Health and Social Care

Lord Jackson of Peterborough Excerpts

Tuesday 2nd June 2015 Commons Chamber

[Andy Burnham]

The Conservatives are fond of saying that we did not fix the roof when the sun was shining, but I can tell the hon. Gentleman that we did fix the leaking roofs of hospitals and GP surgeries that they left behind, and we had to invest a significant amount to do so. When we came to office in 1997, more than half the NHS estate predated the NHS itself, and people remember those days. We had to put that right: we had to rebuild substantial portions of the NHS simultaneously by means of the PFI, which, I might add, was inherited from the Major Government.

[Mr Stewart Jackson (Peterborough) (Con)]

The right hon. Gentleman has clearly forgotten the patient records IT project—at £12 billion, it is officially the most disastrous white elephant IT project in British political and Government history—and the £250 million spent on independent sector treatment centres and on higher tariffs to private providers for operations not done, and the £63 billion on the private finance initiative. That is the record of the Government of which he was a part. Has he forgotten that voters made their decision on that record on 7 May?

[Andy Burnham]

I will tell the hon. Gentleman what I remember: I remember NHS waiting lists in 2010 being at their lowest ever level; I remember public satisfaction with the NHS being at its highest ever level; and I also remember leaving behind a financially solvent national health service. Let us look at it today: NHS waiting lists at a six-year high; cancer patients waiting longer for their treatment to start; A&E in crisis; and, as I said, a £1 billion deficit, and rising, at the heart of the NHS. That is the Secretary of State’s record, and a little more humility might not go amiss.

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[Dr Wollaston]

Absolutely, and I recognise and value the work that has been done. We also need to look at the skill mix across the NHS. It is unsustainable to deliver the commitments to primary care and to improve access to primary care unless we look further at the skill mix across the wider NHS. For example, we talked in Health questions about the use of pharmacists. The one area of the NHS where there is not any kind of workforce shortfall is in pharmacy, and that industry has much to offer to primary care. We also need to consider the role of physician associates and nursing assistants, and look at how we can diversify and provide better continuing professional development across the NHS. All those things will be important as we move forward.

[Mr Jackson]

My hon. Friend will know that in the previous Parliament the Public Accounts Committee expressed concerns about the use of clinical excellence awards for senior clinicians and the very high levels of senior management pay. It felt that they were incongruous when compared with the restraint shown towards lower- paid and more junior staff. Does she think that Select Committees such as her own—if she is re-elected to it—and Ministers need to look at that in the future?

[Dr Wollaston]

I thank my hon. Friend for his points. There is an important piece of work that can be done by the next Health Committee in looking at all the wider workforce issues across the NHS, including those to which he refers.

I shall now touch on seven-day access for the NHS. Such a service is vital, but we must focus on safety. The primary focus of seven-day access must be eliminating the unacceptable variation in mortality rates across the NHS on different days of the week. It is important that we address the issue of reducing avoidable and unnecessary hospital admissions. Perhaps the Minister could look at the frailty service in Newton Abbot which considers how GPs can work together to prevent unnecessary hospital admissions. If we broadened access to general practitioners at the weekends, we might be able to reduce unnecessary admissions to hospital, for example of children with asthma. There is much that can be done, but if we are prioritising providing 8 till 8 access in very rural areas there might be unintended consequences in general practice. If we are diverting funding into areas where we are providing a service in which several practices over a large geographical area have to federate, we could inadvertently end up with patients having to travel further than they would to visit a local out-of-hours service.

Will the Minister carefully consider the unintended consequences when we implement seven-day access to ensure that we do not divert essential funds that could be used for safety and avoiding unnecessary admissions into something that is worth while in theory but that might not give the best outcomes for patients? I hope that the Minister will be able to reassure me that the Government will allow local CCGs to look carefully at what is best, while consulting local communities, and to be as flexible as possible.

