National Health Service

Sarah Newton Excerpts

Wednesday 21st January 2015 Commons Chamber

[Andy Burnham]

I said that I am going to make progress.

Today’s Age UK survey finds that the number of over-65s receiving care has fallen by 380,000 under this Government. Half of the 1 million people who struggle to wash or bathe now get no help at all. Two thirds of the 250,000 people who struggle to feed themselves every day are now left to fend for themselves. There are over 100,000 fewer day care places and over 50,000 fewer people getting meals on wheels. Age UK says:

“Our state-funded social care system is in calamitous, quite rapid decline.”

But worse, it is dragging down the NHS.

[Sarah Newton (Truro and Falmouth) (Con)]

Will the right hon. Gentleman give way on that point?

[Andy Burnham]

In a moment. I said that I had given way for the last time, but I will do so once more for the hon. Lady.

Record numbers of very frail, elderly people are arriving at A and E due to a lack of support in their own homes. Between 2009-10 and 2012-13, there was a 48.1% increase in the number of people aged over 90 being admitted to A and E via blue-light ambulance—in other words, 100,000 very frail, very frightened people in the backs of ambulances going round our towns and cities to be dropped off at a busy A and E. That is what is happening on this Government’s watch.

[Sarah Newton]

Today’s Age UK report contains aggregated England data. Does the right hon. Gentleman not agree that all over our country there are councils integrating social care with the NHS, and, indeed, increasing their social care budgets? Does he not recognise the good work that is going on in the integration pilots in Cornwall, for example?

[Andy Burnham]

I have repeatedly praised Torbay council in the hon. Lady’s part of the world, which was the well regarded pioneer of integrated care. Yes, there are examples of councils around the country trying to do the right thing, but let me make two points: first, the Torbay model has been broken apart by the Health and Social Care Act; and, secondly, councils are trying, but they have been battered by the massive cuts to their budgets about which Age UK is warning today, and which are setting back the cause of integration.

The reality is that elderly people are going into A and E and getting trapped there. As I have already mentioned, there is the sad case of an elderly women in Lincoln who spent an entire calendar year in hospital because a care home place could not be found. That is simply wrong on every level, and it is unsustainable in human and financial terms. The collapse of social care is a root cause of the current A and E crisis because it has led to increased pressure at the entrance door of the hospital, and to the exit door becoming blocked.

For those who still get some support, 15-minute visits are becoming the norm. Richard Hawkes, chairman of the Care and Support Alliance, has said that A and E

“is forced to pick up the pieces when people become isolated, can’t live on their own and slip into crisis.”

My last question to the Secretary of State is: does he agree with Richard Hawkes that cuts to social care have contributed to the extra 600,000 people who now attend A and E every year?

The evidence is clear: on NHS 111, on walk-in centres, on GP services, on social care—this is a mess of the Government’s making. I am sure that the text of the Secretary of State’s speech is full of the usual spin and self-serving excuses, but he must not sit down until he answers directly the four questions I have put to him, not for my benefit, but so that he does not insult the intelligence of the people watching. He is in charge, not me. People are looking to him for answers and solutions, so let me give him some in the time I have left.

As I have said, let us get nurses back on the end of the phones at NHS 111, and let us have a review of the 111 service. I hear that contracts are about to be signed—for instance, to take a contract off an ambulance service—and they will extend this flawed model of care. Will the Secretary of State intervene to stop those contracts being signed until there has been a proper review?

Will the Secretary of State review the plan to relax ambulance response times in the pilot? That is surely the wrong response during this very difficult winter. Is he absolutely convinced that now is the right time to experiment with relaxing established standards? Does it not make sense to delay it until a quieter time of the year, and not to do it in the most troubled ambulance service in the country?

On walk-in centres, would not one of the simplest things the Secretary of State could do to stop the A and E situation getting worse be to commit to halt any further closures? We know that walk-in centres in Jarrow, Nuneaton and Chelmsford are under threat. Would it not help everybody if he just removed that threat today? On GP services, has he considered putting a GP in every A and E?

--- Later in debate ---

[Kevin Barron (Rother Valley) (Lab)]

It is a pleasure to speak in the debate, and to follow the hon. Member for Norwich North (Chloe Smith).

My hon. Friend the Member for Dudley North (Ian Austin) mentioned private health insurance. In America, 80% of the population have great health care through private health insurance, but for the many people who cannot afford any private health insurance and rely on charity, it degrades very steeply. My parents used to have to rely on charity in the 1930s in this country. If any so-called political party is talking about returning to health insurance, I have to say that people will get what they can afford and the bulk of people will get very little. What Nigel Farage said the other day was completely consistent with UKIP’s 2010 manifesto— I have a copy of it.

I want to talk briefly about the pressures on accident and emergency. It is no coincidence that when the economy is being run more “efficiently”, as I think the hon. Member for Norwich North put it, through cuts and austerity, there will be an effect on services. Figures from an Age UK report that came out this week show that despite rising demand from growing numbers of people in need of support, the amount spent on social care services for older people has fallen nationally by £1.1 billion, or 14.4%, since 2011, even accounting for additional funding from the NHS, and by a total of £1.4 billion, or 17.7%, since 2005-06. That is quite a large cut.

According to the Health and Social Care Information Centre, between 2010-11 and 2013, the number of older people receiving home care fell by 31%, from 542,000 to 370,000; the number of day care places plummeted by 66.9%, from 178,000 to 59,000; and the number of older people receiving vital equipment and adaptations to help them remain safely at home dropped by 41.6%. This is the austerity that the people on the Government Benches say our economy needs.

[Sarah Newton]

rose—

[Kevin Barron]

In a few minutes—let me get to my third page, and I will gladly give way.

Spending on home care has dropped since 2011 by 19.4%, from £2.2 billion to £1.8 billion, while the amount spent on day care has fallen even more dramatically, by 30%, from £378 million to £264 million.

[Sarah Newton]

I read the Age UK report with great interest, but the data, which the hon. Gentleman has cited, is aggregated information from across England. Not all local authorities are cutting social care. Some really good local authorities are coping with the reductions in funding from central Government, prioritising the needs of the most vulnerable people in their communities and finding innovative ways of working with the NHS and the voluntary sector to improve the self-reported well-being of the people they serve. It is not the blanket situation across the UK that he describes.

--- Later in debate ---

[The Minister of State, Department of Health (Norman Lamb)]

The NHS across the UK, including urgent and emergency care services, is facing enormous challenges. By the end of this Parliament, there will be nearly 1 million more over-65s than there were at its start, which means substantially more patients with more complex health needs, but such pressures are not unique to England. All hon. Members need to think very carefully about how we pursue the debate on the challenges and pressures that the NHS is facing. Patients and the NHS do not need or want cynicism and party point scoring. My right hon. Friend the Member for Chelmsford (Mr Burns) and my hon. Friend the Member for Cambridge (Dr Huppert) were absolutely correct to make that point.

[Sarah Newton]

Does my right hon. Friend agree that the pioneer programme in Cornwall is really leading the way, with the provisional results showing a 41% reduction in A and E and in-patient visits?

[Norman Lamb]

My hon. Friend makes a very good point. The Cornwall pioneer programme is doing the most amazing work making innovative change, involving Age UK alongside local doctors, and it is delivering real results.

Why does the Labour party make constant claims that the NHS in England is in crisis, when the position is so much worse in Wales, where Labour is in power?