National Health Service (Amended Duties and Powers) Bill

Debate between Robert Flello and Andy Burnham

Friday 21st November 2014 Commons Chamber

[Andy Burnham]

The Bill before us deals comprehensively with that threat from any proposed TTIP treaty. I am glad to see the hon. Gentleman in his place today.

[Robert Flello]

Is my right hon. Friend aware that the companies on the list of preferred bidders to provide cancer care in north Staffordshire include CSC computer services, which was responsible for the £10 billion IT failure, the Lorenzo system, and Interserve Investments, which was fined £11 million by the Office of Fair Trading for anti-competitive bid rigging? These are the sort of firms that our cancer services might go to.

[Andy Burnham]

Those examples will alarm people. In Greater Manchester, a bus company has been running ambulance services. We had news this week that an arms manufacturer is bidding for a GP contract. These are the things that are beginning to happen to the NHS. Nobody’s constituents have ever given their permission for any of this to happen.

We heard speeches from the hon. Member for Bosworth (David Tredinnick) and the right hon. Member for Banbury (Sir Tony Baldry), who said that nothing had changed and what was happening in the NHS now was just a continuation of what the previous Government were doing. No, it is not. The right hon. Member for South Cambridgeshire said in a speech on 9 July 2005:

“The time has come for pro-competitive reforms in…health”

and he help up the example of utilities and rail. That was the specific inspiration for his reorganisation. He sold his Bill on the basis that doctors would decide, but doctors tell us that they have no choice but to put services out to the market. Section 75 says that commissioners may not run a tender if there is only one available provider. That is never the case, which is why CCG lawyers conclude that they have no choice but to put services out to tender.

That is why we see, according to figures from the NHS Support Federation, that 865 contracts for NHS services, worth £18.3 billion, have been offered to the market. Some 67% of the contracts awarded so far have gone outside the NHS. It is this decision to mandate the tendering of services which places the NHS in the full glare of EU procurement and competition law. Because Ministers have refused to exempt the NHS from the TTIP treaty, we could soon have private US health care providers ringing up CCGs to challenge them on their commissioning decisions.

This Bill legislates to remove that threat. It repeals section 75 and it really does let doctors and local commissioners decide. It restores the role of the Secretary of State and brings much needed ministerial accountability back to this House. No longer will Ministers be told to write to NHS England when they have concerns. Instead, there will be answers from the Government Dispatch Box about the service that matters most to their constituents. It removes the role of the competition authorities that the Government’s Act introduced. It stops the ludicrous situation where hospitals such as Bournemouth and Poole are not allowed to collaborate. Importantly, it stops hospitals devoting half their beds and half their facilities to the treatment of private patients.

Francis Report

Debate between Robert Flello and Andy Burnham

Wednesday 5th March 2014 Commons Chamber

[Andy Burnham]

That is the problem. The Government’s focus is on hospitals. All the while, alternatives to A and E are being degraded and taken away. It is an undeniable fact that it has become much harder to get a GP appointment under this Government. The Patients Association warns that it may soon be the norm to have to wait for up to a week. [Interruption.] The Secretary of State says, “Nonsense.” He should get out and speak to people. The people I speak to tell me they are getting up in the morning and ringing the surgery at 8 am or 9 am, only to be told there is nothing available for weeks. As my hon. Friend the Member for Stockton North (Alex Cunningham) said, they ring 111 and the advice given is to go to A and E.

The Government have created the situation that the Secretary of State will not address. He wants to put it all in his own terms, but this is the reality in the NHS right now and this is what has happened since the publication of the Francis report. He has put more pressure on hospitals, because he has made it harder for people to get a GP appointment, and hospitals today face greater difficulty in meeting their targets. Indeed, as I just said, in the 12 months since the Francis report, hospital A and Es have missed the target 32 times running. These issues go to the heart of what we are debating today.

[Robert Flello (Stoke-on-Trent South) (Lab)]

Constituents across the country will be really concerned that the Secretary of State was shaking his head when my right hon. Friend noted the fact that hospitals are under pressure and that that will have an adverse impact. Macmillan Cancer Support notes that four in 10 people are leaving hospital without enough support from health and social services. That shows there is a crisis across the entirety of the NHS, not just in A and E.

