Health

Nicholas Brown Excerpts

Monday 9th June 2014 Commons Chamber

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

It is a pleasure to follow the hon. Member for Newbury (Richard Benyon). Let me begin where he left off. For the past two years, along with other Members of Parliament representing the north-east and Cumbria, I have been arguing against attempts to alter the health service’s funding formula and reallocate funding, taking it away from deprived areas with poorer health outcomes and giving it to more affluent areas with better health outcomes. Last year, the Government’s original proposals would have led to a reduction of £230 million in the annual health funding of the north-east and Cumbria. NHS England eventually opted for inflation-proofed increases for all clinical commissioning group areas, along with extra increases for some favoured clinical commissioning groups in more affluent parts of the country. I should welcome an assurance from the Minister that we will not have to go through that fight again.

The Government’s top-down reorganisation of the national health service is riddled with gaps and negative consequences. It has significantly increased pressures on A and E departments, which have now become the default places to visit if people need to see a doctor within days. It is no longer possible to make an appointment with a GP a day or so in advance, and many people have to wait several weeks for an appointment. There are arbitrary, cost-influenced restrictions on procedures and treatments, leading to a postcode lottery whereby some services are free in certain parts of the country but not in others.

Clinical commissioning groups are reported to have spent more than £5 million on competition lawyers to try to navigate competition law in relation to commissioning services. More than £1.4 billion has been spent on redundancies in the NHS, only for thousands of people to be re-hired under the new structures. I understand the latest figure is over 4,000. That point was made forcefully by my right hon. Friend the Member for Leigh (Andy Burnham) in his opening speech, and I support every word that he said.

There has to be an answer to this, and it is not coming from the Government. Health Ministers are increasingly hiding behind NHS England when it comes to big policy questions relating to the NHS, and more and more answers to parliamentary questions are being referred away from the Department and to unelected, largely unaccountable bodies. There is also the overarching issue of GPs’ now having key functions as commissioners, as well as functions as providers of services that are being commissioned. The obvious conflict of interest is corrosive to the ethical underpinning of the NHS.

I have the honour to represent the Freeman hospital and its internationally renowned heart units, including its high-achieving children’s heart unit. In the 2001 review of the Bristol children’s heart unit, Professor Sir Ian Kennedy clearly stated that England needed a smaller number of centres of excellence to undertake the complex, highly skilled procedures involved. No one has refuted his arguments, but, 13 years later, we are no closer to achieving the outcome that he said was desirable.

We cannot, and should not, let that issue drift. The Government have an obligation to set out a clear way forward that is compatible with Sir Ian’s recommendations, and to do so on the merits of the medical arguments and not on the basis of political expediency. The delays in addressing the issue over the four years of the current Parliament pose the risk that it will extend beyond the next general election, yet we are no clearer about the future of children’s heart units in England. Again, a response from the Minister on the issue would be welcome.

I want to raise the recommendations of the NHS Pay Review Body and the blocking of the recommendations by the Government. That decision comes after a two-year pay freeze and significant pay restraint following the two-year period. When factored against inflationary pressures, nurses’ pay has fallen by 10% in real terms over the past four years. Alongside that, contributions to the pension arrangements have increased, coming out of take-home pay.

The Government should not treat individual increments as if they were pay rises. Forty-five per cent. of nurses do not receive an increment. The Government should not set the NHS Pay Review Body recommendations to one side. They are wrong to insist instead on an offer of a 1% non-consolidated payment for this year, followed by a 2% non-consolidated payment for the following year. If nothing else happened at the end of this period, the nurses would be substantially worse off than they are today. These are pressing issues for the national health service.

I should like to make a more general point about the Queen’s Speech’s failure to touch on the most significant problem facing the north-east of England. Unemployment in the region remains the highest in the country, at 10.1%. Despite recent national falls in unemployment, it remains stubbornly high in the north-east.

The unemployment rate for the region has actually increased in 2014. There is a continued need to create sustainable well-paid jobs through private sector economic development in the region. The tragedy is that the parties do not quarrel about this: we agree on what needs to be done. The issue is doing it. Youth unemployment remains high and more needs to be done to open up opportunities to work and training.

Four years ago, the Government made sweeping changes to the delivery of economic development in the English regions. The Government’s reorganisation is not working for the north-east of England. Apart from the projects that were already under way under the last Labour Government, the present arrangements have little to show. Governments often make their largest mistakes in their first 100 days. Having abolished the regional development agency and Business Link, the Government have spent the last four years trying to set up structures that will carry out the functions that those bodies used to undertake, and in our region the efforts so far have achieved very little. This matters because it is our region’s core problem.

The Government’s original idea was that the new localism contained the answer to the north-east’s economic development questions. The coalition Government argued that the setting up of new locally based bodies would be the right way to provide economic development at local level. Over the past four years, the means has become the end. All energies have been focused on those structural questions. The purpose for which they were originally intended has been almost completely lost sight of. A single Minister needs to get a grip of these arrangements, which now span a range of different Departments, and force them to focus on specific economic development initiatives.

These are important issues. Now that the House has committed itself to fixed-term, five-year Parliaments, it is likely that all future final Sessions will have something of the character of this one. There is something unsatisfactory about it all. I feel that some of the big questions and the attendant debate are slipping away from Parliament.