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The right hon. Member for Rother Valley (Mr. Barron) said that the public sector can sometimes be rather self-serving. I know what he is talking about
and I note his comments. I remember a time when I worked in the NHS, when the first aim and objective of many public sector workers was their pay and conditions of service. Their second objective was service delivery. That was in the ’70s and I remember it well. I do not believe that that is the case now or that the Royal College of Nursing did what it did the other week—or is coming here to do on Thursday—because those people are self-serving and are simply thinking of their own jobs. People are behaving like that because they are frustrated and because they do not feel that the Government are listening.
Mr. Devine: The hon. Lady will remember from when she worked in the national health service that, when the pay review body was set up, for seven out of 10 years her party implemented a staged pay rise. That has not happened under this Government.
Anne Milton: My problem is that I was not a Member of Parliament then. I remember what it felt like in the NHS and perhaps it is of note that it was because of my experience in the NHS that I went into politics—and I am on the Conservative, not the Labour Benches. There is a reason I joined the Conservative party and not the Labour party and if Labour Members really want me to go back and describe the situation in the NHS when I was a nurse, I will gladly tell them about it. When I could not get a porter to take a patient to the ward and wheeled him myself, the porters went on strike for 24 hours because I was doing their job. We can all go back, but, as I said earlier, it is important that we look ahead.
The situation for my constituents in Guildford feels rather grim. We have a review of acute services in Surrey and while we would welcome many of the changes that the Government are talking about and that the hon. Member for Dartford mentioned, maternity services, paediatrics, and accident and emergency at the Royal Surrey county hospital are all going to be under threat. The problem is that, on the one hand, the Government talk about delivering services more locally and closer to people’s homes and, on the other hand, they talk about reviewing acute services and moving such things further from people.
I admit to a certain amount of confusion and we have heard a confused story this afternoon and this evening. A lot of Conservative Members have talked about community hospitals and midwife-led units closing, while some Labour Members have told us how wonderful the NHS is. My constituents have been refused PET scans and DAT scans, and even a hernia operation, because the PCT is not buying them any more, on the grounds of cost. The hospital says that the PCT will not pay for them and the PCT says that it has funded them, but the patients are left terribly confused and do not know who is making the decision. The NHS about which some Labour Members talk is not the NHS that I recognise at the moment in Guildford. The situation is not all bad, but there are serious problems and we are finding that our services are being cut.
The headlines that we have seen in the papers recently are not just made up. Such headlines include “10,000 nurses ‘can’t find a job’ in cash-strapped NHS” and “Treatment centre programme in disarray as contacts
axed”. The hon. Member for Wyre Forest talked about that problem earlier. The new independent sector treatment centres are being paid whether they do work or not. They are coining in the money, but are operating at about 50 per cent. They get the money even if they do not do the work. Other headlines include “How NHS cash goes to waste on private ops”, “NHS ‘facing worst financial crisis’”, “Threat to funds for medical training as hospital advertises for four risk assessment managers” and “NHS faces job cuts as financial crisis deepens”. Those stories are not made up.
I urge hon. Members on both sides of the House not to dismiss contributions from Conservative Members as political posturing. I also urge Conservative Members to consider what they have heard from Labour Members. We have to find a solution. I know that I need to protect and look after my constituents and that they need and deserve a better NHS than they are getting at the moment. It would be becoming of all of us to look ahead and find real solutions to some of the problems.
8.47 pm
Natascha Engel (North-East Derbyshire) (Lab): Thank you, Mr. Deputy Speaker, for calling me to speak in this important debate.
I am surprised by the choice of subject for this Opposition day. I seem to remember that a previous Opposition day was dedicated to welfare reform. Today, the Conservatives have once again been kind enough to choose a subject for debate on which we have led the way since 1997. I thank Conservative Members for giving us the opportunity to celebrate our successes.
Since 1997, we have doubled investment in the NHS, and by 2008 we will have trebled it. Waiting lists are at their lowest ever. No one now waits more than six months for an operation and no one with suspected cancer waits more than two weeks to see a specialist from the day that their GP refers them.
The hospital that serves my constituency of North-East Derbyshire, the Chesterfield Royal hospital, is beating those national statistics. The national standard for a first routine out-patient appointment is 13 weeks. At Chesterfield, a patient waits a maximum of 10 weeks, although most people do not have to wait even that long. That success is largely due to a close working relationship between our primary care trust and the hospital to ensure that waiting times are some of the lowest in the country. By the end of March last year, every single patient who was referred with suspected angina was seen within two weeks. Every single patient with suspected cancer saw a cancer specialist within two weeks, and every single patient diagnosed with cancer was treated within one month. The hon. Member for Guildford (Anne Milton) was absolutely right that this is not about politics or point scoring. What we have been doing since 1997 means that more people’s lives are being saved.
