Social Care (Liverpool)

Steve Rotheram Excerpts

Tuesday 7th March 2017 Westminster Hall

[Steve Rotheram (Liverpool, Walton) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Hollobone. I congratulate my hon. Friend the Member for Liverpool, Riverside (Mrs Ellman), my constituency neighbour, on securing this important debate and on her speech, during which she laid bare any claim by the Government that they have any intention other than passing the buck for the health and social care crisis.

The Minister will be aware that, in the past few weeks, one of the main local hospitals in Liverpool has reported that an almost unprecedented 20% of its capacity has been taken up by people who do not need to be there. That, of course, has a knock-on effect and reverberates across the whole NHS system. The Government’s myopic approach has led to cancelled elective surgery, delays in A&E and ambulances backing up at hospital entrances, resulting in an incredibly inefficient use of already overstretched NHS resources. More importantly, it is not in the best interests of patients and patient care.

Keeping people who do not need to be in hospital in expensive NHS beds, instead of making provision for their illnesses to be treated at home or through other resources, is a wasteful and nonsensical way to spend taxpayers’ money. The Secretary of State has claimed that delayed discharge is not just about social care funding. Perhaps when the Minister responds, he would care to identify a single local authority that has had the same Government funding cuts inflicted on it as those in Liverpool and yet has managed to avoid a delayed discharge crisis. I await his response with anticipation.

A recent report by the Chartered Institute of Public Finance and Accountancy and the Institute for Government identified that people were waiting longer for critical hospital services such as A&E and cancer treatments. It highlighted the fact that delays in transferring people from hospitals into social care have risen by 40% since 2014. The Government cannot wash their hands of the crisis that has been created in Downing Street. They cannot simply shift the blame for the shambles they have presided over for the past seven years on to the shoulders of councils such as those in our area.

I should declare an interest in what I will say next, as a candidate in the Liverpool city region metro Mayor contest. If I am elected in May, I offer to work with the Minister’s departmental officials and the leaders of the six districts in the Liverpool city region to convene a health and social care summit, to examine the current situation and look at how we might work together across the piece at what could be done better. As my hon. Friend said, there are some innovative approaches and best practices in our area, and the Government might even learn something if they took part. Councils in our area have already shown the leadership on social care that the Government are singularly failing to, so that summit is a chance for the Government to answer their critics, see for themselves the pressures that local authorities are having to contend with on a daily basis and work to tackle the problem at source.

We have a duty of care to ensure that health and social care work is as seamless and joined up as possible within the current structures of responsibility and funding restrictions. However, the Government need to accept their duty in relation to health and social care. In our area, the so-called social care precept would not even go close to backfilling central Government cuts to date, as we have heard, and it is seen as a scam to shift the burden of funding on to the shoulders of local taxpayers. Liverpool has a predominance of terraced streets—what we used to call two-up, two-downs—so the imbalance of band A and B properties means that for every 1% increase in council tax in our area, we raise about £1.4 million to £1.5 million. However, with a similar 1% increase in some of the leafy suburbs down here, councils can raise more than £5 million. That situation perpetuates the growing gap between the haves and the have-nots, and we will see tomorrow whether the Chancellor recognises that the cuts being inflicted on councils such as Liverpool, Halton, Knowsley, St Helens, Sefton and Wirral have gone too far, and whether a fairer settlement is offered.

We are doing our bit in our city region. The Government now need to accept their responsibility to the elderly and their families and carers. They have often tried to use a sticking plaster to offer a solution, but they know that a sustainable solution must be found to this growing problem. I hope that all the relevant factors—including demographic, socioeconomic and health inequality data—are included in any formula that the Treasury uses to calculate additional funding need. Perhaps tomorrow’s Budget will see yet another sticking plaster applied to the crisis in social care and in our hospitals, but mark my words: it will be no more than a temporary measure at best. At worst, it will be more smoke and mirrors that will fall apart just days afterwards upon further scrutiny. I cannot believe the Government will allow that to happen.

At Prime Minister’s Question Time, the Leader of the Opposition mentioned that Liverpool’s director of adult social care, Samih Kalakeche, had handed in his notice because he was tired of being held responsible for axing services for the elderly and vulnerable in our city. Mr Kalakeche told The Observer:

“Frankly I can’t see social services surviving after two years. That’s the absolute maximum. If we don’t do something within the next six months, I believe social services will not exist by 2018-19. This isn’t scaremongering, this isn’t me asking you to feel sad for me—whoever is making decisions out there has looked at social care as the Cinderella of the service…People are struggling, people are suffering, and we’re really only seeing the tip of the iceberg.”

