NHS (Government Spending)

Stella Creasy Excerpts

Wednesday 28th January 2015 Commons Chamber

[Chris Leslie]

That was a very helpful intervention. I thank the hon. Gentleman, who has only a number of months to go in his current job. We have explained how we can hire a further 5,000 home care workers, a further 3,000 midwives, a further 20,000 nurses and a further 8,000 GPs through the time to care fund—the £2.5 billion a year that is fully costed and fully funded. I will methodically go through the detail of how we pay for that—he need not worry about that.

[Stella Creasy (Walthamstow) (Lab/Co-op)]

Let us take this debate back to the people we care about most—the patients, such as the mum who got in touch with me today who had rung her local GP 28 times to try to get through to get an appointment for her daughter, and whose friend had been told, “Don’t risk it—go to A and E because we simply cannot see our doctors.” Does my hon. Friend agree that the fragmentation of the NHS has made it much harder to hold to account our local health care services such as the Royal Free trust?

[Chris Leslie]

I am glad that my hon. Friend mentions the situation with GP numbers, which is another factor in the NHS infrastructure being under such pressure.

Let us look at what has been happening with GP numbers, which are not keeping up with demand in the rising population. In 2009, there were 62 GPs for every 100,000 people; that has now fallen to 59 and a half GPs per 100,000 people. We have also seen cuts to GP training. It is no wonder that the Government ditched the 48-hour guarantee for people to be able to see a GP.

NHS Commissioning Board (Mandate)

Stella Creasy Excerpts

Tuesday 13th November 2012 Commons Chamber

[Mr Hunt]

May I thank my hon. Friend for his work campaigning on cancer? He is absolutely right. We want to make sure that we pick up rarer cancers, so we are moving towards a composite indicator for cancers with the one and five-year measures. He is absolutely right that, properly to drive improvement, we need to compare not just hospital and consultant-led teams, but local GP-led commissioning groups, so that where there are successful outcomes everyone knows that. To get that comparison to work, we have to ensure that we compare the demographics. Part of the work we are doing is to understand how we can meaningfully compare CCGs, so that the public can truly understand who is doing best and who needs to do better.

[Stella Creasy (Walthamstow) (Lab/Co-op)]

The Secretary of State talks about operational independence on the ground for doctors and CCGs. He did not mention anything in his statement about sexual health care. One issue that we have been struggling with for some time in Walthamstow is the limitations of doctors who have decided to deny women even the most basic contraceptive services. We are still struggling with how the new mandate and new services will deliver them. Will the Secretary of State meet me and women from Walthamstow to discuss the issue, so that we can be confident that the changes will not lead to a further deterioration in sexual health care services across the country?

[Mr Hunt]

We will publish a sexual health strategy at the end of this year that will look at variation in services across the country and at the kind of problems the hon. Lady raises. It will be led by the public health Minister, my hon. Friend the Member for Broxtowe (Anna Soubry), who will be happy to meet the hon. Lady to discuss the issue further.

Oral Answers to Questions

Stella Creasy Excerpts

Tuesday 27th March 2012 Commons Chamber

[Mr Lansley]

My hon. Friend will be aware that the distance from target on the existing formula for Cornwall in particular has narrowed and is only just over 2%. For the future, I hope that he and all hon. Members will take considerable reassurance from the fact that not only will the formula continue to be the subject of independent advice, but new statutory provisions will set out that it should be intended to reflect the prospective burden of disease in each area, so it should be matched as closely as possible to the need for services in each area.

[Stella Creasy (Walthamstow) (Lab/Co-op)]

T6. The Government say that clinicians understand patients best, but there are doctors in Walthamstow who will not provide contraceptives to local women, and we now have one of the highest rates of teen pregnancy and repeat abortions in the country. Will the Ministers agree to meet women from my constituency and help them understand who, under the new system and the new layers of bureaucracy, they can hold to account for these problems—yes or no?

[Mr Lansley]

The hon. Lady should first have expressed a welcome for the fact that there has been a further reduction overall in the numbers of teenage pregnancies. As she knows, in her constituency there are doctors who, as she says, do not provide contraceptives, but there are also many other practices that do—17 out 18 GP practices in Walthamstow provide contraceptive services. There was a 60% increase in a decade in the number of managers in her area and the result seems to be that she does not understand how services were managed in Walthamstow. Under local authorities and the clinical commissioning groups in the future, there will be a clearer system.

Health and Social Care Bill

Stella Creasy Excerpts

Tuesday 13th March 2012 Commons Chamber

[David Miliband (South Shields) (Lab)]

I rise today to make a simple point to Ministers and their supporters: however acute the embarrassment of giving up on the Health and Social Care Bill at this stage, it will pale into insignificance compared with the embarrassment, never mind the trauma and cost, of ploughing ahead with this health reform and making it the template for health policy for the rest of this Parliament.

The Bill has achieved a remarkable feat since we contributed to the Second Reading debate. First, it has taken the Government hostage. It is the political equivalent of the Stockholm syndrome: falling in love with your captor. The Prime Minister insists, in one breath, that he must have the Bill to save the NHS and, at the same time, at Prime Minister’s questions, he insists that 95% of the country has already had the benefit of the reforms that he claims the Bill will put through.

