As long as I am a politician, and my right hon. Friend the Prime Minister is, we never will. I find it extremely aggravating and hurtful when this cheap shot is made.

One of the examples of privatisation given is the use of the private sector to improve and enhance the health care of our constituents. Let me just explain something. Over Christmas, I read an extremely good new book, which I strongly recommend to the right hon. Member for Leigh (Andy Burnham), if he has not already come across it. “Nye”, by Nicklaus Thomas-Symonds, is the new biography of Nye Bevan. It is a fascinating book, particularly the part about when he was the Minister for Health from 1945 to July 1948 and putting together and negotiating the creation of the NHS. It sets out the arguments he had with the medical profession and others, and the compromises he had to make to establish the NHS. Many people do not realise that even to this day, as a result of those compromises, 95% of GP practices are private small businesses. I do not decry that, because they are treating patients, under the national health service, free of charge.

Historically, a lot of mental health care has been free of charge, but provided by the private sector. In the 1990s, when I was a Health Minister, I remember John Major using the private sector to bring down waiting lists and waiting times for operations. My constituents had no problem whatever with that, providing it was free and kept to the core principle of the NHS. The last Labour Government, the Blair-Brown Government, were quite happy to use the private sector providing it was benefiting NHS patients.

The shadow Secretary of State kindly mentioned—albeit in passing—Chelmsford walk-in centre and suggested it was a great political scandal and the next bandwagon he was going to jump on. May I point something out to him? The walk-in centre was created from the dying embers of his stewardship of the NHS, in March 2010, to be run by a private company. I have no problem with that, if it is serving NHS patients. However, its sole purpose was to reduce pressures on A and E at the local hospital, and I am afraid it has singularly failed to do that. The use of A and E at Broomfield hospital, just down the road, has increased inexorably and, in that respect, the walk-in centre has failed.

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[Mark Reckless (Rochester and Strood) (UKIP)]

My party believes in an NHS free at the point of use and funded out of general taxation. I support much of what is in the motion today. I, too, would question what it states about outsourcing, as it is not quite clear whether outsourcing will be based on hypothecation in relation to how much the mansion tax raises or on how much the Conservatives happen to be spending. I believe we need to decide the right amount to spend on the NHS and then to commit to it, rather than simply say it should be £2.5 billion above however much the Tories spend—either cutting or increasing. We should make a decision about how much the NHS needs and then fund it properly. I support the principle of joining up adult social care with the NHS, and I thought that the shadow Secretary of State made a persuasive case for a single budget.

[Ian Austin]

What does the hon. Gentleman think it tells us about his leader’s instincts when he said:

“I think we are going to have to move to an insurance-based system of health care.”?

Moreover, what does he think it tells us about his deputy leader’s instincts when he said that he wanted to

“congratulate the coalition government for bringing a whiff of privatisation into the…National Health Service…the very existence of the NHS stifles competition.”?

Does that not prove that ordinary people who rely on the NHS cannot regard UKIP as being in any sense on their side?

[Mark Reckless]

It proves nothing of the sort. The hon. Gentleman faces a very strong challenge from UKIP in his constituency from the excellent Bill Etheridge MEP. The policy of our party—[Interruption.] No, let me answer the point. Our policy is determined by our party as a whole. We are committed to an NHS free at the point of use and funded properly out of general taxation. [Interruption.] May I continue? I personally come from a mother and father who met in the NHS; the NHS and supporting it is in my blood. I believe in the NHS as I have described it, and I would appreciate the courtesy of people accepting the sincerity of what I say on that.

I am pleased to see the shadow Secretary of State still in his place as he has been throughout the debate, but when it comes to funding the social care budget, it is a moving target to determine what that budget is. We know the local government settlement for the year ahead, but not for beyond that. We do not know what either a Conservative-led or Labour-led Government might be able to, or choose to, spend on local government, or what proportion might be allocated to public health budgets. It thus strikes me as a significant risk to say, without greater clarity, “This is what the budget will be, plus the sum of £2.5 billion”—the figure selected by the shadow Health Secretary and his party, irrespective of what the baseline is.

