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As we look to the future, this will become an increasingly ageing society. The number of people aged 85 and over has grown to a record 1.2 million. That is resulting in ever-increasing demands on the NHS, but also in many more hidden and vulnerable people—sometimes without family support—with whom the NHS must make meaningful contact. As in the past, the national health service must be reformed and expanded to cope with the changes. By 2025, the number of people aged over 85 will have increased by two thirds. Each of those people will need, on average, five times as much care as the average 16 to 44-year-old. An NHS that can cope with those pressures requires both investment and reform. In fact, the NHS’s ability to be reformed and to meet the challenges of the day is why it remains one of the most popular institutions in Britain.
During the 1980s and the early 1990s, NHS staff were let down by the Government. During the 1980s, the Conservatives managed to build just one new NHS hospital in Britain. Since Labour came to power in 1997, we have turned that decline around. By 2008, more than £90 billion will be invested in the NHS, in a huge range of services. As a result, the NHS is treating more people and treating them faster than ever before, with treatment free at the point of need and available to all.
Grant Shapps: Will the hon. Gentleman give way?
Andrew Gwynne: No, I will not.
Stepping Hill hospital is being rebuilt and Tameside general hospital has been approved for a massive £80 million private finance initiative investment programme. That will include the building of a new state-of-the-art health facility, including an expanded and improved accident and emergency department. The improvements being made to the NHS are, however, not simply a result of investment, but of careful reform. The Conservative party did not want careful reform. Just over a year ago, the Tories believed that the best way to help the people of Britain would be allow the wealthy to pocket NHS money, provided by hard-working families all over Britain, and take it away to subsidise private treatment. That would have left areas in which people have relatively poor health and low incomes, such as parts of my constituency, starved of much-needed funds. The Tories are still at it. Having voted against the extra investment in the NHS, they now want that money to be spent only in their areas, where deficits have accrued. They cannot campaign for more money in public while voting against it in the House of Commons.
Our challenge is to find the most efficient way of providing health care to all, not the fastest way to drain the NHS of funds. If NHS money is better spent caring for people in their own homes than in hospital beds in large general hospitals, that is what should be done. If the money is better spent on specialist units, that is what should be done, and if the money is better spent on an expanded and improved accident and emergency department at Tameside general hospital, that is what should be done—and that is what is being done.
A modern NHS requires a range of different services to provide the best care. If money is taken away from one service, it is not being cut or disappearing. It is being channelled towards a service that is better for more patients. The NHS survives through reform and investment. British society has changed immeasurably. We are living longer, becoming more demanding and expect state-of-the-art treatments when it is convenient for us, and rightly so. The people have not, however, changed their minds about the NHS. My constituents want the NHS. They want the first class state-of-the-art treatments that will soon be provided by the new £80 million investment at Tameside and by the new facilities at Stepping Hill, but they also want the freedom to choose when they want that treatment and whether they would rather stay in hospital or recover, supported by medical practitioners, in their own home. Many of my constituents are not the wealthiest people in Britain—far from it—but they deserve the best possible treatment.
The history of my Greater Manchester constituency is one of change. Denton was famous for making hats. Huge swathes of the population of Denton and Stockport were involved in hat manufacturing, as well as other textile and heavy industries. Today, the people of Denton and Reddish lead different lives, so the NHS must continue to find new ways to make itself accessible to people with varied lifestyles. It has been argued by many that the importance of choice in health care is exaggerated. No; choice in health care is not like choice in shopping—it is much more important than that.
Many people in my constituency—often those in the most deprived areas—are not sufficiently connected with doctors and nurses. Those connections must be strengthened for the sake of both my constituents’ health and the efficiency of health provision. If my constituents, some of whom are trying to hold down two or three part-time jobs, cannot choose when and where they and their families access health care, their quality of health and NHS money will be wasted. If a range of times and locations are not available to those in need of treatment and advice, appointments will be missed. When that happens, treatments and advice are not given, medical practitioners are not able to understand further their patients’ needs and public money is wasted. Without more freedom, many of my most vulnerable constituents will not access health care and health advice.
The health profile of England maps, which were published yesterday, show the problems that we still face, and I am well aware that my constituents face them every day. Like many northern areas of England, Denton and Reddish has higher obesity rates, more smoking-related deaths and, consequently, lower life expectancies than the English average. Men can expect to live for 74 years and women 79 years, but both figures are lower than the national and regional averages. The goal for the NHS should be to make it as easy as possible for those in need to receive the advice and treatment that they need to the end the health divide.