I also ask the Minister to consider the importance of volunteering across the NHS. In all our constituencies there will be extraordinary organisations that work as partners with the NHS, but I have some concerns, one of which I would like to share with the Minister. In my area, a wonderful charity called Cool Recovery worked with users of mental health services and their families to provide an extraordinary level of support. Sadly, particularly given that I was a patron of this charity, I have to report that it is having to fold for the want of a relatively small amount of stable long-term funding. The voluntary sector—those partner organisations across the NHS—is calling out for access to stable long-term funds. Newly set-up charities gain access to very valuable funding sources, but when they apply for funds once they are established, the response is that it should be provided by commissioners. I ask the Minister to consider carefully how we can sustain some of the extraordinary charities working across the country by giving them access to stable long-term funding so that they can carry on with their work. This issue was raised with the Select Committee by the voluntary sector during our inquiry into children and adolescent mental health services, so it is an issue across the NHS that is causing real problems.

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[Mr Stewart Jackson (Peterborough) (Con)]

It is always a pleasure to follow the hon. Member for Clacton (Mr Carswell), whose contributions are always very thoughtful.

One of the great lessons of the election campaign for the Labour party in the context of its leadership election is that it will have to look at its past and its future in respect of the NHS. The general election tested to destruction the idea that it is possible to repeat the claim, “24 hours to save the NHS,” without a proper, well thought out and coherent policy for our national health service. The irony is that in many respects there is consensus across the parties on the big issues that the national health service will have to face in the next 10 or 20 years, including demographic and societal changes that are above party politics.

That apart, given the very challenging fiscal inheritance of 2010, this Government did an extremely good job on the NHS. We were committed to making those savings while at the same time driving up clinical numbers. My own trust has a 13% increase in the number of nurses and a 9% increase in the number of doctors and carries out 850,000 operations each year. Allowing for inflation, £5.5 billion was put into the NHS under the previous coalition Government. Important issues that had previously been neglected were also addressed, including giving parity to physical and mental health, reducing the stigma and encouraging local clinicians, commissioners and providers to treat people with mental health issues in exactly the same way as they would treat people with physical ailments.

Yes, we had problems with the A&E target, but I am very proud of what we did on, for instance, the cancer drugs fund, an initiative that received cross-party support and which has affected hundreds of thousands of people positively.

We made savings. I accept that very difficult decisions had to be taken on staff salaries, and in my intervention on my hon. Friend the Member for Totnes (Dr Wollaston) I made the point that there is an incongruity between what we are asking people lower down the skill base in the NHS to take and what we are awarding senior managers and, through clinical excellence awards, senior clinicians. We need to sort that out.

A lot of nonsense is spoken about the Health and Social Care Act 2012, but it has set in stone the ability to make incremental savings while protecting front-line clinical services and put into the driving seat local clinicians who are best placed to make commissioning decisions. I welcome the £8 billion funding commitment, and I particularly welcome seven-day-a-week GP access, which the coalition Government pioneered. I know that we will have the support of Her Majesty’s Opposition and other parties on that.

The better care fund is welcome, although the Government should think again about the collaborative work that needs to be done with the Local Government Association—I declare an interest as a vice-president of the LGA—to try to fund the gaps. We will make long-term savings and drive up productivity, which will affect all our constituents, only by properly integrating acute health services and GP and primary care with social care. That is extremely important.

On dementia, prior to this debate we received a very useful and comprehensive briefing from Alzheimer’s Research UK. We need to build on the Prime Minister’s challenge on dementia by making improvements in dementia diagnosis and providing better care. I pay tribute to the work undertaken by Peterborough Dementia Resource Centre in the Millfield area of my constituency. It is important that we also encourage dementia-friendly cities and towns throughout the country.

There are other issues that we must address urgently. My right hon. Friend the Secretary of State made the use and cost of agency staff a central issue that will inform NHS policy under the Conservative Government. That is vital. It is not an easy issue to deal with, but we must grasp the nettle now if we are to protect front-line services.

On private finance initiatives, unfortunately my acute district hospital trust officially has the most indebted PFI settlement in the country—and, I have to say, the worst and most disastrous. Peterborough and Stamford Hospitals NHS Foundation Trust has a £40 million structural deficit. That is unsustainable over the medium and long term. We need the Treasury and the Department of Health to work together to assist such challenging healthcare economies, because they will affect all areas, including social care, primary care and acute hospital care, particularly for older people. Older people account for a disproportionately large number of admissions to acute district hospital trusts. Given that the number of over-85s will double in the next 20 years, we cannot put this issue on the back burner—we need to look at it as a matter of urgency.

