Health, Social Care and Security

Debate between Stella Creasy and Rosie Cooper

Wednesday 28th June 2017 Commons Chamber

[Rosie Cooper (West Lancashire) (Lab)]

The issues that I wish to discuss encapsulate how the Health and Social Care Act 2012 is, day by day, weakening the fundamental foundations of the NHS; they include disparities in salaries and pay rises, lack of scrutiny and accountability, severe deficiencies in financial governance with regard to public moneys, and an emerging culture in which bosses feel they can act with impunity.

When I asked the Prime Minister about pay rises given to the Liverpool clinical commissioning group board, that information caused uproar and disbelief in health circles and among the wider public. While frontline staff were subject to the pay cap, the board gave themselves increases of between 15% and 81%. The chair got a 50% increase, taking him to £150,000; a practice nurse got 62%, taking her up to £65,000; and the chief executive and the finance director got 15% each. The board had only two non-exec directors; one was paid £105,000—a 42% increase—while the other got £55,000, a 25% increase. Deloitte’s limited-scope review confirmed that there were serious failings in governance, conflicts of interests, and payments to the board and non-exec directors that fell outside existing guidance. Only the chair of remuneration has resigned. The whole board who gave themselves these pay rises have not been held to account at all.

I alerted Simon Stevens to a cavalier attitude to contracting, including in the Liverpool Community Health NHS Trust break-up, in which the CCG insisted on a clinically unsustainable contract figure of £77 million, and then hid behind weak, low-ranking NHS Improvement employees. The conduct of the CCG in these matters fell well below that which would be required in commercial circumstances and should be investigated.

I alerted NHS England to the CCG’s handling of the SSP Health surgery contracts. One of the failing practices was allocated to the CCG chair’s practice. Several other surgeries went to Primary Care Connect, an organisation that did not even exist when the bids for these surgeries were opened and had only one director, who happened to be a former GP member of the governing body. I have had complaints from right across the city about how this was handled. The CCG is cutting clinical funding to vital organisations, telling them, “Don’t talk about it because you’ll be biting the hand that feeds you.”

[Stella Creasy]

My hon. Friend is describing an absolutely shocking case, which is about the treatment of NHS workers in her constituency. She talks about people being told not to talk about it. Today we have heard this Government say that they have heard our message about the importance of proper pay in our NHS, and now they are trying to shut that down because they are frightened about the reaction on their Back Benches. Is that not a terrible indictment of how they intend to run our country?

[Rosie Cooper]

It is a terrible indictment; the NHS is doing exactly these things. The CCG employed a senior administrator, paid them £70,000, and then seconded them to the GP Federation—a private company. While giving itself huge pay rises, cutting cash to organisations, and making unilateral financial decisions that threw NHS organisations into crisis decision making, it still found £14,000 to sponsor a “women of the year” dinner. NHS England has indicated that the financial governance is poor, but not fraud, because the Health and Social Care Act was so loosely written in this regard. I ask the Secretary of State whether the Government intend to tighten the rules to prevent such outrageous decisions being made ever again. Highly paid auditors who passed each year’s accounts without qualification did not notice. The ultimate accountable body is NHSE; so far, it has investigated remuneration governance, not governance generally, and it has taken no action against the accountable officer, the finance director and the board, who have shown them themselves to be failing in their duties. To me, this says institutionalised dishonesty bordering on corruption.

Sadly, I believe that the NHS is now so used to fudging and mudging that not sticking to the rules is becoming acceptable practice. We need to recalibrate our response to bad behaviour and make sure that the people who show it are held to account. We need an independent, systematic investigation into Liverpool CCG—and indeed the wider Liverpool health economy. Will the Health Secretary ensure that Liverpool CCG is independently investigated, and that any failings are openly addressed to ensure that this cannot and is not happening elsewhere in the country? After all, this is our taxpayers’ money.