I think those comments are directed fairly and squarely at the Government’s door.

However, it is not only Samih who claims that. Last month, the Conservative chair of the Local Government Association, Lord Porter, said that services supporting the most vulnerable people in our communities were at breaking point. He said that

“extra council tax income will not bring in anywhere near enough money to alleviate the growing pressure on social care both now and in the future. The social care precept raises different amounts of money in different parts of the country. Social care faces a funding gap of at least £2.6 billion by 2020. It cannot be left to council taxpayers alone to try to fix this crisis. Without genuinely new additional government funding for social care, vulnerable people face an ever uncertain future where they might no longer receive the dignified care and support they deserve. This is not only worse for our loved ones but will also heap further pressure and wasted expense on the NHS.”

Opposition Members could not agree more.

I know that our area, like the other 150 councils in England, will not get a sweetheart deal from the Government—sorry, I of course mean a memorandum of understanding allowing for a pilot of business rate retention. In any case, such deals are yet another example of the Tory approach that “to those that hath shall be given”. For example, Westminster City Council raises so much money in business rates that it could probably afford to actually pay its residents to live there instead of taxing them. However, there are certainly limits to what can be achieved in our area at a local or even sub-regional level with the current inadequate resourcing.

I slightly disagree with my hon. Friend the Member for Garston and Halewood (Maria Eagle), who welcomed the Government’s social care commission. I do not think we need another commission; I think we all know what is happening in our areas. The Government need to start listening to people—to patients, carers and families who have to go through terrible circumstances on a daily basis. It is time for action, not for commissions. Our elderly family members and our overstretched and all-too-often under-rewarded social care workers deserve nothing less. I hope the Minister will talk about action in his response.

--- Later in debate ---

[David Mowat]

I was just making the point that the figure the hon. Member for Liverpool, Riverside used was £130 million and the figure I have is £194 million. I accept that that number is not for today, and I also accept, as I have said many times in the Chamber, that the social care system is under pressure throughout the country, and Liverpool is part of that.

[Steve Rotheram]

I am trying to be helpful to the Minister. I quoted a former director of adult social care in Liverpool, Samih Kalakeche, who said:

“If we don’t do something within the next six months, I believe social services will not exist”

by the time that the Minister believes we will get the additional funding.

[David Mowat]

Today is not Budget day. I accept that the systems are under pressure. The precept has raised something, and Liverpool’s budget for social care is increasing next year, but it is fair to ask whether it is increasing enough given the pressures we are under—that is a reasonable point. My point about the £194 million figure was in response what was said earlier. Although I and the Government accept that there are pressures, it is important that we share accurate numbers with each other.

The hon. Member for Liverpool, Riverside also made the good point that there is now an increasing tendency for care to be provided in people’s own homes. If we look at the care home market over the past decade, we see that roughly speaking there are the same number of beds today as there were 10 years ago, and that is clearly in the face of a considerable increase in demand. That is because far more people are now being looked after through domiciliary packages in their own home, and that is the market we need to get right and make effective.

The hon. Member for Garston and Halewood (Maria Eagle) raised the potential issue of councils being punished in the Budget for being efficient. I will be very disappointed if that is the case—it is not my understanding of what will happen—but it is a fair challenge, and we will have to see about that when the Budget comes out.

The hon. Lady raised a number of points about the STP. We all share the STP area, and there is work to do on it. I will make this point, however: she talked about cuts of £908 million, but those are cuts against an increase in demand—they call it the counterfactual—of 4% or 5% over the next period. The truth is that Cheshire and Merseyside will be getting real-terms increases in funding for every year up to 2020. Nevertheless, that does not mean that there are not challenges, for some of the reasons we have heard, such as demographics and all that goes with that.

The hon. Member for Liverpool, Wavertree (Luciana Berger) asked for a glimmer of light and hope; hopefully, between myself and the Chancellor tomorrow, we can achieve that. She also raised the cases of Sobia and Veronica and their care packages. It is difficult for me to respond to that, other than to say that the Care Act 2014 set out statutory requirements for what councils need to do. If those statutory requirements are not being met, and the way she described those cases implied that might be the case, that is clearly against the law and there is recourse either to the local authority itself or to the ombudsman. I would be happy to talk to her about that in more detail.

