Healthier Together Programme (Greater Manchester)

Debate between Norman Lamb and Julie Hilling

Tuesday 22nd July 2014 Westminster Hall

[Norman Lamb]

I take that concern on board, and the hon. Lady should respond to the consultation. It is really important for hon. Members to do that.

Incidentally, I should say something on behalf of my hon. Friend the Member for Cheadle (Mark Hunter), because he is a Whip and so is unable to speak in the debate, although he has attended it all. He has expressed particular concerns about the potential implications for the University Hospital of South Manchester and Stepping Hill, and about options 4.1 and 4.2. It is important that I place that on the record.

[Julie Hilling]

Will the Minister give way?

[Norman Lamb]

Will the hon. Lady let me make another point that is on the tip of my tongue? I will then be happy to give way.

The hon. Member for Stalybridge and Hyde expressed the concern that, in his assertion, we are moving away from integrated care. Precisely the opposite is the case. Indeed, the hon. Member for Copeland (Jonathan Reynolds), the shadow Minister, expressed clearly some of the fantastic potential gains that could be achieved in the Greater Manchester area if the objectives were achieved. When I announced the pioneer programme to demonstrate the exemplars of integrated care, Greater Manchester was one of the applicants to get on to the shortlist and was close to securing pioneer status, so my every impression is that exciting work is going on in Manchester to change local health and care services in a way that all of us could probably sign up to.

[Julie Hilling]

rose—

[Kate Green]

rose—

[Norman Lamb]

I give way first to the hon. Member for Bolton West.

[Julie Hilling]

I thank the Minister for giving way. The bit that I do not understand is that local authorities, leaders such as Lord Smith and others, have been saying, “Yes, we need to sort out the integrated care”, but the consultation has been putting front and centre the need to change the status of hospitals. What everyone in the conurbation is saying is, “Let’s look at the integrated care and then see what comes out of that”, rather than putting changing hospitals up front, which is what exercises the whole community.

[Norman Lamb]

I note the hon. Lady’s point, but I come back to Lord Smith’s statement:

“We accept the case for change made in this consultation document”.

It cannot be clearer than that.

--- Later in debate ---

[Norman Lamb]

I acknowledge that, just as in London, there are real bottlenecks in Manchester. I have a son who was at university in Manchester—and found it to be a very fine city—so I understand the transport challenges there completely. The point remains that specialisations can save lives. We all have to recognise that.

All service changes should be led by clinicians and be based on a clear, robust clinical case for change that delivers better outcomes for patients.

[Julie Hilling]

Will the Minister give way?

[Norman Lamb]

I really cannot. I have been pretty generous in giving way many times, so I will make a bit more progress.

It is therefore for NHS commissioners and providers to work together with local authorities, patients and the public in bringing forward proposals that will improve the quality and sustainability of local health care services. Government policy has been to emphasise local autonomy and flexibility in how NHS organisations plan and deliver service changes, subject to meeting legal requirements, staying within the spirit of Department of Health guidance and ensuring schemes can demonstrate robust evidence against four tests. Those are that there is support from GP commissioners; there is a focus on improving patient outcomes; that schemes consider patient choice; and that they are based on sound clinical evidence.

I recognise that change is often difficult to achieve because the consequences of not getting it right could be so profound—hon. Members have been absolutely right to raise their concerns. It is therefore right that the NHS does not rush into change without fully understanding all the potential consequences, sometimes including unintended consequences. Change can be difficult to explain to patients who have had quite reasonable anxieties exacerbated by speculation—in many cases, in the media—about whether this or that service might close. Services are sometimes described as closing when in fact they are simply being provided in a neighbouring facility or changing for the better in response to advances in treatment.

For example, my hon. Friend the Member for Macclesfield (David Rutley) referred to the possibility of hospitals closing, but I am not aware of any proposal to close hospitals. When we communicate to patients and the public, it is important that we are clear on what this issue is and is not about, so as not to raise anxieties. From my perspective, we have to be careful to avoid ramping up anxieties inappropriately by playing on fears. We see that too often; unfortunately, it stifles genuine debate and discussion about what health services will need to change in order to do better in future. But I applaud all hon. Members for speaking in this debate very reasonably and about legitimate concerns.

The right hon. Member for Leigh (Andy Burnham) has agreed that the NHS needs to have the freedom to change the way services are provided. He said:

“If local hospitals are to grow into integrated providers of whole-person care, then it will make sense to continue to separate general care from specialist care”—

the point made by the hon. Member for Wigan a moment ago—

“and continue to centralise the latter. So hospitals will need to change and we shouldn’t fear that.”

Perhaps the hon. Lady will take the point better from her party’s health spokesperson than from a Minister, but the right hon. Member for Leigh was making the case for the specialisation of services.