Oral Answers to Questions Debate
Full Debate: Read Full DebateSimon Burns
Main Page: Simon Burns (Conservative - Chelmsford)Department Debates - View all Simon Burns's debates with the Department of Health and Social Care
(12 years, 9 months ago)
Commons Chamber2. What recent assessment he has made of the potential risks of NHS reorganisation.
The Department monitors risks associated with the implementation of the health and social care reform programme on an ongoing basis.
“An open, transparent NHS is a safer NHS”: not my words, but those of the Secretary of State for Health. Is it not amazing that Ministers do not want to release documentation relating to the reorganisation of the NHS? Is it not an absolute scandal that they will not publish the documentation? Is it not the fact that the reorganisation of the NHS is looking a bit like the Norwegian blue? Should it not shuffle off the perch?
No, the hon. Gentleman is wrong. As he, or certainly the right hon. Member for Leigh (Andy Burnham), will know, the risk register is an ongoing document—discussions between Ministers and civil servants on the formulation, implementation and transition of policies—and it would be wrong, in my opinion, for it to be published. That is why my right hon. Friend the Secretary of State appealed to the tribunal following the decision of the Information Commissioner, in line with the precedent adopted by Secretaries of State in the Labour Government in both the Department of Health and the Treasury.
Does the Minister agree that the risk of not reorganising would be the longer waiting lists, longer waits for ambulances and lower access to life-prolonging drugs that we currently see in socialist-dominated Wales under the Assembly?
The Minister will know that large numbers of people from Wales, particularly north Wales, access treatment in England. What assessment has he made of the risks to such treatment if the legislation goes through?
If the hon. Gentleman is trying to tease out of me what is in the risk register, I am afraid he will be unsuccessful, but if it is of any reassurance I can tell him that for people living close to the border there have been arrangements between Wales and the English NHS and they will continue. Those people will benefit if treated in England, because waiting times are falling in this country, unlike Wales where they are increasing.
What a pleasure it is to see the Secretary of State here today; he managed to make his way in.
I am afraid I have to describe the Minister of State’s answer as codswallop. Let me give him an example of one risk to the NHS that we already know about. The number of NHS nurses has fallen by 3,500 since the general election, and that figure could be at least 6,000 by the end of this Parliament. The Bill is damaging front-line services in the NHS right now. Why does the Minister not put patients before his, the Secretary of State’s and the Prime Minister’s pride, drop this unwanted Bill, and use some of the money it would save to protect those 6,000 nursing posts?
I have to say that, unfortunately, notwithstanding what the hon. Gentleman thought was a rather clever way of describing my answers, his figures are factually incorrect. As Jim Callaghan once said, an inaccuracy can be halfway round the world before truth gets its boots on. The facts are these: there are 896—[Interruption.] If the hon. Gentleman would listen to the answer he asked for, he might learn something and stop making misrepresentations. There are 86 more midwives working in the NHS—[Hon. Members: “86?”]—896, which is an increase of 4%. There are 4,175 more doctors working in the NHS: an increase of 4%. There are 15,104 fewer administrators working in the NHS—a decrease of 7.4%—and 5,833 fewer managers. There are more doctors. There are more midwives. There are fewer administrators.
3. What recent assessment he has made of the future of private health care.
13. What assessment he has made of the involvement of the private health care sector in the NHS.
The Department has made no assessment of the future of private health care. This is not the role of the Department of Health. The private sector has always provided services to the NHS and the Department monitors trends where it does so—for example, the number of NHS patients choosing a private provider under patient choice.
Given that the Prime Minister said there would be no top-down reorganisation of the NHS, the coalition agreement ruled it out and nobody voted for it, what exactly is the Secretary of State’s mandate for turning the NHS into a “fantastic business”, as the Prime Minister has said?
I am extremely sorry if the hon. Lady really believes the mantra that she has just spewed out. If she had read pages 45 and 46 of our manifesto, she would have seen that it says that we would introduce clinical commissioning groups, take away political micro-management from Whitehall, free up the NHS and cut bureaucracy, as we are doing, which will save £4.5 billion to reinvest in the health service. Our coalition colleagues, the Liberal Democrats, had in their manifesto the abolition of SHAs. So I have to tell the hon. Lady that she is wrong. The test of what is going on and what is a success is the fact that if one meets GPs around the country, they support commissioning for their patients.
On the BBC’s “Newsnight”, the Minister of State stated that the Health and Social Care Bill would turn the NHS into a “genuine market”. How does this belief fit in with the NHS founding principle that access should be based on need, not market forces?
I am sorry—the hon. Lady has obviously not listened properly to me. It has been my guiding principle and my core belief from the day I entered politics that we should have a national health service free at the point of use for all those eligible to use it. In no shape or form does the Bill, or any actions by this Government, compromise that core belief of mine.
The Minister is aware that funding for the health service in Wales and Scotland is through the Barnett formula. For every pound saved by the Government—in other words, for every pound less spent per person in England—there is a knock-on consequence for the budgets in Wales and Scotland. What assessment has he made of the fact that he will be funding NHS provision from private patient fees, rather than the public purse?
