Health

Tom Blenkinsop Excerpts

Monday 9th June 2014 Commons Chamber

[Andy Burnham]

My hon. Friend is absolutely right—the deterioration in general practice has been marked during the past few years. There have been changes that have disadvantaged patients. Within weeks of taking office, the Government removed the guarantee that patients could have an appointment within 48 hours. That explains the situation that my hon. Friend describes, alongside cuts to funding of general practice to the point that some practices now say they are on the brink of deciding whether or not they can remain open. The Government have responsibility for that situation, but there is not a word from the Secretary of State about it and there is not an acknowledgement that people have severe problems in accessing their GP.

[Tom Blenkinsop (Middlesbrough South and East Cleveland) (Lab)]

In my constituency, the minor injuries unit at Guisborough hospital, the minor injuries unit at East Cleveland hospital in Brotton, a walk-in centre and medical centre in Skelton, and a medical centre in Park End—all primary or intermediary level facilities—will be closed, putting further pressure on the excellent but already outlying A and E unit at James Cook University hospital. When I write to Ministers to ask questions and for a meeting, I am told that I have already had too many discussions with them and that I cannot bring it up any further. Will my right hon. Friend please enlighten me about what he would do if he were in power?

[Andy Burnham]

I will move on to that point. Whenever there is a problem, we are told, “Speak to NHS England.” I am afraid that is not good enough. Up and down the country we are seeing services closed without adequate consultation. NHS walk-in centres continue to be closed, piling more pressure on A and E departments. It is just not good enough. We have seen top-down changes driven through, and the hospital closure clause is on the books, so sadly this will continue. It will only change when we have a Labour Government back in control—a Government committed to putting the public and patient voice at the very heart of the NHS.

I was talking about A and E and the reorganisation. We know that Ministers were explicitly warned about an A and E recruitment crisis by the College of Emergency Medicine a couple of years ago, but they said they were too absorbed with the reorganisation to listen or act. That brings me to the nub of the matter before the House: the root cause of the deterioration in the NHS is that reorganisation, which nobody wanted and nobody voted for. It threw the service into chaos just when it needed stability. As we warned, it has damaged standards of patient care. Four years ago the Government inherited a self-confident and successful NHS, with the lowest ever waiting times and the highest ever public satisfaction. Since then it has been destabilised, demoralised and reduced to an uncertain organisation that is increasingly fearful of the future.

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[Angus Robertson (Moray) (SNP)]

It is an honour to follow the hon. Member for Burnley (Gordon Birtwistle). The House was listening raptly to a speech full of humanity and compassion. I pay tribute, too, to the right hon. Member for Cynon Valley (Ann Clwyd), who read out a lot of examples of what everyone will agree was shocking treatment. I genuinely hope that Ministers listened closely to those speakers and to many others who have made important points.

In the limited time available, I should like to draw attention to the obvious point that this is the last Queen’s Speech before the historic and exciting independence referendum in Scotland on 18 September. It is worth making the point that this Queen’s Speech and Westminster governance—the choices that the Government have introduced—can and should be seen through that prism. There are 100 days left before people in Scotland are able to determine whether we should become a normal country making all the normal decisions that successful democracies make.

Today, we have been encouraged to speak about health, so I was pleased to find a recent international health watchdog report issued only a few days ago in Canada, which said:

“Imagine a land where a patients’ charter of rights and responsibilities is in place that includes wait-time guarantees; over 90% of patients requiring elective care are treated within 18 weeks from referral by a family physician to start of treatment/procedure including all diagnostic testing and specialist consultations. Over 98% of in-patient procedures and day-surgery cases are treated within 12 weeks of agreement to treat. Over 90% of patients are seen within four hours in the emergency department (i.e., admitted, transferred or discharged). Citizens can access the most appropriate member of their primary care team within 48 hours. Up-to-date statistics and reports on wait times and health system performance indicators are publicly available. In addition to providing timely access, this land has been successful in improving other dimensions of quality of care (e.g., significantly reducing levels of hospital acquired infections, reducing the level of inappropriate care), and performance in all of these dimensions is being tracked through the measurement and reporting of performance targets available for use by patients, providers and system managers alike. Fortunately, this land already exists—Scotland.”

That report was issued only a few days ago by the physicians watchdog in Canada.

I pay tribute, as did the Health Secretary, to the work of health professionals, who make a tremendous difference to people in the NHS system in England and, no doubt, to the NHS system in Wales and Northern Ireland. I pay tribute to all of them, and in particular to those who work in NHS Scotland. I am proud of the difference that the Scottish National party Government have made since taking power in 2007. Staffing has increased under the SNP by more than 6.7%.

