NHS Sustainability and Transformation Plans

Nicholas Brown Excerpts

Wednesday 14th September 2016 Commons Chamber

[Mr Nicholas Brown (Newcastle upon Tyne East) (Lab)]

I welcome the Minister and shadow Minister to their new responsibilities. The Labour party was right to choose this topic for the Opposition day debate. I wish the Minister well in confronting the financial difficulties that face him.

In confronting those difficulties, the Government’s “Five Year Forward View”, which was published in 2014, called for £22 billion of efficiency savings to be found by 2020, on top of the £20 billion of efficiency savings to be found between 2010 and 2015. I simply do not think that should or can be done. The total deficit in all national health service trusts reached £2.45 billion in 2015-16, a figure that is almost three times greater than in 2014-15 and almost half a billion pounds higher than the national health service’s own revised plan. Monitor estimates that even if all realistic efficiency savings were made, a deficit of £1.5 billion would remain in this financial year. It is simply not possible to deal with the situation through efficiency savings. The Government know that and are stuck, hence the sustainability and transformation plans covering the next five years, organised along 44 footprint areas that do not have any existing coherence with existing health service organisational boundaries. In the north-east, the Northumberland and Tyne and Wear footprint covers five clinical commissioning groups, six local authorities and seven foundation trusts.

Newcastle, the city I have the honour and privilege to represent, enjoys well run and efficient health services, which is testament to staff working at all levels in the NHS there. Our health services are well regarded in the local area, but the sustainability and transformation plans raise at least three serious questions. If NHS England and NHS Improvement think that more than half of clinical commissioning groups are underperforming, why are they asking CCGs to draw up the key documents that will transform the structure of the NHS? Given that many CCGs will have to merge, where is the motivation for them to create clear, competent and credible plans? Given that the footprints will have no formal structure, who is accountable for the long-term consequences of the plans?

The approach that is being adopted bears a striking resemblance to the previous top-down, unwanted revision of the NHS that we were promised would not happen when the Government came to power in 2010. They are doing something that one would have thought difficult—they are breaking their promises twice.

This is not the first threat that the north-east has faced. We have faced the redistribution of moneys and the downgrading in the distribution formula of the social deprivation component, with far more emphasis being placed on the age-related part of the formula, which affects the well elderly rather than people who are ill.

In government, Labour promised to increase health spending to match the then European average of 8.5% of GDP. We kept that promise, but successive Governments since—the coalition Government and the Tory Government—have failed to commit funds to the NHS. That is why health spending as a proportion of GDP will fall to 6.6% by 2020-21, which will leave us lagging behind the OECD average spend of 9.1% and comparable countries such as Germany, which spends 11%.

The Government should be honest with people about the challenges the national health service faces and the response needed to meet them. The sustainability and transformation plans are a fundamentally bureaucratic response to the funding crisis in the NHS. As such, the Government completely misunderstand the fact that the NHS needs not more meetings but more money.