We must address senior manager redundancies. When I sat on the Public Accounts Committee in the previous Parliament, we saw some egregious cases of greed, mismanagement and back scratching from senior trust managers who were hiring and rehiring consultants and mates of mates. That is not acceptable when we are asking junior NHS staff to make sacrifices.

Finally, we need to think about an holistic approach to social care. For example, we should give tax breaks for housing and extra care facilities for older people, so that we have a properly co-ordinated system from age 60 all the way through to death. People should have an allocated health service worker, for instance. The health service does not belong to any one party. We have a good and proud record, and I urge the Government to continue their good work.

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[Liz Kendall]

Why is the hon. Lady not talking to her Ministers about the problems created in the NHS? Why do the Conservatives never talk about their reorganisation? I will tell you why: it is because they know it has been a mistake. Far from putting power into the hands of clinicians, let alone patients, it has put power into the hands of bureaucrats.

This Government’s addiction to broken promises goes on. Five years ago, patients were promised that they would be able to see a GP from 8 am to 8 pm, seven days a week. That may sound familiar—well, it should. The Prime Minister has had to make the same promise again in the latest Tory manifesto. It is no wonder that he has had to do that, because, under his watch, it has got harder to see a GP. Two million more patients now say that their surgery is not open at a convenient time, and a quarter say that they cannot get an appointment in a week, if at all, let alone on the same day.

The list of broken promises goes on. The Prime Minister said that, under his leadership, we would never go back to the days when patients waited for hours on trolleys in A&E, or months for vital operations. Yet the number of patients kept on trolleys for more than four hours has quadrupled, and the waiting lists are at a seven-year high. Why is that? It is because the Government wasted three years on reforming backroom structures rather than front-line services. They slashed the very social care and community services that should help to keep elderly people at home, piling further pressure on our hospitals instead.

The Government want us to forget their mistakes. But Labour Members will not let them run away from their record. We will hold them to account for their failures every week, every month, every year. I am talking about their failure on NHS finances and the deficits that have soared to more than £800 million and are set to get worse. Those deficits are predicted to be £2 billion by the end of this year.

[Mr Jackson]

rose—

[Liz Kendall]

What will the hon. Gentleman do about that?

[Mr Jackson]

On the subject of mistakes, apologies and looking back at the past, would the hon. Lady—in her role as a candidate in the Labour leadership election as much as anything else—like to apologise for paying GPs 27% more for doing less work in 2004 through the GPs’ contract, which curtailed out-of-hours services so drastically?

[Liz Kendall]

I will never apologise for Labour’s record on the NHS, for the investment and reforms that saw waiting lists at an all-time low and patient satisfaction at an all-time high, for rebuilding our hospitals and our public health and primary care or for tackling health inequalities. That is more than can be said for the record of Conservative Members. We will hold them to account for their failure on A&E as hospitals miss the four-hour target for the 97th week in a row, and we will hold them to account for their failure on cancer care. The cancer treatment target has now been missed for more than a whole year, and 21,000 cancer patients have waited more than 62 days to start their treatment. Anyone who has a relative or friend with cancer waiting to start treatment knows how desperate that can be, and it is not going to get better anytime soon.

The day before Parliament was dissolved for the election, NHS England snuck out a report saying that the cancer target will not be met again until at least March of next year. Would the Minister like to confirm that? If she will not confirm that, will she tell me how many patients will wait longer as a result so that Members can tell their constituents? Does she think that it is acceptable, and what is she going to do about it? I would be happy to give way to the Minister if she would like to respond. No? Well, that is typical of Conservative Members, who create the problems but refuse to admit to them and do not have a plan to deal with the result.

Five years ago, Government Members made important promises to patients and the public on the NHS. They promised stability, but their reorganisation created chaos. They promised to maintain Labour’s historic low waits for treatment, but waits have risen year on year on year. They promised seven-day access to a GP, but it is getting harder to get an appointment, and they promised to make the NHS more efficient, but they have wasted billions of pounds on their reorganisation, on agency staff, management consultants and soaring delayed discharges because elderly people cannot get the services they need at home. They come to this House today and repeat their promises and claims, but NHS staff do not trust them, patients will not believe them and we will not allow them to get away with five more years of letting patients down.