National Health Service

Debate between Paul Maynard and Steve Baker

Wednesday 21st January 2015 Commons Chamber

[Paul Maynard (Blackpool North and Cleveleys) (Con)]

It is intriguing to follow the hon. Member for Rochester and Strood (Mark Reckless). I will leave my intrigue at that point and focus on the debate rather than him.

It is a shame that the shadow Secretary of State has left the Chamber, as I was about to say something relatively pleasant and polite about him—he will not hear it now. When he came up to Lancaster and Fleetwood a few weeks ago he joined me in praising my local A and E department, which had seen 97% of patients within four hours, the fifth best performance in the country that week. That is a superb achievement given the complex health economy in Blackpool. It is very rare that we are at the top of a league table for the right reasons in Blackpool, whether that is for football or for health care, so I welcome that.

It was interesting to note a more hidden and nuanced message in what the shadow Secretary of State had to say. The medical director of Blackpool Victoria says that between April and September 2014, 36% of those arriving at A and E did not need to be there. They could have received their diagnosis or treatment somewhere else, and the cost to the hospital was calculated at £842,000. The message I draw from that is that we still have an immense amount of work to do to ensure that people know where to go for the right treatment at the right time. It is, of course, incumbent on us to ensure that those alternatives are resourced, that people know where to go and that people have confidence in the alternatives.

We have not spoken enough today about pharmacies. Pharmacy trade bodies and the industry put so much into lobbying Members on both sides of the House, but I think it will require another decade or so of intensive lobbying of MPs before we finally get the message that it is far better to have first recourse to the local pharmacist to see whether one needs to go further in seeking appropriate health care. I rely on regular repeat prescriptions for my epilepsy, and I have saved myself many a GP visit by asking a question at my local pharmacy. We are overlooking the most basic corner-of-our-street access point for primary health care, and we should not forget it.

I want to praise another Member of a different political party from mine, and he is sitting on the Government Front Bench: the Minister of State has already been praised today for his approach to mental health care. It is warmly welcomed, particularly in a town such as Blackpool. Our new 74-bed harbour unit is about to open on the edge of the town. It has been long-awaited, and is much-needed following some of the appalling standards of care at the Parkwood unit over the past decade.

The Minister will know that he faces great challenges. I could easily have come here today and read out a number of immensely tragic cases involving young people not getting the appropriate mental health care. He still faces a battle with the profession, because clinicians differ over their assessment of this issue. I see far too many young people with some learning disorder who are somewhere on the autistic spectrum, where the clinician refuses to accept that they can both have a learning disorder and a mental health problem. They fall into that gap and are batted backwards and forwards between different providers. There must be a battle in the medical profession over how to reconcile those two different forms of clinical diagnosis.

Another point I want to raise—I have far more than I will be able to get into my remaining four minutes—was mentioned by my right hon. Friend the Member for Chelmsford (Mr Burns). I was struck by the shadow Secretary of State’s sudden enthusiasm for the walk-in centre in Jarrow—his instant commitment that it would be saved were Labour ever to come to power. We then heard from my right hon. Friend that these things are sometimes trickier than that—that there is more nuance, perhaps. We in this Chamber often think we know it all—don’t we? We think we know everything there is to know and that we can learn nothing from anybody else about anything in our constituency—that we are the sole experts of what is right. Occasionally it would be nice to listen to the clinicians. There might actually be a clinical argument for why a particular unit has to open, close or reconfigure, but all too often debates on the reconfiguration of services become a political football—which is exactly what my right hon. Friend was saying.

A good example is the stroke unit in Blackpool. It has been a controversial addition because it was designed to serve the entire north-west. Patients were coming down the M6 from south Cumbria, past four or five other hospitals, to get higher quality treatment in Blackpool. As the hon. Member for Oldham East and Saddleworth (Debbie Abrahams) chuntered during the Secretary of State’s speech, the important point is that it was about outcomes. People were going to have a better chance of survival if they went to the stroke unit in Blackpool rather than their local A and E. Yet when that was debated, it was very hard to tease out the medical arguments in favour of this innovation, because all too often we were more concerned about focusing on saving bricks and mortar in our own backyards rather than on what is actually best.

[Steve Baker]

Does my hon. Friend agree that the two brands in the NHS that the public really understand above all are A and E and GPs, and all the time we are talking about A and E we are getting away from the fact that sometimes care is better provided in a specialist stroke or heart centre?

[Paul Maynard]

My hon. Friend makes an important point, which is that so many different terms are used and answers given in this Chamber and elsewhere about where patients need to go. What they actually want is reassurance and confidence that when they go somewhere they will get the right treatment at the right time that solves their problem. They do not want it to be overcomplicated, and neither do we.

We have heard a lot of criticisms of this Government’s health reforms—they seem to be very unpopular on the Opposition Benches in particular—but let me highlight two that have been very good. One of them goes back to my younger days—when I had a finer figure, perhaps. My first proper job—Opposition Members will not like this—was as a health policy officer in the Conservative research department in 1999, so I listened with delight to the right hon. Member for Holborn and St Pancras (Frank Dobson) telling me all about the wonders of his time, because I scrutinised it quite carefully on a daily basis. I used to get a monthly present from the Association of Community Health Councils for England and Wales in the form of the London “Casualty Watch”, a monthly census of trolley waits in London accident and emergency departments. It was a pretty thick document. The census detailed page after page of trolley waits of more than 24 hours, and it was a shocking indictment of how Labour was running the NHS at that time.