The hon. Member for Liverpool, Walton made a number of points and started by talking about delayed transfers of care. He rightly said that I have talked on a number of occasions about variations between councils in delayed transfer of care performance. I will say that DTOC is not the only measure of the effectiveness of a social care system; it just happens to be one the easier ones that we can get a metric around. The fact is that if we look at the 10% worst and the 10% best councils in the country—Liverpool is round about the middle—the level of delayed transfers differs by a factor of around 20 or 30. I absolutely concede that social care systems work better with more money, but it is not just about money, because that is about different working practices and different people doing things in different ways. It is right that we have the debate about that, as well as about the need for more money.

The hon. Gentleman challenged me to name some councils that were much better than Liverpool in terms of delayed transfer of care, within a similar budget environment. I do not know what the budget environment is, but I have a list I can give him of councils that have fewer delayed transfers of care. As I said, Liverpool is not a particularly bad council, and I do not want to imply that it is, but Durham, Kirklees, Sunderland, Barnsley, Newcastle-upon-Tyne and St Helens all have at least 10 times less delayed transfers of care than Liverpool. I was taken to task at a recent Conservative councillors meeting, in which people said that having a good social services department is not just about delayed transfer of care; it is to do with a whole lot of other things. I absolutely accept that, but in a sense the hon. Gentleman started it, so I wanted to give him those figures.

[Steve Rotheram]

Will the Minister therefore pay tribute to Liverpool for what it has done and its innovative approach? My question was about councils that have had similar cuts to Liverpool of around 60%. None of the councils that he mentioned has had the same degree of cuts as Liverpool City Council.

[David Mowat]

The hon. Gentleman mentioned some councils that were in the south and I picked some that were not, but fair enough—I accept his point. He mentioned that, depending on the result of his election, he would have a summit. I would be delighted to attend, if he were to invite me—although who knows where I will be by then.

[Steve Rotheram]

It’s only in May!

[David Mowat]

Indeed. On Thursday, I am going to Liverpool to give a talk at a care conference. I would be very happy during that visit to come along and talk to the council about some of the issues raised here today. As the hon. Gentleman rightly said, I am sure that the Government can learn from Liverpool. Frankly, we can all learn from each other. When I went to Whiston hospital and saw discharges to St Helens and to Liverpool, I saw some wonderful things happening there. Anyway, the offer stands.

Community Pharmacies

Steve Rotheram Excerpts

Wednesday 2nd November 2016 Commons Chamber

[Nigel Mills (Amber Valley) (Con)]

I declare an interest, as my wife works as a community pharmacist just outside my constituency. It is probably fair to say that from my discussions with her and with my local pharmacists, I know the valuable work they do and the pressures on them, as well as the changes that they would like so that they can give a better service.

The Public Accounts Committee has had nine or 10 inquiries in the past year or so looking at the pressure on NHS finances and the various deficits in the system. It is therefore quite hard to stand up and say that the Government are completely wrong to try to find some efficiency savings from the pharmacy budget, or that we should just ignore the £3 billion or so paid to pharmacies each year without trying to find some savings. If we are going to hit the efficiency target across the NHS of £22 billion during this Parliament, while having all the services we want, we will have to accept such savings in every area, although it is not going to be easy wherever they fall. I can therefore see the logic of why the Government need to look at the pharmacy budget.

I also accept the logic that although the system we have ended up with, in which we give each pharmacy a fixed establishment payment, may well have been suitable when we had a very controlled regime, under which a licence had to be got to open a new pharmacy, it probably did not fit well with the old 100-hour regime, under which there was a vast expansion in the number of pharmacies across the country. It is right to look at that system. It may also be right to look at the 100-hour pharmacies to see exactly what the rules for them should be.

I welcome the pharmacy access scheme, which is a very welcome improvement on what was originally suggested for this round of cuts. Two pharmacies in my constituency will benefit from it. I met both pharmacists when the cuts were first announced. Those pharmacies provide the only health provision in the villages they serve, so it is vital for them to be saved.

