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Mr. Richard Spring (West Suffolk) (Con):
I echo the sentiments that were ably expressed by my hon. Friend the Member for Eddisbury (Mr. O'Brien) in saying that the NHS is of course a patient-centred organisationhe paid tribute, as I do, to the wonderful work that is done by the nurses, doctors and ancillary workers in our hospitals. I myself spent some time working as a porter in West Suffolk hospital, and I saw the professionalism and good humour of those who work magnificently in our NHS. I emphasise that point because people who work so ably and selflessly in the NHS in Suffolk are
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under massive pressure and subject to great anxiety because of a crisis in funding and an implosion in some of the services.
Before I became a Member of Parliament in 1992, there was a West Suffolk health authority. We were told that a pan-Suffolk health authority was essential on the grounds of economies of scale, procurement, minimising overlapping and so on. Somehow it was deemed to be the right way to go. A few years ago, we were told that that was all wrong and that we had to have primary care trusts because decisions had to be made more locally and be more attuned to the circumstances of the area. They had to be made closer to the patient.However, a huge error was made. In a county the size of Suffolk, which has a population of only 683,000, no fewer than five PCTs were created, all with expensive chief executives and staff, despite the opposition of Members of Parliament, councillors and health professionals. The Government ignored all their advice. The PCTs were introduced in 2002 and we were told that it would take 18 months to assimilate the reforms. We were supposed to experience the benefits only 18 months afterwards. I say with great regret that there have been few benefits.
The new proposals go full circle, back to a pan-Suffolk health authority. Goodness knows the amount of taxpayers' money that has been wasted in getting back to the future, but the problem is not organisational. As we know from the consultation process, which has elicited responses from throughout the county, the problem is the operation of the funding formula. The Under-Secretary shakes his head, so I shall spell out the matter clearly.
After the first change was made in 1998, I went to the then Secretary of State for Health and pointed out its likely effect on rural areas, especially those with an ageing population. Since 2001, no fewer than four changes have taken place. Suffolk West PCT has the third worst audited deficit in the country and is £13.7 million in debt. West Suffolk hospital, the biggest hospital in the area, is running a deficit of £11.3 million this financial year. The total deficit in the county of Suffolk is £35 million. For the strategic health authority area, it is a gargantuan £85 million. That is the heart of the problem and it springs substantially from the change in the formula for NHS per capita spending, which has discriminated against an essentially rural area with an ageing population. No organisational changes in the county will remedy that.
If the figures sound abstract, I point out that, even in the midst of the consultation process, no fewer than 55 beds have been removed from the West Suffolk hospital in the past few months and 260 staff15 per cent. of the totalhave lost their jobs. Hospitals throughout the countyin Ipswich, Bury St. Edmunds or, indeed, Addenbrookes hospitalare permanently on red or black alert. The position is therefore serious.
We held a meeting here with the strategic health authoritythe body that is charged with overseeing the finances of the PCTsat the beginning of 2005. There was complete complacency in that meeting. The Members of Parliament present understood what was going on, but the SHA representatives seemed to have no grip of the situation. How could that be? Their function was inexplicable to all of us.
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By June, the SHA had a new chief executive because the previous one resigned, as did the chairman. When its representatives came up to the House of Commons, their attitude was that we Members of Parliament were being somewhat hysterical, and that the problem that concerned us so much did not exist. However, they had changed their tune when we had another meeting last month. There was a sense of desperation in the SHA management, amid concerns that it might not be possible for Suffolk's NHS trusts even to meet their national insurance and tax liabilities.
As the SHA has overseen the development of such problems, my colleagues on the Front Bench are right that it should be abolished. It has no clear function whatsoever. The SHA's chief executive earns £145,000 a year, and the directors of performance and of service modernisationwhat a wonderful euphemismboth earn more than £100,000. Its clinical director gets £150,000 and the chief executive of the work force development confederation £100,000. If those people are being paid such sums to look after three counties, goodness knows what will happen if their responsibilities extend to six. Will they get a proportionate increase in pay? It is no wonder that people feel that the NHS is being undermined by a level of expensive bureaucracy that is not appropriate for its task.
Suffolk is a rural county, and my constituency of West Suffolk gets £1,156 per capita in health service funding. The Prime Minister's constituency gets £1,576, and the Secretary of State's Leicester, West constituency gets £1,428. The Minister of State's constituency, Doncaster, Central, gets £1,489, while the national average is £1,388. If the county of Suffolk received even the national average, we would not be facing the current crisis. The same is true right across the south and south-east of the country.
