NHS (Government Spending)

Lord Walney Excerpts

Wednesday 28th January 2015 Commons Chamber

[Dr Poulter]

As the hon. Lady will be aware, front-line staff use IT and understand the importance of joining it up to benefit patient care while also protecting confidentiality. On the point about district nurses, she is right that we need to transform the model of care, which is why the Government set up the £5.2 billion better care fund—to ensure we join up more effectively what happens between our acute hospitals, the wider NHS and adult social care. This approach will be transformative, delivering better care for the frail elderly and providing more care in people’s homes.

Of course, part of that is about changing work force models and ensuring that staff who have traditionally worked only in hospitals, supporting people with long-term conditions such as multiple sclerosis, can also work in the community. [Interruption.] The hon. Lady is chuntering away, but I have answered her question in an informed and sensible way, having spoken about how our work force models need to change as part of our investment in integrating and joining up care so that patients looked after now in a purely hospital environment can have access to staff across both community and hospital care, which is important for people with long-term conditions such as diabetes, multiple sclerosis and dementia. I hope she can support that.

It is also important to consider some of the equally important funding decisions we have made in maternity care. In 2013-14, we provided £35 million of capital funding for the NHS to improve birthing environments, which represents the single biggest capital investment in maternity care for decades. That has benefited more than 100 maternity units, including through the establishment of nine new midwifery-led birthing centres in eight areas, and transformed many local maternity services across the country. Improvements delivered by our maternity investment fund include: more en-suite bathroom facilities in more than 40 maternity units, providing more dignity and privacy for women; more equipment such as beds and family rooms in almost 50 birthing units, allowing dads and families to stay overnight and support women while in labour or if their baby needs neonatal care; and bereavement rooms and quiet areas at nearly 20 hospitals to support bereaved families after the thankfully rare but always tragic loss of a baby.

Our £35 million maternity investment has made a big difference to the experience mums and families have of NHS maternity services.

[John Woodcock (Barrow and Furness) (Lab/Co-op)]

Will the Minister give way?

[Dr Poulter]

I have been very generous in giving way, but I must now make some progress.

[John Woodcock]

rose—

[Dr Poulter]

No, on this occasion, the hon. Gentleman will have to forgive me.

Our capital investment in maternity services, which, as I said, is the biggest for decades, is making a big difference to mums, dads and new families. Thanks to our investment in the midwifery work force, we now have the highest ever number of midwives working in our NHS—about 2,000 more than in 2010—providing more personalised care and support for women and new mums. However, we must all recognise the challenges facing our health and care system in the months and years ahead. NHS England’s “Five Year Forward View” argued that we needed to do more to tackle the root causes of ill health through a radical upgrade in prevention and public health; to give patients more control over their own care, including through the option of combining health and social care, and new support for carers and volunteers; to ensure the NHS changes to meet the needs of a population that lives longer; and to develop and deliver new models of care, local flexibility and more investment in our work force, technology and innovation, some of which I have already outlined.

That is why the Government have provided additional funding for NHS front-line services in 2015-16, including £200 million to pilot new care models and £250 million for the first tranche of the new £1 billion fund, spread over the next four years, for investment in new primary and community care facilities to support our GPs and primary and community care work force in the important work they do. In community care, we are committed to undoing the terrible mistake that was Labour’s 2004 GP contract, which left so many people, particularly the frail elderly, without the GP care they needed at evenings and weekends. Our investment will support GPs to provide care for patients seven days a week so that patients will once more be properly supported during evenings and weekends. We are also training an extra 5,000 GPs, in addition to the 5,000 extra we have already seen under this Government, to provide that care.

We are clear, however, that if the NHS is to meet the challenge of increasing patient demand and expectations, it cannot stand still. By 2018, 3 million people in our country will have three or more long-term conditions, so we must continually adapt and change how we deliver care to support patients, families and carers, and deliver more care in people’s homes and communities. For our part, and as part of our plan for our NHS, not only are we delivering a strong economy so that we can protect our NHS budget, but we will continue to be ruthless in delivering greater efficiencies in estate management and procurement and in reducing back-office costs so that we can reinvest that money in front-line patient care. Furthermore, we will continue to back front-line staff with the training, equipment and new technology they need to do their job and provide high-quality patient care, which is why we have already made available an additional £2 billion down payment to deliver NHS England’s “Five Year Forward View” and why the Prime Minister has committed to continuing to protect our NHS and ensuring that it has the additional money it needs to deliver first-class patient care in the months and years ahead.