[Steve Rotheram (Liverpool, Walton) (Lab)]

Does the hon. Gentleman agree that it is a false economy to cut services, given that the knock-on effects on GP services and the NHS will cost more, and that it will do nothing to alleviate the problem of health inequalities in this country?

[Nigel Mills]

It would clearly be a false economy if it resulted in losing pharmacies in areas where we need them. Equally, we would have to say to GPs, “I’m sorry. We can’t take the money off the pharmacies. We are taking it off you instead.” That would make it harder for them to deliver the services that they want to deliver. I do not think there are any easy answers. The system is under so much financial pressure that we must find savings wherever we can.

I have a few areas on which I want the Minister to comment when he winds up. The first is the hub-and-spoke model. Such a model would have been a complete disaster for community pharmacies. If the system is to work, we need pharmacists who know and are trusted by their patients so that they can deliver to patients the extra services that they need. If we moved to a hub-and-spoke model, in which the pharmacy knows almost nothing about the patients—the drugs are just prepared in a factory somewhere and then turn up for the patient—we would not have the community advantages from the pharmacy network that we all want. I hope that that idea, which may have been raised by some management consultants, can safely be binned—where most such ideas are probably worth sending.

The second area is the provision of services by pharmacists. I know that my local pharmacies are very keen to deliver more value-added services. They see that as right for the NHS and in the best interests of their patients. As I found out five years ago, when we went through the clinical commissioning group reform, they are not quite so sure that local GPs are keen on commissioning new services from pharmacies, rather than carrying out those services and taking the revenue themselves. We know that there is pressure in the GP sector, so we can see the point of that.

We need to have a vision throughout the country about what core services should be commissioned from pharmacies. I think the word the Government use about the minor ailments scheme, which I generally support, is that we should “encourage” all CCGs to commission such a scheme. I hope we can do something a little stronger than encourage, and that we can have a broader list of services for CCGs to commission from pharmacies. I have seen great work done on that in my constituency. Permission has been given for syringe driver services to be carried out by some pharmacies, rather than hospitals, so that they can be got to the patients needing them much more quickly and cheaply. Some pharmacies do warfarin testing, because it is much more convenient for patients to go to their local pharmacy than to have to trek to the nearest hospital or to their GP. Those services are very patchy and do not even cover a whole constituency, so I hope we will draw up a core list of services that can be done better by pharmacies and which will be used.

I will quickly touch on the third area, which is the variety of opening hours. Quite rightly, we are to start directing patients from the 111 service to their pharmacy rather than to out-of-hours doctors as the first port of call for emergency repeat prescriptions. However, there is an interesting mix in that some pharmacies open for 100 hours a week—perhaps opening at 6 am and closing at midnight—and other pharmacies open from 9 o’clock to 5 o’clock from Monday to Friday and may open for a couple of hours on Saturday morning. How will we commission all pharmacies to carry out such a service if some do not open out of hours? On the flipside, we still require many of them to open for 100 hours a week, even though it is not economic for them to do so during many of those hours. There is therefore scope for a review of the hours during which we expect pharmacies to open.

Junior Doctors Contract

Steve Rotheram Excerpts

Wednesday 6th July 2016 Commons Chamber

[Mr Hunt]

My hon. Friend is right to say that. One of the things that is clear to me is that the reason that the May deal is better than the deal that we were going to introduce in February is because of the involvement of the BMA and the BMA leaders in telling us the concerns of junior doctors at the coalface, and the specific niggles and annoyances, many of which we were able to sort out very straightforwardly. I strongly hope that junior doctors will remain in all the discussions that we have, so that we try to get even better solutions.

[Steve Rotheram (Liverpool, Walton) (Lab)]

At the start of his statement, the Secretary of State used sophistry to try to call into question the result of the ballot, by implying that 58% did not provide legitimacy for the rejection of the Government contract offer. Does he regret using smoke and mirrors, and does he agree that if his flawed methodology were used for other electoral processes, he would not be sitting in this House, there would not be a Tory Government, and we would still be in the EU?

[Mr Hunt]

The hon. Gentleman has misinterpreted what I said. I am clear on this. I said in my statement that 58% voted against the contract, and I accept that that was a majority of BMA members. I stated the fact that on a 68% turnout, around a third of serving junior doctors actively voted against the contract. That is factually correct.