Secondly, in the real world—many miles from the claims of Ministers that they wanted an unprecedented consensus between politicians and professionals—this Bill is without friends. Even more remarkable, and shocking to me, is that it is a Bill that has lost friends at each and every stage of its passage through Parliament. Every compromise, every “concession” and every retrofit has cost the Bill coherence, cost the Bill support and raised levels of anxiety about the Bill.

The reason for that is simple: the Prime Minister, the Secretary of State and the Deputy Prime Minister have made it their calling card to say that the choice is between this Bill and inertia. I know that tactic, as I have written those speeches and those articles, but in this case the problem is that that is not true. The Leader of the Opposition and the shadow Secretary of State for Health have put forward practical proposals to achieve some of these aims that are shared across the House.

The Secretary of State will recognise that more reform is going on in the English health service than in any other health service in the world at the moment—that is the product of what was done under the previous Government. That is perhaps one reason why it is improving faster than those anywhere else. The choice is between good reform and bad reform, and this Bill is bad reform: it gives reform a bad name. In fact, it threatens to set back the cause of reform for a generation, and I want to explain why.

As amendment has been piled on amendment, the Bill has gone from being wrong to being the most half-baked, quarter-thought-out shambles that the NHS has ever seen. I want to give three examples that go to the heart of the issues raised by the Secretary of State and the Prime Minister in their speeches to launch the Bill. The first and most important is managing service change. That is most important, because everyone agrees that the health service has to change to deal with the challenges of demography, drug costs and medical technology, and that means changing in the way in which services are organised. Yet in its hatred of planning and confusion about competition the Bill makes change at a local level not more likely but less. Why? The levers of change have been neutered. Clinical commissioning groups are too small and weak as replacements for primary care trusts, the NHS Commissioning Board is too remote and gargantuan and, as the Palmer study of reorganisation in south-east London shows, market forces on their own will not reconfigure services in a coherent way.

[Stella Creasy (Walthamstow) (Lab/Co-op)]

This weekend I met 80 women from Walthamstow who are desperately concerned because we do not have a sexual health service there, so we have very high levels of teenage pregnancy and repeat abortion, as there are doctors in the constituency who will not provide contraceptives. Does my right hon. Friend agree that the changes could make dealing with such problems harder, not easier?

[David Miliband]

My hon. Friend makes an important point. Far from driving the health service towards a coherent vision of the future, the Bill promises frenetic gridlock as professionals try to make the best of the bad job they have been left by the Health Secretary.

The second example is promoting efficiency. The Select Committee on Health stated:

“The reorganisation process continues to complicate the push for efficiency gains.”

It is, of course, right. The story today that senior GPs are spending four days a week coping with reorganisation rather than treating patients is, I predict, only the first step on that road.

The third example is accountability. If there was a germ of an idea in the original Bill presented by the Secretary of State, it was to align clinical and financial responsibility. In May last year he said that the key question was to

“put the right people in charge”.

After a year, it is completely inexplicable who is in charge: not GPs, because they are overseen by the greatest behemoth of them all, the national NHS Commissioning Board; not hospital trusts, because they are answerable to Monitor and the competition authorities; not the sectoral replacements for strategic health authorities, because they are only temporary; not the managers, because they are being sacked just before they reapply for their old jobs, which now have new names; and not the clinical senates, because their purpose has not yet been defined.

In truth, the new system hardly deserves the title of a system at all. It is not just that people do not support what the Government are doing, but that they simply do not understand what the Government are doing. I warn the House that the real danger for the NHS is a perfect storm of rising costs, rising demand and opaque and inexplicable decision-taking structures.

The Government promised clarity but have delivered complexity. They promised devolution but have had to create the biggest quango of them all. They promised efficiency and they have delivered bureaucracy. The result is that at the end of this Parliament we will once again be back in a debate that I thought we had buried for ever, about whether a tax-funded health service free at the point of need could deliver for the whole population of Britain. That is the last debate we should be having, but it will be the product of the shambles now being created.

I believe the Secretary of State when he says he supports the NHS passionately, but by the end of this Parliament, when the structural flaws of the plan are clear, he will not be around to defend it. That is the true danger of this misconceived and unloved Bill, and that is why this Secretary of State, in his last act of kindness to the NHS, should kill the Bill.

Oral Answers to Questions

Stella Creasy Excerpts

Tuesday 12th July 2011 Commons Chamber

[Stella Creasy (Walthamstow) (Lab/Co-op)]

12. What estimate he has made of the change in net public expenditure on older people’s social care since April 2010.

[The Minister of State, Department of Health (Paul Burstow)]

The latest available data on social care expenditure are for 2009-10, when net expenditure on social care for older people was £7.5 billion.

[Stella Creasy]

Many of my constituents will have been deeply concerned by the admission of Peter Hay, the president of the Association of Directors of Adult Social Services, that nearly £1 billion is being taken out of social care budgets following cuts to local government, and by his warnings about the consequences for provision. When will the Minister deliver interim funding relief, so that patients are not stuck in hospitals because they cannot be discharged, and so that we can be sure that we will avoid a crisis in social care?

[Paul Burstow]

If the hon. Lady had read on, she would have found that £700 million of the £1 billion is to be found not through cuts in services, but through efficiency savings, for example through the use of telecare, which significantly reduces costs, and investment in reablement services, which save resources and help people to get back on their feet. That is all in the report that she is waving around. When it comes to investment, the Government have already made clear their commitment through the spending review, and are investing, by the end of this Parliament in 2014-15, an additional £2 billion—something that her party did not do when in government.