Defending Public Services

Maria Miller Excerpts

Monday 23rd May 2016 Commons Chamber

[Heidi Alexander]

I am grateful for the reading advice from the right hon. Gentleman, but I simply say this: I am very happy to defend the record of the previous Labour Government, who trebled the NHS budget and had the highest-ever public satisfaction ratings and the lowest-ever waiting lists.

We should be crystal clear about the crisis that we face today. The decade from 2010 to 2020 is set to be marked by the biggest sustained funding squeeze on the NHS ever. As a percentage of GDP, spending on health is set to fall from 6.3% in 2009-10 to just 5.4% by the end of the decade.

[Mrs Maria Miller (Basingstoke) (Con)]

People who are listening to this debate will want some clarification. Is the hon. Lady denying the fact that if Labour were in government it would not have increased NHS spending in the way that this Government have done? I think she needs to be clear on that point.

[Heidi Alexander]

We were very clear at the last election that we would have had an emergency Budget to put every penny that the NHS needs into its funding.

I was talking about the reduction of NHS spending as a proportion of GDP. In terms of real funding, the House of Commons Library has shown that, if spending as a percentage of GDP had been maintained at Labour levels, by 2020, £20 billion more would be being spent on the NHS each year. That demonstrates the scale of underfunding that we have already seen and just how tough the coming years are going to be. That is not to mention the deep cuts to adult social care, which have piled the pressure on to hospitals, and the £22 billion-worth of so-called efficiency savings that this Government have signed up to. I have yet to meet anyone who works in the NHS who thinks that efficiencies on this scale are possible without harming patient care.

--- Later in debate ---

[Mrs Maria Miller (Basingstoke) (Con)]

I welcome the legislative programme that the Government have set out in the Queen’s Speech, particularly on improving life chances for disadvantaged people, which is in the very best traditions of one nation Conservatives.

In opening the debate, my right hon. Friend the Secretary of State demonstrated his strategic vision and his clear personal commitment to improving life chances through the NHS. We owe him a debt of gratitude for the work he is doing in that respect, and for his work on ensuring that the NHS is fit for the future. There has been a great deal of discussion about NHS budgets—perhaps there was a lack of clarity from the Labour Front Benchers on their budgets—but, as my right hon. and learned Friend the Member for Rushcliffe (Mr Clarke) said, we need to talk not only about the budget, but how we use that money. That is the point I will focus on in my contribution.

In this Session, whether through legislation or other ministerial action, we need to ensure that we have a nimble, agile and responsive NHS for the future. We need public services that respond to people’s needs as they change. People’s lives are changing: we are living and working longer, and we have growing communities with more housing. The NHS, not simply Ministers, needs to respond to those changes to reflect our changing community needs.

The NHS cannot afford to lag behind its users—its patients—in its thinking. That is why I believe that, more than ever, the Government need in this Session to ensure that there is more devolution to local government to join together NHS spending and social care spending, which will help to make sure that our money goes further in future.

Sir Bruce Keogh, medical director of the NHS, has set out a compelling vision for the NHS in this changed world. People with non-life threatening needs should have access to care as close to home as possible, and people with life-threatening conditions should be treated in centres with the very best 24/7 consultant-led care. That is safer and better for patients.

Like many constituencies throughout the south-east, my community has grown not only in recent years, but throughout the recession. We need the Secretary of State to press for a nimble NHS that can respond to the changes in our community, and hopefully plan for the future. We need clinical commissioning groups to work to ensure that new doctors’ surgeries are delivered where there are new houses, and that hospitals deliver the very best every day of the week.

In my constituency, we are truly fortunate to have clinicians who are already ahead of that thinking. The Hampshire Hospitals NHS Foundation Trust already has fully funded plans, a site with planning permission and support across the community to establish a 24/7 critical treatment hospital, bringing together emergency care for the sickest patients in one site, leaving those requiring walk-in A&E, planned surgery and out-patient care to our local hospitals in Andover, Winchester and Basingstoke.