Contaminated Blood

Steve Rotheram Excerpts

Tuesday 12th April 2016 Commons Chamber

[Mrs Murray]

I completely concur with my hon. Friend. My constituent is particularly concerned about proposals to withdraw index linking from annual income and to refuse to increase it by any meaningful amount. I understand that there is a recommendation to fix annual payments at a flat rate of £15,000 a year, which would leave my constituent with a nominal financial increase of about £240. There are also proposals to withdraw back-up services for emergencies and to withdraw support, which my constituent will certainly require, given the severity of her condition.

May I ask my hon. Friend the Minister to clarify the position, and to take my constituent’s concerns into account when formulating final proposals? My constituent previously enjoyed a successful career in the legal profession, but she became too ill to pursue it after her infection with contaminated blood. Her career was, sadly, cut short, as was her considerable earning potential and professional development.

Patients must be treated with fairness, and each case must be assessed and supported on its merits. I am grateful that the Prime Minister acknowledged the scale of the tragedy and apologised on behalf of the UK Government. I welcome the additional funding for England that was announced in 2015 to ease the transition to a reformed scheme and ensure its sustainable operation with patients at its core. That scheme must provide a robust and fair system that supports and compensates those who are affected and removes any unnecessary complexity and unfairness.

[Steve Rotheram (Liverpool, Walton) (Lab)]

At the start of her speech, the hon. Lady mentioned the excellent work of the APPG. It is right to highlight that, because it has shed a lot of light on the issue. In every constituency, there are heart-breaking stories like that of her constituent. I have two constituents who, through no fault of their own, received contaminated blood products, and one of them feels as though he has a death sentence hanging over his head. Does the hon. Lady agree that we should not, quite literally, add insult to injury, and that a just and fair settlement must be found as soon as possible? I know that the Conservative Government were not necessarily responsible for the blood products, but it is in the gift of this Government to sort the matter out once and for all.

[Mrs Murray]

I sincerely hope that the Minister is listening to what the hon. Gentleman has to say, and that she and the Government will take action to make it easier for affected people to live as good a life as they can expect to.

There are currently five different organisations funded by the Department of Health to which affected individuals can apply for support. It is encouraging that staff in those schemes have said that the system would be more efficient and consistent if the organisations were combined. Other concerns that have been raised should be addressed through the consultation and subsequent proposals. Those concerns include the fact that beneficiaries are not individually assessed, and that bodies operate different payment policies. The APPG is quite correct to state that the system is not fit for purpose. The consultation that the Department of Health is conducting, which concludes this week, is a helpful step. I am pleased that the Department of Health has reached out to, and sought views from, affected patients and their beneficiaries, and I congratulate the Minister on that. The outcome must lead to a fair and sustainable solution for my constituent and for impacted individuals and families across the country.

Health and Social Care

Steve Rotheram Excerpts

Tuesday 2nd June 2015 Commons Chamber

[Mr Hunt]

Yes, I absolutely can. Let me give him one specific example. A couple of years ago, I noted a statistic that showed that 43 people died because they were given the wrong medicine by an NHS doctor or nurse. That problem could be avoided if doctors and nurses had access to people’s medical records so that they could see whether patients had allergies and give them the right medicine. The previous Labour Government had a crack at electronic health records. It was not successful, but they were right to try. We have to get it right if we are to have the best health service in the world. I am committed to that.

[Steve Rotheram (Liverpool, Walton) (Lab)]

The Secretary of State will know that prevention is better than cure. He spoke about parity of esteem for mental health services. I wrote to him last year about a teenager who was threatening to commit suicide. He had been given a counselling appointment through his GP four weeks ahead, even though the kid was saying that he was going to kill himself that day. What will the Secretary of State do about improving counselling services to stop young people wanting to take their life because their appointment is many months away?

[Mr Hunt]

The hon. Gentleman is right to raise that issue. The previous Minister with responsibility for mental health set up the crisis care concordat, which he got all parts of the country to sign up to, to provide better care. There is a big issue with the quality of child and adolescent mental heath services provision. We want to cut waiting times for people in urgent need of an appointment, so I recognise the problem and I hope that the hon. Gentleman will give us some time to bring solutions to the House.

