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Primary Care (West Bromwich, West)

9. Mr. Adrian Bailey (West Bromwich, West) (Lab/Co-op): What steps her Department is taking to improve access to primary care services in West Bromwich, West. [56299]
 
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The Parliamentary Under-Secretary of State for Health (Caroline Flint): I am pleased to say that in my hon. Friend's constituency primary care practices report that the number of patients able to see a GP within two working days increased from 73.8 per cent. in June 2002 to 100 per cent. in December 2005. Our recent White Paper, "Our health, our care, our say", looks at ways to develop and extend choice, and to make sure that those reports match patient experience.

Mr. Bailey: Although I recognise the huge improvement in primary care services in my constituency, we are still under-supplied with doctors, who are being helped out by United States accredited physicians' assistants. What is the Minister doing to improve the training, and thereby the number, of British accredited physicians' assistants to help constituencies such as mine?

Caroline Flint: We are expanding training generally, and I shall be happy to write to my hon. Friend on that particular issue. I am pleased to see that his constituency contains two primary care access centres to support GPs, a pharmacy minor ailments scheme that has been developed across Sandwell and two local improvement finance trust schemes, one of which is already open; the other is due to open later this year.

NHS Expenditure

10. Mr. Henry Bellingham (North-West Norfolk) (Con): What estimate she has made of the total level of overspending in the NHS in 2005–06. [56300]

The Secretary of State for Health (Ms Patricia Hewitt): The month six forecast was for overspending of £620 million in this financial year. I stress that the majority of NHS hospitals and other organisations are not only improving patient care, but doing so within their increased budgets. As the hon. Gentleman knows, we have already provided additional management support to the small number of organisations with the worst problems, and I am determined to do everything possible to return the NHS to financial balance by the end of the next financial year.

Mr. Bellingham: Is the Secretary of State aware that PCTs in Norfolk, Suffolk and Cambridgeshire now face a combined shortfall of almost £100 million? Is it true that hospitals in Norfolk have been told to halt additional sessions, peg operating capacity at current levels and put a brake on making further inroads into waiting lists? The Secretary of State keeps saying that everything in the NHS is perfect, but she should try saying that to consultants and staff who are now closing wards and cancelling operations.

Ms Hewitt: What I have said on several occasions, both to the House and to the hon. Gentleman when I have met him to discuss the situation in his constituency and the wider area, is that although most NHS institutions are continuing both to improve patient care and to live within their budgets there are serious financial problems in a small number of organisations and in some areas. We are therefore working with the strategic health authorities to do everything possible to
 
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ensure not only that we continue to meet our targets—for example, waiting no more than six months for an operation anywhere—but that we deal with the financial problems in that minority of organisations.

Jim Cousins (Newcastle upon Tyne, Central) (Lab): Will my right hon. Friend bear in mind the position of hospital managers in Newcastle, who are containing spending and growing services against a background of trying to carry out a big PFI project and to cope with money following patients, no certainty about the future structure of commissioning bodies, a big switch of resources away from acute care and into primary care, and the possibility of their application to become a foundation trust being turned down next month because they cannot guarantee long-term stability in their financial base? Will she consider the situation of managers faced with that sort of uncertainty?

Ms Hewitt: I would like to take the opportunity offered by my hon. Friend's question to pay tribute to the excellent managers whom we are fortunate to have across the national health service. They are helping to ensure that one of the largest and most complex organisations in the world is treating more patients better and faster than ever before. That is due to the superb work of our front-line staff, supported by management and backed up by the investment that we have made.

I would also like to point out that the tradition over many decades in the NHS has been for overspending in some areas, notably the south and the east of the country, to be matched by underspending in the north. That is not fair, it is not efficient and it cannot continue.

Dr. Richard Taylor (Wyre Forest) (Ind): Will the Secretary of State tell the House how many trusts have minimised their deficits for this year by one-off brokerage, which cannot be repeated in 2006–07?

Ms Hewitt: The hon. Gentleman raises an important issue. The sort of informal one-off brokerage to which he refers has been a feature of NHS financial management for the best part of 60 years, and I do not regard it as a good feature of financial management. Part of our work this year and next will be to ensure much greater financial transparency, so that we can both get better services for patients and obtain best value for patients and for public money. I hope that the whole House endorses that aim.

