NHS: Targets

Lord Brooke of Alverthorpe Excerpts

Thursday 6th February 2020 Lords Chamber

[Lord Brooke of Alverthorpe (Lab)]

My Lords, I am most grateful to my noble friend Lord Hunt for such a great and devastating speech. He has great experience in and insight into the NHS, and he does not lightly make attacks without good foundation behind them.

To the noble and gallant Lord, Lord Stirrup, I say that we have been here before. In 1997, the health service was in a hell of a mess and the Labour Government were elected to try to put right some of the problems we had with declining public services. It was done. The Blair and Brown Governments reversed the decline, in part by introducing targets, which were very successful indeed in many areas. Regrettably, since 2010, both the coalition Government and the Tory Government, for a variety of reasons, have dismantled some of those targets and we have suffered as a consequence. We argued that it was the wrong thing to do when they took away the target for the time that doctors should see patients. The Government’s cover was that they wanted to extend the availability of surgery from five days to seven days, but of course there were no extra staff to do that. In turn, we said that people would wait longer to see their GPs than they had in the past. Is that true? Yes: everybody is now complaining about the difficulty of accessing a GP of their choice.

We now have the argument about A&E targets. The Government want to abandon them. Why? It is a bit like the five people who have been sent to prison giving the Government cause for a major examination of the funding of the BBC. Whenever we see these changes coming, there is an ulterior agenda behind them. I hope that I am wrong on this and that the Minister will put me right, as I am sure she will.

Problems have been arising in A&E where the Government could have taken action. Yes, they are trying to deal with more people and yes, more patients are going there who should be going to their GPs rather than to A&E, but also—here I am banging on about my favourite subject, as noble Lords will know—more and more people are going there with alcohol problems. This causes great stress and strain to the staff involved and, in turn, great pressure on the number of beds that they go to afterwards. All the statistics indicate that the issue has got worse since 2010. Only yesterday in the Times, there was a report about the rising number of people who have been taken in, particularly from age 45 upwards, who are drinking too much and then putting pressure on the service.

When we look at what the Government have done in this area, it can be argued that they have taken steps that have made matters worse. A regulator was introduced in 2008 to ensure that duties on alcohol went up on an annual basis linked to RPI. What did the next Government do? In 2012, they abandoned that. Year on year, the Government have in fact been freezing duties or, in some cases, even reducing them. Has that helped the case and the numbers of people who are being affected by alcohol? No, it has made matters worse. Statistics show that beer duty has been cut by 18%, spirits and cider duty by 10% and wine duty by the low figure of 2%, so overall, we have lost £1.2 billion a year in income for the Government that could have been going into the NHS because of those changes. So who are the beneficiaries, and why? At the end of the day, the public have to pay for the people who end up in A&E and in hospital.

I hope that the Minister will be prepared to say something about this and the importance of campaigning on the public health side, which we have not mentioned greatly. I believe that changes in lifestyle need to be addressed more seriously than we have done in the past. I know that there is a Green Paper coming on that and I look forward to having a debate on it. In the meantime, urgent action can be taken. Can she persuade the Chancellor in the forthcoming Budget not only to restore the duty calculator linked to RPI but to add 2% to that figure? If she does that, we will start to see fewer people ending up in A&E and fewer people who work in the health service being unhappy, and we will have a healthier and happier community.