Of course I accept that there have been medical improvements and huge technological advances over the past few years. That has happened continuously since the NHS was created after the war, but the cuts being made are unprecedented. The White Paper mentions various much cherished and valuable community services but they are now under threat, with rehabilitation beds already being closed down.
The Minister who is to wind up the debate may think that I am exaggerating, but I can tell him that the clergy in and around my constituency have been organising petitions. They are anxious about NHS provision in the area and about the stories that their parishioners tell them. The state of the health service is such that they feel compelled to place petitions about it in their churches and places of worship. The situation is terrible.
Amalgamation may offer some managerial advantage, but the Government must address the problem of funding and deal with the dead hand of the SHAs by abolishing them. Unless those steps are taken, the NHS will never deliver proper value. That will have consequences for the people in our communities who want the service to work and to succeed, and who are hugely disappointed that it is failing to do so in wide swathes of the country.
Mr. Robert Flello (Stoke-on-Trent, South) (Lab):
I shall deal in turn with the issues of PCTs, SHAs and the ambulance service, but I want to begin with a few
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general comments. We in this House agree that we must ensure that NHS funding is used most effectively on the front line, but we must also accept that we cannot preserve the service in aspic.
At the risk of mixing my metaphors and similes, we might compare the NHS with a supertanker. A vessel that is so big can turn only very slowly, and in the same way change in the NHS must involve many incremental alterations. I shall offer another illustration: if the NHS were a country, the size of its budget means that it would bear comparison with Poland. It is important that we recognise that the NHS needs to change; the question is how those changes are brought about and implemented. We also need quality management and good administrators in the NHS, and we need to value those support staff. Equally, we need to test every pound that goes into the health service to ensure that we get best value for patients.
The Conservatives devalue some of their arguments by suggesting that everything in the NHS was wonderful before 1997, and that it has all become terrible since then. That is contradicted by the Fenton health centre, which has just been opened in my constituency, and by the Willow Bank surgery, which opened about a year ago in Longton. It is also contradicted by all the additional doctors and nurses that we now have.
Mr. Stewart Jackson (Peterborough) (Con): Does the hon. Gentleman acknowledge that between 1979 and 1997, there was a 64 per cent. real-terms increase in funding for the NHS, and that £1 million was spent on a capital project in the NHS for every week of every year of that Conservative Government?
Mr. Flello: I am grateful to the hon. Gentleman for that interesting intervention. The revenues from North sea oil would have funded a new hospital roughly every week during that time, yet there were no new hospitals built until we came into Government. Constituencies such as mine saw no infrastructure changes of any note in the period that the hon. Gentleman mentioned. My hon. Friend the Member for Newcastle-under-Lyme (Paul Farrelly) made the point that there has been a 95 per cent. increase in NHS funding in the past few years, thanks to the new investment that is going in. It is disingenuous of the Conservatives to suggest that everything was perfect before 1997 but not since; the opposite is in fact the case.
There are two primary care trusts in Stoke-on-TrentNorth Stoke and South Stoke. They were, de facto, merging; they were working together more closely all the time. To suggest having a single PCT for the whole city therefore makes a lot of sense. It is simply making a reality of what was happening anyway. I pay tribute to the work of my hon. Friend the Member for Staffordshire, Moorlands (Charlotte Atkins) on these issues, but there is still a lot of work to be done to ensure that the appropriate options are put in place for the rest of Staffordshire and that they are able to be introduced.
We need to recognise, however, that the existing system is not the most effective. The Donna Louise Trust, the children's hospice in my constituency about which I have lobbied the Under-Secretary of State for Health, my hon. Friend the Member for Birmingham, Hodge Hill (Mr. Byrne), is a perfect example of primary
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care trusts not working together collectively. In that instance, a smaller number of PCTs might have the clout to do more.
That brings me to the subject of strategic health authorities. The system of consultation has not been open or accessible to the people of Staffordshire; it has not been working. The SHA in charge of putting that consultation system together has done a splendid job, if I can put it like that, of obfuscating and making a mess of the whole thing. If that is its role, heaven help us, but I hope that it will have a much more positive one in future. One such role might be in the managing and integration of services, involving not only the PCTs but social services in coterminous areas. The SHA could have a role to play there.
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