In conclusion, I would like to thank the dedicated NHS staff working incredibly hard to keep us well looked after and safe in this busy winter period. As a practising doctor—I know Labour does not like it, given its dearth of real-life experience and the number of former special advisers on its Front Bench—I know how hard our NHS staff work and how dedicated they are to delivering the highest-quality patient care. I remind the House that we have been able to increase the money available to our NHS only because we have the growing economy to pay for it; because our long-term economic plan is working; and because, under this Conservative-led Government, there are more people in work than there were under Labour. Anybody who does not have an economic plan for the economy—and Labour has no plan for our economy, as has certainly been clear in today’s debate—does not have a plan for the future of our NHS. Through economic policies and by creating growth and jobs, we have been able to announce additional NHS funding for 2015-16 without having to raise taxes, including on people’s homes, as Labour would like to. This gives our NHS the funding it needs to begin implementing the plan set out in NHS England’s “Five Year Forward View”, so that it can continue to be a world-class, sustainable health service, delivered free at the point of need.

When we came into power, we took two big strategic decisions with our NHS: to increase funding and to cut bureaucracy and waste, and to reinvest that money in more doctors, nurses and front-line staff and to improve front-line patient care. That is exactly what we have done, so the choice on 7 May will be clear: between a Labour party that bankrupted Britain and would do so again, at the same time bankrupting our NHS, and a Conservative Government, committed to securing our NHS by delivering a strong, stable and growing economy.

--- Later in debate ---

[John Woodcock (Barrow and Furness) (Lab/Co-op)]

I have a great deal of affection for the hon. Member for Daventry (Chris Heaton-Harris), but I have to say to him that the only people who are using that word are those on the Government Benches, because they apparently have nothing to say about the future of the NHS under the stewardship of a Conservative Government—God forbid—or about the real crisis that our accident and emergency services are suffering across the country. I should like to hear a little more from them about what they actually plan to do, rather than hearing this ridiculous nonsense.

We all know that the national health service faces major funding challenges in the years to come. NHS England has set that out clearly, and we have put forward concrete proposals to raise the extra money that our NHS needs. That will involve increased funding and, I have to say, radical reform. The merging of health and social care is a major undertaking that will unlock huge efficiencies and deal with one of the major pinch points of inefficiency that is wasting billions of pounds as well as creating great difficulties in people’s lives. Families simply do not know where to turn at the moment.

That scale of ambition has not been matched by the Government. In fact, at the very moment that they should be encouraging front-line workers to innovate and work together from the bottom up to come up with the new ideas necessary to take the NHS to a new level, they are tying them up with the red tape of compulsory competitive tendering. That is the last thing those people need at a time when a radical new approach to delivering services is needed.

I want to focus on the specific funding situation in the University Hospitals of Morecambe Bay NHS Foundation Trust. It is regrettable that the Under-Secretary of State for Health, the hon. Member for Central Suffolk and North Ipswich (Dr Poulter), who is a doctor, refused to take my intervention on the subject of maternity services. He must know, given that we have been talking about my maternity unit and maternity services across the Morecambe Bay area for some years now, that the situation is now critical. It will be the subject of a major report in the next couple of weeks, and there are real funding issues involved.

I shall run briefly through the trust’s recent funding history. In 2011, the University Hospitals of Morecambe Bay NHS Foundation Trust announced that it was facing a cut of £15 million—around 4% of its annual budget—as a result of the efficiencies and cuts to hospital funding being required by the Government. At that stage, it managed to avoid reductions in front-line staffing and facilities. The required additional spending resulting from the clinical and staffing failures found by the serious Care Quality Commission reports led to the trust’s finances falling into deficit by about £25 million annually. Ministers are still insisting that that must be eliminated.

The Better Care Together reconfiguration plan was submitted to NHS England and Monitor by the trust last July. It set out a scheme that would allow for up to £18 million of annual savings achieved over a five-year period. The trust, NHS England and the Department have been going backwards and forwards on the details of this plan, but it has boiled down to this basic point: innovative changes in approach and some difficult decisions mean that local health care experts are proposing to reduce the trust’s deficit by a full 70%, but—this is the key point—our whole area is clear that the unique combination of geographical isolation, poor transport links and severe health needs in pockets of some of the worst urban deprivation in the country in Barrow make this a unique case, meaning we cannot go further than that 70% proposed reduction without cutting deeply into vital services across our hospitals.

It is a shame that the hon. Members who represent the Royal Lancaster infirmary, which is part of Morecambe Bay’s trust, are again not here to make this case. However, I want to ask the Minister something, and she can rise now or deal with this in her summing up. Will she follow the lead of the shadow Secretary of State, recognise our unique case and pledge to bridge the gap? Until we get that promise I will keep working with anyone in our community across Morecambe Bay who will join us in demanding the funding deal our hospitals desperately need.

The hon. Members for Lancaster and Fleetwood (Eric Ollerenshaw) and for Morecambe and Lunesdale (David Morris) are not here to stand up for their hospital today, so I will be out at the weekend with the people who will replace them as MPs: our brilliant candidates Amina Lone and Cat Smith. We will not stop until our hospitals are secure. The Government are proving themselves to be not up to this job, so they should get out of the way.