That situation led to one of the Labour Government’s most shameful decisions: to abolish community health councils. I know that many Labour Members are embarrassed about that even now. One of the great things about our health reforms is that we have brought back Healthwatch, which has proved to be a thorn in the side of local health providers, of Members of Parliament and of the Government. We have brought back the ability of ordinary patients to affect the nature of the care in their communities. That is happening right now in Blackpool, and it is making a difference. I am delighted about that.

Another positive element involves putting public health matters into the local council. As I have said, Blackpool faces immense public health challenges, but putting Dr Rajpura, our local director of public health, into the council has been a tremendous success. It has helped to pull together all the disparate strands within the town as we face those challenges. Again, this has happened only as a result of our health reforms.

Another example that I want briefly to mention is the fact that some of our local nurses at the hospital have spun out their rehabilitation service into a community interest company called Spiral, which is now winning awards for the quality of its patient care. I am concerned that, if Labour were to reverse all these changes, the good things we have achieved would be washed away and lost, and the people who would suffer would be my constituents, including those who have turned to Spiral for their rehabilitation. That is my real concern.

High Speed 2

Debate between Paul Maynard and Steve Baker

Thursday 13th October 2011 Commons Chamber

[Steve Baker (Wycombe) (Con)]

I congratulate my hon. Friend the Member for South Northamptonshire (Andrea Leadsom) on securing the first debate on high-speed rail to be held in the Chamber. This is, however, the fourth debate that we have had on the subject since the election. We debated it in Westminster Hall on 23 November, 31 March and 13 July, so we have discussed it every four months or so. I notice that the period between debates is becoming ever shorter, so by the time HS2 delivers any value, we might be debating it every day.

Contrary to certain assumptions, I am the only Buckinghamshire MP whose constituency is not affected by the high-speed rail proposal. I know that your constituency is affected by it, Mr Speaker, and that your constituents have very strong views and that you submitted a substantial response to the consultation. The Secretary of State for Wales, my right hon. Friend the Member for Chesham and Amersham (Mrs Gillan), responded robustly to the consultation on behalf of her constituents, delivering seven files of objections and evidence against HS2, which will cut a deep scar through the middle of the area of outstanding natural beauty in which her constituency sits. The Minister for Europe, my right hon. Friend the Member for Aylesbury (Mr Lidington), and the Attorney-General, my right hon. and learned Friend the Member for Beaconsfield (Mr Grieve), were present earlier, and I know that their constituents are implacably opposed to HS2. Many other members of the Government also have objections, including the Lord Commissioner of Her Majesty's Treasury, my hon. Friend the Member for Lichfield (Michael Fabricant), who also has strong views.

Although my constituents are not directly affected, they oppose HS2 on a number of grounds, but before I go on to explain my opposition, I wish to welcome the Government’s noble intentions. Whether in seeking the rejuvenation of the economy, the revitalisation of the north or the protection of the environment, or in trying to attract international inward investment, their intentions are indeed noble, but I regret to say that I do not support the means by which they seek to meet those ends.

The Secretary of State reflected on capacity, carbon and international competition in his evidence to the Transport Committee. On the question of the economics, as we have already learned in this debate, it is possible to refer to the titles and authors of reports both for and against the proposal. I am afraid that for every economist who comes down on one side of the debate, there will always be another economist on the other side. The Economist magazine came out against HS2, and when I put that to the Secretary of State, he was quick to rebut it and explain that he was about to write a letter.

The truth is that this project is awash with entrepreneurial risk. It is impossible to get hold of any hard facts showing whether it is a good idea. There is certainly an economic case, but I am afraid that it is ethereal: the moment we grasp it, it seems to disappear.

[Paul Maynard]

My hon. Friend claims that there is no economic case, but does he recognise that there may be a strategic case?

[Steve Baker]

I enjoy serving on the Transport Committee with my hon. Friend, but I am not saying there is no economic case; rather, I am saying that we cannot nail down that case because of the entrepreneurial risk. In my view, when very large sums of capital are being allocated in an environment of entrepreneurial risk, entrepreneurs should bear that entrepreneurial risk.

I asked an international investor, “What do you think of HS2?” The answer was, “It would be wonderful to arrive fresh and relaxed in no time at all.” I then asked, “Would you invest in it?” The response now was, “That’s unfair. Of course I wouldn’t invest in it.” The market would not deliver high-speed rail, and that would be a market success, because to do so would be a misallocation of capital.

I put it to the Secretary of State that this project would socialise risk and privatise profit. He explained that that was to be expected, and we had to be realistic about it. I do not share that sense of “realism” on that point; I think that in reality this will be loss-making, in any commercial sense of the term. The whole point of loss is that it directs entrepreneurs to do something else with their capital, because if they are making a loss they are destroying value, not creating it.

I shall now deal with the carbon implications of this line. Something profound is going on in relation to carbon. The Secretary of State talked about the need to keep going until we were absolutely sure that we would decarbonise the roads. There is a vision at the heart of HS2 that we have not yet fully grasped. Given that I have 30 seconds available to me, and others wish to speak, I shall just refer to a letter that I sent shortly after I arrived in this place. I said that the Government could not afford high-speed rail, that they would not be able to afford it, that it would be a disaster if they did this—my basis for saying that was David Myddelton’s book “They Meant Well: Government Project Disasters” —and that the Government should not do it in any event, because it should be left to entrepreneurs. Nothing that I heard during the Select Committee on Transport inquiry has changed my mind.