NHS and Social Care Commission

Mark Tami Excerpts

Thursday 28th January 2016 Commons Chamber

[Helen Whately (Faversham and Mid Kent) (Con)]

It is an honour to follow my hon. Friend the Member for Stafford (Jeremy Lefroy), who made some very good points and helpfully referred to the Barker report, which deserves to be debated. We must take a grip of some of its proposals. Although I am sure we do not all agree with everything in the report, it is a good thing to talk about.

It is also an honour to follow the hon. Member for Walsall South (Valerie Vaz). I am now a member of the Health Committee, so it is good to hear about her experiences on the Committee and to reflect on what I might do with my fellow Committee members to make sure that we are effective in driving forward the agenda of the integration of health and social care, about which she spoke so powerfully.

I thank the right hon. Member for North Norfolk (Norman Lamb), the hon. Member for Leicester West (Liz Kendall) and my hon. Friend the Member for Central Suffolk and North Ipswich (Dr Poulter) for calling for this debate. It has been a good, wide-ranging and productive conversation about the future of the health service and social care. There have been extremely interesting contributions from my hon. Friends the Members for Totnes (Dr Wollaston) and for South West Wiltshire (Dr Murrison), the right hon. Member for Sheffield, Hallam (Mr Clegg) and my hon. Friend the Member for Lewes (Maria Caulfield), among others.

I share the desire and aspiration of the right hon. Member for North Norfolk to take the politics out of the NHS and discussions about the health service and social care. There are certainly situations, particularly in the run-up to elections, when there is very unhelpful scaremongering from all sides about what is going on.

[Mark Tami (Alyn and Deeside) (Lab)]

I agree with the hon. Lady. We need to look at this matter for the long term. Whoever makes such statements during election campaigns—whether it is us or the Government—the talk of death taxes and such things is not particularly helpful, because we need to form a cross-party view, given that we require long-term measures that will cost money. There is no way of getting out of that.

[Helen Whately]

The hon. Gentleman might want to hear what else I have to say before he agrees entirely with what I am saying, but we share the view that scaremongering is unhelpful.

In a health system that spends £135 billion of taxpayers’ money every year, that employs 1.3 million staff and that has over 60 million users in the British population, there is no way in which this issue cannot be political, as the hon. Member for Leicester West said. It just is political. It is no bad thing that it is political, because it means that there is a debate about it and, out of debate, we get better answers. It also means that the public are given a choice.

One concern I have about the proposed commission is that there appears not to be a consensus on what it should be about among those who support it. I have heard this afternoon that it should be about the future funding settlement for health and social care, but also that it should be about public health, the structure and configuration of the NHS—the estate solutions—the future role of mental health in the health service, prevention, and the integration of health and social care. To me, that is a problem. If the commission is to be effective and short—a period of one year is proposed—and if it is to lead to something concrete, it cannot possibly be that wide-ranging. I worry that those involved in the commission will spend a huge amount of time working out, and disagreeing among themselves about, what the commission is looking into. That process would be an enormous waste of time, money and attention—there is a limited amount of attention, brain power and resources to put into such a discussion about the future of health and social care, which is an opportunity cost.

To the extent that the commission might focus on future funding for the long term of health and social care, that is important and should be given a huge amount of attention. We need to look further out, but if anything is political, it is that question. Questions such as how much as a society we should spend on health and social care, what proportion of GDP or what amount per person we should spend, and how it should be funded—should it be taxes, charges or co-payments—are important, but they are very political. They are questions of value. It would be incredibly difficult to take the politics out of them.

In fact, it would be wrong to come to a consensus. We need a debate and we need to disagree. We need to give the public a choice. Just as the current funding settlement through to 2020—the £8 billion or £10 billion in this Parliament—was put to the public last year at the general election as part of an overall package of Government spending, taxation, debt and deficit proposals, future funding for the health and social care system should be put to the public at a future election. It is not something that should be agreed by insiders in a commission between now and the next election—the suggestion is that it should move quickly. That is a worrying proposal if I have understood it right. The public should decide that and it should be debated in the run-up to an election.