National Health Service Funding

Natascha Engel Excerpts

Tuesday 22nd November 2016 Commons Chamber

[Jonathan Ashworth]

I give way to my hon. Friend. [Interruption.]

[Madam Deputy Speaker (Natascha Engel)]

Order. That is enough shouting.

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[Dr Allin-Khan]

I thank the right hon. Gentleman for allowing me to speak again. I shall refer at length to St George’s hospital in my speech, but it is very unfair of him to bring it into this debate. It is because of this Government that St George’s hospital is operating at a £50 million deficit. It is because of this Government that we are now in special measures. It is—

[Madam Deputy Speaker (Natascha Engel)]

Order. The hon. Lady is hoping to catch the eye of the Chair later in the debate. As it is, there will be a five or four-minute time limit, so Members who intervene must do so very briefly and not very frequently. If they do not do so, I am afraid that they may not be called to speak.

[Mr Hunt]

The shadow Health Secretary also did not talk about cancer. In 2010, we had the lowest cancer survival rates in western Europe. Since then, we have referred for cancer tests 2,200 more people every day, and 100 more people are starting cancer treatment every day. The cancer charities say that this is saving 12,000 lives a year. On mental health, he did not mention the fact that we are treating 1,400 more people every day, with record dementia diagnosis rates.

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[Several hon. Members rose—]

[Madam Deputy Speaker (Natascha Engel)]

Order. Before I call the SNP spokesperson, I must inform hon. Members that, including her speech, we have calculated, generously, that every speaker will have five minutes, but we will probably have to go down to four minutes at some point.

[Dr Philippa Whitford (Central Ayrshire) (SNP)]

Does that include five minutes for me also?

[Madam Deputy Speaker]

Obviously the hon. Lady has no speech limit, but the speech limit has been calculated with her mind. I am just saying that the longer someone speaks for, the less time everyone else will have.

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[Several hon. Members rose—]

[Madam Deputy Speaker (Natascha Engel)]

Order. Following that public service announcement, I must reduce the time limit for Back-Bench speeches to four minutes.

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[Margaret Greenwood (Wirral West) (Lab)]

The funding crisis in the NHS is no accident. It is a political choice made by the Tories for which patients and NHS staff are paying the price in longer waiting times, delayed operations, and increasingly stressful working conditions. It is a crisis driven by the Government’s demand that the NHS make £22 billion-worth of efficiency savings—or cuts. This is impossible without huge damage to our national health service.

An analysis by The Guardian of 24 of the 44 STPs stated:

“Thousands of hospital beds are set to disappear, pregnant women will face long trips to give birth and a string of A&E units will be downgraded or even closed altogether as part of controversial NHS plans to reorganise healthcare in England…Dozens of England’s 163 acute hospitals look likely to have services, including cancer, trauma and stroke care, removed as a result of the plans”.

In the 2015-16 financial year, the NHS reported a record net deficit of £2.45 billion—nearly three times higher than in 2014—and so we see the crisis in services accelerating. Last week, the chief executive of NHS Providers, Dr Chris Hopson, said:

“The NHS simply cannot do all that it is currently doing and is being asked to do in future on these funding levels.”

STPs are supposed to facilitate the integration of health and social care, for which they require the support of council leaders, yet the leader of Wirral Council has said in the past 24 hours that he has not been given the opportunity to feed into the development of the local plan. The STP for Cheshire and Merseyside is of great concern to my constituents because it requires nearly £1 billion to be taken out of local health services. If this goes ahead, the impact on the NHS will be devastating; it is impossible that it would be otherwise.

There was recently a proposal to close Arrowe Park hospital, Clatterbridge hospital and Countess of Chester hospital and build a new hospital in Ellesmere Port, and there has been no denial that such a conversation has taken place. The annual report of the foundation trust that runs Arrowe Park and Clatterbridge says:

“The Trust will explore with Countess of Chester Hospital the potential for the development of a single acute general hospital covering Wirral and west Cheshire within the next 10-15 years …Another option is to move all planned surgery and procedures to Clatterbridge, while Arrowe Park will become a ‘hot site’ dealing mainly with emergencies.”

It is not clear what a “hot site” is if it is not a hospital. Surely the point about an A&E is that it needs to be in a place where there is a very wide range of expertise on how to deal with any emergency. I have very real concerns about the future of Arrowe Park hospital, which is a major hospital highly valued by my constituents who use its services and who work there; indeed, it is a major employer in my constituency. The STP talks of “hospital reconfiguration”. It is no wonder that local people are up in arms about the plans.