[Tom Blenkinsop]

Will the hon. Gentleman give way?

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[Tom Blenkinsop (Middlesbrough South and East Cleveland) (Lab)]

Over the space of a few weeks from this April, my constituency has been overwhelmed by a perfect storm of cuts and closures pushed through by NHS England and the local clinical commissioning group, all the result of this Government’s agenda.

People in the rural East Cleveland part of my constituency need NHS services and support seven days a week, and that is why the last Labour Government proudly introduced NHS Direct and walk-in centres, but East Cleveland now faces a triple whammy. The South Tees clinical commissioning group wants to end minor injuries provision at East Cleveland hospital and Guisborough hospital. It has also decided to cease walk-in provision at Skelton medical centre at the end of June, while NHS England wants to abolish GP provision at Skelton medical centre.

Ending minor injuries provision does not, in the words of the CCG consultation letter, provide

“better care for the vulnerable and elderly”,

and I fear that the CCG is trying to disguise cuts to vital minor injury provision. This leaves no urgent care services in East Cleveland.

That is particularly problematic for the villages of East Cleveland, where public transport links are poor and an ambulance service provided by the North East Ambulance Service trust “cannot cope”, as its chief executive admitted. Over six months last year, the North East Ambulance Service recorded 10,599 delays, 196 of which were for more than two hours. Paramedics are left unable to respond to waiting 999 calls, and a regional BBC programme only last week showed that the situation is worsening. I have raised this matter in the House on many occasions.

Both the two small hospitals I cited were once run by the local primary care trust, but after the coalition NHS reforms were pushed through they were passed on to the main hospital trust for our area, the South Tees Hospitals NHS Foundation Trust, which runs the excellent James Cook university hospital in Middlesbrough. The trust is already facing a £30 million to £50 million black hole in financing, having had only a £5 million deficit last year; it is being investigated by Monitor and has to make drastic cuts. It is little wonder that what might be seen as easy targets in ancillary units such as these two small local hospitals come up on the trust’s radar.

In addition, we have had the CCG and NHS England turning their big guns on another NHS facility in East Cleveland: they are looking at, and have announced as a fait accompli, the total closure of the Skelton health centre and medical walk-in centre. That proposal is part of a national coalition approach that has been targeting walk-in clinics set up by the last Labour Government. If the closure goes ahead, Skelton will lose one of its GP practices, a nurse practitioner clinic and the attached pharmacy. The clinic serves people from the poorer areas of the ward such as Hollybush, the Courts and north Skelton.

Like local people, I feel that NHS England is basing its views on old numbers which we feel are suspect. The provider, LivingCare, which owns the practice, is gobsmacked, as closure letters to people on the surgery list went out before they were told about the possibility of closure. In certain instances not enough letters were sent to people actually registered with the GP practice. Skelton as a town is undergoing vast expansion, with new housing going up and more planned. More than 1,000 new homes have been built in the past three years, with the new local plan indicating a further 400 homes on open land to the east of that new estate.

LivingCare was hit by a further blow when NHS England then announced the imminent closure of another GP facility it runs in my constituency. Unlike the earlier closures, this was not in rural East Cleveland, but in deep urban south Middlesbrough, on the Park End estate. I know the area well as my mother was for many years a teacher at the St Pius X Roman Catholic primary school on the estate, and I have relatives who still live there. The estate has profound social needs, with associated poverty and high indices of ill health. The cuts occurring locally in my constituency will increase the likelihood of people going to A and E, even when that is not appropriate. Our A and E has struggled to cope with demand over recent years, so these cuts are a false economy.

The mess of the Tory-Lib Dem NHS reorganisation, and the human tragedy it brings in its wake, deepens by the day. The coalition has already wasted £3 billion on a reorganisation and £1.4 billion on redundancies, and it is leaving the NHS weakened and confused. Locally, through this consultation, we are beginning to see the consequences on our constituents’ doorsteps. The approach being taken flies in the face of the call by NHS England’s new chief, Simon Stevens, for a marked change in policy and a shift away from big centralised hospitals. The health service chief executive says that we need new models of care built around smaller local hospitals and that, combined with comprehensive walk-in and GP care, is what my constituents need, deserve and rightly demand.

