(4 years, 9 months ago)
Commons ChamberI am afraid that the right hon. Gentleman does not quite explain the situation as it really is. You see, this Parliament, as the Parliament of the United Kingdom, passed certain rules some time ago, and it is not correct to say that Members from Scottish constituencies are locked out; far from it. Members from Scottish constituencies, and constituencies in every part of the United Kingdom, have not been locked out. They have been allowed to participate in the debate, but not to vote in it. Members from Northern Ireland constituencies and from Welsh constituencies are similarly categorised for the purpose of these particular Divisions.
Further to that point of order, Dame Eleanor. Is it not the case that health is a devolved matter, and that the NHS in Scotland is the responsibility of the Scottish Parliament? Is it not the case that, therefore, Members of this House have no votes on, or say in, what happens in the NHS in Scotland, and is it not appropriate to point out to SNP Members that while they stage these stunts here, the Royal Hospital for Sick Children in Edinburgh, for which they are responsible, remains closed, and cases of poisoning in hospitals in Glasgow for which they are responsible remain undealt with? Until the Scottish Government make sure that the health of the people of Scotland is looked after, the people of Scotland will regard this as a transparent stunt on the part of people who, instead of representing their constituents, seek to manufacture grievance.
I fully appreciate the point—[Interruption.] Order. This will not degenerate into a shouting match.
The right hon. Gentleman has expressed his view with his usual rhetorical flourish. My only comment must be that this is a very narrow Bill, specifically making provision for the funding of the health service in England. I have to go with what it says on the Bill, and it is therefore correct for it to be administered in this way.
(8 years ago)
Commons ChamberI will give way in a moment.
The maintenance situation has got so bad that the NHS faces a backlog of £5 billion in repairs.
I will give way in a moment. The former Education Secretary needs to calm down, Madam Deputy Speaker.
Public health budgets, which fund projects to tackle teenage pregnancy, excessive alcohol consumption, sexually transmitted infections and substance misuse and to provide anti-smoking interventions, will have been cut by 9.7% by the end of this Parliament. That is a completely false economy leading to greater demands on the acute sector. As my hon. Friend the Member for Worsley and Eccles South (Barbara Keeley) so brilliantly outlined last week, the adult social care budget has been slashed.
My right hon. Friend is right and she is a brilliant campaigner for the health service in Enfield. The points that she makes about the staffing crisis in the NHS are well made. I hope that the Secretary of State will respond to her.
Things are so bad for the Health Secretary that even the NHS chief executive told the Health Committee that
“2018-19 will be the most pressurised year for us…will have negative per-person NHS funding growth.”
Those were the chief executive’s words. Will the Health Secretary sit up and listen, and respond to the chief executive, or will we get what we saw in the Sunday newspapers—briefing against him? We heard that the Government are “gunning for” Mr Stevens and are going to “fix” him. I hope the Secretary of State will repudiate that briefing when he responds to the debate and distance himself from it.
The only people who do not appear to accept the need for more money for the NHS are the Prime Minister and the Secretary of State. We anticipate what the Secretary of State will tell us from the Dispatch Box. The right hon. Member for Chelmsford (Sir Simon Burns) alluded to it and I will now answer his question. The Secretary of State will not only tell us that we have a generous, munificent Conservative Government who have given the NHS the money it asked for, but persist with the fiction that the NHS is receiving an extra £10 billion. However, we all know—and I suspect that the Secretary of State knows, because he now distances himself from the figure when he does interviews—thanks to the Health Committee and others that this £10 billion claim is bogus. It is a claim universally derided and discredited, apart from in the drawing room of 10 Downing Street.
It will be a pleasure to give way to the former Education Secretary.
The chief executive of the NHS, whom the hon. Gentleman has just mentioned, welcomed that additional £10 billion and said that it gives the NHS the extra headroom we need. Will the hon. Gentleman repudiate his criticism now and make it clear that he associates himself with the chief executive of the NHS in welcoming that £10 billion of extra funding?
The chief executive’s comments to the Select Committee speak for themselves. Talking of repudiation, when are we going to get £350 million a week, or were the Tories typically saying one thing before the people voted and something completely different after they had had their say? That is what the ex-Education Secretary should be telling us.
