NHS Winter Crisis

Debate between Philip Dunne and Peter Bone

Monday 8th January 2018 Commons Chamber

[Mr Peter Bone (Wellingborough) (Con)]

Does the Minister agree that the social care system is broken and that the leader of the Liberal Democrats is right that we are not going to solve the problem unless we all work together?

[Mr Dunne]

I do not think my hon. Friend will be surprised if I say no, I do not agree that the system is broken. I do accept that it requires more funding, and that is why more funding was provided. It also requires local authorities to work more closely alongside the NHS to try to share these problems and find solutions together.

Kettering General Hospital

Debate between Philip Dunne and Peter Bone

Friday 21st October 2016 Commons Chamber

[Mr Dunne]

I have responsibility for the acute sector, not the community sector, so initially my visit would be focused on Kettering hospital. I will certainly do what I can, but I think that it will have to be some time next year. My hon. Friend has previously met my predecessors to discuss health services in his constituency. He has raised a number of issues today, and I will attempt to address most, if not all, of them in the time that I have.

I wish to start with my hon. Friend’s concerns about the underfunding of his local clinical commissioning groups. That was a point also raised by my hon. Friend the Member for Wellingborough. NHS England is working to move CCGs towards their target fair share of funding, but this has to take place at a pace that maintains stability in the system across the country at a time of significant financial challenge. I feel that quite acutely as a local Member of Parliament representing a rural constituency that has been consistently underfunded. We are taking steps, as I mentioned to the House in a debate earlier this week, to look at introducing a fairer share of funding for rural areas and addressing other issues such as social deprivation. A consequence of that has been to try to bring those CCG areas that are recognised to be underfunded closer to the target.

The point was made that Nene and Corby CCGs have been beyond 5% of the target. I am pleased to confirm the figures that were mentioned earlier by my hon. Friend the Member for Kettering: Nene and Corby CCGs received cash increases of 5.2% and 9.4% respectively in the current year. Those increases are significantly above the average for English CCGs and bring them both within 5% of their target allocation in this year. I think that 9.4% is one of the highest increases in allocation that we have seen this year across the country, so I hope that he recognises that we are moving to right that historic challenge. This year, more than £757 million will go into my hon. Friend’s local area, and allocations over the next few years should bring both Nene and Corby CCGs even closer to their funding target.

I will take a moment to touch on the national pressures that are affecting the NHS. The NHS is very busy, but hospitals are generally performing well. The latest figures for August 2016 show that more than nine out of 10 people were seen in A&E within four hours. During 2015-16, nearly 2,500 more people were seen in A&E each day within four hours compared with 2009-10.

Paramedics respond to the majority of life-threatening cases in under eight minutes. More than 567,000 emergency calls received a face-to-face response from the ambulance services across England in August 2016 alone—an average of 18,300 a day. Ambulance services are busy, which is why we are increasing paramedic training places by more than 60% in this year alone, on top of the 2,300 extra paramedics who have joined the NHS since 2010. That allows more than 200 additional ambulances to be deployed by the NHS compared with 2010.

[Mr Bone]

The Minister is making a very good point. Does he not accept that if an ambulance were to take a patient to the Isebrook hospital, it is 10 minutes’ transport, but if it has to go to Kettering, it is 45 minutes’ transport? Is that not the sort of thing that we should look at as an efficiency saving, which is worth the investment in Isebrook?

[Mr Dunne]

I would agree with my hon. Friend in the event that the hospital in Wellingborough were able to cope with the condition, but many of the most serious conditions need to go to the best place to deliver the service, even if it takes a bit longer to get there. The quality of treatment in our ambulances now, with the skills of the paramedics who are on board in almost all cases, is such that very few people die while in transit. They are kept stable, and they need to go to the best place for treatment.

Going back to the national picture, the NHS last year treated, on average, 21,000 more outpatients a day and performed more than 4,400 operations a day compared with 2010. There is substantially more activity across the NHS, which is one reason why we have recruited so many more clinicians to help cope with this activity. We now have over 8,500 more doctors and over 2,700 more nurses, paid for in part by having nearly 7,000 fewer managers. Ultimately, we want to reduce pressure on services by reforming the urgent care system and caring for people better in the community, and that is where I think some of the things being done and being planned for the Kettering area are so interesting. It is clear that the NHS in the constituency understands the scale of the challenge and is taking action to address it.

Defence Expenditure (NATO Target) Bill

Debate between Philip Dunne and Peter Bone

Friday 23rd October 2015 Commons Chamber

[Mr Dunne]

I have sympathy with my hon. Friend’s comment about the accounts, which are just short of 200 pages long. But there are some helpful guideposts through them—including the photographs, which take up a number of pages; they include an excellent picture of the Red Arrows, which, were he here, my hon. Friend the Member for Gainsborough would surely applaud.

The short answer is that when scrubbing the numbers, as is done from time to time in making declarations, the Department realised that there was a significant gap of billions of pounds between what we spend on defence and what NATO said we spent on defence. We wanted to ensure that we got it right. An exercise was done ahead of this year’s submission to NATO on how much genuine cash was paid by the MOD for defence purposes— it is not the same as the amount of money we receive from the Treasury for spending. It is therefore entirely legitimate for us to take the opportunity to take that into account.

Another example from the income category is the £50 million paid by entitled personnel for food. I am sure my hon. Friend has had the opportunity to visit many messes, particularly in the RAF bases he has visited, and that he has enjoyed the food, for which some payment must be made. I suspect that he has often been the guest of the base commander and that he has not personally had to contribute to the MOD’s coffers, but personnel routinely contribute. That is hard cash that comes into the Department and is spent. It is entirely appropriate to include income we have generated, which for this year amounted in total to £1.3 billion.