[Andy Burnham]

That is what I am saying: A and E is the barometer of the whole system. If there is pressure anywhere, in the end it shows up in A and E. Hospitals become jammed: they cannot admit people from A and E to the ward because people in the ward cannot be discharged home. This is what we are seeing. The Secretary of State is in denial, basically. He is shaking his head and saying that this is nothing to do with the issues raised by the Francis report. I am afraid that this is the real experience of people—staff and patients—up and down the country, and the sooner he wakes up to it the better for us all. If he thinks the situation with regard to getting a GP appointment is acceptable at the moment that is up to him, but those of us on the Opposition Benches find it completely unacceptable. It is simply not good enough and the sooner he pulls his finger out and does something about it the better.

The Secretary of State’s failure even to acknowledge these issues today is a matter of some amazement, given that he could find time to talk on an area that is not his responsibility—the NHS in Wales. There are, of course, important issues that the Welsh Assembly needs to address, but voters in England might appreciate it if he spent a bit more time sorting out problems here rather than pointing the finger over there.

Accident and Emergency Waiting Times

Debate between Robert Flello and Andy Burnham

Wednesday 5th June 2013 Commons Chamber

[Andy Burnham]

The room went quiet when the nurse spoke at the summit. I pay tribute to my hon. Friend for being at the summit during the parliamentary recess to hear that nurse. It was a valuable event. My hon. Friend is absolutely right: the loss of simple support in the home for people such as that woman means that they are left with no alternative but to go to A and E or the hospital as the last resort. That is the false economy that I am talking about. By ransacking council budgets to pay for their NHS spending plans, the Government have left this system with major problems that they urgently need to address. The worst thing of all is that they have left older people with no option but to end up in hospital.

[Robert Flello (Stoke-on-Trent South) (Lab)]

I am grateful to my right hon. Friend for giving way; he is being very generous with his time. He is absolutely right: areas such as Stoke-on-Trent have had their budgets slashed and destroyed year on year under this Government. In Stoke-on-Trent, which is the third hardest hit area, the local authority is expected to spread the money it does have even more thinly across a population that is not only deprived, but ageing. The sniping and comments from those of the Government Front Bench are totally inappropriate. Does my right hon. Friend know when the Government got the NHS to write to accident and emergency departments to ask for their plans?

NHS Funding

Debate between Robert Flello and Andy Burnham

Wednesday 12th December 2012 Commons Chamber

[Andy Burnham]

That is what the letter says, but it is a cut; that is what the letter says. The right hon. Gentleman might say that, in the context of the NHS budget, £1.9 billion is not very much, but it is still a change, and it is a cut. He stood for election on a manifesto promising a real-terms increase. He has just acknowledged that there has been a real-terms cut. Does he acknowledge that there has been a real-terms cut? I think he will have to. I am amazed; the Conservatives come here today to try to con the public, yet again, into thinking that they are fulfilling their promise.

[Robert Flello (Stoke-on-Trent South) (Lab)]

I enjoy every moment in which a blow is landed on the Government; they squirm and try to come back. Will my right hon. Friend comment on how much of the budget is being thrown away and wasted on top-down reorganisation, redundancy payments and everything else that is going on?

--- Later in debate ---

[Andy Burnham]

Yes, I have done so, Mr Deputy Speaker.

If in future any Minister mentions the NHS and real-terms increases in the same sentence at the Dispatch Box, Members on all sides will at least have the facts. Better still, by carrying our simple motion this evening, we can give the House the opportunity to make sure that Ministers take much more care than they have previously shown with their statements on NHS spending.

Let us look to the future. What does all this mean for the NHS and what effect is the Government’s cut to its budget having in the real world? In its briefing for today’s debate, the NHS Confederation refers to a survey of NHS leaders which found that a full 74% described the current financial position as “the worst they had ever experienced” or “very serious”. The reason why the Government’s cuts feel much deeper to people working in the NHS, as we heard a moment ago, is that they are contending with the added effect of a reorganisation that nobody wanted and that they pleaded with the former Secretary of State to stop.

Cuts and reorganisation are a toxic mix. According to the Government’s own figures, a full £1.6 billion has been diverted from patient care and the NHS front line and spent on back-office restructuring. Look at the waste already: a full £1 billion spent on managerial redundancies—1,300 six-figure pay-outs and, scandalously, 173 pay-outs over £200,000. [Interruption.] The Secretary of State chunters away. I am surprised he has the nerve even to be here. Such pay-outs are unforgivable and unjustifiable when patients are seeing treatment restricted and nurses laid off in their thousands. But it is not just the financial cost. It is the opportunity cost—the colossal distraction this has proved to be from having the focus where it should be—on the money.

After the election, the £20 billion Nicholson challenge should have been the only show in town. Instead, no one stood up in Cabinet to the previous Secretary of State, who was allowed to proceed with his vanity reorganisation of the NHS. The consequence has been two years of drift, where no one knows who is making the decisions. The danger of this unwieldy and unmanaged approach to the efficiency drive is that, as trusts start to panic about the future, increasingly drastic cuts are being offered up that could have serious consequences for patient care.