I make no apology for being parochial. The successes and changes that we have seen in North-East Derbyshire have been astonishing, but what is most significant is the massive cultural shift that we have seen in the health service in empowering patients. From
direct personal experience, I can say that the shift in emphasis to put the patient at the heart of the NHS has been our greatest success.
I have recently had two children at Chesterfield Royal hospital. The first baby was born five weeks prematurely and had to spend 10 days in the special care unit. I cannot speak highly enough of the nursing staff and the doctors. It was our first baby. It was a terrifying experience. By informing us and involving us in every decision made, we knew exactly what was going on and what to expect.
I recently met the North-East Derbyshire patient and public involvement forum. If it is anything to go by, the voice of the patient is being heard loud and clear. This and other such forums were set up three years ago to provide a local voice for the community on health matters. They are independent of the NHS and it is the Appointments Commission that has responsibility for appointing members to the forum.
Martin Horwood: Will the hon. Lady give way?
Natascha Engel: I know what the hon. Gentleman is about to say. However, I shall complete my point.
The task of the forums is to gather views about the quality of service, to monitor the gaps and provisions and to make suggestions on improving services. They regularly meet the chief executive of the North-East Derbyshire primary care trust—a relationship that needs strengthening. I hope that the forums will become better resourced and will be a focal point in the health service, whatever their name is in future. They will do that by putting patients at the heart of the NHS. I would like some reassurances from the Minister that they will be able to continue to do their good work.
Martin Horwood: I had a similarly excellent experience—it was not quite the same as that of the hon. Lady’s—with my wife at St. Paul’s Cheltenham maternity wing. Sadly, it has been closed under the current financial cuts. The hon. Lady talks about patient involvement and a patient-centred NHS. Has she noted the comments by a governor who has resigned from the acute trust in Cheltenham. He said:
“I was elected to represent the people of Cheltenham, but if no one takes any notice then it is quite useless. I am not going to be some sort of window dressing.”
There is the recent resignation of the patient and public involvement representative on the primary care trust. There are the 13 governors of the acute trust—
Mr. Deputy Speaker (Sir Michael Lord): Order. The hon. Gentleman has made his point.
Natascha Engel: I really cannot comment. The forum is extremely well attended. It is successful in getting the voice of patients heard within the NHS. I cannot say more than that.
I shall end on a more personal note. I have recently been to St. Thomas’s hospital over the river. I visited Calvin Thomas, who is one of the Doorkeepers. He
was rushed to hospital just before Easter. I heard today that he has had a successful operation to have a special pacemaker fitted. I am sure that everyone in the Chamber will join me in wishing him a speedy recovery. We all look forward to hearing directly from him about the positive experiences that he has had from the NHS, which is free at the point of use for everyone, based on their need and not on their ability to pay. The NHS is still our greatest achievement, and I thank the Opposition for giving us the opportunity to highlight our greatest achievement since1997.
8.54 pm
Mr. Brian Binley (Northampton, South) (Con): I welcome the new Minister to the Government Front Bench. I welcome, of course, the other Minister, but I greet the newly appointed Minister particularly.
I am not a doctor, and I have hardly any medical experience. I think that indigestion is a heart attack. I do not want to comment on medical matters. I know a bit about business management and a bit about financial structure. I know that there are some serious problems, not least for the area that I represent. I want, therefore, to dwell on those matters.
I have listened to the debate with interest and want to establish a couple of positions that I hold. I do not want to destroy the health service. Indeed, I have been a supporter of it all my life. I am a working-class boy, and I thank whoever started it, whoever it was. A wonderful institution was started.
I regret that myth and history are being used politically. I look directly at the Government Benches. It is a pity that that attitude should have been taken, and I think that it has belittled the debate. I remember 1977, and I remember the winter of discontent. We can all play the game, but that does no good in this debate. I have been rather saddened by some of the comments that have been made. I hope that that is taken on board. Finally, I wish to come to my main point.
Tom Levitt: Will the hon. Gentleman give way?
Mr. Binley: No, you have been up and down like a yo-yo, and you have said enough.
Mr. Deputy Speaker: Order. The hon. Gentleman is addressing the House, so he must use the correct parliamentary language, otherwise I shall find myself interrupting him frequently.
Mr. Binley: I apologise, Mr. Deputy Speaker. I am surprised, however, that someone on the payroll—never mind, I will not comment further.
Mr. Devine: As the hon. Gentleman expressed support for the national health service, will he confirm that he is not covered by a private medical insurance scheme?
