NHS Winter Crisis

Debate between Sarah Wollaston and Philip Dunne

Monday 8th January 2018 Commons Chamber

[Mr Dunne]

As I have already said, the social care funding has gone up very significantly this year, and there is a second billion pounds to go into social care over the next two years. The hon. Lady is right to point to Scotland having a slightly better A&E performance than England, and the two countries are far better in performance terms than any other country that we regularly monitor, but she has to be a little careful when she talks about how Scotland is performing so much better. She talked about waits. It is the case that the over-12-hour trolley waits in England for November were half the rate of over-12-hour trolley waits in Scotland. We are providing information, and we are increasingly trying to be more transparent about the impact of winter on our health service in England. I strongly encourage her to take back to her colleagues in the Scottish Government the amount of data that is being published in England and to see whether they can try to match it.

[Dr Sarah Wollaston (Totnes) (Con)]

I join the Minister in thanking NHS staff and in commenting that there is nothing new about winter pressures in the NHS. What is different is that they are extending now into traditionally quieter months, and that the depth of those pressures is so much more profound over the current winter, because there has been a failure over successive Governments to plan sufficiently for the scale of the increased demand across both health and social care. Will the Minister think about the forthcoming Green Paper for social care and think about combining it with health, so that we can see this as a truly across-system approach? I would also like to reiterate the points made by the hon. Member for Central Ayrshire (Dr Whitford) about the role of bed-occupancy levels. Can the Minister tell us what the current bed-occupancy levels are in the NHS in England?

[Mr Dunne]

On the last point, I can confirm to my hon. Friend that, at Christmas eve, the bed occupancy rate was 84.2%, below the target of 85% that we set going into this particular winter period. Of course the rate fluctuates daily and I do not have the figures for the most recent days. We did at least start this holiday period in that position, which is a great tribute to the work done in preparing for winter. I wish to reiterate to her, as I did to my right hon. and learned Friend, the importance of the integration work being done through the sustainability and transformation partnership process between NHS organisations and social care providers. It is part of the solution for the longer-term arrangements that we need to put in place to try to make sure that people who are living longer live better, more healthily and in a more independent way out of hospital.

National Health Service Funding

Debate between Sarah Wollaston and Philip Dunne

Tuesday 22nd November 2016 Commons Chamber

[Mr Dunne]

Mr Deputy Speaker, the facts speak for themselves, as you have just told us: eight Conservative Back Benchers and only six Labour in an Opposition day debate—what a shambles.

I do not question the fact that the NHS faces a significant challenge. Increasing demand for healthcare is a consequence of our ageing and growing population. It is our determination to look after each and every NHS patient with the highest standards of safety and care. These all contribute to the challenge, but, despite increasing pressures, the NHS is rising to meet this challenge, carrying out more than 5,000 operations every day compared with 2010, and handling 780,000 more accident and emergency attendances in the second quarter this year. That is 15.1% more than in the same quarter in the last year that Labour was in office. Today it is the Conservative party that is the party of the NHS. That is why we pledged more than Labour and why we are delivering more funding, with a higher proportion of total Government spending going into health in each year since 2010.

Some hon. Members have drawn international comparisons on spending. I gently remind the more excitable Opposition Members that, according to the OECD, total health spending in the UK for 2014 is 9.9% of GDP, which is 10% above the OECD average of 9% and just above the EU15 average of 9.8%.

Several hon. Members have today also questioned the figures around the rises in funding that we are providing over the term of this Parliament. I welcome confirmation from my hon. Friend the Member for Totnes (Dr Wollaston), the Chairman of the Select Committee, that she can see how the Secretary of State arrives at his figures, and she graciously conceded that both sides are correct. I want to focus directly on the straightforward maths.

[Dr Wollaston]

All I clarified was that the way it had been arrived at is not a way that the public would understand health spending, so I think the Minister is perhaps taking my words out of context, if he will forgive me.

[Mr Dunne]

We never claimed that we were increasing the Department of Health’s budget; we were talking about the increases to the NHS. For complete clarity, in 2014-15 the NHS budget was £98.1 billion; in 2020-21, it will be £119.9 billion. For Opposition Members who cannot do the maths, that is a £21.8 billion increase in cash terms to NHS England, or £10 billion in real terms. We promised £8 billion; we are delivering £10 billion.

We also listened to NHS leaders’ requests for a front-loaded settlement and delivered on that—it was welcomed by hon. Members in today’s debate—with £6 billion of the £10 billion increase coming by the end of this year, including a £3.8 billion real-terms increase in this year alone.

We have also created a £1.8 billion sustainability and transformation fund for the current year to help providers to move to a sustainable financial footing. This fund will mainly be allocated to emergency care provision, which faces some of the greatest demand growth and financial pressures within the system.

This brings me to the next important point I want to address. While more funding is obviously welcomed, hon. Members have drawn attention to rising deficits in the budgets of NHS providers. We recognise that stronger financial management is required to turn this situation around, and we have introduced robust governance arrangements to get things back on track. There are four main elements to this plan: extra investment in the spending review, as I have discussed, and freeing up local government to spend more on adult social care; restoring financial discipline in the short term, through the measures set out by NHS England and NHS Improvement in July, with a wide-ranging set of actions; reducing demand for acute care in the longer term; and driving efficiency and productivity across the provider sector, building on the work of Lord Carter, who has identified large variations in efficiency across non-specialist English acute hospitals, and controlling cost pressures. The need to reduce variations was raised by my hon. Friend the Member for South West Bedfordshire (Andrew Selous) in his very constructive contribution, and by the hon. Member for Strangford (Jim Shannon). We agree that we need to reduce the variability in the poorly performing trusts and bring them up to at least the average standard, if not higher.

