Health and Social Care

Maria Caulfield Excerpts

Monday 27th February 2017 Commons Chamber

[Maria Caulfield (Lewes) (Con)]

It is a pleasure to follow the hon. Member for Lewisham East (Heidi Alexander), although she will not be surprised to learn that while I agree with some of the points she made, I do not agree with all of them.

In the time that I have, I want to cover a few points; I do not want to repeat much of the excellent statements many Members across this House have made, but I do want to go over a few issues.

While I welcome the Government’s extra funding, and the £6 billion this year in particular, with the changes in national insurance contributions and pension contributions, the costs of running the NHS are going up all the time, so the extra money is being swallowed up without it necessarily going to frontline staff. I particularly agreed with my hon. Friend the Member for Newton Abbot (Anne Marie Morris) when she said that in an estimates debate we should not just be talking about the money we need to spend, but also need to look at the demand and the type of services that we need to fund. There is no doubt that the demand for NHS services and social care is increasing, so even by providing extra funding we are really just standing still in terms of the services we are providing.

We know there is an increase in numbers across the country. We know, as has been said, that there are new treatments that need to be provided. We know that patients are changing, too; they often have multiple co-morbidity, so whereas in years past they would have been admitted with one illness, treated and gone home, now when they are admitted they have many illnesses that are not so easy to treat, and that is often why discharges are delayed.

From NHS England’s own data, we know that there is around a 7% increase in demand for services across the board. There is also a 7% increase in the number of ambulance calls made. There is a 3% increase in the number of A&E visits. We know that the Tuesday after Christmas was the busiest day ever in the history of the NHS, and it takes extra money to be able to deliver that service. We know that there is a 6% increase in diagnostic tests, and consultant-led treatments are up 6%, too. So demand is rising, and although the extra money is welcome, it is not dealing with the level of service that is required.

I want to make a plea, as someone who still works in the health service and sees, and works with, colleagues across the NHS on a regular basis. While the services are under a lot of pressure and there is a lot that we can be concerned about, some amazing work is going on in our NHS, and I welcome NHS England’s announcement only last week that it is again going to start to fund second stem cell transplants. We have had debates in this place about how important that is to those patients whose first transplant fails. We also know that there are going to be new drug treatments for kidney disease and for pulmonary hypertension. All those announcements are really welcome, and we must recognise that there is great work being done on the frontline.

I am particularly pleased that the Department of Health has given £1 million to the British Heart Foundation to provide defibrillators up and down the country. That will make a tremendous difference, given that 12 young people a week die from cardiac arrest in this country. Innovative, ground-breaking work is also being done in cancer care. My old hospital, the Royal Marsden in London, is making strides in cancer research that are not only innovative in Europe but making breakthroughs worldwide. We should never forget that we often lead the field in research at a global level. We should be extremely proud of that.

In response to the Health Committee’s report, the Government made a number of recommendations on tackling the problems facing the NHS and social care, and I want to touch on two of them. The first dealt with the need to arrive at a degree of financial discipline in the health service. For years, there have been problems of financial mismanagement. As someone who has worked in the health service, I know how heartbreaking it is to see money being squandered. We have talked about the PFI deals, which have affected many parts of the country, but we must also remember the IT system that cost billions of pounds but never saw the light of day. It was supposed to move us away from paper records to a paperless system. Today, the NHS spends huge amounts of money on the storage of paper notes in offsite facilities. Hospitals have to pay to store those patient records. The agenda for change, which was introduced many years ago, was supposed to reconfigure the staff pay structure and improve patient productivity, but it never really worked. It just rearranged the deckchairs on the ship. It was a huge wasted opportunity that cost the NHS millions of pounds that could have been used to give staff a well-deserved pay rise.

Financial discipline is important. There are two big general hospitals near my constituency. They have the same financial settlement and a similar group of patients to look after. One of them is in special measures and struggling to cope with its discharging, while the other, less than five miles down the coast, is rated as outstanding and is able to provide excellent care. This has to be about more than the amount of money that is given out; it is also about what is done with that money. We need to look at that, and hospitals need to share best practice. It cannot be right that one hospital is able to manage its budget while another one is not. My experience of 20 years working in the NHS is that there are lots of opportunities in this regard. Financial discipline should not be about top-slicing; it should be about using the available money as wisely as possible. If Ministers want suggestions about how to make financial savings, I would recommend that they speak to the healthcare professionals. They often have the answers, and if they were only asked on a more regular basis, they would be able to provide some fantastic solutions.

The other recommendation that the Government want to take forward relates to reducing demand, which is easier said than done. I started by saying that demand was increasing by about 6% a year. For too long, we have focused on hospitals and—I say this with no disrespect to doctors, as my hon. Friend the Member for Totnes (Dr Wollaston) is sitting next to me—we have been much too medically focused in the way we manage our NHS. We have missed the opportunity to look at what other healthcare professionals can offer.

Pharmacists, for example, are highly educated, experienced and qualified individuals, and there is ground-breaking work happening out there in community pharmacies. This can involve simple things such as the scheme in Scotland in which patients have to register with a pharmacist as well as a GP. That would make a tremendous difference to patients’ lives if we were to introduce it here. Why are pharmacists not contacted on discharge, as GPs are? I was recently talking to a pharmacist who said that around 30% of readmissions are caused by patients not taking their medicine properly. If pharmacists had a list of chronically ill patients whose medicine they were in charge of, we could easily avoid so many readmissions. We heard earlier about nurse practitioners who are doing blood tests to predict bacterial infections and work out who does and does not need antibiotics. We need to upskill those healthcare professionals so that they can take on more roles. Some paramedics in the community are going to people’s homes instead of those people going to A&E, for example.

This is an estimates debate about how we use the money, but we need to forecast demand properly, use existing resources better and look at best practice to share the good work that is happening in our NHS.

[Several hon. Members rose—]