Mr. Kevin Barron (Rother Valley) (Lab): Will the overspending in the NHS that my right hon. Friend describes be dealt with by those who overspend, and not by the wider health community?

Ms Hewitt: My right hon. Friend makes an extremely important point. Unfortunately, the scale of the overspending and the accumulated deficits in a small minority of areas and organisations is such that it is simply not possible for those organisations—or even, in some cases, the wider areas in which they sit—to solve the financial problems on their own. We are working closely with strategic health authorities to put in place the necessary action to ensure that the NHS returns to financial balance at the end of the next financial year.
 
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Robert Key (Salisbury) (Con): I support the Secretary of State's requirement that primary care trusts should balance the books and I want that to succeed, but will she ask for a report into the consequences of that for Amblescroft unit at Fountain way in Salisbury, where 12 elderly vulnerable people have been told to leave by the end of April because the unit is being closed, and for the Greencroft centre, where 150 people with mental problems face the closure of the centre, because of the interface with the county council and the provision of social services? A tab of some £2 million has been picked up this year because of overspend in the health service. Much as we might wish to reduce that debt, it has consequences for a small number of the most vulnerable people.

Ms Hewitt: I will be happy to look at the two specific cases that the hon. Gentleman has raised; perhaps I could write to him on that point. More generally, I stress the point that we made in our recent White Paper that it is absolutely essential in future that we get the social services authority and the primary care trust working much more closely together, with joint care plans, particularly for the most vulnerable people, and, where possible, pooled budgets and joint commissioning.

Rosie Cooper (West Lancashire) (Lab): Will the Secretary of State comment on the difference in the treatment of debt between trusts where brokerage is available and those where the trust debt is treated as in deficit control, and the impact that that might have on the financial recovery of trusts such as Southport and Ormskirk in my constituency?

Ms Hewitt: Most organisations that at month six predicted an overspend for the end of this financial year have a relatively small problem. With a little extra focus and effort, it should be possible to bring the situation back under control in the very near future. There are, however, other organisations, including particularly the 15 or so where we have appointed additional financial management support—the turnaround directors—where the problems will take longer to resolve. That is why strategic health authorities have the necessary discretion to treat different organisations differently depending on the nature of the problem that they face.

Mr. Andrew Lansley (South Cambridgeshire) (Con): Four months ago, in reply to our debate, the Secretary of State said that she had all the recovery plans in place to deliver a net deficit in the NHS below £200 million this year. Now she says that it is £620 million as at month six, and she simply will not tell the House what her latest figures on months 10 and 11 are telling her. We can see the reality from board papers across the country: the deficit is approaching £800 million.

I am sure that the House joins the Secretary of State in appreciating Sir Nigel Crisp's contribution to the NHS, not only in his present role as chief executive, but in previous roles. Perhaps he does not yet appreciate to what extent he is going to give a last service to the NHS, or at least to the Secretary of State, by acting as fall guy for the lack of financial control in the NHS. Will the Secretary of State at least have the courtesy to come to the Dispatch Box and tell the House her current estimate of the projected deficit this year, which has caused the
 
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Department of Health to send threatening letters to chief executives the length and breadth of the NHS? Will she say now that she will take responsibility for the end-year financial outturn?

Ms Hewitt: I regret the tone of the hon. Gentleman's comments about Sir Nigel Crisp, who has made an outstanding contribution to the NHS in a variety of roles. I can tell the hon. Gentleman that the £200 million end-year deficit that I told the House last year I hoped that we would be able to achieve looks increasingly unlikely. We are, however, absolutely determined to keep the end-year deficit as low as possible. We are putting all our efforts into working with the strategic health authorities and the individual organisations with the worst problems to ensure that that is the case. As soon as I have the end-year management figures I shall, of course, publish them for the House, as I did last year. I underline the point that I was making: not only are we determined to keep this year's deficit as low as possible, but we are already putting in place the necessary steps to return the service to balance in the next financial year.

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