I have not been idle on these issues, but all my efforts have been stymied by a combination of bureaucratic blocking and ministerial indifference, resulting in Ministers’ responding to my requests for meetings with refusals, despite earlier friendly patter. Despite an outcry from local people, a full-page protest poster in the local newspaper Coastal View & Moor News and a massive petition, I managed to organise a meeting with NHS authorities that was unhelpful to say the least. Instead of a commitment to examine the clinical arguments and the issue of closures putting more pressure on the A and E unit at James Cook university hospital—a hospital with one of the longest waiting times for A and E in the region, if not the country—the NHS reps at the meeting retreated behind the protection of contractual timetabling, based on funding cuts issued by the Department of Health, because the “Darzi clinics”, as they were at the time, are coming to the end of their five-year contracts. I can say now, without equivocation, that such an approach will inflame my constituents, as I have seen already on the doorstep.

I still want to offer Ministers the option to meet me to talk about this issue, because I really fear the consequences for East Cleveland, and for Park End in particular, of these services being taken away. There is absolutely nothing in the consultation offering the individuals there any other option. There is no plan to put people in other GP practices. My fear is that we will have a time lag, and about 2,000 to 4,000 people not knowing where to go for primary care and ultimately ending up in the A and E unit—again.

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[Norman Lamb]

That is equivalent to about 6,000 nurses a year. The right hon. Gentleman has to demonstrate how that would be paid for. The fact is that there is an average wage increase of 3% as a result of annual pay increments under Agenda for Change. We have ensured that at least everyone will get a 1% increase. If he is arguing for something different, he has to say where the money would come from to pay for it and how he would cope with 6,000 fewer nurses, which would be the result of his action.

For the first time, it is this Government who have made decisive moves to join up the care and health system and focus more on preventing ill health. Contrary to the shadow Secretary of State’s claims, the better care fund has been widely welcomed, and it has initiated action across the country to join up a very fragmented system. We have sent out the signal that we encourage innovation and change, driven by clinicians from the bottom up, not from the top down. Brilliant pioneers across the country are ending this fragmented system that has interrupted patient care for so long and failed patients. Those pioneers are combating loneliness, which my hon. Friend the Member for Burnley (Gordon Birtwistle) spoke passionately about. It is so far removed from the caricature offered by the shadow Secretary of State and the tired old refrain about privatisation. It was, after all, a Labour Government who mortgaged the future of the NHS to the tune of billions of pounds with their private finance initiative programme, giving massive windfall profits to private consortiums—a scandal of historic proportions. Yet Labour Members continue to argue that the Government are privatising—an argument that is based on thin air, not substance.

[Tom Blenkinsop]

Will the Minister tell the House at what point the provisions of the Competition Act 1998 were introduced into the Bill that became the Health and Social Care Act 2012? I think it was this Government who did that. In the Public Bill Committee, I commented on the fact that they were exposing the NHS and undermining the category B status of the European competition regulations by putting the Competition Act at the very heart of the Bill.

[Norman Lamb]

I am sorry to disappoint the hon. Gentleman, but it was under the Labour Government that it was made clear that competition law applied to the health care system. Indeed, the Labour Government’s guidelines on the NHS replicated exactly the regulations under section 75 of the Competition Act that this Government have introduced. Time and again, we hear false claims by Labour Members.

This Government have developed a new health and care system that is totally patient-centred, led by health professionals, and focused on delivering world-class health outcomes. The difficult decisions that we have made on public finances have meant that we have been able to protect the NHS budget. The shadow Minister spoke as though the Government have had to face no financial challenge at all. She knows that across Europe, Governments have slashed pay for health workers and introduced co-payments. We have done none of that. We have protected the budget for the NHS, and we are proud of doing so; Labour did not commit to that in its manifesto at the last election. The truth is that the NHS is doing extremely well under a great deal of pressure.

This Government have laid solid foundations to transform our NHS to help it to meet the challenges of an ageing population, drive up standards, and focus absolutely on compassionate care. My hon. Friend the Member for Mid Worcestershire (Sir Peter Luff) spoke movingly about his experience of the importance of compassionate care. We have introduced tough, robust inspections overseen by new chief inspectors of hospitals, of social care, and of general practice. We have introduced ratings of hospitals, care homes and GP practices so that people know how good their local services are. We have introduced, for the first time, fundamental standards and the ability to prosecute—to hold to account organisations and directors who seriously fail patients. We have introduced a fit and proper person test for directors; for the first time, compulsory training for health and care assistants; and—I am particularly proud of this—a statutory duty of candour to ensure that there is openness when things go wrong in the NHS or the care system.