As the hon. Gentleman knows better than I do, the running of the NHS in Scotland and Wales is a matter for the devolved authorities. I speak for the English NHS, and I can tell him that that we have guaranteed that the budget of the NHS in England will be a protected one for this Parliament in which there will be real-terms increases, albeit more modest than in the past. But we have seen in Wales in particular a fall of just over 8% in funding. That is the decision of a Labour Welsh Government. The moneys that are saved in the health service in England through cutting out bureaucracy and through greater effectiveness in delivering care will be totally reinvested—100%—in the NHS in England.
I may have an interest—a remote one—in this question. I expect my right hon. Friend would agree that every patient who chooses to have private health care rather than national health service care, for whatever reason, is one less case on the national health cost and care bases. Does my right hon. Friend agree that it may be appropriate for the Treasury to do a cost-benefit analysis so as to consider a tax encouragement for individuals, especially those over 65, to take out private health insurance?
I do not want to disappoint my hon. Friend, but I am afraid I do not agree with that. What the Government have to concentrate on is giving the maximum amount of resources within the protected budget to the provision of health care in this country, to ensure, enhance and improve the quality of care for patients in England. That is the priority, not providing tax relief in any shape or form for people who use their choice for private health care.
Professionals working in the NHS told the Health and Social Care Bill Committee that income from private patients was important to the development and improvement of NHS services. What steps will my right hon. Friend take to ensure that that income benefits NHS patients?
I am grateful to my hon. Friend for her question, because it might clarify some of the misinformation being bandied around on the Opposition Benches. Any money generated by private patients or by the private sector within the NHS must be spent on NHS patients, so it will benefit NHS patients and the NHS, and that is to be welcomed.
Does my right hon. Friend agree that collaboration between the NHS and the independent sector can deliver real benefits for both patients and the taxpayer?
My hon. Friend is absolutely right, because we need to drive up the quality of care. What we are doing with the Health and Social Care Bill is closing a loophole so that there can be no favouritism towards the private sector, so the travesty introduced under the previous Government, including the right hon. Member for Leigh (Andy Burnham), whereby independent treatment centres had an advantage that put the NHS at a disadvantage in providing care, and were paid more than the NHS, will stop, because it is unacceptable.
Part 3 of the Health and Social Care Bill will introduce competition policy to the NHS by law for the first time in its history. Does the Minister think that that is likely to lead to more private care in this country or less?
4. What steps he is taking to address underperforming hospital management teams.
11. If he will withdraw the Health and Social Care Bill.
I respect the Minister, but massive opposition to the Bill is mounting at the same time as its meagre support is ebbing away. Any more rational process would have resulted in the dignified withdrawal of the Bill long ago. Is there anything that would persuade the Secretary of State—frankly, he should be answering this question—to change his mind?
The straightforward answer is no, because everyone, including the right hon. Member for Leigh (Andy Burnham), accepts that the NHS has to evolve to keep up and meet its challenges. What matters to patients is not who delivers their care but the quality of the care that they receive, their experience of that care and the dignity and respect with which they are treated at all times. Cutting bureaucracy by a third to reinvest £4.5 billion in front-line services between now and 2015 is the way forward. Frankly, if one goes and talks to doctors around the country, one finds that they wish that Labour’s party political squabbling would stop so that they can get on with implementing the modernisation programme.
The Minister talks about party politics. Is he not aware that not a day goes past without an organisation representing doctors and nurses coming out against his Bill? Most recently, the Royal College of Physicians is having to hold an extraordinary general meeting because of pressure from its members. The Royal College of Paediatrics and Child Health is consulting its members. Why should anyone in this House support a Bill to which the men and women who work in the health service are so opposed and which even Tory Cabinet Ministers are briefing against?
I suspect that the hon. Lady does not get out and about much to meet doctors who are beginning to commission care for their patients. If she did, she would know that the mantra she is repeating from organisations that are not representative of doctors in this country—[Interruption.]
Order. The Minister of State is such an emollient fellow that I cannot imagine why people are getting so worked up, but they are getting very worked up, and they must calm themselves. We are only on Tuesday; we have got some time to go. Let us hear the Minister.
Very briefly, Mr Speaker, I can say to the hon. Lady that a number of the organisations that she mentions are trade unions that do not represent the views of GPs up and down the country who are actually engaged in implementing the modernisation by commissioning care for their patients.
12. What steps he is taking to improve the standard of dementia care in hospitals.
T7. Northamptonshire residents are rightly concerned that in the county in the last four months of 2011 the East Midlands ambulance service reached fewer than 69% of category A calls within eight minutes. The target is 75%. What hope can my right hon. Friend offer to local residents that this poor performance will rapidly improve?
I hope that I can give some reassurance to my hon. Friend by telling him that East Midlands ambulance service is working with commissioners, hospital trusts, community health services and social care services in taking measures to address its response time performance. NHS Milton Keynes and NHS Northamptonshire have received £1.7 million in additional funding, and NHS Midlands and East advices me that some of that has been used to fund further measures to help improve EMAS response times, including through the provision of additional ambulance crews and the deployment of hospital-ambulance liaison officers in each accident and emergency department to improve handover and turnaround times.
T3. The Secretary of State says he acts on advice. May I advise him to read the horrendous report from Mencap that details the death of 74 people with learning disabilities due to a lack of basic care and a lack of understanding of the health care needs of people with learning disabilities? Will he follow the advice of Mencap and ensure that the undergraduate and postgraduate training of doctors and nurses includes intensive training in the needs of people with learning disabilities, so that there will be no further unnecessary deaths of people with learning disabilities due to neglect in NHS hospitals?