Under the Tories, the funding for hospitals was skewed towards richer areas, which embedded inequalities. The Labour Government are reforming the system because we believe that the divide is
unacceptable. Since my election, I have worked hard in my constituency to ensure that our local PCT and acute services are reforming their provision of care. The Labour record on expanding NHS capacity should not be in doubt. Labour health reforms have been, and will continue to be, changes for the better.
4.57 pm
Tony Baldry (Banbury) (Con): Various things have happened in the NHS in the past year. The crisis involving deficits affected many NHS trusts and demonstrated itself through the closure of many community hospitals, or, in my constituency, the non-opening of a new community hospital, which the right hon. Member for Darlington (Mr. Milburn) had promised from the Dispatch Box when he was a Health Minister. He said that we would have a new and enlarged community hospital in Bicester, but that has not happened and clearly will not now happen. The Secretary of State’s speech gave us no explanation of why the Government have suddenly turned their back on community hospitals.
We are now moving towards another trend of downgrading so many services in smaller general hospitals that they effectively cease to be general hospitals. Such a thing is proposed and threatened for the Horton general hospital in Banbury. The hospital serves a large catchment area—much of south Northamptonshire, much of south Warwickshire and west Oxfordshire—which is why today my right hon. Friend the Member for Witney (Mr. Cameron), my hon. Friends the Members for Stratford-on-Avon (Mr. Maples) and for Daventry (Mr. Boswell) and I have submitted a joint observation to the Oxford Radcliffe Hospitals NHS Trust. If hon. Members want to read it in full, it can be found at www.save-our-services.com. The important point is that we say:
“We believe that the Oxford Radcliffe NHS Trust, the Strategic Health Authority and the Government should be seeking to ensure that we can keep the Horton as a General Hospital delivering all the clinical and medical services that one would reasonably expect a local General Hospital to deliver”,
The tragedy about the proposals is that they are not a consequence of the trust saving particularly large sums of money. In fact, over a full year, the trust would save only some £1 million to £1.3 million, which is between 0.25 to 0.5 per cent. of the total Oxford Radcliffe Hospitals NHS Trust budget. If the trust, the strategic health authority and the Government had the will, they could find those savings elsewhere in the trust budget without leading to a significant downgrading of services at Horton general hospital—a downgrading that will have a major impact on local people.
The downgrading starts with the downgrading of paediatric services. The sadness of the matter is that long ago in 1974 a young boy from Bloxham, a village just outside Banbury, died. The then Secretary of State, Barbara Castle, ordered an independent inquiry that found that there should be 24/7 paediatric services at Horton general hospital to serve the wider catchment area. Under the proposals, we will effectively go back 30 years to the period before Barbara Castle’s decision. The knock-on effect of not providing 24/7 paediatric services is that one can no longer provide obstetric services, because there is no special care baby unit, yet
we are proposing to set up the largest midwife-led maternity unit in the country.
The consequence of the proposals is that 58 GPs—I hope that the House takes note of that number—have collectively made a submission to the Oxford Radcliffe Hospitals NHS Trust, in which they say in excoriating terms that the proposals are unsafe and inhumane. The GPs make excoriating criticism, too, of the fact that the consultation has been carried out with total disregard for any medical or professional consideration:
“Local services for children are the key issue around which many other services hinge. They have a significant impact on the viability of other hospital departments especially maternity and accident and emergency.
It is evident that paediatric emergencies such as meningitis, septicaemia, respiratory distress, and serious poisoning may all incur dangerous delay in receiving appropriate care if the nearest paediatric department is an hour away.
Serious, life-threatening illnesses do not confine themselves on the working day.”
On maternity services, the GPs say that
“under the proposals, mothers who required unexpected medical care during birth would need rapid transfer to Oxford...This would carry significant risk and would be inhumane.”
Even on the trust’s own figures, a very large number of mothers who elected to have their babies at the Horton hospital would have to move to the John Radcliffe hospital in Oxford during labour. That is wholly unacceptable in the 21st century.