We are now beginning to see the first fruits of the plan, with the publication last Friday of the figures for the second quarter deficit, which has been reduced to £648 million, down from £1.6 billion in the same period last year, representing a £968 million improvement. Progress halfway through the financial year is therefore encouraging, but there is no room for complacency. That is why the system needs to stick to its strong financial plan, supported by our investment and by a series of measures set out to help hospitals to become more efficient and to reduce the use of expensive agency staff.

Several hon. Members talked about the sustainability and transformation plans, 28 of which have now been published. The remainder will be published by the end of next month. Half of the Labour Members who spoke in the debate talked specifically about the STP covering Cheshire and Merseyside. It was disappointing that only one of those three Members was able to attend the Westminster Hall debate earlier today in which we discussed conditions in Cheshire and Merseyside. I remind Labour Members that that STP was led by the chief executive of Alder Hey hospital in Liverpool, with whom I would strongly encourage hon. Members who are complaining about a lack of engagement to have a conversation.

A&E Departments: Winter Pressure

Debate between Sarah Wollaston and Philip Dunne

Thursday 3rd November 2016 Commons Chamber

[Dr Wollaston]

I thank the shadow Minister. The Committee agrees that there needs to be more funding for social care. We were concerned that the evidence we heard in this inquiry and previous inquiries is that the money raised from the social care precept has been swallowed up by the cost of the living wage. We absolutely welcome an increase in pay for hard-pressed care workers, but we feel that the increase in funding is completely inadequate to deal with the scale of the increase in demand.

[The Minister of State, Department of Health (Mr Philip Dunne)]

I would like to add my welcome for the work of the Health Committee in this report and to say how pleased I was to have the opportunity to appear before my hon. Friend’s Committee for the first time since taking up this post.

We all recognise that the system is facing a challenging winter, but we are determined to ensure that the NHS and the social care sector are focused on trying to deliver for patients and that the national organisations, where possible, are in a position to support them effectively this winter.

This year, the NHS is better prepared for winter than ever before, with NHS staff working incredibly hard throughout the year and more ready for what will be the busiest time for the NHS. Despite increased demand, the NHS is performing well, with nine out of 10 people seen in A&E within four hours.

We have ensured that there are robust plans in place. That includes providing for the availability of key services, such as primary and social care, during the Christmas and new year bank holiday periods in advance, which has not happened before. For the first time, there is also a national A&E improvement plan to improve flow through hospitals from the front door to final discharge, with the implementation of five initiatives, and there is a specific intervention on discharge.

The Select Committee’s report highlights continuing pressures on emergency departments, so does my hon. Friend share my welcome for the 25% increase in doctors—almost 1,200 more doctors—working in emergency medicine since 2010?

[Dr Wollaston]

Of course I welcome the increase in staff in our accident and emergency departments. As the Minister will recognise, there is further to go in this regard.

SELECT COMMITTEE ON HEALTH

Debate between Sarah Wollaston and Philip Dunne

Thursday 3rd November 2016 Commons Chamber

Dr Wollaston

- Hansard -

I thank the shadow Minister. The Committee agrees that there needs to be more funding for social care. We were concerned that the evidence we heard in this inquiry and previous inquiries is that the money raised from the social care precept has been swallowed up by the cost of the living wage. We absolutely welcome an increase in pay for hard-pressed care workers, but we feel that the increase in funding is completely inadequate to deal with the scale of the increase in demand.

The Minister of State, Department of Health (Mr Philip Dunne)

- Hansard - - Excerpts

I would like to add my welcome for the work of the Health Committee in this report and to say how pleased I was to have the opportunity to appear before my hon. Friend’s Committee for the first time since taking up this post.

We all recognise that the system is facing a challenging winter, but we are determined to ensure that the NHS and the social care sector are focused on trying to deliver for patients and that the national organisations, where possible, are in a position to support them effectively this winter.

This year, the NHS is better prepared for winter than ever before, with NHS staff working incredibly hard throughout the year and more ready for what will be the busiest time for the NHS. Despite increased demand, the NHS is performing well, with nine out of 10 people seen in A&E within four hours.

We have ensured that there are robust plans in place. That includes providing for the availability of key services, such as primary and social care, during the Christmas and new year bank holiday periods in advance, which has not happened before. For the first time, there is also a national A&E improvement plan to improve flow through hospitals from the front door to final discharge, with the implementation of five initiatives, and there is a specific intervention on discharge.

The Select Committee’s report highlights continuing pressures on emergency departments, so does my hon. Friend share my welcome for the 25% increase in doctors—almost 1,200 more doctors—working in emergency medicine since 2010?

Dr Wollaston

- Hansard -

Of course I welcome the increase in staff in our accident and emergency departments. As the Minister will recognise, there is further to go in this regard.