NHS Funding

Sarah Wollaston Excerpts

Monday 31st October 2016 Commons Chamber

[Mr Hunt]

I start by welcoming the hon. Gentleman to his first urgent question in his new role. As I am a relative old timer in my role, I hope he will not mind me reminding him of some of the facts about health spending.

First, the hon. Gentleman said that the Government did not give the NHS what it asked for. Let me remind him that Simon Stevens, a former Labour special adviser—I know for new Labour, but he was none the less a Labour special adviser—said at the time of the spending review settlement last year that

“our case for the NHS has been heard and actively supported”

and that the settlement

“is a clear and highly welcome acceptance of our argument for frontloaded NHS investment. It will…kick start the NHS Five Year Forward View’s fundamental redesign of care.”

I will tell the hon. Gentleman who did not give the NHS what it asked for: the Labour party. At the last election, it refused to support the NHS—[Interruption.] I know this is uncomfortable for the new shadow Health Secretary, but the reality is that the party on whose platform he stood refused to support the NHS’s own plan for the future. As his question was about money, I will add that the Labour party also refused to fund it. The NHS wanted £8 billion; Labour’s promise was for additional funding of £2.5 billion—not £6 billion or £4 billion, but £2.5 billion, or less than one third of what the NHS said it needed. Even if we accept the numbers of the Chair of the Select Committee—and, as I will go on to explain, I do not—Labour was pledging over the course of the Parliament only around half of what this Government have delivered in the first year of the spending review.

The hon. Gentleman used other choice words, one of which was “spin”. I will tell him what creates the most misleading impression: a Labour party claiming to want more funding for the NHS when, in the areas where they run it, the opposite has happened. Indeed, in the first four years of the last Parliament, Labour cut NHS funding in Wales when it went up in England—[Interruption.] Yes, it did. Those are the official figures. That is in a context in which the Barnett formula gives the Government in Wales more than £700 more per head to spend on public services, so there is more money in the pot.

The hon. Gentleman talked about social care. May I remind him of what the shadow Chancellor at the time of the last election—Ed Balls, who is now sadly no longer of this parish—said? During the election campaign, he said of funding for local councils “not a penny more”. We are giving local councils £3.5 billion more during the course of this Parliament.

The hon. Gentleman talked about other cuts that he alleges will happen in A&E departments and other hospital services. I simply say to him that we have to make efficiency savings. I do not believe they will be on the scale he talked about, but how much worse would they have to be if the NHS got a third of the money it currently gets?

If the hon. Gentleman and his party think the NHS is underfunded, they need to accept that the policies that they advocated in the past two elections were wrong —they advocated spending less than the Conservatives. Until they are serious about changing their policy, no one will be serious about listening to their criticisms.

[Dr Sarah Wollaston (Totnes) (Con)]

I agree with the Secretary of State that prevention is better than cure, but he will know that achieving the aims of the five year forward view was dependent on a radical upgrade in public health and prevention. He will know that it was also dependent on adequate funding for adult social care. In addition, there are continuing raids on the NHS capital budget, and we need to put in place the kind of transformation that he and our sustainability and transformation partnerships wish to achieve.

Will the Secretary of State therefore confirm that he recognises the serious crisis in social care and the effect it is having on the NHS, and the effect that taking money from public health budgets is having? Although I accept that he does not agree with the Health Committee’s appraisal of the £10 billion figure, I am afraid I stick by those figures.

[Mr Hunt]

I have enormous respect for my hon. Friend. I respect her passion for the NHS, her knowledge of it and her background in it, so I will always listen carefully to anything she says. I hope she will understand that just as she speaks plainly today, I need to speak plainly back and say that I do not agree with the letter she wrote today, and I am afraid I do think that her calculations are wrong.

The use of the £10 billion figure was not, as she said in her letter, incorrect. The Government have never claimed that there was an extra £10 billion increase in the Department of Health budget. Indeed, the basis of that number has not even come from the Government; it has come from NHS England and its calculations as to what it needs to implement the forward view. As I told the Select Committee, I have always accepted that painful and difficult economies in central budgets will be needed to fund that plan. What NHS England asked for was money to implement the forward view. It asked for £8 billion over five years; in fact, it got £10 billion over six years, or £9 billion over five years—whichever one we take, it is either £1 billion or £2 billion more than the minimum it said it needed.

I think my hon. Friend quoted Simon Stevens as saying that NHS England had not got what it asked for. He was talking not about the request in the forward view, but in terms of the negotiations over the profile of the funding we have with the Treasury. The reason that the funding increases are so small in the second and third year of the Parliament is precisely that we listened to him when he said that he wanted the amount to be front- loaded. That is why we put £6 billion of the £10 billion up front in the first two years of the programme.

I fully accept that what happens in the social care system and in public health have a big impact on the NHS, but on social care we have introduced a precept for local authorities combined with an increase in the better care fund—[Interruption.] This is a precept, which 144 of 152 local authorities are taking advantage of. That means that a great number of them are increasing spending on social care. It will come on top of the deeper, faster integration of the health and social care systems that we know needs to happen.

On public health, I accept that difficult economies need to be made, but it is not just about public spending. This Government have a proud record of banning the display sale of tobacco, introducing standardised packaging for tobacco, introducing a sugary drinks tax and putting more money into school sports. There are lots of things that we can do on public health that make a big difference.

On capital, I agree with my hon. Friend about the pressure on the capital budget, but hospitals have a big opportunity to make use of the land they sit on, which they often do not use to its fullest extent, as a way to bridge that difficult gap.