We included other categories of expenditure this year when we did the exercise, one of which is Government cyber-security spending. We decided to include spending on some aspects of our cyber-security in the NATO calculation this year because the MOD is taking a more central role in providing cyber-defence and co-ordinating that work across Government Departments. Another category is those elements of the conflict stability and security fund relating to peacekeeping activities undertaken by the MOD. In 2015-16, that is estimated to be £400 million. That money is spent by Defence and is therefore eligible. We have also included the costs of defence pensions, because NATO recognises that that is permissible expenditure and other nations include it. That includes the cost of MOD civil servants’ pensions—such pensions are part of other nations’ calculations. Those are all legitimate expenses and are not a sleight of hand, as has been alleged.

In the same vein, I should like to address hon. Members’ concerns that there is a measure of double-counting in the figures for defence and international aid. Just as NATO sets the guidelines for defence spending, so the OECD sets the guidelines for our official development assistance. We adhere to both sets of guidelines. There is a modest measure of overlap between the two, but that is to be expected. As I will go on to explain in my concluding remarks, defence and development are two sides of the same coin.

The second element of my hon. Friend’s Bill is his desire to

“make provision for verification that NATO’s criteria for defence expenditure are met in calculating the UK’s performance against this target”.

I would argue that that, too, is unnecessary.

[Mr Peter Bone (Wellingborough) (Con)]

I have not heard most of the Minister’s speech because it has gone on for more than 1 hour and 20 minutes, but the thrust of it is that the Bill is a waste of time because what it proposes is already happening, and we do not want to take up valuable parliamentary time. If we do not want to take up valuable parliamentary time, why is he still wittering on?

[Mr Dunne]

I am sorry that my hon. Friend regards my speech as a wittering one. He has a remarkably impressive credential in the House. His son is a serving officer—a pilot in the Chinook fleet—whom I had the privilege to meet on a base. I discovered that his father is my hon. Friend, which I had not previously appreciated. He takes a great interest in defence. I am sorry he was unable to be in the Chamber for the earlier parts of my speech with other hon. Members, but he will enjoy listening to me describe the Government’s commitment to defence as I continue my remarks on the subject of the verification of NATO figures.

We submit financial data to NATO annually in the form of a detailed, classified financial return. Our NATO returns are independently reviewed and verified by NATO staff, and are peer-reviewed by NATO allies during the defence planning process. That provides independent testing and impartial scrutiny of the UK’s plans, and builds confidence among allies that we will do as we say. It is entirely right that NATO and not the UK decides the definitions of defence expenditure. That is the only way to ensure consistency and build relationships across the alliance. Significantly, even if further verification is put in place, any such findings will be irrelevant, because NATO determines what can be counted as defence spending.

I accept that that is not to say that more cannot be done. I remind the House of the defence pledge from which I have quoted. At the NATO summit in Wales, we agreed not only to review national progress annually, but that the scrutiny would come from the very top—from the Heads of Government—at all future summits.

My hon. Friend’s suggestion of independent UK verification would merely add yet another administrative step to the process, an example of the creeping red tape that bogs down Departments in the very bureaucracy that he and most other hon. Members on our side of the House are keen to see eliminated. My hon. Friend the Member for Gainsborough, as a former Chairman of the Public Accounts Committee, is right to be concerned that enshrining the pledge in legislation would add to the burden of red tape that the Government are seeking to avoid.

Let me turn briefly and almost finally to the question of international aid. It is now becoming far harder to argue that aid does not matter. Globalisation has meant that instability in one part of the world has direct repercussions for us over here, whether in terms of terrorism, mass migration or disease. Whereas defence is essentially reactive, development is proactive. By investing early on, we can avoid counting the cost further down the line, stabilising countries and avoiding the future commitment of our troops.

My hon. Friend the Member for Congleton highlighted our leading work on Ebola in west Africa, which is an excellent example. We have funded laboratories in Sierra Leone to speed up the time taken to diagnose the disease and to help to stop its spread across the country. We have supported 700 Ebola treatment beds that provide direct medical care for up to 8,800 patients over six months and we are working with communities on new burial practices. Thanks to the pioneering work of the Defence Science and Technology Laboratory, in conjunction with the BBI Group, great British brains developed a rapid Ebola test to aid identification in the field and potentially help minimise the spread of the Ebola virus. I know that my hon. Friend the Member for south-west Wiltshire, who is unfortunately not in his place but was making interventions earlier, is a doughty champion for the work of the DSTL in his constituency.

Oral Answers to Questions

Debate between Philip Dunne and Peter Bone

Monday 13th July 2015 Commons Chamber

[Mr Dunne]

I confirm that of the five principal helicopter fleets, two are manufactured by AgustaWestland and supported from Yeovil; one is supplied by Eurocopter, which has activities in Oxfordshire; and the Chinook and Apache fleets are Boeing.

[Mr Peter Bone (Wellingborough) (Con)]

Does the Minister agree that we want the best helicopters for our forces? It is right that there is a spread, but we want the best, not necessarily just ones that were made in this country.

[Mr Dunne]

I completely agree with my hon. Friend, who has some knowledge of this subject; I met his son flying one of the Chinook aircraft in his constituency. It is right that we invest in the best capability and provide our forces with the best equipment that is available across the world, irrespective of where it is manufactured.