Mr. Binley: I am proud to be covered by such a scheme, as there is room in the business for both sectors. Indeed, it is important that we attract more money into health. I am surprised that the hon. Gentleman does not realise that more money needs to
be spent on health or that we need to find various ways to attract it. He may wish to take that lesson on board.
Northamptonshire is desperately underfunded. We have heard that there are many problems and that people wish to transfer money from the wealthy areas to the poor ones. I am not sure that we are a poor area, but we are certainly heavily underfunded in local government, policing and health. The Minister for Local Government acknowledged those problems but did not act to deal with them when I visited him in December last year. They are caused by various factors—I shall not go into all of them, because time forbids—but a serious shortfall has resulted from the formulaic underfunding of Northamptonshire in general and Northampton in particular. We face an additional problem as the result of the sustainable communities programme that the Government have forced on us, but which most of us reject. There is sizable growth, but the need to fund extra medical provision has simply not been recognised by the Government.
The most serious problems are in health. Leicestershire, Rutland and Northamptonshire strategic health authority is the worst-funded SHA relative to the notional capitation formula. Together with our PCTs, it was underfunded by £88 million—5.3 per cent. of the budget—and thus significantly below the capitation funding level at the end of the last financial year. Northampton general hospital faces severe demands for a reduction in spending in two areas in particular. It has been forced to reduce spending on the 2006-07 budget by £7.8 million or 4.5 per cent. of the budget, which means reductions in the length of stay and staffing—particularly health service staff, as well as increased day care treatment. Doctors may wish to recommend that a patient remain in hospital, but the hospital fears that it cannot allow them to do so.
In addition, the hospital faces a further reduction of another £8 million because of the transfer of certain functions to the primary care sector. I accept that that is Government policy, but it creates a massive challenge for both the hospital and the primary care sector, as there will be a 10 per cent. cut in the hospital budget and a 5 per cent. minimum increase in work load for the primary care sector. Any business man knows that there is a huge risk attached to such change within a year. I am not sure that the Government have understood what that risk element means. I can tell them. It means possible cuts in services, a lack of resource to service the requirements, and less good treatment for the patient. On top of that, we have a further problem in Northamptonshire because £25 million of underfunding has been carried forward.
The Office for National Statistics said that we were to have no growth in Northampton between 2001 and 2008. I invite the Minister to come to Northampton. By God, he will see growth on a massive scale, yet the ONS said that we were to have no growth, which meant that we were not funded. That was accepted by the Government. What have they done? They have given us slightly increased growth for 2006-07, but have taken no account of the £25 million underfunding.
That is placing a massive burden on the primary care trust. I plead with the Minister to reconsider. Please come back to us with a more favourable view. That is what I mean by flexibility in the system. It is okay
looking down from the macro level. I understand why you make the decisions that you do. I understand the problems that you are faced with and what you are trying to achieve, but at the micro level the impact is different and needs to be understood equally well. It will not be understood unless you come to my constituency and other constituencies around me—
Mr. Deputy Speaker: Order. I did warn the hon. Gentleman. I hope he now realises that he is using the wrong terminology.
Mr. Binley: I apologise again, Mr. Deputy Speaker. Thank you for your advice. My use of the wrong terminology demonstrates my care for the subject.
I hope the Minister will accept my invitation, come and talk to our primary care trust and see what problems we face. There is an underfunding problem in Northamptonshire that we will find it difficult to face and a level of risk that is unacceptable for the people whom I represent.
9.2 pm
Ms Diana R. Johnson (Kingston upon Hull, North) (Lab): I disagree with the hon. Members for Guildford (Anne Milton) and for Northampton, South (Mr. Binley). I passionately believe that the NHS and health care is a political matter. Hon. Members who choose to vote against increases in funding to the NHS and health care are making a clear political statement by doing so, and that is to be regretted.
In the city that I represent in east Yorkshire, Hull, we have people who are severely disadvantaged in terms of the economic success that they enjoy, the jobs that they are able to get and the health care that they were able to access in the past. Examining and investing in public health in Hull is key to the future prosperity and regeneration of Hull and that part of East Yorkshire. The life expectancy of a man in Hull is at least two and half years off the national average. For a woman, the corresponding figure is just over a year. That says something about the health of people in Hull. We need to discover where health inequalities exist and address them.
In Hull we have single-handed GP practices, with GPs operating in small houses that they have changed into surgeries. Those are not suitable for the kind of health care that we need in 2005-06. In the past, the emphasis was on acute hospitals—district general hospitals. We will always need hospitals, but we also need to ensure that we invest in our community sector. I was pleased that there was some debate earlier about the LIFT programme and the money that the Government have identified to go into enhanced service delivery for GPs, linked to the wider regeneration of areas such as Hull.
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