That approach has been developed by clinicians to keep services safe and sustainable, and I urge the Secretary of State to ensure that we listen to clinicians carefully. They often see the needs of the NHS changing before others do, and we need to ensure that those changes are put in place. The NHS investigation unit is looking at how we deal with delays at A&E, because the changes proposed by clinicians have not been brought forward in a timely manner. We are now awaiting a new models of care programme, and sustainability and transformation plan. In the meantime, my constituents regularly face more than four-hour waits in A&E, which I hope will come to an end when the long-awaited centralised critical treatment hospital is brought to fruition—after four years of planning and discussion.

Within the NHS programme for the future, we need to find ways to respond to the needs of other groups of people. The first Women and Equalities Committee report brought the needs of transgender people to the fore. It was clear from the evidence we received that access to primary and specialist care for this group of people was far from routine and, in some cases, quite shocking—another example of the need for the NHS to respond carefully to the needs of communities. I do not underestimate the challenges GPs face in our communities, but we need to ensure that they are tasked with, and deliver on, treatment and care plans for every group of people and do not leave minority groups out.

We live in a country with a proud tradition of fairness and some of the most comprehensive legislation in the world to protect disadvantaged people—the theme of the Queen’s Speech. Too often, however, legislation does not create the change in the delivery of public services that we in this House would perhaps like to see. I hope the Government will use every Bill in this parliamentary Session to challenge themselves on whether there is more that can be done to support disadvantaged people: whether, in the modern transport Bill, the Government could consider how disabled and older people can benefit from important developments in transportation; whether, in the local growth and jobs Bill, the Government could look more closely at the three quarters of pregnant women and new mums who suffer negative or discriminatory experiences at work, and bring forward measures to help to address this problem more speedily to unlock this important pool of labour for the future; and whether, in the education for all Bill, the Ministers responsible could look carefully at the House of Lords Select Committee paper on the achievements of disabled children in schools. Despite a great deal of work in recent years, we still need to be better at unlocking the educational achievement of disabled children. At the moment just 18% of children with special educational needs achieve good development, compared with 65% without.

The prison reform Bill will of course be pivotal in supporting disadvantaged people. I am sure there will be a great deal of debate on that today, but I would like very briefly to touch on the importance, in relation to the Bill of Rights, of the need to ensure that we really do tackle the disadvantage that people face. I refer again to the need to address the rights of transgender and non-gendered people. They suffer great disadvantage in our society. If we are to have a Bill of Rights, we need to tackle this issue head on.

Before I close, I want to touch on something very close to my heart from when I was a Minister: superfast broadband. I was delighted to see the Government propose a Bill to ensure that superfast broadband is seen as the essential utility that it is. I am sure the Health Secretary will have responded to this with great joy too, given his previous role as Culture Secretary.

The experience of my local authority means that I will be looking very carefully at the detail of the Bill. My local authority in Basingstoke has long seen superfast broadband as essential infrastructure, but when trying to make it happen, in terms of planning conditions for building, it has been blocked pretty firmly by the local planning inspector. Basingstoke and Deane Borough Council and Hampshire County Council have looked long and hard at how they might make progress on this. I am sure they will welcome, as I do, the measures in the Queen’s Speech. Indeed, they have asked the Government for superfast broadband to be a material planning consideration. I hope the Minister will clarify that superfast broadband will be a material planning consideration and indicate when that will come into force. My local community, like those of many other Members, has seen a rapid increase in the rate of house building, and we need to know when this might come into play.

[Mr Jim Cunningham (Coventry South) (Lab)]

Coventry has also experienced problems with BT’s delivery of broadband. That is one of the big problems. I know that Ministers have been looking at this, but we need urgent action. BT is a big problem in this regard.

[Mrs Miller]

The hon. Gentleman makes a point that many Members have made, but I am making a very different point—about ensuring that local authorities can make superfast broadband an essential prerequisite for new house building. No one can build a house in this country without water, electricity and the many other utilities we have come to rely on. Superfast broadband has fast become a basic utility of life, and that is how it needs to be viewed; I am sure that other Members will mention the performance of those who put the service into place.

The Government have a powerful opportunity to continue on their mission to improve life chances for disadvantaged people, not only in the obvious Bills, such as the one on prison reform, but in every single Bill on their agenda. I urge Ministers to consider carefully how they can bring that into play. While we might have some of the best equalities legislation in the world, when it comes to putting it into practice, we sometimes fall short. We need to admit that and up our game.

[Several hon. Members rose—]