Let me remind the House what the Health Committee said. I see the hon. Member for Totnes (Dr Wollaston) in her place, and she said:
“The continued use of the figure of £10 billion for the additional health spending up to 2020-21 is not only incorrect but risks giving a false impression that the NHS is awash with cash.”
She is sitting only a little further down from the right hon. Member for Surrey Heath (Michael Gove). Perhaps he can have a word with her if he disagrees.
The Secretary of State hopes we do not notice that he is stretching the timeframe over which he presents this funding allocation. He hopes we do not notice that NHS spending has been redefined by the most recent spending review. He hopes we do not spot that he is cutting billions from public health budgets and other Department of Health funding streams—a £3 billion cut. But we have noticed.
My hon. Friend is extremely knowledgeable about the health service and has been campaigning vigorously on the STPs. She is completely right. We will see hospitals merged in the Merseyside area and in London, hospitals lost in Durham, and efficiencies found by changing staffing levels. In fact, the STP for Cheshire and Merseyside, the area that she represents, talks enticingly of
“Exploration of a Factory Model”.
Doesn’t that sound nice?
With cuts to services and rock-bottom staff morale, we have the Sports Direct approach to the NHS, with the Secretary of State playing the part of Mike Ashley. The public deserve better than this bargain basement approach. Scaling back the acute sector while not investing in the community sector simply does not work. The Prime Minister might have ruled out extra funding—
I have listened with great interest to the hon. Gentleman. He has spoken eloquently of his concerns about the NHS, but has not, in the course of 18 minutes, put forward a single positive policy or explained where a single penny of additional funding would come from. He has secured the time for this debate, so would he at least put forward a positive policy for the NHS, or a suggestion as to where the money should come from?
The right hon. Gentleman really does have a brass neck. We still do not know when we are going to get the £350 million from him, but next time he intervenes perhaps he will tell us.
My hon. Friend is absolutely right. I will now make a bit of progress because I know that other Members are anxious to speak.
The Chancellor should respond tomorrow to the growing body of evidence that the NHS has not been given the money that it needs. Tomorrow, we need an end to the scandal of crumbling hospitals. Tomorrow, the Chancellor must put right the Government’s greatest betrayal on adult social care. Tomorrow, the Government must deliver the long-overdue investment that our NHS needs.
My right hon. Friend is right. I congratulate him, because he was part of the shadow Health team that persuaded the then shadow Chancellor and Leader of the Opposition that we needed to make that investment, thanks to which the NHS is doing 5,000 more operations every single day.
My right hon. Friend has been very gracious in taking interventions from all sides, and also in citing independent voices. Has not the independent King’s Fund also pointed out that the sustainability and transformation plans that he is overseeing are the “best hope” of securing long-term improvement for both health and care in this country? Does he agree that the Opposition should pay rather more attention to those independent experts, rather than repeating their own press releases?
My right hon. Friend is right that just occasionally we should listen to experts—but only very occasionally. In the spirit of listening to experts, and as the Leader of the Opposition is here, I will tell my right hon. Friend something else the King’s Fund has said that he will agree with, which is that
“claims of mass privatisation were and are exaggerated.”
Let us not go chasing down rabbit holes.
The result of this Government’s commitment to the NHS is that real-terms spending per head has gone up by 4.6%, which is double the rate in Scotland and three times the rate in Wales. The hon. Member for Leicester South also mentioned the National Audit Office. He did not mention that the numbers quoted in the NAO report are last year’s figures. He chose not to mention this year’s numbers, which were published last week. They show that 40 fewer trusts are in deficit. Yes, a year ago, half of trusts were missing their financial plans, but now 86% are hitting those plans.
The latest figures, from Friday, show that the deficit will fall 73% from last year, and even lower than the year before. Why is that? It is because of a sustained effort by the NHS to tackle the problem. [Interruption.] The Opposition do not want to hear this, but the truth is that the NHS is gripping the very problem the shadow Health Secretary called a debate on. Agency spend, one of the biggest challenges, is on track to go down from £3.7 billion to less than £3 billion. The rates paid for agency nurses are down 18% on a year ago, and for locum doctors they are down 13%. Our procurement changes are on track to save half a billion pounds. The money we raise from international visitors is up three times, from £84 million to £289 million.
