Oral Answers to Questions

Debate between Ruth George and Steve Barclay

Thursday 4th April 2019 Commons Chamber

[Ruth George (High Peak) (Lab)]

T2. The Prime Minister has confirmed that the future declaration is not legally binding, so what assurances can the Government give us on trade tariffs, rights at work, food standards and environmental protections that will be binding on whoever ends up negotiating our permanent deal with the EU?

[Stephen Barclay]

As the hon. Lady knows, there will be ample opportunity for the House to legislate during the passage of the withdrawal agreement Bill. As she also knows, there is legal wiring—for example, through article 174, which deals with best endeavours and good faith obligations under the withdrawal agreement, and how they connect. If it is one of the matters the House looks at in the future, it will be able to choose to put into legislation negotiating objectives. The point is that the hon. Lady has opposed the withdrawal agreement that the EU says is necessary for any deal, and we cannot get on to the future relationship without a withdrawal agreement.

Derbyshire CCGs’ Finances

Debate between Ruth George and Steve Barclay

Tuesday 4th September 2018 Westminster Hall

[The Minister for Health (Stephen Barclay)]

It is a pleasure to serve once again under your chairmanship, Sir Christopher. I congratulate the hon. Member for High Peak (Ruth George) on securing this important debate. She has effectively put on record her concerns about the financial challenge faced by the Derbyshire CCGs.

The hon. Lady is right to recognise that the Government are committing more money to the NHS. That is why the Prime Minister has announced a funding increase of, on average, 3.4% each year to 2023-24. The NHS budget will therefore increase by more than £20 billion a year compared with today. Alongside that, it is also right for NHS England, the independent organisation that allocates funding, to question the efficiency of CCGs, in particular by comparison with other CCGs, looking for what efficiencies can be found. Indeed, the four CCGs in Derbyshire have already identified £39 million of savings, against our target which is 3% of their overall budgets. Significant progress has therefore been made to meet the challenge set by NHS England.

[Ruth George]

Part of that £39 million is £5 million of decommissioning, which includes those voluntary services, so they are now having to be reviewed. That £39 million in cuts is not good news—it is pretty bad news for the NHS, as I have set out.

[Stephen Barclay]

I was just about to come on to the voluntary sector, because that is where the hon. Lady’s speech started, but in her remarks she talked about the four CCGs coming together as part of the “efficiencies of scale”—her precise phrase—so I shall come back to the voluntary sector later.

--- Later in debate ---

[Stephen Barclay]

To some extent, that is already happening in the form of the £45 million of the deficit that is being absorbed by NHS England, but part of the NHS England consultation is assessing where the CCGs are against their target allocation—it is part of the consideration of the £40 million of capital bids for Derbyshire and part of the £12.5 million that was secured for the improvements at Derby county. It is also part of other issues in the NHS such as length of stay—43% of patients in acute hospitals do not clinically need to be there and would be better served in the community, which is where those value for money assessments need to play a part.

[Ruth George]

Why are 84 community beds, and my beds in Buxton at Fenton ward, which are the only place where patients in acute care can be transferred, being cut?

[Stephen Barclay]

Again, local clinical decisions are taken by the CCGs, which is the correct approach. This goes to the heart of the point raised by my hon. Friend the Member for North East Derbyshire. Driving efficiency as part of spending more on the NHS is not about not having any change. Indeed, the hon. Lady previously expressed concerns about the specialist dementia inpatient beds in her constituency. Again, those are specific commissioning decisions—it is inappropriate for a Minister to comment on specific decisions—but, although I understand her concerns in relation to the number of specialist dementia inpatient beds, I am assured that the model implemented in Derbyshire reflects the changing needs and approaches to providing health and care for dementia patients. Patients benefit from structured care in their homes or in an adult care-led facility—that model is supported by clinicians.

We need to differentiate legitimate questions from NHS England in an area that is receiving more than its target allocation and where there are opportunities for efficiency, while taking on board the concerns raised by my hon. Friend the for Amber Valley about the transition as the additional Government funding comes, and while allowing the NHS in Derbyshire to change. Just as the additional funding to Derby will unlock efficiencies, so will the vanguard programme and other local initiatives on, for example, dementia care to deliver an NHS that is fit for the future. It needs to evolve but is also needs to take the community with it. That is why it is right that we have a discussion about the voluntary sector without scaring people that decisions have been taken, when services such as the three I mentioned have already been protected and I am told that no decisions have been taken on the other voluntary’s services.

We are committed to spending more on the NHS in Derbyshire. That is the clear commitment the Prime Minister made. The CCG has made significant progress on delivering efficiencies against its 3% target, but we are building an NHS fit for the future, which includes ensuring that we give more money to Derbyshire. As part of the 10-year plan being devised by NHS England and NHS Improvement, Derbyshire will receive its fair share of that additional funding.

Question put and agreed to.