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Dr. Julian Lewis (New Forest, East) (Con): I hesitate to give advice to the hon. Member for Colne Valley (Kali Mountford). She has many admirers on this side of the Chamber, and I think that I am right in saying that she entered the House at the same time as I did in 1997. I would merely say to her that in the 1997 Parliament it was acceptable for Labour Members to argue that everything was the fault of the previous Conservative Government. In the 2001 Parliament, it was arguably acceptable for that to happen. However, this is the 2005 Parliament and it is incredible to argue that this is all the fault of a Conservative Government who lost power way back in 1997.
Before I leave the party political part of my speech, I must point out that I would never have imagined that, six months after a general election that the Government won with a majority of 60, the best that the Government could do in a major Opposition day debate would be to get only four Back Benchersincluding one whom I believe to be a Parliamentary Private Secretaryto support their ministerial team. It is a sign that all is not well with this Government.
My final point about the hon. Member for Colne Valley is that it is precisely because we like and admire her that it is sad to see her having to speak so defensively about a record that she knows in her heart is not satisfactory. I would not discourage her from doing that because, as time goes on, if the Government continue to try to purvey a message of good news to a country that knows that the news is thoroughly bad they will simply lose credibility.
I come now to the events in the constituencies of New Forest, East, New Forest, West, and Romsey, to which the hon. Member for Romsey (Sandra Gidley) briefly referred. I thank her for the way in which she has co-operated with my hon. Friend the Member for New Forest, West (Mr. Swayne) and me in fighting to save the five community hospitals based in our three constituencies. I was sorry to hear the spat between my hon. Friend the Member for Reigate (Mr. Blunt) and the hon. Member for Crawley (Laura Moffatt) about the fight over which community hospital should be saved in
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their constituencies. The reality is that if constituencies work together, they maximise their chance of saving all their community hospitals, because this is not a zero-sum game.
When I asked the Secretary of State whether she valued the role of community hospitals I expected her to say yes. However, I also hoped for an answer to the question whether she thought that their closure was a matter of dogma or of economics. It should not be a matter of economics. During our campaign against the closureswhich is not over yet, although things are now looking promising for the five hospitalswe discovered that the running of the community hospitals accounted for between only 1 and 2 per cent. of the total operating costs of the PCTs concerned. Those PCTs admitted, without too much pressure, that the reason they were in gross financial deficit had nothing whatever to do with the cost of running the community hospitals. I am only sorry that the Secretary of State was not prepared to concede that point when I asked her to do so.
The reality was that five community hospitals were to be closed. There was, however, supposed to be consultation and originally it appeared that the consultation would be on all the possible options. Option one out of five was to keep all the beds, or at least some of the beds, in all the community hospitals. Option five was to close all the beds in all five hospitals. In between, there was a series of cunningly designed options, such as closing one hospital but keeping others open, or closing two hospitals but keeping others open. It was patently obvious what was being planned. The idea was that the consultation would set hospital against hospital, community against community, and then the PCTs would be able to go back and say, "None of the communities can agree on which of their hospitals should survive, so we will just do what we consider best."
What did the PCTs consider best? Extraordinarily, when the truth was told, they did not like the idea of people being treated in community hospitals. Indeed, one non-executive director of the New Forest PCT, who subsequently became acting chairman for a period, said at an early meeting that treating people in community hospitals rather than in their own homes was archaic. If we wish to develop services to encourage people to be treated in their own homes more than at present, the best way to do thatafter all, people do not go into hospital for funis to persuade them that if the time comes when their condition deteriorates to the point that they will need in-patient care, those in-patient beds will be available.
I wanted to finish with a few tips and hints for people campaigning on these issues, but something strange is going on nationwide. It is not clear whether it is a movement among PCT bureaucrats or whether they are being surreptitiously encouraged by the Government. The Government say that they value community hospitals and I would like to believe them. If they do, the movement is among bureaucrats. Whatever, there is an attempt to say that community hospitals are not necessary and that people can be treated at home. That smacks of something that we have seen beforewhat happened to mental health services when care in the community swung the pendulum too far against professional care in institutions.
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There is a grain of value in what is being recommended, but the reality is that valued, trusted and loved organisations will be thrown away for the sake of dogma. When that dogma is found to have failed, the unelected bureaucrats, whom no one put into power except the Government, and whom no one can remove except the Government, will no longer be there. It is no good the Government saying to us that such decisions must be taken locallyour answer is that such decisions must be taken democratically.
Dr. Richard Taylor (Wyre Forest) (Ind): While I welcome the extra money going into the health service and some of the improvements that have occurred, I find it incredibly hard to understand why only a quarter of trusts are in deficit, when in my area all three of the primary care trusts and the acute trust are desperately in deficit. I want to try to persuade the Government to admit that at least some of the deficits are their fault.
"is it not also part of your job to tell the Government that with Agenda for Change, GP contracts, consultant contracts, out-of-hours care and all these further reconfigurations, that even though they put extra money in, you do not have enough?"
"you are absolutely right that if you look at those examples you gave, whether it is Agenda for Change, the consultant contracts, the GP contracts, all of those cost more money than we originally identified in the arrangements to do it, and we make that very clear to Sir Nigel Crisp and his team when we meet them."
As an independent Member, I have the immense privilege of being able to attack both the previous Government and this Government. I refer the House to an article in the Journal of the Royal Society of Medicine in 2003, which reviewed all the changes imposed on the NHS up to that date, which it called, "organisational upheaval". I am glad to tell the House that the score is 13 to 12 in the Government's favour, or rather disfavour. From 1982 to 1996, there were 12 reorganisations. From 1997 to 2003, there were a further six. By my counting, since 2003, seven or eight more have taken place. The author of that article concluded:
"perpetual reform is very costly, both in terms of the time and effort invested by managers and other NHS staff, and in terms of the financial costs of establishing the physical fabric of new organisations and of meeting the redundancy or retirement costs of displaced staff."
As I said in a debate in Westminster Hall this morning, one of the consequences of deficits in my area is that the acute trust is £20 million to £30 million short. Some of that is because of inefficiency, and I welcome the drive for efficiency-increased productivity. I am saddened, however, that there are threats, yet again, to hospital services in my county.
Apart from threatened reconfigurations, the PCTs have deficits, which affect me and, I suspect, other hon. Members in the form of battles with NICE guidelines.
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I have had a tremendous battle to get funding for the anti-TNF drugs for rheumatoid arthritis, which are approved by NICE. I am having a battle over biventricular pacemakers, which every cardiologist reckons are far better than the old-fashioned pacemakers, and yet a patient must go before a special complex case panel to be approved to have what is well known to be the most effective form of pacing. There is, of course, a battle over Herceptin, and in my area each case is being examined specifically. There is NICE blight, whereby things that are about to be tested are not even considered by PCTs. Then there are things that are not even on the NICE list, such as the treatment for sleep apnoea. Any Members who are overweight and whose wives tell them that they snore loudly might need that treatment at some point.
My plea is that we should recognise the causes of the deficits, slow down some of the reforms and give the staff time to care for their patients. It is all very well to rule that GPs must do Saturday morning clinics. But who stopped the Saturday morning clinics? The Government accepted the new GP contract, which did just that.
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