(8 years ago)
Commons ChamberUrgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
Each Urgent Question requires a Government Minister to give a response on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
First, may I welcome the hon. Lady to her place in this House? I am sure that she will make an extremely important contribution. Yes, she is filling very big boots, but, if I may say so, she has made a very good start.
On what happens with A&E departments, changes in the pattern of the services we provide have been a feature, both when the hon. Lady’s party has been in power and when my party has been in power, because the needs of the people who use the NHS also change. We therefore need to strike the right balance between reassuring people that services are provided near where they live, while ensuring that they receive the right care when they get there. For strokes, that does not always mean going to the nearest hospital, but somewhere with 24/7 stroke care and the greatest chance of saving the patient’s life. If the hon. Lady has concerns about Dewsbury hospital, I am very happy to talk to her further.
At a time when every Department, with the exception of the Department for International Development, has to reduce public expenditure, it seems a remarkable feat of political skill to have secured an increase for the NHS bigger than either the Home Office budget or that of the Ministry of Justice. Will the Secretary of State tell me whether there are parts of the United Kingdom where health expenditure is not rising as fast as in England? If there are, which political parties are in charge there?
I thank my right hon. Friend, whose passion and commitment to higher standards for the constituents he serves have inspired me in this job, just as I know they have inspired many others in the education field. There are indeed parts of the United Kingdom that allow us to make a very good comparison of the commitment to and funding of the NHS. In Wales, funding went down in the first four years of the previous Parliament. In Scotland, funding went down over the course of that Parliament. Both the Scottish National party and the Labour party like to talk about the NHS, but when it comes to writing the cheques, they are nowhere to be seen.
(8 years, 1 month ago)
Commons ChamberI thank the hon. Lady for her point. She mentioned Scotland’s minor ailments programme. The announcement I made on that about a week ago was in many ways modelled on the Scottish model, because we know that pharmacies can do much more on minor ailments than at present. That will be commissioned separately from the other things we are talking about today, and paid for separately from the integration fund. We are a little behind Scotland in that regard, and we are going to catch up.
I congratulate the Minister on recognising what Labour failed to: that NHS money is taxpayers’ money and the priority should always be patient care, not the profits of private equity firms. May I further congratulate him on making it clear that those living in our most deprived communities will be protected and have services enhanced as a result of this change, and may I invite him to say more?
I will not say much more because of time constraints, but I thank my right hon. Friend for his comments. He is right to remind the House that this sector is quite concentrated towards public companies. That is not to say there are not some individual pharmacists that will be affected, but about 25% of pharmacies are owned by two or three public companies.
(8 years, 2 months ago)
Commons ChamberI do not have figures to hand for exactly what the number will be this year—I will certainly let the right hon. Gentleman know—but around 11,500 extra doctors will be trained during the course of this Parliament.
As I said in the statement, it is important to recognise that the changes involve not only junior doctors. We need more weekend consultant cover—that is particularly important—and more people who are able to do the diagnostic tests. A whole range of people need to take part in the changes to improve standards of care at the weekends.
I congratulate my right hon. Friend on his reasonable yet resolute approach throughout the negotiations, which has been reflected in the fact that the leaders of so many royal colleges chose to criticise the decision to go on strike. The suspension of the strike action is therefore wholly welcome.
My right hon. Friend made the point that clinical standards will be improved as a direct result of the move towards a seven-day NHS. Will he enlighten the House about which particular types of patient in which circumstances will benefit as a result of his welcome drive to improve patient care?
I am happy to do that. Indeed, I am delighted to take a question from my right hon. Friend, because it is after someone has long departed an office that people actually appreciate that big, important changes were made, which was certainly the case from his tenure as Secretary of State for Education.
One of the clinical standards states that people admitted at weekends should be seen by a senior doctor—a consultant or an experienced junior doctor—within 14 hours. They will be seen by a doctor much sooner than that, but they should be seen within 14 hours by someone experienced enough to know whether there is something to worry about. That would happen in most places during the week, but it does not happen in many places over the weekend. Another standard relates to the most vulnerable patients who are at real risk of going downhill. This is not the clinical term, but doctors say that spotting people who are going downhill is one of the most important things. Such people should be checked at least twice a day by someone experienced enough.
Those are two of the four clinical standards that we want our constituents to be reassured are in place across the country. We think that that will make a big difference.