I want to end by focusing on four such consequences. First, let us look at staffing levels on the NHS front-line. For two years, we have had the mismatch of Ministers making boasts about rising spending while the number of staff was dropping at an alarming rate. A full 7,134 nursing posts have been lost since the coalition came in, with 943 in the past month alone. [Interruption.] Government Members keep mentioning doctors. We left those plans for doctors coming through. The Secretary of State has not done anything about the training of those doctors, but on his watch he has seen more than 7,000 nursing posts cut.

Training places are being been cut by 4.6% this year, after a 9.4% cut in 2011-12. No wonder the chief executive of the Royal College of Nursing warns that we are “sleepwalking” into a crisis. Peter Carter says:

“On a daily basis, nurses are telling us they do not have enough staff to deliver good quality care.”

The situation has taken a serious turn. In its annual report, the Care Quality Commission found that 16% of hospitals in England did not have adequate staffing levels. I am surprised that a warning of this seriousness has not received more attention. It cannot go ignored. It would seem that the NHS is failing to learn the lessons of the failure at Mid Staffordshire, where the first Francis inquiry found inadequate staffing levels to be one of the main reasons why care standards fell so low.

The Health Secretary tells the Health Service Journal today that he is not going to interfere with the day-to-day running of hospitals, but let me remind him that it is his responsibility to ensure that our hospitals are safe. He must develop an urgent plan to stop the job losses and protect the NHS front line. He should tell us which hospitals do not have enough staff and explain what action he is taking on the CQC’s warning to ensure that all hospitals in England have safe staffing levels.

The second consequence of Government cuts to the NHS is the growing number of restrictions on treatment. We have revealed how 125 separate treatments have been restricted or stopped altogether since 2010, including cataracts, knee replacement and varicose veins. Just as they make false boasts about increasing NHS spending, so we hear repeated claims about reducing waiting lists. But that is because people cannot get on the waiting list in the first place.

Figures from the House of Commons Library show the effect of those restrictions on patients. More than 50,000 patients are being denied treatment and kept off NHS waiting lists, and there have been big falls in operations for cataracts, varicose veins and carpal tunnel syndrome. Ministers have promised to stop cost-based rationing if they are given evidence of it, but we have presented them with the evidence on a number of occasions, so let us now see some action.

Thirdly, the lethal mix of cuts and reorganisation is destabilising our hospitals. They are the first to feel the full effects of the free-market ideology that the Government have unleashed on the NHS. There is no longer one NHS approach in which spending is managed across the system; there is a broken-down, market-based NHS. The Government’s message to England’s hospitals is this: “You’re on your own. There’ll be no bail-outs. Sink or swim. But if it helps, you can devote half your beds to treating private patients.” We see the signs of increasing panic as hospitals struggle to survive in this harsh new world. In Bolton, South Tees, and Maidstone and Tunbridge Wells, a large number of staff have been given 90-day redundancy notices, and we see half-baked plans coming forward to reconfigure services with efforts to short-circuit public consultation.

Will the Secretary of State today remove the immediate threat to Lewisham A and E by stating clearly that it is a straightforward breach of the administration process rules to solve the problems in one trust through the back-door reconfiguration of another? Will he ensure that the future of all A and E provision in Greater Manchester is considered in the round as part of a city-wide review, rather than allowing the A and E at Trafford to be picked off in advance. In St Helens and Knowsley Hospitals NHS Trust, will he reverse the comments of the previous Secretary of State, who told the clinical commissioning groups that they had no obligation to honour financial commitments to the hospitals entered into by the previous primary care trusts? It is chaos out there. The Secretary of State urgently needs—[Interruption.] In fact, all the Health Ministers urgently need to get a grip, not just the Secretary of State.

[Robert Flello]

Is my right hon. Friend aware that the West Midlands ambulance service only yesterday advised that there are about half a dozen hospitals in the west midlands whose A and E staffing situation is so critical that it is having a knock-on effect on their ambulance turnaround times?

[Andy Burnham]

I hear reports from ambulance services all over the country that they simply cannot hand over patients at the door of A and E departments and are having to queue outside. Consequently, large swathes of the country are being left without adequate ambulance cover. That is unacceptable, especially as we go into winter and temperatures drop. We need to see some evidence that the Government have a grip on these things. I have been told that large parts of my constituency have occasionally been left without adequate ambulance cover. We must have answers on these matters today.