Epilepsy

Steve Rotheram Excerpts

Thursday 26th February 2015 Commons Chamber

[Laura Sandys]

Absolutely. I totally agree. In many instances, people with epilepsy also have other chronic conditions, which are no doubt contributory factors. The level of support for research on epilepsy is significantly lower than for other conditions. Again, it is seen as a secondary or tertiary priority when it comes to research funds. It is absolutely crucial to understand the interrelationship between epilepsy and autism, as well as between epilepsy and school achievement and all sorts of not only chronic conditions but life-restricting—as well as life-enhancing—problems. I believe that we need a lot more research, but this comes down to people being clear that epilepsy matters.

[Steve Rotheram (Liverpool, Walton) (Lab)]

On that point, I have had correspondence with a hospital in my constituency called the Walton neuro centre. It says that neuropsychological care is very important, especially for younger people who, if they have access early enough, have the propensity to go on and achieve their full potential. Does the hon. Lady agree that Ministers should consider what more they can do on access to such neuropsychological assessment and care, and in supporting the work of the Walton neuro centre?

[Laura Sandys]

Absolutely. There are some wonderful, excellent centres in constituencies around the country, including in the hon. Gentleman’s constituency, but there are too few of them and there is not enough immediate referral to tertiary care once a GP identifies that epilepsy might be at the heart of a problem. We need to ensure that there is a greater understanding at the core of our health sector so that there is more referral. To be frank, we need more specialists. There is a major problem in the referral process. Epilepsy Action says that 138,000 people have been misdiagnosed. Some people are diagnosed with epilepsy who do not have it and others do not have the right medication. It is crucial to address the huge problem with referrals to tertiary care.

Following diagnosis, the cost-effective and life-enhancing pathway is to ensure that the ongoing care fits the bill. There are straightforward National Institute for Health and Care Excellence guidelines that lay out a clear pathway. There must be access to an epilepsy nurse. It would be fantastic if more GPs had epilepsy as a specialism. There must be a wrap-around package that allows people to live their lives and take control of their chronic condition. We must ensure that we have the right level of support at every single level. I am talking about people who are still potentially going to work and living their life.

We have a serious problem with SUDEP, or sudden unexpected death in epilepsy. That is an outrage. About 1,000 people every year die in their sleep. Many of them are younger people who are just moving from youth to adult services and there is not the wrap-around care that is needed. We all know from our casework that in every instance and with any condition, moving from youth services to adult care is a problem. We are seeing serious problems with those who have night-time seizures. To be frank, although people say that that is a problem, there are examples of countries in Europe that are doing better. It is crucial that we meet those targets and ensure that we do not fall behind the standards of other European countries.

I see that Mr Deputy Speaker is looking for me to wrap up. I would like to commend three sets of people, but also to challenge them. People with epilepsy live with a difficult and unpredictable condition. I take my hat off to them and to the people who care for them. However, I want them to come out and talk about epilepsy. I ask them to please ensure that their voice is heard, because if it is not, we will not get the care that we need. The charities are important, but they need to work together more. Their voices must be unified to ensure that they are heard. I call on the Government to address the Cinderella status of epilepsy. We should be doing so much better. We have criteria and there are examples, globally, of countries that are doing better. We must give people with epilepsy a lifeline to ensure that they can live a full life, and we must put the right level of investment into research to address chronic epilepsy in the long term.

Francis Report: Update and Response

Steve Rotheram Excerpts

Wednesday 11th February 2015 Commons Chamber

[Mr Hunt]

I absolutely will. This is a great example, and I would like to thank my hon. Friend for the interest he has shown in this issue. For one hospital to have 390 more nurses over four years is remarkable. It may interest my hon. Friend to know that those numbers do not include agency staff, so if the hospitals have any such staff, they will be counted on top of those figures. This is a dramatic turnaround for the quality of patient care, which we all welcome. That just shows that if we get the incentives right from the centre, trusts do want to do the right thing. We did not instruct the trust to employ a single extra nurse; rather, we set up a new inspection regime and special measures regime, and what my hon. Friend said shows it has worked.

[Steve Rotheram (Liverpool, Walton) (Lab)]

I, too, welcome the report. In his statement, the Secretary of State committed to the view that the new measures are not about “naming and shaming”. Does he therefore agree with the Prime Minister, who said:

“Francis does not blame any specific policy. He does not blame the last Secretary of State for Health. And he says we should not seek scapegoats”?