The STP for Cheshire and Merseyside appears to set a great deal of store by the development of ACOs, or accountable care organisations. These are an idea brought from America, where of course there is no national health service. They integrate health and social care, and have a strong emphasis on cost reduction. The core issue is that people in England often pay for social care, but certainly do not expect to pay for healthcare, other than through direct taxation. There is real concern that the introduction of ACOs through STPs is part of a desire on the part of the Government to introduce a private insurance-based healthcare system in England instead of our national health service. I would be grateful if the Minister could give some clarification on that point.

It is my belief that the Government are cutting the supply of healthcare in the public sector to create demand for a private health insurance marketplace like the one in America, and there is nothing in the STP to reassure me that that is not the case. The document is riddled with the language of the market, talking of increased customer satisfaction, better user experience and “commercially sustainable” clinical support services. If the STPs go ahead across England, we can expect to see A&E closures, hospital closures, downgrading of services, patients waiting longer for treatment, and deterioration in the pay and conditions of staff as the drive to cut costs takes its toll. I urge the Government to use the autumn statement to address the underfunding of the NHS and to give it the funds it needs.

[Madam Deputy Speaker (Natascha Engel)]

May I just make an apology to Hansard? It is one thing reading a speech, but that was a record level of reading into the record. I appreciate that time is short and that the hon. Lady wanted to put those things on the record, but if she speaks a little bit slower and allows other Members to understand what she is saying, it will give them an opportunity to intervene and she will gain some extra time.

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[David T. C. Davies (Monmouth) (Con)]

I am very pleased to pick up where the hon. Member for Tooting (Dr Allin-Khan) left off. Quite frankly, I find it extraordinary that Labour Members have the audacity to come into the Chamber and trumpet their views about the national health service when they know that they have had 18 years of running the NHS in another part of the United Kingdom and that, on any of the performance indicators that are looked at, the NHS in Wales is performing less well than the NHS in England. I do not for one minute want anyone to think that I am criticising NHS staff—the nurses and doctors—because I am not, and I am not running down Wales either, because I know exactly where the blame lies. It lies at the feet of the Labour party for implementing exactly the same policies that Labour Members are now calling on the Minister to implement.

There is no need to take my word, or that of any Conservative, for this; one can simply get hold of the Nuffield Trust report on “The four health systems of the United Kingdom: how do they compare?” This independent report looked at a range of indicators, and it makes this very clear. I am very happy to read from the report, which in its own way is far stronger than anything the Conservative party could publish. It says that waiting times in Wales have lengthened since 2010, with striking rises in waits for common procedures such as knee and hip replacements. When language such as “striking rises” is used, surely people should take notice of the report, especially when, as Labour Members must realise, those striking rises are being caused by the policies they are asking my hon. Friends to implement.

The report talks about how amenable mortality rates are lowest in England. In other words, people live longer in England. It also talks about waiting times, which are an absolute disgrace. There is a target waiting time of 26 weeks in Wales, whereas it is just 18 weeks in England. More than that, the report shows that some people are waiting for up to 170 days for knee and hip replacements in Wales, as opposed to just 70 days in England.

The report shows that funding in Wales has been cut in real terms. Wales is the only part of the United Kingdom where funding for the national health service has been reduced; in England it has been going up.

The report shows that there is a shortage of GPs. My hon. Friends have increased the number of GPs to 0.75 per 1,000 people, compared with 0.66 per 1,000 in Wales. On stroke care, 39% of patients spent 90% of their time in a stroke unit, as opposed to 51% of patients in England—a much higher amount. The figures for MRSA show, once again, that England is ahead of Wales. The figures for ambulance response times show that 75% of ambulances make it within eight minutes in England, as opposed to 65% in Wales.

Perhaps one of the most shocking differentials in service between England and Wales is in the access to cancer drugs. Constituents have come to see me because they have had to go sofa-surfing with relatives in England to get access to standards of care that patients on this side of the border take for granted.

I issue a challenge to everyone in this House. If Opposition Members think that the Welsh NHS, the policies of which they want to follow, is as good as the English national health service, they should allow patients to choose. I constantly write to my colleagues on the Front Bench asking them to allow patients from Wales to access the national health service that they are delivering so well in England. Unfortunately, it is not always possible to do so. We should have a truly national health service that allows people in Wales to go and be treated in England if they want and, indeed, people in England to be treated in Wales if they want, and adjust the block grant accordingly.

In the meantime, I very much hope that my hon. Friends will stick with the policies that are delivering higher standards of healthcare in England because, if nothing else, it means that my constituents have something to aim for and can demand that the Labour party in Wales follows the successful policies that are being followed in England.

[Madam Deputy Speaker (Natascha Engel)]

A couple of Members who were on the list are not in the Chamber and will be written to. That means that the last two speakers have up to six minutes each.