National Health Service

Debate between Simon Burns and Baroness Keeley

Monday 16th July 2012 Commons Chamber

[Mr Burns]

I will now make progress.

Treatments available on the NHS are based on clinical need. There should never be any arbitrary rationing based on cost either locally or nationally—[Interruption.] The right hon. Member for Leigh shouts from a sedentary position, “There is”, and waves a piece of paper a little like Chamberlain on his way back from Munich, but if the piece of paper that the right hon. Gentleman is waving is his NHS health check, which officials in my Department have looked at, it is as worthless as the piece of paper that Chamberlain brought back from Munich.

If the right hon. Gentleman has any genuine evidence based on the cost of care, I and the Department of Health will certainly investigate it. Such practices are totally unacceptable, and we will take them very seriously indeed, but until then, although the motion talks about “the evidence presented”, the truth is that there is none.

The right hon. Gentleman claims that the number of cataract operations has fallen significantly since we came to power, but the reason for the fall is that clinicians have advised that the surgery is inappropriate in many cases—on clinical grounds. Surgery is available, however, for those patients who are clinically eligible, and they will receive it when there is a clinical reason.

[Barbara Keeley (Worsley and Eccles South) (Lab)]

Will the Minister give way?

[Mr Burns]

No, I am making progress.

The motion notes the growing involvement of the private sector, insisting that it represents evidence of growing privatisation. Not only is that unadulterated tosh, but I personally find it offensive to be accused of seeking to privatise the NHS, when in my political philosophy one of my core beliefs is in an NHS free at the point of use for all those eligible to use it.

Not only does the right hon. Gentleman have some difficulty understanding the meaning of “privatisation”, but he forgets his own record in government. The only plan to increase the private provision of NHS services came under the previous Government when he was Minister, when his hon. Friend the Member for Leicester West (Liz Kendall) was the special adviser and when Patricia Hewitt was Health Secretary. In May 2007, the right hon. Gentleman said:

“Now the private sector puts its capacity into the NHS for the benefit of NHS patients, which I think most people in this country would celebrate.”

Those are his words. It was his Government who saw private companies paid 11% more than NHS providers for doing the same work, and who wasted £297 million on operations that never happened at independent sector treatment centres. Given that he may have forgotten, I must tell him that the Labour party manifesto in 2010, when he was the Secretary of State for Health, stated:

“Foundation trusts will be given the freedom to expand their provision into primary and community care, and to increase their private services—where these are consistent with NHS values”.

That suggests that, as Secretary of State, he was prepared to have in his own party’s manifesto a policy allowing and encouraging foundation trusts to attract more work from the private sector.

This Government’s Health and Social Care Act 2012 specifically prohibits the Secretary of State, Monitor or the NHS Commissioning Board from favouring any type of provider, be they from the NHS, the charitable sector or the independent sector. It does so because this Government understand something that the right hon. Gentleman’s never did—it is not the nature of the provider, but the quality of the outcomes that matters most to patients.

Health Funding

Debate between Simon Burns and Baroness Keeley

Tuesday 22nd June 2010 Westminster Hall

[Mr Burns]

I can reassure my hon. colleague that it will not. It will be something completely different. It will be a stand-alone body that will be the driving engine of the NHS, in its required field.

By strengthening the link between investment and outcomes, the board will enable the NHS to deliver improved quality, higher productivity and better value for money. I am sure that my hon. colleague will appreciate that I cannot yet discuss the precise functions of the board, nor its composition, but our proposals underline our central belief that resources should be allocated according to need, without ministerial interference.

[Barbara Keeley (Worsley and Eccles South) (Lab)]

Perhaps the Minister can touch on another hospital situation. I understand that the Secretary of State visited Bury on Friday and overrode a clinically reached decision on maternity units. He said that, in his judgment, Fairfield General hospital’s maternity unit could remain open, against a clinical decision made in the “Making things better” reorganisation in Greater Manchester.

[Mr Burns]

I hope that the hon. Lady is aware of the announcement that my right hon. Friend the Secretary of State made shortly after he assumed his current position, in which he laid down new criteria for determining the reconfiguration of hospital services. Prior to the general election, when he was the shadow Secretary of State for Health, he made it a priority that, in particular, maternity units and accident and emergency units would be looked at far more closely than they had been looked at. That is why, on assuming office, he strengthened the criteria for carrying out consultations on proposed reconfigurations, and brought in four new criteria that will apply to any future reconfigurations, and current ones that are still in the process. They will have to abide by the new strengthened criteria, which include ensuring that the wishes and views of GPs, clinicians, local stakeholders and the general public are taken into account. Decisions that affect local communities and people will have the input of local people, rather than simply being imposed on communities which, for a variety of reasons, do not want what is being proposed.

[Barbara Keeley]

Those of us in Greater Manchester who are affected by the decision and the new process that the Minister is outlining are struggling to understand how to square the clinicians’ recommendation, which was based on things such as the number of doctors available, doctor training and the experience that has to be gained in maternity to deliver a safe service—a clinically led decision was made in that case—and the community’s wish and desire always to keep maternity and A and E units. It is hard for local people to understand how such things can be squared. Most constituency MPs understand that no one ever wants to lose an A and E or maternity unit. Does that really mean that clinically led decisions, such as those in Hartlepool and Manchester, will be overridden if local people do not want them?

[Mr Burns]

No, it does not mean that. What I said when explaining the criteria that the Secretary of State has laid down is that it will strengthen the consultation process leading to decisions, but obviously there will be a number of processes thereafter. The different processes of assimilation before a final decision must ensure that the Secretary of State’s criteria for greater input of clinicians’, GPs’ and local communities’ wishes are taken into account. In the past, reconfigurations have too often left the impression among local communities that they have not been consulted or listened to, and that decisions have been made by managers or others based only on their narrow point of view without taking account of other people’s views.

[Barbara Keeley]

Will the Minister give way?

[Mr Burns]

No. I have been generous, and I want to make progress.

That is the principle for the criteria, but it will not mean automatically that there will never be any changes because there is a block. We are strengthening the process to take account of local wishes and needs. There is a balance to be struck, which will emerge during the reconfiguration process.