Oral Answers to Questions

Simon Burns Excerpts

Tuesday 29th June 2010 Commons Chamber

[Derek Twigg (Halton) (Lab)]

2. What assessment he has made of the effects on NHS waiting times of NHS targets in the last 10 years.

[The Minister of State, Department of Health (Mr Simon Burns)]

Targets focused the NHS on bringing down waiting times, but also put process above clinical judgment and patient choice. Changing the way in which we manage waiting times will empower both patients and clinicians. NHS targets have dictated clinical priorities and harmed patient care. Focusing on long waits has meant less progress on reducing average waits than could otherwise have been achieved.

[Derek Twigg]

I noticed that in his answer the Minister did not say that any assessments had taken place. How many representations has he received from clinicians, people working in the NHS and the public demanding the removal of the 18-week target, for instance? Targeting is about making people better and getting them seen more quickly, so is not the real reason for dropping targets the fact that the Minister wants to undermine the NHS again?

[Mr Burns]

I am sorry, but the hon. Gentleman, for whom I have considerable respect, is just plain wrong. There have been a number of representations over the last seven weeks or so. In addition, as my right hon. Friend the Secretary of State and his shadow team went round the country over the past five years, they were constantly told by GPs and clinicians from hospital to hospital that politically motivated targets were distorting clinical decisions and patient care.

[Mr Stephen Dorrell (Charnwood) (Con)]

Does my hon. Friend agree that by far the most important way of improving the service delivered by the NHS is to focus on the three key indicators of clinical outcomes, patient experience and value for money? Can he assure the House that the Government will pursue those, particularly against the background of increasingly scarce resources, in order to deliver the objective we all have: a better-quality NHS?

[Mr Burns]

I am extremely grateful to my right hon. Friend, who is absolutely right, and I can give him the categorical assurances he is seeking, but I would also like to add one more: we need information to empower patients, because if patients are going to be at the heart of the NHS they must have the information to take the decisions that are important to their health care.

[Mr Speaker]

Order. May I gently ask the Minister to face the House? I am sure that Opposition Members will want to see his face.

[Andy Burnham (Leigh) (Lab)]

We do, Mr Speaker, very much; we want to see him squirm.

First, let me say that we welcome the Minister back to the Department of Health; he was a Minister in the Department 13 years ago. As I have said before, we trust that he finds the NHS in much better condition than when he left office. Last week we had an independent verdict on those 13 years. The independent and respected Commonwealth Fund said that the NHS was one of the best health care systems in the world, and, indeed, that it was top on efficiency: a ringing endorsement of Labour’s stewardship of the national health service. That verdict reflects the huge progress on waiting times that has been made over those 13 years. So does not the abolition of the 18-week target, which the Minister announced last week, put all that progress at risk? Will he today give us a straight answer to this question: can he guarantee that waiting times will not rise, and that patients will still be treated within 18 weeks?

[Mr Burns]

I thank the right hon. Gentleman for the kind comments at the beginning of his remarks; things went downhill thereafter, but that is politics.

The right hon. Gentleman needs to understand that patients have to come first in a national health service, and the trouble with the approach he took was that he wanted politicians and bureaucrats to micro-manage it from the top down, rather than having a bottom-up system that listened to local people. One of the key aims is to ensure that people get the finest and best treatment possible, and I am afraid that his approach—a straitjacket of targets in certain areas—did not work then, and will not work now.

[Andy Burnham]

I shall take that as a no, because the Minister did not answer the question; he could not give that guarantee. He says that we must put people and patients first, yet at a stroke he has taken power away from patients and handed it back to the system, turning the clock back to the bad old days of the Tory NHS. Let me quote some comments by Jill Watts, chair of the NHS Partners Network, which represents private providers. In the Financial Times on 18 May, she is reported as saying the following about the loss of targets:

“Waiting times will go up and if people want a procedure they have a choice: they can wait or they can look to pay”.

Is that not always the Tory choice on the NHS: wait or pay?

[Mr Burns]

The right hon. Gentleman is not right. We have not taken that attitude; we never have taken that attitude. We want to have a system whereby the health service is not in a straitjacket of targets that disrupt and distort clinical decisions. We want to empower clinicians and GPs to take decisions about who should be treated when according to their clinical judgment.

[Andy Burnham]

Waffle!

[Mr Burns]

It is not waffle. The right hon. Gentleman is clinging to an outdated philosophy, and he is in denial about the need to change it.

[Toby Perkins (Chesterfield) (Lab)]

3. If he will take steps to increase the number of dentists providing NHS services in Chesterfield; and if he will make a statement.

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[Clive Efford (Eltham) (Lab)]

8. What recent representations he has received on the new community hospital for Eltham; and if he will make a statement.

[The Minister of State, Department of Health (Mr Simon Burns)]

The Department of Health is in contact with strategic health authorities regarding ongoing community hospital programme funding. This includes contact with the London SHA for Eltham and Mottingham community hospital and other schemes in the region.

[Clive Efford]

I am grateful for that answer, as far as it went—but there is a great deal of expectation in the community in Eltham that that project will be delivered. It has been in the pipeline for quite some time and will provide 40 respite beds, diagnostics such as blood tests and X-rays and, I hope, dialysis at a local level, as well as a GP-led walk-in urgent care centre. May I urge the Minister to revisit the project, and when I ask a future question, to come back with a better answer?

