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Protection of Runaway and Missing Children

Helen Southworth accordingly presented a Bill to make provision for a national system to safeguard runaway and missing children; to make provision for the collection and reporting of information about runaway and missing children; to make provision for co-ordination between local authorities and other bodies; and for connected purposes: And the same was read the First time; and ordered to be read a Second time on 12 May, and to be printed [Bill 86].

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Opposition Day

[9th Allotted Day]

NHS Finance

Mr. Speaker: I inform the House that I have selected the amendment in the name of the Prime Minister.

3.44 pm

Mr. Andrew Lansley (South Cambridgeshire) (Con): I beg to move,

That this House supports the provision by the NHS of comprehensive, high quality health services, based on need and not ability to pay; notes that, despite unprecedented resources provided to the NHS, NHS trusts were over £600 million in deficit in 2004–05 and predicts deficits approaching £1 billion this year; believes that these deficits threaten the delivery of NHS services, through service cuts, freezing of staff vacancies and redundancies, bed closures and the closure of services in community hospitals; further believes that the uncertainty caused by proposed primary care trust restructuring should not be used to obscure responsibility for financial recovery and service continuity; wishes to see resources reach front-line healthcare providers; regrets the lack of savings in NHS overhead and administration costs; and calls on the Government to intervene to ensure that the long-term interests of patients are not damaged by short-term financial decisions.

At the heart of the debate is a series of questions. Why, when the Government are spending unprecedented amounts of money on the NHS, are more NHS hospitals and trusts in deficit? Why are services threatened? Why are jobs being lost, and why are community hospitals closing?

In this debate, we will investigate why those things are happening. What are the consequences? We will argue that the long-term interests of the NHS and patients must not be sacrificed to short-term financial decisions.

Let us start with the facts. In the financial year 2004–05, 90 primary care trusts, 65 NHS trusts and a number of NHS foundation trusts—the total has yet to be declared, but I believe it to be 12—were in deficit. The combined deficits amounted to £630 million, even though the Department of Health set control totals in the latter stages of the 2004–05 financial year to limit the overall deficit.

Stephen Hesford (Wirral, West) (Lab): Will the hon. Gentleman give way?

Mr. Lansley: I want to get the facts on the record, and then I shall give way.

The Department of Health aimed for a control total of £70 million. Three months after the end of the financial year, the Secretary of State was questioned on this matter and told the House that the net NHS deficit was £140 million. Despite pressure from Opposition Members, she did not acknowledge or admit that total overspends amounted to more than £700 million.

Shortly after the Secretary of State admitted that the net deficit was twice as large as the control total, the permanent secretary at the Department of Health revealed that the net deficit was £250 million. The figure would have been much higher but for the fact that strategic health authorities had underspent their budgets by some £372 million. To do that, I understand that they raided the budgets of the work force
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development confederations—the very same budgets that the Labour party, in the general election campaign, accused the Conservatives of wanting to abandon as part of our proposals to scrap SHAs.

Stephen Hesford: The hon. Gentleman quoted a figure of £600 million. The NHS Confederation reckons that the net figure is nearer £250 million. How does he account for the difference?

Mr. Lansley: The hon. Gentleman clearly believes the Government's propaganda. I have just explained all this, but I shall do so again. The net deficit in the NHS was just over £250 million because SHAs underspent their budgets—a large part of which was to be devoted to the work force development confederations—by £372 million. Without that underspend, the deficit across the NHS would have totalled £630 million.

Stephen Hesford: Will the hon. Gentleman give way again?

Mr. Lansley: I will, and perhaps this time the hon. Gentleman will explain why Arrowe Park hospital is facing deficits and closing beds.

Stephen Hesford: I shall deal with that when I come to make my speech, but I can tell the hon. Gentleman that he is wrong—[Interruption.] Mr. Speaker, the Opposition do not want to listen. However, when the hon. Member for South Cambridgeshire (Mr. Lansley) quotes a figure of £600 million, is he not simply exaggerating?

Mr. Lansley: There are limits to how many times I can repeat the same figures, even if the hon. Gentleman simply fails to understand them. If he comes to a debate on NHS finance, he should at least take the trouble to understand the subject. The Secretary of State will admit, if she cares to, that the gross overspends reported in the NHS accounts—and I can go through them for the hon. Gentleman, if he wishes—were £630 million. If the right hon. Lady wants to deny that figure, I shall give way to her now. [Hon. Members: "Come on!"] As I expected, the Secretary of State makes no move to respond. Let us get some more facts on the record.

Three years ago, six SHAs were in deficit overall. Two years ago, seven SHAs were in deficit, and last year the total was 12. Half way through this financial year, 21 out of 28 SHAs were predicting deficits. The hon. Member for Wirral, West (Stephen Hesford) seems fond of quoting the NHS Confederation. In its otherwise obfuscatory briefing, it did at least admit that deficits this year are expected to be worse than last year.

Mike Penning (Hemel Hempstead) (Con): If the Secretary of State and Opposition Members do not believe our figures, perhaps they will believe Unison's. My friends at Unison have supplied us with a nice document that tells us that the deficit is £200 million in the eastern region alone. Unless the rest of the country has a tiny deficit, someone is telling porky-pies.

Mr. Lansley: I am grateful to my hon. Friend for that point. Indeed, in Norfolk, Suffolk and Cambridge, the strategic health authority predicted a £92 million deficit in its area alone.
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Two years ago in 2002–03, there were 71 deficits. In 2003–04, there were 106 deficits and by 2004–05 there were 167 deficits, including foundation hospital trusts. As I said this year, the projected deficit is £1 billion, far in excess of last year's. The Department of Health has already set control totals approaching £350 million, but one has little confidence in its ability to exercise financial control. The chief executive of the Department, in a memo leaked last week to the Health Service Journal, said that the NHS is

That is from the accounting officer for the Department of Health. It is little wonder that three months after the end of the financial year the Secretary of State could be nearly 100 per cent. out on the out-turn figures for NHS finances.

NHS trusts have a statutory duty to break even, which is generally interpreted as allowing one financial year to be taken with another, but at this rate they will have to put two or three financial years together. We are now in the fourth year of rising deficits. Many PCTs and trusts have breached their requirements to live within resource limits or external finance limits. In several parts of the country, there is a risk of financial collapse.

Mr. Tim Yeo (South Suffolk) (Con): Is my hon. Friend aware that Suffolk West primary care trust proposes savage cuts in my constituency, including the closure of Walnut Tree and St. Leonard's hospitals in Sudbury with the loss of 68 beds? The cuts will be made at a time when Suffolk county council's social care budget is under extreme pressure and facing cuts, the population of the town is increasing sharply and beds in West Suffolk hospital—the district hospital that serves the area—are also being cut. The PCT's announcement of the cuts came just three months after it had approved the construction of a new replacement community hospital in Sudbury, the announcement of which came—conveniently—just before the general election. Today, Sudbury's existing hospital is to be closed, its new hospital has been cancelled and no replacement community services will be in existence before the cuts are made.

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