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Mr. Gray: My hon. Friend is right about the re-creation or re-amalgamation of PCTs. In Wiltshire, we have re-created something that looks very much like the Wiltshire health authority, which I rather welcome, but on top of that we have something called the Avon, Gloucestershire and Wiltshire strategic health authoritywhat it is for, I know notwhich spends huge sums on bureaucrats, all of them driving BMWs, and on a posh office in my constituency. What is happening? They are closing Malmesbury hospital as a resultclosing a hospital to spend the money on admin.
We have a great deal to do. We need to cut bureaucracy. We need proper risk-sharing agreements between PCTs and hospitals about what is to be done where activity rises and payment by results applies. We need integrated commissioning of emergency care. We need the Government to stop the central imposition of costs through national pay contracts. The working time directive needs to be renegotiated. More than a year ago, the Government promised to renegotiate it in Europe, but we have not heard anything about it since. Most of all, however, we need a Government who do not believe that, while controlling NHS costs and imposing 80 per cent. of the additional cost pressures on primary care trusts, they can at the same time wash their hands of that responsibility which, they say, belongs to local PCTs.
The Government must not be allowed to wash their hands of the deficits that have arisen across the NHS. Resource allocation means that health economies in London, as we heard from my hon. Friend the Member for Ruislip-Northwood (Mr. Hurd), in the south-east, parts of the south-west, East Anglia and parts of the north are in crisis. Hospitals across the country are struggling with rapidly rising cost pressures. Rising emergency attendances are crowding out elective activity in NHS trusts. At the same time, however, the Department of Health top-slices funds for take-or-pay contracts with private sector providers, who are paid regardless of whether patients are referred to them.
Unrealistic and absurd assumptions by Ministers have led to serious underestimates of the cost of consultant and GP contracts. A former health adviser to No. 10 says that too many Government contracts did not incentivise productivity improvements. Small wonder, then, that productivity in the NHS declines every year. PCTs are caught between the rock of rising hospital costs and the hard place of GP contracts and out-of-hours costs. PCTs are cutting services and closing community hospitals and mental health services, as has happened in my own constituency, thus threatening the long-term viability of community services. Short-term cuts threaten the long-term interests of patients. Instead of shifting the blame, the Government must recognise the scale of the problem, intervene to resolve the deficits, and prevent permanent damage to the NHS this year and next. I commend the motion to the House.
"welcomes the Government's record levels of investment in the National Health Service, with expenditure set to rise to over £92 billion by 200708; notes that by this date £70 billion, more than ever before, will be going to the NHS front line; congratulates the Government on delivering investment and reform, leading to historic improvements to NHS services and capacity, reducing waiting times to their lowest in nearly a generation, from over two years to a maximum of six months, and to a maximum of 18 weeks by 2008, employing nearly a quarter of a million more NHS staff than in 1997, including 78,700 more nurses and 27,400 more doctors, and undertaking the largest hospital building programme in the history of the NHS, including investing £100 million in a community hospitals programme; further notes that the NHS has achieved overall financial balance in each of the past four years, and last year carried a deficit of around only 0.4 per cent. of total resources; compares this with the record of the previous Government which left the NHS with a £460 million deficit in 199697 which amounted to almost 1.5 per cent. of total resources; and agrees that, given the record increases in health funding available coupled with the strengthening of Primary Care Trust commissioning, all NHS organisations should be able to live within the resources available to them and to provide excellent services to their populations."
This morning, I had the enormous pleasure of accompanying my hon. Friends the Members for East Ham (Mr. Timms) and for West Ham (Lyn Brown) to the official opening of the NHS gateway treatment centre in Newham, which is one of the most diverse communities in the country, with the UK's youngest population. It also has some of the most pressing health needs. Now, however, the new NHS treatment centre, which is part of the growing Newham health village, is offering outstanding care to NHS patients. There is a wonderful new environmentally sustainable building, which is the result of a £17 million investment with which we helped. The centre offers patients the choice of three-bed ward or a single-bed room. It was designed with clinicians to speed up care and recovery.
Ms Hewitt: No, I will finish my example before giving way. I know that the hon. Gentleman has received excellent health care and will readily give way to him in a moment. [Interruption.] If Opposition Members will permit me, I want to say a little more about what the staff at the gateway centre are doing. It was a pity that the hon. Member for South Cambridgeshire (Mr. Lansley), who spoke at some length, did not give one word of thanks to our outstanding NHS staff.
Mr. Lansley: The Secretary of State knows perfectly well that this whole debate is in the interests of NHS staff. However, I would like to pay tribute to the staff of hospitals in Newham, because Newham general hospital is the successor institution to the East Ham memorial hospital, where my father ran the pathology laboratory for nearly 30 years.
I am glad that the hon. Gentleman has now made that point. The staff at the Gateway centre, led by the consultant surgeon Mr. Nigel Fieldman, are working in new and better ways. They are making much
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greater use, for instance, of nurse practitioners and operating department assistants. The result is that a patient coming in for a hip replacement or some other elective procedure, who, in the old hospital, would have faced an average stay of 10 days, now has an average stay of just five days, and the staff believe that they can get that down even further.
Ms Hewitt: Before I give way, I want to pay tribute to the outstanding work of all the staff at the Gateway centre, but in particular to Mr. Fieldman, who is due to retire shortly and will leave behind him a centre that is a shining example of the future of our national health service.
Mr. Graham Stuart: Some hon. Members may have noticed that the sling was off last week. I was a poor patient and had to put it back on this week. I am delighted to hear of the reaction of staff in Newham at being provided with decent facilities with which to look after their patients. We only wish that were true across the country. We wish that the right hon. Lady would speak to the staff in Withernsea and Hornsea in my constituency and tell them about decent facilities. They want them there so that people can have better care in east Yorkshire, not just in central London.
Ms Hewitt: It is a great pity, then, that the hon. Gentleman's party voted against the national insurance increases that are delivering the record levels of investment that are paying for improved facilities right across our country.
Is that an error? In Wellingborough only two weeks ago someone showed me that they were being asked to wait for 40 weeks for treatment, and two other people were being asked to wait 52 weeks. To me, that is more than six months.
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