[Mr Hunt]

I do not think we should seek scapegoats, but I do think we need to understand where policies have inadvertently led to the wrong outcomes. Sir Robert talks clearly about the dangers of an excessive focus on targets, which is one of the things that have driven the wrong culture. On that, I hope to get cross-party agreement.

National Health Service

Steve Rotheram Excerpts

Wednesday 21st January 2015 Commons Chamber

[Mark Reckless]

It proves nothing of the sort. The hon. Gentleman faces a very strong challenge from UKIP in his constituency from the excellent Bill Etheridge MEP. The policy of our party—[Interruption.] No, let me answer the point. Our policy is determined by our party as a whole. We are committed to an NHS free at the point of use and funded properly out of general taxation. [Interruption.] May I continue? I personally come from a mother and father who met in the NHS; the NHS and supporting it is in my blood. I believe in the NHS as I have described it, and I would appreciate the courtesy of people accepting the sincerity of what I say on that.

I am pleased to see the shadow Secretary of State still in his place as he has been throughout the debate, but when it comes to funding the social care budget, it is a moving target to determine what that budget is. We know the local government settlement for the year ahead, but not for beyond that. We do not know what either a Conservative-led or Labour-led Government might be able to, or choose to, spend on local government, or what proportion might be allocated to public health budgets. It thus strikes me as a significant risk to say, without greater clarity, “This is what the budget will be, plus the sum of £2.5 billion”—the figure selected by the shadow Health Secretary and his party, irrespective of what the baseline is.

[Steve Rotheram (Liverpool, Walton) (Lab)]

Can the hon. Gentleman be absolutely certain of what his party might or might not do should it ever—unfortunately—find itself propping up a Government? Can he assure us that the road to Damascus-style conversion that he is describing represents the view of the whole of his party, and not just his individual view?

[Mark Reckless]

Yes, I can give the hon. Gentleman that assurance. It is the view of my party, it is the view of the whole party, and it is my own personal view, which is core to my politics and what I came to the House to represent.

The Prime Minister said earlier that I came to the House week after week to discuss the NHS in Kent. Following what could perhaps be described as an endorsement of my approach from the Prime Minister, I now wish to raise some of the issues that have arisen in Medway. One of the problems with the motion is that it makes no mention of introduction of the new GP contract in 2004, which I believe has been a significant driver of increased demand for A and E services.

In Medway, where the proportion of single-handed general practices is significantly higher than the national average, the burden of out-of-hours care falls largely on an organisation called MedOCC. While I would encourage constituents to use MedOCC rather than A and E when that is appropriate, I have one or two concerns about the way in which it operates.

Like the hon. Member for Wirral South (Alison McGovern), we had a young child who was ill, and we sought an appointment. My wife telephoned MedOCC and we were offered an appointment at a particular time, but were then told that the wait would be an hour and a half. We said “If the wait will be an hour and a half, why do you not give us an appointment an hour and a half later than the one that you have just given us?” However, that was not allowed. We had to wait for an hour and a half, because that was the procedure, and that was the way it had to be. Although we went to the MedOCC clinic because we thought that that was the appropriate service, I would understand it if a constituent in the same circumstances decided to take his or her chances at A and E, where it might even be possible to be seen more quickly.

It is important for an out-of-hours service—in our case, MedOCC—to be flexible and responsive, and to be operated in a way that makes it an attractive and appropriate alternative to A and E, and I shall develop that point further when I meet members of the clinical commissioning group on Friday.

National Health Service (Amended Duties and Powers) Bill

Steve Rotheram Excerpts

Friday 21st November 2014 Commons Chamber

[Clive Efford]

All Governments have lessons to learn. This party is not saying that it has nothing to learn, but it wants to end the privatisation of the national health service. We must understand one thing: next May is when we have to fight to save our national health service. If we continue under this Act to keep privatising our services, we will not have a national health service as we understand it.

[Steve Rotheram (Liverpool, Walton) (Lab)]

Like me, is my hon. Friend amazed by the faux indignation of some Government Members? Those Members will be the ones who will benefit from the donations of some of the private sector companies that are winning the contracts in our NHS service.

[Clive Efford]

We have seen the names—64 of them. We will see how they vote today, and then let the public know what they are doing with our national health service.

