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It being Ten o'clock, the motion for the Adjournment of the House lapsed, without Question put.



10 pm

Bob Spink (Castle Point) (Con): The Magna Carta, the Act of 1406 and the William and Mary Bill of Rights of 1688 all gave rights to citizens to petition the Government. MPs have a duty to present petitions, even where the terms of the petition may be disagreeable to them personally. I disagree with the terms of the petition on the war on Iraq that I am about to present. The Iraqi people, the region and the world will benefit in the longer term from the war, even though its prosecution has been poorly directed. We can all agree, however, that our forces on the ground are acting with great courage and professionalism and, where necessary, with compassion.

The petition states:

To lie upon the Table.
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Health Service Funding (Barnsley)

Motion made, and Question proposed, That this House do now adjourn.—[Mr. Watson.]

10.1 pm

Mr. Eric Illsley (Barnsley, Central) (Lab): I am grateful for the opportunity to raise the funding of health services in the Barnsley area. This is not the first occasion on which I have done so in an Adjournment debate, as you, Mr. Speaker, and the Under-Secretary of State for Health, my hon. Friend the Member for South Thanet (Dr. Ladyman), are probably aware.

Health funding in Barnsley has been a problem for several years, mainly because the area has one of the greatest needs for health services in the country, but it is among the lowest funded. Over the years, our area, which used to be part of the former Trent health authority, has been funded well below the 100 per cent. target. It is now said that we are funded below our fair share, which is a more descriptive and apt phrase. We have a high level of health need in Barnsley, but our funding simply does not reflect that.

I shall go into further details later, but first I shall give some background and highlight a few issues affecting Barnsley's health services. To some extent, they are good news stories. First, Barnsley district general hospital is currently being considered for the award of foundation status, and we are optimistic that a positive decision will be made. I wish to place on record my congratulations to all the hospital staff, who worked hard to achieve the three-star ratings over two years that enabled the application to proceed. We await the decision with interest. Secondly, Barnsley has opened the first three facilities under the LIFT—local improvement finance trust—programme nationwide. It has provided three needy communities within the Barnsley area with excellent new health facilities, and we are proud that we were the first area to open such facilities. That 10 million investment is probably the biggest investment in primary and community health facilities that Barnsley has ever had. At this point I should flag up a caveat. The primary care trust signed contracts for a number of LIFT facilities before funding under the LIFT programme was restricted because of high demand. That could lead to contractual problems and funding concerns in the near future.

Another success story is the e-booking system, or choose and book, as it is called in the Barnsley area. Barnsley is proud that a local general practitioner was the first to implement the service, under the pathfinder or early implementer pilot scheme. Despite an article on the subject that appeared in The Sunday Times yesterday, which reported that the programme had been frozen, I am reliably informed today that the programme is continuing in the Barnsley area and is working well. It provides patients with a choice of hospital date to see their consultant.

Intermediate treatment centres are another innovation for which the local PCT is signed up, but we need to encourage more take-up by the local populace. We are contracted for a five-year period and unless people attend the centres, there will be financial consequences. It is worth noting that our waiting lists are comparatively low and we do not have problems of bed blocking in our area. We are fully behind the
15 Nov 2004 : Column 1134
Government's programmes and initiatives relating to health. We are delighted to have had those two firsts under the LIFT programme and the choose and book programme, but we have a continuing problem with regard to funding.

To provide some background to the situation in Barnsley, I refer my hon. Friend the Minister to the 2002–03 annual audit letter from the Audit Commission in respect of Barnsley PCT. Under the heading "Key messages" the Audit Commission commented:

Later in the same audit letter, under the heading "Financial standing", the Audit Commission made further comments in relation to Barnsley's funding situation:

I am speaking of 2002–03—I will come to the present situation in a moment—to highlight the background to the continuing shortfall in our finances. The Audit Commission went on to deal with our financial standing in 2003–04 and reported:

The Audit Commission continued:

Even with those savings, the PCT was still required to find a further £2 million of savings.
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The Audit Commission summed up the position:

Having discussed 2002–03, the letter examined 2003–04, for which the story was exactly the same. The letter stated the position at the end of the financial year 2003–04 and pointed out the problems for 2004–05:

This is the important passage:

For how long can Barnsley PCT be required to broker huge sums of money to meet those funding shortfalls? In the previous financial year, it provided £2 million of brokerage, and it is required to broker £9 million to achieve financial balance at the end of this financial year. Basically, it must make £6 million of cuts in the current financial year to meet that break-even position. How long can it continue to borrow such sums while making cuts at the same time?

In 2005–06, Barnsley will receive £15.5 million less than its fair share of resources, and the allocation of resources—it is known as "the pace of change"—means that we are unlikely to reach our 100 per cent. target before 2015. We are in danger of replacing what we used to call the postcode lottery on health care with a postcode funding lottery.

What are the effects of the shortfall in funding? The 18-week target for "see and treat" will provide a major improvement to patient care. However, the shortfall will have an impact on acute capacity. For Barnsley, that capacity is likely to cost £20 million from now until 2008. Barnsley PCT simply does not have the resources to deliver that 18-week target. I make a plea to the Minister. Future funding allocations must recognise that. We must either reduce the target in relation to our PCT or improve the resources available to it.

I have already mentioned the LIFT programme. Improving primary care is a national and local priority. We need to improve access, and the range and quality of services. To do that in Barnsley, we need between eight and 10 primary care centres. I have mentioned that we have three already. Those are funded from the general medical services contract and from the NHS bank, but the funding is now over-committed and, as a consequence, is being rationed. Therefore further developments have to be funded from baseline allocation. Barnsley PCT simply cannot allocate any
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more funds to the LIFT programme, so our development is likely to be curtailed, although we may achieve one more LIFT initiative.

There is a fear that the local private-public partnership LIFT company, which was established to deliver that programme, could face insolvency very soon. Obviously, because of the unavailability of further GMS revenue funding, any further GP-led primary care developments are likely to be curtailed. So having been led to believe that we were to get up to 10 new premises, we will be lucky to achieve four. That is simply unfair.

I have outlined clearly my concerns regarding the funding of Barnsley PCT. As I have mentioned, we have high levels of need, mortality and morbidity—some of the highest in the country. To give two quick examples, a boy born today in the most disadvantaged part of Barnsley can expect to live 12 years less than a boy born today in an affluent part of England, and Barnsley's death rate is 15 per cent. higher than the England and Wales average. As I have pointed out, ours is one of the lowest funded health authorities in the area and it constantly struggles to balance the books. It is high time that struggle was ended and our financial situation once and for all improved.

10.17 pm

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