NHS

Norman Lamb Excerpts

Wednesday 5th February 2014 Commons Chamber

[Andy Burnham]

My hon. Friend’s point was also made powerfully by ambulance staff at an A and E summit held by the shadow Front-Bench team in Parliament before Christmas when a paramedic spoke of the phenomenon she has just described. He mentioned an occasion when staff were at the door of A and E waiting to hand over a patient to A and E staff, when the patient had a heart attack. The staff did not know what to do and had to go back to the ambulance to try to stabilise the patient. Those sorts of joining points or disconnects in the system are leading to real pressure on staff who do not know what to do in those difficult circumstances. The system is in danger of being overwhelmed, and the pressure on staff must be addressed urgently.

[The Minister of State, Department of Health (Norman Lamb)]

I share the right hon. Gentleman’s view that delays in handover at A and E are not acceptable, and I remember well that last decade, under the previous Government, ambulances were stacking up outside the A and E at the Norfolk and Norwich hospital. Does he welcome the fact that this winter, delays of longer than 30 minutes are down by more than 30% compared with last year?

[Andy Burnham]

Yes, there has always been pressure on the ambulance service at this time of year, but if the Minister wants me to join in with his complacency, I am afraid I will not. The past 12 months have been the worst in A and E in a decade, and there are reports of ambulances across the country held in queues. Is the Minister satisfied with the performance of the ambulance service in his region of east England? Was he satisfied with the way the case I mentioned was handled? I do not believe he was or that his complacency at the Dispatch Box will be appreciated by his constituents.

--- Later in debate ---

[Grahame M. Morris]

I am grateful to my hon. Friend for that intervention, and I hope that her point will not be lost on Ministers. That is a significant factor.

The lack of adequate support in the community and in the home has stored up problems in the NHS, and I am convinced that they will be exacerbated by what is now happening. I know that we have done some good work on the Care Bill—there is good intent there—but I have real concerns about whether the resources necessary to make social care really work will be provided. We have seen attendances at hospital A and Es continuing to rise.

[Norman Lamb]

We have had this discussion on the Care Bill. The hon. Gentleman talks about the need for additional resource, but in Committee there was no indication from the Opposition that they would make a commitment to provide extra resources. Is he now saying that they would do so?

[Grahame M. Morris]

I cannot thank the Minister for that intervention. We have had many exchanges during the passage of the Care Bill, but that decision is above my pay grade. It would be for those on our Front Bench to determine the level of such resources. The purpose of this debate is to consider the A and E crisis. I would like to think that that commitment could be made, however, and if the Minister is asking me personally whether I support it, the answer is that I do. I believe we should also support free end-of-life care, which I know the Minister and many others on the Government Front Bench support. However, I must make some progress with my speech.

The lack of adequate support in the community has had an impact. It has contributed to increased attendances at A and E departments. I hope that Members will not have forgotten that, two years ago, the Prime Minister said:

“I refuse to go back to the days when people had to wait for hours on end to be seen in A&E”.

Well, I am afraid that we have gone back to those days. Sadly, by removing the social care needed for many elderly people to avoid unnecessary trips to hospital and to return home when their stay should be over, the Prime Minister is bringing back those days. I urge hon. Members to support the Opposition motion today.

--- Later in debate ---

[The Minister of State, Department of Health (Norman Lamb)]

This afternoon, we have been presented with more of the same from the Labour party—the same scaremongering, the same misinformation, the same unwillingness to offer solutions. In short, it is the same old Labour party.

Earlier this week, we heard from the right hon. Member for Leigh (Andy Burnham) that the N was being wrenched off the NHS and that it was being sold to any company, but in reality only 6% of expenditure in the NHS goes to private providers. He talks about “market madness running riot through the NHS”, but listen to the facts: between 2006 and 2010, under Labour, total spending on the independent and private sector more than doubled; and between 2007-08 and 2010-11, under Labour, the number of operations conducted by the independent sector tripled. Since then, the figure has been around 46%.

Labour is desperately trying to make the public believe that its skewed vision is the reality of the NHS, but this view is of course total nonsense, and I am happy to try to set the record straight.

[Andy Burnham]

I think the Minister was in the Chamber when his predecessor as care Minister held his hands up and admitted he got it wrong on competition when the Health and Social Care Bill went through the House. He has given hints to newspapers that he feels the same way. Would he care to step into the confessional and admit that the Liberal Democrats got it wrong on competition in the NHS?

[Norman Lamb]

I certainly think we have to avoid any repeat of what happened in Bournemouth. It is absolutely right for politicians to make that clear.

The Labour party has tried to paint a picture of crisis in A and E. We know that there is more pressure on this vital service.

