NHS in London

Debate between Wes Streeting and Meg Hillier

Thursday 24th March 2016 Westminster Hall

[Wes Streeting]

They may well be the judge, but I am standing down as a councillor in 2018. I was elected to Parliament while serving as a councillor, which is a good indication.

Seriously, the London Borough of Redbridge has the fourth lowest public health grant in London. Given the diversity of our population, and the pressures that that brings, it is a cause for concern. In that context, I was even more disappointed to find that the Government have cut our public health grant in-year. As a former cabinet member for health and wellbeing in Redbridge, and as the former chair of our health and wellbeing board, I know that we were already struggling to meet our statutory duties on public health, not least the new responsibilities we have been given, such as for health visiting, for which the allocation received from the Government was not sufficient. We managed to squeeze some extra funding out of the Government, but we are still struggling.

The reduction is disappointing, particularly in the context of London, where people’s healthcare needs and lifestyles are placing pressures on the NHS. Public health investment is an upfront investment in people’s lifestyles that will reduce NHS costs in the longer term, as well as improving people’s health and wellbeing. I cannot understand why, in that context, preventive budgets such as public health budgets are bearing the brunt of cuts. I hope Redbridge’s public health allocation in particular is something that the Department of Health will revisit.

I have talked about the financial challenge for local authorities, and I will now address the financial challenge facing the NHS and our local health economy. I was concerned, as everyone else was, to read David Laws’s revelation at the weekend that, far from the £8 billion that keeps being mentioned as the hole in the NHS budget, Simon Stevens actually identified a £30 billion hole, of which he said £15 billion could be found through efficiencies and improvements. My maths makes that a £15 billion hole in the NHS budget, and it is a source of concern that the £8 billion promised by the Conservatives at the last election is still not there. We have seen the Chancellor having to shuffle money around. Earlier, my hon. Friend the Member for Lewisham East (Heidi Alexander), the shadow Secretary of State for Health, talked about the reallocation from capital to revenue in terms of the health budget.

[Meg Hillier (Hackney South and Shoreditch) (Lab/Co-op)]

The Public Accounts Committee recently considered the health budget following a National Audit Office report. There is a £22 billion gap, and one of the key drivers of that is the 4% efficiency savings year on year. Simon Stevens has himself acknowledged that that is too high and that 2% would be more reasonable. The head of NHS Improvement also acknowledged that it is a cause of acute hospitals’ deficits at the moment.

[Wes Streeting]

I am grateful to the Chair of the Public Accounts Committee for giving us that insight, which gives me even greater cause for concern about our local situation in Redbridge. The overall gap in funding for the NHS should be a concern to the whole country.

In my borough in particular, I am concerned by a report produced for NHS England by McKinsey & Company in, I believe, July 2014. The report has just been released by NHS England following a freedom of information request, and it identifies a Barking, Havering and Redbridge system gap of £128 million for commissioners and £260 million for providers. I am concerned by several things. One is that one way in which McKinsey identified that the BHR system will be able to address that gap is through acute reconfiguration of King George hospital, where the accident and emergency department is threatened with closure. I am deeply disappointed that, at a recent meeting of the Ilford North Conservatives attended by the hon. Member for Richmond Park (Zac Goldsmith) for his London mayoral campaign, the Conservatives once again stood up and said, “People should not worry about the accident and emergency department, because we always say it’s going to close and it never does.” The only reason why the accident and emergency department at King George hospital is still there is not because of a positive decision to keep it but because the NHS trust and the local health economy are in such a mess that it would not be clinically safe to close it at this time; the accident and emergency department is still very much at risk.