[Mr Burns]

I am a bit perplexed by the hon. Gentleman’s comments, because I have answered the specific narrow question that he asked—but let me try to cheer him up, if I can. We understand that he has been a redoubtable campaigner for the hospital, and we support the principle of community hospitals. The Department, as the hon. Gentleman knows, allocated £4.58 million to help the community hospital in Eltham and has already given about £1.9 million to NHS Greenwich, the primary care trust, for it. I hope that the hon. Gentleman will not have to come back to me with another question, because I trust that I am now going to cheer him up: I can announce today that the balance of the money will be paid and made available during the current financial year.

[Mr David Evennett (Bexleyheath and Crayford) (Con)]

I congratulate my hon. Friend on that announcement, which will bring considerable pleasure to people in south-east London. He is well aware that proposals are being made within our area of south-east London to reorganise health provision, which are causing considerable concern. Will he ensure that vital services are maintained in our area for patients?

[Mr Burns]

I am grateful to my hon. Friend. As he rightly says, I am aware of the situation. As he will be aware, we believe that local people, local clinicians and local GPs should have an input into any reconfiguration of health care provision. As my right hon. Friend the Secretary of State said when he announced the changes to the criteria, there will be an assessment of whether they apply to the reconfiguration to which my hon. Friend refers. Once that has been done and decisions have been reached, we will be able to move forward in the proper way.

[Jim McGovern (Dundee West) (Lab)]

9. What plans his Department has for health warnings on labels of alcoholic drinks.

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[Helen Jones (Warrington North) (Lab)]

15. What percentage of patients at Warrington Hospital were treated within 18 weeks of referral in the last 12 months for which figures are available.

[The Minister of State, Department of Health (Mr Simon Burns)]

At the Warrington and Halton Hospitals NHS Foundation Trust, in the 12 months up to April 2010, 93.2% of patients admitted to hospital for treatment and 97.8% of patients whose treatment did not require admission to hospital waited 18 weeks or less from referral.

[Helen Jones]

I am grateful to the Minister for that reply. What percentage of patients does the Minister now believe will be treated within 18 weeks, and which people exactly does he think deserve to wait longer than that?

[Mr Burns]

May I reassure the hon. Lady that in my lexicon no one “deserves” to wait longer. What I want, and my right hon. and hon. Friends want, is a first-class health service that makes decisions based on clinical reasoning and gives treatment swiftly and relevantly to those who need it. My right hon. Friend the Secretary of State has made some changes to some of the targets to ensure that clinicians and clinical decisions dominate, not political decisions by politicians and bureaucrats.

[Stephen Twigg (Liverpool, West Derby) (Lab/Co-op)]

16. What progress he has made on establishing his proposed commission on funding long-term care; and if he will make a statement.

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[Duncan Hames (Chippenham) (LD)]

T7. What encouragement is the Secretary of State giving to primary care trusts to restore minor injury services to towns such as Melksham in my constituency? It saw its minor injuries unit close under the last Government.

[The Minister of State, Department of Health (Mr Simon Burns)]

I am very grateful to the hon. Gentleman for that question. It is up to local communities and local health providers to identify what they believe are the local needs of their communities and then go through the procedures, measures and mechanisms to seek to achieve what they want—in this case, that could be a new A and E. It is not for Ministers to promise such provision; there are proper procedures, from the local area upwards, for achieving such aims.

[Several hon. Members]

rose—

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[Julian Sturdy (York Outer) (Con)]

T9. I am sure that the Secretary of State will remember visiting my constituency earlier in the year and listening to constituents’ concerns about the withdrawal of spinal injections on the NHS. Given that the PCT’s decision is set to become another example of the postcode lottery in the health service, will his Department consider the ongoing debate about spinal injections in York and support the attempts of my constituents as they seek to shape local health services around their specific needs?

[Mr Burns]

I am a bit confused as to where to look. [Interruption.] Right, I will look forward.

My right hon. Friend the Secretary of State well remembers his visit in April to meet the York and District pain management support group. He made it plain at the time that it should be for GPs and their patients to decide what treatment should be given, as opposed to a decision by the PCT to veto spinal injections for all sufferers of long-term chronic back pain. We will, in due course, set out our proposals to put more power in the hands of patients and GPs.

[Vernon Coaker (Gedling) (Lab)]

T3. Does the Minister agree that it is crucial for patients to have information if we are to make a reality of choice within the NHS? In that respect, does he agree that if we are to give people a real choice as regards the choose and book system that GPs operate, there is a need to ensure that patients have the information about the success rates of different hospitals, and different surgeons, as regards operations?

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[Robert Halfon (Harlow) (Con)]

Will the Minister review the problem of highly priced patient lines and introduce competition so that patients in Harlow and elsewhere no longer pay extortionate prices to watch TV or make phone calls?

[Mr Burns]

I am extremely grateful to my hon. Friend for raising an issue that I know is of concern to many people. Although I cannot make promises about the outcome of any review, he has my assurance that we will be looking into this, and that we take on board the concerns that have been expressed over a number of years.

[Mr Nick Raynsford (Greenwich and Woolwich) (Lab)]

The Secretary of State has halted the reconfiguration of services in south-east London, which was clinically led, the subject of detailed public consultation and approved by the reconfiguration panel. The outcome is to leave my PCT and hospital trust acutely troubled about their ability to deliver the improved health services that were promised under “A picture of health” and to meet their financial targets. What does that say about the Government’s commitment to evidence-based policy making?