Health and Social Care Levy

Paul Bristow Excerpts

1st reading
Wednesday 8th September 2021 Commons Chamber

[Paul Bristow (Peterborough) (Con)]

I rise as a member of the Health and Social Care Committee to support this measure today, and as I do so I would like to direct Members’ attention to my entry in the Register of Members’ Financial Interests. I sit on the Health and Social Care Committee, and only yesterday morning in the Committee we heard from two patients who talked clearly about the delays that they faced in accessing care in the NHS. The first was a lady called Shirley Cochrane, who sadly had an aggressive form of breast cancer. During her time on an NHS waiting list, waiting for treatment, she felt alone and said that she was not listened to and did not get the attention she needed. The second was a gentleman called James Wilkinson. He had myocarditis, a condition that I know a little bit about myself, having had that condition in the past. While waiting for aortic valve replacement surgery, he had the surgery cancelled three times.

We face an enormous challenge. In that same Committee, we heard from the Health Foundation, which talked about the enormous sums that would be needed to solve this backlog. It also talked about the number of consultants, NHS staff and nurses that would be needed to increase capacity in our NHS. Opposition Members need to understand that, if we are going to face up to the enormous challenge that our NHS and social care system is facing, it has to be paid for. It cannot just be borrowed. If they have a better way of paying for this, they need to outline it now.

When the lady from the Health Foundation was giving evidence to our Committee yesterday, she said that three things were needed to resolve the backlog. Those three things were more money, more capacity and a plan. I have been involved in health politics for 15 to 20 years, and every single review that I have seen the NHS conduct has said that it needs more money, more staff and a plan. That has happened under Labour Governments and under Conservative Governments. So if we are going to go ahead with this plan, which I support, we need to ensure that it goes with reform and innovation too.

[Catherine West]

With his wealth of experience in health politics, does the hon. Gentleman accept that we do not know, because the Secretary of State for Health and Social Care has not outlined it, how many of the people on waiting lists will actually be seen and dealt with, and that this is a bit of blank cheque?

[Paul Bristow]

We will not approach the backlog unless we have the money and capacity to fund it, and that needs to go hand in hand with what I said about innovation, new pathways and new ways of working. I remember talking to someone who told me that we had three years’ worth of innovation in the NHS in just three months because of the pandemic. New ways of working and new pathways were adopted.

Every time we talk about innovation in our NHS and new pathways—the accelerated access review, the “Innovation Health and Wealth” report and a new life sciences strategy all talk about innovation and new ways of doing things in our NHS. But those new ways of doing things need to be spread at pace and at scale. There is no excuse not to do it now. If it works in one part of the NHS, it will work in another. Culturally, the NHS needs to grasp the nettle and spread that innovation and new ways of doing things so that we can get productivity and outcomes for patients. Now is the time to do it.

[Mr Betts]

The Health and Social Care Committee, of which the hon. Gentleman is a member, estimated last autumn that there was a £3.9 billion funding gap in social care. I assume that he agreed with that report. Can he explain, therefore, how this levy will deliver £3.9 billion a year for social care? I have not seen any figures showing that at all.

[Paul Bristow]

Having no plan will not provide the £3.9 billion, and Labour Members have indicated today that there is no plan.

This is a significant tax increase. I am a Conservative, so I do not like tax increases, but I also understand that an enormous thing happened between the manifesto and now. There has been a global pandemic, and Labour Members seem to have missed that fact. We need to shorten waiting lists, we need to do something about it and we need to correct it.

[Several hon. Members rose—]

[Paul Bristow]

I have given way twice, and I would like to continue because I want to make another important point.

This tax, this levy, needs to be accompanied by reform. The Health and Care Bill is in Committee, and it is really important. The way incentives are geared within the system is one reason we can power through elective waiting lists. We pay for care through a system of tariffs. I urge Ministers and others to think carefully about how we pay for elective procedures in our NHS, because any system of tariffs needs to ensure that hospitals are paid properly for carrying out procedures. There need to be proper incentives for hospitals to carry out hip, knee, cataract and hernia operations, which are the majority of the backlog, as well as treating cancer, heart conditions and everything else. If we are not able to find the right levers within our NHS system to ensure that we power through those elective procedures, we will not be able to solve some of the more serious operations at the end.