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[Ian Austin (Dudley North) (Lab)]

It is always a pleasure to follow the hon. Member for Stafford (Jeremy Lefroy).

I ask Ministers to look at the situation at Russells Hall hospital in my constituency. Like anyone who lives in Dudley, I queue up at Russells Hall when I am ill. I know how hard the doctors, nurses, midwives and all the other staff at the hospital work. Over Christmas, they battled heroically to tackle unprecedented demand in A and E. The chief executive herself pushed trolleys around as they fought off the crisis that has been seen in hospitals elsewhere. I place on the record my appreciation for all their hard work over these difficult weeks.

Last week, we had the shocking news that 400 of Russells Hall’s 4,200 staff—that is one in 10—will have to go, including 200 over the next couple of months. In common with other NHS trusts, the Dudley Group NHS Foundation Trust is required to make efficiency savings of 4% a year, which equates to £12 million each year. At the same time, the hospital is facing cost pressures that are caused by increasing demands on emergency services and the need to provide seven-day services. As a result, the hospital is predicted to face a deficit of more than £7 million by the end of March. I want Ministers to see what they can do to address that issue.

As a first step, the hospital is looking to make voluntary redundancies. Depending on how that goes, it might have to make compulsory redundancies. Like at any hospital, managers at Russells Hall have to ensure that every penny is spent wisely and that every possible efficiency is made before they cut staff and front-line services. People in Dudley agree with me: two-thirds of the hundreds of local people who responded to my survey this week think that front-line staff must be the priority. Community GP practices were their second priority.

Everyone agrees that savings should first be sought among management and back-office functions. However, even if every manager at Russells Hall was sacked—obviously, that cannot be done—it would not come close to the savings that the hospital needs to make. Instead, the redundancies that the hospital is making might include theatre staff, radiologists and staff who deal with things such as blood tests. Even some midwives will be able to apply for redundancy. The trust says that it will do everything it can to protect the service that patients receive, but no one can pretend that our hospital can lose almost one in 10 of its work force without it having an impact on front-line patient care. We just need to look at the pressures that they have faced over the past few weeks. How will they deal with a situation like that after losing so many staff?

Local people share my concerns. I asked thousands of them about this issue this week and 98% said that they thought care would get worse if the job cuts went ahead and eight out of 10 said that they were already noticing longer waits for treatment locally.

I have raised this issue in the House with Ministers before. I warned them last year that more resources were needed to deal with waiting times and with the deficit. I ask Ministers to look at this situation and to ensure that our hospital has the resources it needs to serve my constituents and not lose those members of staff.

My second point contrasts the current Government’s record with that of the previous Labour Government. The previous Government built a brand new £300 million hospital in Dudley, with more doctors and nurses treating more patients more quickly than ever before. Despite promising no top-down reorganisation, this Government squandered billions that should have been spent on front-line patient care—£20 million in Dudley alone—on a bureaucratic shake up. As a result, local people are facing longer waits at A and E, cancelled operations are at their highest level for decades and waits for vital tests and treatments are increasing. We need a Government who put patients in Dudley first. That is why I welcome our plans to tax homes worth more than £2 million to pay for 20,000 more nurses, 8,000 more GPs, 5,000 more home care workers who have time to look after the elderly and vulnerable people they care for, and 3,000 more midwives.

My third point—it is a shame the hon. Member for Rochester and Strood (Mark Reckless) has left the Chamber—contrasts our proposals with what UKIP has said about our NHS. Nigel Farage said:

“I think we are going to have to move to an insurance-based system of healthcare.”

His deputy, Paul Nuttall, said that he wanted to

“congratulate the coalition government for bringing a whiff of privatisation into the beleaguered National Health Service”

and that the

“very existence of the NHS stifles competition”.

That is what senior people in UKIP believe.

Just this week, Nigel Farage suggested that the NHS might have to be replaced by a system of private health insurance within 10 years and that his party will return to that idea after the general election in May. When I challenged the hon. Member for Rochester and Strood about that, he said that his parents met in an NHS hospital, as though that trumps what his leader and deputy leader have said about how the NHS should be organised. Utterly ludicrous. UKIP must be the only political party in history that, when asked about its policies, asks us to discount what the leader and deputy leader have said. It is completely nuts. The serious point is what it says about UKIP’s instincts and values that it wants to replace our NHS with a US-style insurance system in which the treatment and care someone gets depends on the cover they can afford, because that is what Nigel Farage’s plan would mean.