[Margot James]

My hon. Friend is making some excellent points about Labour’s record of inviting competition into the NHS when in office. The success of that record might have been the reason why Labour’s manifesto in 2010 promised:

“Patients requiring elective care will have the right, in law, to choose from any provider who meets NHS standards of quality at NHS costs”.

[Norman Lamb]

If I am right, that is called “any qualified provider” or “any willing provider”, which is exactly what this Government have pursued. Labour’s rewriting of history is breathtaking.

There are 1.2 million more people visiting A and E than three years ago—the hon. Member for Stretford and Urmston (Kate Green) is right that the system is under pressure—but the increase in the number of A and E attendances peaked in 2009-10, under the previous Labour Government, when there was a year-on-year increase of 4.7%. Since then, the increase has been slower, and in the last full year for which data are available it was just 1.2%—clear evidence that the Government’s policies are starting to work.

Doctors and nurses in our A and E departments up and down the country are doing brilliant work. Last week the NHS not only met the four-hour A and E target, but improved on its score from the same time last year. By contrast, in Labour-run Wales, A and E targets have not been met since 2009. The College of Emergency Medicine has said that Welsh A and E departments are on their knees, at the “point of meltdown”, and are putting patients at risk in Labour-run Wales. The college has complained of the ruthless

“pursuit of targets and financial balance at the expense of quality of care.”

In England, we have already met the target for more weeks this winter than when the right hon. Member for Leigh was Health Secretary. He missed his A and E target for two of his three quarters—was that a crisis in those days?—whereas we are seeing 2,000 more patients every day in under four hours than when Labour was in government. Ambulance performance is better than at the same time last year, meaning more ambulances arriving on scene in under eight minutes. Across the country, delays in handing over patients at A and E have dropped by a third compared with last year as a result of new sanctions, so we are not complacent.

As my hon. Friends the Members for Suffolk Coastal (Dr Coffey) and for Witham (Priti Patel) rightly said, we are sorting the problem. Opposition Members would like people to think that the NHS is going to ruin. They are so desperate—using the examples of scurvy and rickets. Of course, when that happens it is incredibly serious, but to suggest that that is part of the problem is outrageous. We heard the figures for scurvy, but there were 66 admissions for rickets in 2010-11 and 65 in 2012-13, so the figure has gone down. The truth is that we inherited a dysfunctional system that was crying out for reform—too many people ending up in hospital because of crises in their care, and far too much money spent on bureaucracy, as my hon. Friend the Member for Witham made clear.

For years I have argued the case for a different approach. We are making the essential changes and supporting NHS staff through difficult times. For this winter we are investing an additional £400 million in total—more than ever before. Having put plans in place earlier than ever before, with urgent care boards deciding what works in local areas, we are already seeing the benefit of those additional funds, with 320 more doctors, 1,400 more nurses, 1,200 other staff—occupational therapists, physiotherapists and so on—and more than 2,000 additional beds.

Throughout this debate we have heard that urgent and emergency care needs to change, and rightly so, but may I remind the House that we are the Government who are making that change? We have asked Bruce Keogh to undertake a fundamental review of urgent and emergency care, but there are still far too many people ending up in hospital because of crises in care. There are too many people with long-term conditions who are still receiving unco-ordinated care. That is frustrating for the patient, it wastes money for the system and it can lead to worse health outcomes, as we fail to prevent such conditions from getting worse. It is our aim in government to join up services, fitting them around people’s lives and providing better care closer to home.

The right hon. Member for Leigh seems to have had a recent damascene conversion to the case for integration. It is a shame that in the 13 years his party had in power, it did nothing significant to achieve it. In fact, many of the things it did and the decisions it made took the NHS in the wrong direction—on tariffs, on incentivising more activity in hospitals, on the disastrous private finance initiative and on the equally disastrous GP contract. I am proud to say that it is this Government who are taking the practical steps to make integration more commonplace throughout the country. We have selected 14 integrated care pioneers and we now have the £3.8 billion better care fund to achieve joined-up care throughout the country.

The truth is that the right hon. Gentleman and the whole of the Opposition have systematically dismissed the real issue with empty rhetoric. They want better care in A and E, yet we have started the reforms that will revolutionise urgent and emergency care. They want the health and care services to become more integrated. We are leading the charge to make that happen, and to improve care and support for people throughout the country. They want us to change competition law. We have made it clearer and easier to understand, and have balanced that with the need for integration, and the need to help doctors to know how and when to use it.

The Opposition are fighting their own shadow. Well, they can shadow-box all they want. They can waste time complaining rather than coming up with solutions, but this Government are actually tackling the issues, and making the changes to the health and care system that patients so desperately need.

Question put (Standing Order No. 31(2)), That the original words stand part of the Question.