National Health Service

Sarah Newton Excerpts

Wednesday 26th October 2011 Commons Chamber

[Andy Burnham]

My right hon. Friend makes an important point. When we were in government, we said that there had to be a clinical case for change, if changes to hospital services were to be made. I mentioned Greater Manchester a moment ago. There was a clinical case to support those reforms. The experts, to which she rightly pointed, said that about 50 babies’ lives would be saved every year by specialising care in fewer locations. In such circumstances, politicians have a moral obligation to listen to those experts and to make changes, no matter how politically difficult they are. That is why I say that it was sheer opportunism of the worst kind for the Government, when in opposition, to say that they would have a moratorium on any changes and to tour those marginal constituencies promising to overturn decisions, when in fact they had no intention of doing so. I put it to the House that the people of Bury, Burnley and Enfield have now clearly discovered what opportunism there is from those on the Conservative Front Bench.

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

Does the right hon. Gentleman therefore welcome one of the Government’s first actions, which was to change the NHS operating guidelines for reconfigurations to ensure categorically that clinicians and the communities they serve were in the driving seat for future reconfiguration of the NHS?

[Andy Burnham]

If that is the case and the people of Enfield are in control of the decision, would Chase Farm A and E be closing? What the hon. Lady describes is a complete and utter reinvention of the moratorium policy. She stood on an election manifesto that promised a moratorium. Where is it? It has not materialised. It is a mythical policy that was designed to win votes; it had nothing to do with the good stewardship of the national health service.

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[Sarah Newton]

The image that the right hon. Gentleman has just painted is totally inaccurate. The Royal Cornwall Hospitals NHS Trust is struggling with an enormous debt, which it incurred as a result of enormous reorganisations under Labour and a ridiculous accountancy measure that doubles the debt every year. I will not take comments like that from the right hon. Gentleman, because Cornwall has been left in a very difficult situation that this Government have been left to sort out.

[Andy Burnham]

I did not say that everything was perfect, but I said a moment ago that we took a grip on those problems and dealt with them from the centre. In the hon. Lady’s Government’s NHS, there will be—what are the words?—no bail-outs. Everyone will be left to fend for themselves. Does that mean that her hospital will be allowed to go bust? I do not know, but that is the implication of the Secretary of State’s White Paper and Bill, and she needs to direct her questions to him.

The fact is that we are now looking at a national postcode lottery, in which GPs are free to send letters to patients telling them that minor operations must now be paid for, and in which hospitals no longer have maximum waiting times for NHS patients and can devote the freed-up theatre time to private patients as there is no longer any cap on private work. The Government have placed the NHS in the danger zone. It has been placed there by a Prime Minister who said “Trust me” and has gone back on his word. He wrote cheques for the NHS in opposition that he knew he would not be able to cash when in government. He made promises that he knew he would be unable to keep, in order to win votes. This is the Prime Minister’s very own great NHS betrayal, and, far from detoxifying his party, he has proved once and for all that we really cannot trust the Tories with our NHS.

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[Sarah Newton]

I agree with much of what my hon. Friend says. Does he agree that on such an important subject as the NHS, the people we represent and who sent us here would expect us to be thinking about how we can improve the NHS for patients and for the people who work in it, rather than engaging in this ridiculous tit-for-tat party political scrap that we are seeing this afternoon?

[Chris Skidmore]

I entirely agree. A constituent, a lady who sadly lost her foot through a rare cancer, came to my surgery recently. She is allowed only one type of plastic foot from the NHS and the PCT. She wants what is called an Echelon foot which will allow her to walk up a hill—she is a hill walker—but under the current model she cannot get that alternative foot. By bringing in any qualified provider, we will allow patients and clinicians the freedom to choose for the first time—a choice that was denied under the “any preferred provider” model that the shadow Secretary of State still clings to vainly. We need to ensure that our NHS operates for the 21st century and I hope the reforms will deliver that.

To sum up, I will oppose the motion. It is juvenile—the text could have been written by Adrian Mole. This is about getting away from the politics of debate in the Chamber and giving the NHS back to the professionals and the patients. It is not our NHS; it is their NHS, and we need to ensure that we achieve that aim.

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[Dr Poulter]

I thank the hon. Lady for her intervention. Any period of transition will be difficult, and must be managed. Will the mechanisms and bodies that the Health and Social Care Bill will put in place be better able to deliver community-focused, integrated care than the existing system? I want to consider two matters that we will come to later: health and wellbeing boards, and basing commissioning fundamentally in the community. Both are good mechanisms for delivering better integrated care, and I will return to that.

We have too many silos in the NHS. The primary care sector often does not integrate with the secondary care sector as well as we would like. For example, hospitals are paid by results, but they have no financial incentive to ensure that they prevent inappropriate hospital admissions. We talk about better looking after the frail elderly and about ensuring that we prevent people with mental health problems from reaching crisis point and having to be admitted, but there are no financial incentives and drivers in the system to ensure that that is achieved to the extent we would like. A and E admissions in many hospitals are rising year on year—in rural areas that is partly because we do not have an adequate out-of-hours GP service—and far too often the frail elderly are not properly supported in the community.

If we put the majority of commissioning into the community with local commissioning boards, that will provide a more integrated and joined-up approach to local commissioning, which will undoubtedly help to prevent inappropriate admissions. We no longer want an NHS in which people with mental health problems or the elderly present in crisis because they have not been supported in the community. That must be the focus of care, and the focus of delivery of services.

[Sarah Newton]

I wholeheartedly agree with my hon. Friend about the importance of integrating social care and the NHS. I want to share with him the good, concrete steps that are being taken in Cornwall, where we have a pilot health and wellbeing board, and the beginning of integration. That has not happened before in Cornwall, and we are about to have the first joint commissioning of services. That is the way forward to improve patient experience in the NHS.

[Dr Poulter]

I thank my hon. Friend for a helpful intervention, which makes the point very well that we need integration through community-based commissioning.

The other key factor is how better to integrate adult social care—the right hon. Member for Leigh made the point, as did the Secretary of State—into the current NHS system. At the moment, integration of services is sometimes variable. There is a good example in Torbay of a more integrated system, but what are the Government proposing that will at least facilitate the integration of services? Local health and wellbeing boards are definitely a step in the right direction because for the first time they will bring together adult social care from local authorities with housing providers, the NHS, and primary and secondary care. That must be a step in the right direction for delivering the integrated care that we all want. It will help to provide more community-focused care.

I referred to the concern about inappropriate admissions, and the fact that elderly people are not supported in their own homes. The savings in adult social care from doing things well are NHS savings, but at the moment there are different cultures in two different organisations, which do not always talk to each other in different parts of the country, and that will not benefit patients. Bringing people together on a health and wellbeing board must be good for patients and integrated care.

For all those reasons, I hope that we will have more positive Opposition day debates on the NHS, and I hope that the Opposition will at least concede that some good things are happening as a result of health care reform.