National Health Service Debate
Full Debate: Read Full DebateTony Baldry
Main Page: Tony Baldry (Conservative - Banbury)Department Debates - View all Tony Baldry's debates with the Department of Health and Social Care
(12 years, 10 months ago)
Commons ChamberIt is clear that we will get to the bottom of this, because the Secretary of State has committed to publishing the minutes, and if he is suggesting that the RCN has been inaccurate, he needs to produce the evidence.
That takes me to the Prime Minister’s second personal promise on the NHS, which deals with hospital reconfiguration and the mythical moratorium.
I shall give way in a moment.
If we thought that the Conservative party’s promises on funding were bad enough, the sheer audacity of its claims on hospital closures is breathtaking. Before the last election, the right hon. Gentleman toured the country promising the earth to every Conservative candidate he met. I recall seeing his commitments—I have them here—pile up in the Ashcroft-funded glossy leaflets that landed on my desk in the Department of Health. He said that he would reopen the accident and emergency department in Burnley; he said that he would save and A and E in Hartlepool, but, scandalously, only if the town elected a Conservative MP; and I well remember the day he visited his hon. Friend—although, after this week, I doubt that the Government Front Bench team still consider him a friend—the hon. Member for Bury North (Mr Nuttall) and promised the people of Bury in the leaflets I have here:
“Vote Conservative and if there is a Conservative government the maternity department will be kept open.”
It could not be clearer. However, the maternity department at Fairfield hospital is scheduled to close next March. It is disgraceful. However, the Prime Minister’s most shameful politicking came in north London. I lost count of the number of times he promised to save the A and E department at Chase Farm hospital.
After that rude interruption from the hon. Member for Kingswood (Chris Skidmore), I shall get back to my script.
Just days after the election, the Prime Minister went to Chase Farm hospital, with the Secretary of State, to announce the coalition’s new policy of the moratorium and the following commitment in the coalition agreement:
“We will stop the centrally dictated closure of A&E and maternity wards.”
I have with me the photograph from that very visit of the Secretary of State holding up a placard stating his opposition to any changes to the A and E at Chase Farm hospital. However, he has recently failed to prevent those changes to the A and E department and maternity unit at Chase Farm hospital, leaving the new hon. Member for Enfield North writing a desperate letter to the Prime Minister stating that his constituents had been utterly let down by them both. I do not know whether the Prime Minister or the Secretary of State have the decency to feel embarrassed today, hearing these cynical promises repeated in the House. The proposed moratorium and opposition to closures were purely political and designed to help the Conservatives win votes in marginal seats. That is a fact.
I apologise for not having intervened quickly enough earlier, but the right hon. Gentleman says that he accepts the Nicholson challenge. Given that efficiency savings will have to be made in the NHS, where does he envisage those savings being made? It seems to me that every hospital trust will have to make efficiency savings somewhere, as a result of the Nicholson challenge.
The hon. Gentleman asks a very fair question. It is precisely such issues—about how to produce the savings—that are the important issues. Care has to be taken out of the hospital setting and we have to prevent too many elderly people, in particular, from going into hospital in the first place if we are to create an NHS that is able to face the future and that is financially and structurally sound. That is why I take such exception to the naked opportunism that we saw before the election, when I, as Health Secretary, was taking on some of those difficult challenges and grasping the nettle, including in my own backyard in Greater Manchester, where there was a difficult review of maternity and children services, involving the closure of four maternity units and shrinking their number to eight. We did that, we took on that debate, and yet the now Health Secretary was touring those marginal constituencies in Greater Manchester, saying that he would overturn our decision in office, but he has not done it. That is precisely the point that I am making to the House. We need a Health Secretary prepared to take those difficult decisions, if the NHS is to be able to make the savings that will sustain it in the long term.
No. I think that the moratorium has led to a better way forward even in Enfield. It is in the hands of the commissioners and the local authority in Enfield collectively, to make decisions for Enfield. Within two months I shall receive a report from NHS London advising whether it would be better organisationally for Chase Farm to be combined with North Middlesex rather than Barnet, and I should be interested to know the hon. Gentleman’s view on that. We continue to seek not top-down forced reconfigurations, but reconfigurations that consistently meet the four tests, and do so in the best interests of the NHS.
The right hon. Member for Leigh (Andy Burnham) implied that my right hon. Friend should have completely ignored the advice of the independent reconfiguration panel. Can my right hon. Friend tell us whether, when the right hon. Gentleman was Secretary of State for Health, there were any occasions on which he sought to ignore the panel’s advice?
The right hon. Member for Leigh says from a sedentary position that he did not ignore the panel’s advice. I do not believe that a Secretary of State has directly sought to contradict the panel since its establishment, or has sought not to comply with its recommendations. After all, it is there for a reason. The point is that, as I have made clear, the panel should be involved in the application of those four tests, and in the past that has tended not to happen.
Let me explain why I am asking the House to reject the motion. I believe—and this was always my approach in opposition—that when we table such a motion, we ought at least to be clear about what our alternative solution would be, but there is no such solution in the motion. Let me remind the new, or recycled, shadow Secretary of State what his old friend James Purnell wrote last February:
“The Tories appear to have the centre ground. Labour need to take it back—by coming out in favour of free schools and GP commissioning”.
The right hon. Gentleman did not come out in favour of free schools. He now says that he is coming out in favour of GP commissioning. If he believed in GP commissioning, why did he do nothing about it? Why did everyone in the general practice community, throughout the length and breadth of the country, believe that practice-based commissioning had come to a virtual halt? Why did David Colin-Thomé, the right hon. Gentleman’s own national clinical director for primary care, effectively say that it had completely stalled and was not going anywhere?
I know that the right hon. Gentleman agreed with this at one time. Back in 2006, he said of GP commissioning:
“That change will put power in the hands of local GPs to drive improvements in their area, so it should give more power to their elbow than they have at present. That is what I would like to see”.—[Official Report, 16 May 2006; Vol. 446, c. 861.]
If the right hon. Gentleman wants that to happen, he must support the Bill that will make it happen. The same applies to health improvement and public health leadership in local government, and to our finally arriving at a point when, as was the last Labour Government’s intention, all NHS trusts become foundation trusts. We are going to make those things happen, but in order to do so we must have a legislative structure that supports them. That is evolutionary, not revolutionary. However much the right hon. Gentleman rants about the changes being made in the Bill, the truth is that it will do—in what his predecessor, the right hon. Member for Wentworth and Dearne (John Healey) described as a “consistent, coherent and comprehensive” way—much of what was intended by our predecessors as Secretaries of State under the last Government. The fact that the right hon. Gentleman turned his back on that at the end of his time in office—mainly at the behest of the trade unions, which seem to be the dominant force in Labour politics—does not absolve him of his responsibility to accept that we are now delivering the reforms that he talked about.