NHS Services (Access)

Steve Rotheram Excerpts

Wednesday 15th October 2014 Commons Chamber

[Andy Burnham]

May I remind the hon. Gentleman, for whom I have a lot of respect, that I, as Health Secretary in 2009, introduced to the national health service a policy of NHS preferred provider? That is because I am not neutral about the NHS. I believe in the public NHS and what it represents, which is people before profits. Any policy that I develop will always be based on that principle. I was attacked at the time by the Conservative party for introducing such a policy, but I make no apology for it. We used the private sector in a supporting role, but the Government want to use it in a replacement role, and there is a very big difference between the two things. If they were continuing what we had done, why did they need a 300-page Bill to rewrite the whole legal basis of the national health service?

[Steve Rotheram (Liverpool, Walton) (Lab)]

Is my right hon. Friend aware that even the Chancellor agrees that the disastrous top-down reorganisation of the NHS was a huge strategic error? Does he agree that those on the Government Benches, including the hon. Member for St Ives (Andrew George), should apologise—I include in that the newly elected hon. Member for Clacton (Douglas Carswell) who has somehow found his way on to the front Bench on the Opposition side, but hopefully not for long—and support the private Member’s Bill of my hon. Friend the Member for Eltham (Clive Efford) when it comes before the House on 21 November?

[Andy Burnham]

I am interested to see this new friendship that my hon. Friend has struck up with the hon. Member for Clacton (Douglas Carswell) on the Front Bench. My hon. Friend is absolutely right. The promise was that there would be no top-down reorganisation. We told the Government that it would be a major mistake to break that promise. They broke that promise and now they are admitting it in private to newspapers. I will come to that point a bit later.

--- Later in debate ---

[The Secretary of State for Health (Mr Jeremy Hunt)]

I do not think I have ever heard such a misuse of statistics and facts in this House as we have heard today.

I am delighted to debate the NHS, which has been independently rated—[Interruption.] Labour Members do not like to hear this. The NHS has been independently rated by the Commonwealth Fund this year as having become, under this Government, the best out of 11 industrialised countries. It is a better health care system than those in France, Germany and Australia. [Interruption.] Labour Members do not like to hear this, but the independent experts in Washington have said that the NHS has become the best in the world under this Government. The most uncomfortable thing of all for the Labour party is that the NHS has become better than it ever was under the previous Labour Government, when the right hon. Member for Leigh (Andy Burnham) was Health Secretary.

If the right hon. Gentleman wants to talk about Government mistakes, we will do so, but he will find that, on Mid Staffs, the private finance initiative, botched IT projects, a disastrous GP contract, unsafe hospitals, low cancer survival rates and little action on dementia, it is the Labour party, not this Government, that must be held accountable for mistakes in running the NHS. Indeed, after years of mismanagement it is this Government who are finally putting high-quality patient care back at the heart of what the NHS stands for.

[Steve Rotheram]

rose—

[Mr Hunt]

I will give way in a moment, but I want to make some progress.

I want to go through the arguments of the right hon. Member for Leigh in detail, but let me start with the elephant in the room: the massive financial pressure facing the NHS if it is to meet our expectations in the face of an ageing population. There are now nearly 1 million more people over 65 than when this Government came to office. Our economy then was nearly bankrupt. Despite those extraordinary challenges, this Government have been able to increase spending on our NHS—including on Leigh infirmary in the right hon. Gentleman’s constituency—because of our difficult decisions, which were opposed at every stage by the Labour party. Government Members know one simple truth: a strong NHS needs a strong economy.

On the day that unemployment fell below 2 million and the claimant count fell below 1 million, there was nothing in the right hon. Gentleman’s speech about the need for a strong economy to support our NHS and nothing about learning from the Labour Government’s disastrous mistakes, which were so bad that they were in fact planning to cut the NHS budget had they won the election. We should remember that countries that forgot about the deficit ended up cutting their health budgets—Greece by 14% and Portugal by 17%. [Interruption.] Well, these are the facts. We must never again in this country allow the poor economic decisions that have been the hallmark of every Labour Government in history.

[Mr Hunt]

I will tell the hon. Lady what we are doing: we are integrating the health and social care systems through the Better Care fund—a £3.9 billion programme—which is something that Labour could have done in 13 years in office but failed to do. That will make a massive difference to the social care system. Let us move on to some of the detailed arguments.

[Steve Rotheram]

Will the Secretary of State give way?