In the US, insurance can cost families up to £10,000 a year. It can cost almost £20,000 to have a baby privately, and treatment for a knee operation can cost £11,000. Imagine the crippling impact that treatment for life-threatening diseases or emergency treatment could have on the finances of an ordinary family in Dudley. Local people are overwhelmingly against that kind of privatisation, and nine out of 10 people told me in this week’s survey that they are totally against any introduction of a US-style health insurance system.

When I asked the hon. Member for Rochester and Strood about that, he mentioned my constituency and the forthcoming election. If he were here now, I would tell him that I will be telling people in Dudley what UKIP’s policy for our NHS would mean for them every day between now and polling day. When people in Dudley compare our plans for more doctors, nurses and care workers, quicker GP appointments and faster cancer tests and results with the Government’s plans for increased savings, longer waiting lists and redundancies, or with an insurance-based system and more privatisation from UKIP, I am sure they will know who is on their side.

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[Mr Stewart Jackson (Peterborough) (Con)]

Despite the £40 million structural deficit and a dodgy PFI deal that the right hon. Member for Leigh (Andy Burnham) shackled my local hospital to, in the past four years we have increased the number of nurses by 14% and the number of doctors by 9%. On the subject of apologies, would the hon. Lady like to apologise for her party’s dodgy £63 billion encumbrance of PFI off-balance-sheet deals that have been forced on my constituents and others?

[Ian Austin]

On a point of order, Mr Speaker. Is it in order for someone who has not been in the debate at all this afternoon to stand up and make these sorts of points during the wind-ups?

[Mr Speaker]

There is no breach of order; that is a matter of taste and judgment for individual Members.

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[Norman Lamb]

My hon. Friend makes a very good point. The Cornwall pioneer programme is doing the most amazing work making innovative change, involving Age UK alongside local doctors, and it is delivering real results.

Why does the Labour party make constant claims that the NHS in England is in crisis, when the position is so much worse in Wales, where Labour is in power?

[Ian Austin]

Will the Minister give way?

[Norman Lamb]

In a moment.

Why does the Labour party claim that the reforms are to blame when there has been no reform in Wales, yet the position there is worse? What people need and want is an open and honest debate about what should be done to secure the future of the NHS. The motion is about the pursuit of votes, not the interests of patients. If Labour Members—

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[Norman Lamb]

I apologise, Mr Speaker. The right hon. Member for Kingston upon Hull West and Hessle (Alan Johnson) spoke very candidly about the role of the private sector under the previous Labour Government, which the shadow Secretary of State constantly seeks to deny.

[Ian Austin]

Will the Minister give way?

[Norman Lamb]

No. I need to make progress, and I have very little time.

In a Guardian debate yesterday, in which I took part, Peter Carter, the respected chief executive of the Royal College of Nursing, spoke of the need for political consensus

“so that we stop this ridiculous points-scoring”,

which

“frankly is destructive and does nothing to enhance the quality of the debate.”

Let us take his plea on board. I have argued for a non-partisan review of NHS and care budgets this year —whoever is in power—which would engage the public. We should all commit to that.

Labour claims that it will increase funding, but its proposed way of doing so appears to be unravelling before our eyes. Lord Mandelson has described the mansion tax as “sort of crude” and “sort of short-termist”. In the debate, the hon. Member for Hackney North and Stoke Newington (Ms Abbott) cast doubt on how much the policy would raise.

Before I address the main issues, I want to pick up the remarks made by the right hon. Member for Kingston upon Hull West and Hessle, who raised important issues about mental health. He talked about the case of his constituent, Beth. It is intolerable that she has been shunted around the country. I have met the right hon. Gentleman, and I am happy to engage with him again. It is unacceptable for this to continue to happen. That is why there is an urgent need for children’s mental health services to be reformed, and our taskforce will soon report on the essential changes that are necessary.