Innovation tariffs, for example, would also help by encouraging new ways of doing things. We cannot have a system where, financially, trusts and our NHS are not incentivised to do the things they need to do to be more productive. They should not pursue short-term financial measures when we really need incentives to make sure that they do the right thing.

I will be marching through the lobby to support the Government today, because this is really important.

[Jess Phillips (Birmingham, Yardley) (Lab)]

Will the hon. Gentleman give way?

[Paul Bristow]

I have given way a few times.

We must grasp the nettle of NHS reform, backed with finance so that our NHS staff have the bandwidth to deal with the needed reform. That bandwidth is capacity and money. If that does not happen, we will borrow more and spend more in the long term and this ever-lasting round of more staff, more money and more plans will go on and on.

I urge hon. Members to support the Government’s motion today.

Health and Social Care Levy Bill

Paul Bristow Excerpts

2nd reading
Tuesday 14th September 2021 Commons Chamber

[Paul Bristow (Peterborough) (Con)]

I refer the House to my entry in the Register of Members’ Financial Interests. As a member of the Health and Social Care Committee, I rise to support the Bill and to argue that the money raised by this levy be spent well. I commend my right hon. Friend the Member for South West Surrey (Jeremy Hunt) on his chairmanship of the Committee, in which we are conducting those lessons-learnt inquiries to ensure that our money is spent well. I want to mention three areas; if we focused on them, we could ensure that this money is spent well and get the desired outcomes.

The first is capacity in the acute sector. It is clear that the NHS needs to strike a long-term deal with the independent sector to try to power through the backlog of elective procedures. We are talking about hips and knees, hernias and cataract operations. I read and hear reports, with alarm, that the independent sector capacity that the NHS has bought is being underused—or, if it is not being underused yet, there is a fear that it may well be—because of ideological reasons that the independent sector should not be used and we should be funnelling all these procedures into the NHS. If we do not use the independent sector, we will not have the desired outcomes. We cannot let ideology dictate, as this will ensure that people are left in pain for longer and do not have the right quality of life. We need to ensure that the independent sector is used to its full capacity, so that we can get through this elective backlog.

Similarly, we need to ensure that initiatives such as “Getting It Right First Time”, or GIRFT, are used properly. The NHS has spent money, resources and experts’ time on understanding which procedures work at high volume and low risk. We should use the lessons learnt from GIRFT to deal with the elective backlog. Let us not reinvent the wheel, but let us ensure that we do learn those lessons. Ultimately, these are usually minimally invasive techniques and technologies for procedures that can be done as day surgery, and this will ensure that we power through the backlog and get the elective procedure waiting list under control.

The second issue that the Health and Social Care Committee has heard about is the importance of the diagnostic sector. In the past, I think the NHS has been guilty of focusing on the treatment of conditions, rather than on prevention. If we get the early diagnosis correct and invest in diagnostics technology, we can find out who is at risk of suffering from cancer, heart disease and other long-term conditions before they present at an acute level. It is really important that we invest in that sort of technology, so that we can save money in the long term.

Finally, let me turn to innovation in our NHS in general. I have worked in health politics, if you like, for 20 years. As I said last week, there is a cultural aversion to the private sector, technology and innovation in our NHS. That aversion may be at the margins, but it is at least having an impact, and it needs to be dealt with straight away. If we do not adopt innovation—new technologies, pathways and ways of doing things—we are not going to ensure that this money is spent well.

I would challenge that something that should come out of the health service reforms that we are looking to introduce is the appointment of an innovation officer, or someone who is responsible for innovation in every NHS trust. Let us make it their job. I welcome the fact that we are at last beginning to ensure that the NHS will have a degree of accountability again, and that politicians will have the ability to challenge NHS trust managers to ensure that this money is spent well. One way to do that is by having an innovation officer who is responsible for reform and innovation, ensuring that new pathways are adopted and this money is spent well. If we do not, we could be here again in three or four years’ time, and the money that we want to transfer to social care in due course could have been gobbled up by the NHS, which my right hon. Friend the Member for South West Surrey said was a real risk.

As far as I am concerned, those are the three real challenges: acute capacity; investment in diagnostic capability; and ensuring that innovation is properly recognised in our NHS.