The issue is of concern to all political parties locally. Indeed, the “Keep the Horton general” campaign, under the excellent leadership of local Labour councillor George Parish, is supported by people from every single political party. Thousands of people marched through Banbury and rallied in the local parks in support of the issue, which is a completely cross-party concern. It is not surprising that, without dissent, Cherwell district council, said:
“The proposals in the consultation document potentially put patients at risk, fail to deliver the aims of the ORHT”—
that is, the Oxford Radcliffe Hospitals NHS Trust—
“are contrary to current Government Policy, place an unnecessary cost burden on the local population and in no way meet the needs of the local community now or in the future, as such they are wholly unacceptable to this Council.”
They are also wholly unacceptable to the people whom the Horton general hospital has served for the past 150 years. Local people are determined to do everything they can to ensure that the Horton hospital remains a general hospital.
I also hope that Ministers will recognise that the Oxford Radcliffe Hospitals NHS Trust has failed to carry with it any medical opinion. GPs can speak publicly, and they have done so collectively. But another concern that I wish to draw to the attention of the House is that many of those who work for the trust have felt unable to speak openly because of potential disciplinary and other pressures. During the summer I had a number of meetings with consultant specialists at the Horton and the trust, but they wanted to have them away from the hospital, and in private. I asked them, “Why on earth are you unwilling to speak on the record?” They replied that they feel that they would be discriminated against as a consequence. That is wholly
unacceptable. The last time I had meetings of that kind was when I talked with dissidents in eastern Europe before the fall of the Berlin wall. That should not be happening when people are talking about reorganisation of general hospitals in the 21st century.
The proposals will lead to the downgrading of an excellent general hospital to such an extent that it will no longer be a general hospital in the way that people understand what a general hospital is; it will be merely a collection of medical services. The proposals are completely friendless and completely unsupported by medical opinion locally.
I very much hope that in due course the overview and scrutiny committee of Oxfordshire county council refers the proposals to the Secretary of State, and I hope that the very least that the Secretary of State will do is refer them to the Independent Reconfiguration Panel. But I would also hope that before then Ministers will have the nous to wake up to the fact that 58 GPs are opposed to the proposals; there is not a single dissenting GP in the entire area served by the Horton general hospital—there is not a single voice supporting the proposals. In the face of such widespread medical opposition, it might be sensible for the Department to intervene, and to suggest to the Oxford Radcliffe Hospitals NHS Trust that it should think again about this matter and seek to ensure that we keep the Horton general a general hospital.
5.7 pm
Kitty Ussher (Burnley) (Lab): I welcome the opportunity to speak in this debate. I also welcome the fact that the debate has been secured on an Opposition motion because there are a number of questions that the Opposition need to answer about their policies and their record, and the public should hear those answers. Therefore, I have a number of questions for them.
However, let me first talk about our record. As we have heard, NHS spending under this Government has trebled after inflation, from £30 billion to £90 billion.
Mr. Graham Stuart: It has doubled.
Kitty Ussher: No, it has trebled in real terms. I thank the hon. Gentleman for his sedentary intervention, but it will very shortly have trebled in real terms. The number of doctors has risen by 32,000 and the number of nurses by 85,000. We are also meeting our targets on waiting times—we no longer have the shame of front-page headline news of horrific waiting times stretching on for years.
All of those are points of process. The desperately important issue, which we are not hearing about from the Opposition Benches, is that the survival rates and outcome rates are improving. That is what really matters. Under this Government, if someone has a heart attack, they are one third more likely to survive than they would have been under the Conservative Administration. People are also seven times more likely to survive cancer. People are living longer because of the changes that we have made, and will continue to make, in the NHS.
Mr. James Gray (North Wiltshire) (Con): The hon. Lady is making an interesting point, but would she accept the following two points? First, at least part of that greater survivability comes about as a result not of the Labour Government, but of developments in medical science that would anyhow have extended our lives, and secondly, even so, our survival rates are significantly lower than those of the whole of the continent of Europe.
Kitty Ussher: It will not surprise the hon. Gentleman to learn that I do not accept his argument. I agree that medical science advances, but that is because we fund medical science; it produces drugs that cost money, and we are spending the money. It is not inevitable that survival rates improve. Mortality rates are rising in some countries and I am extremely proud that we are not one them, because of the work that Labour Members are doing.
Greg Clark (Tunbridge Wells) (Con): Can the hon. Lady name a continental European country where mortality rates are actually rising?
Kitty Ussher: I do not know the figures for every country, but I am happy to talk to my colleagues on the Public Accounts Committee about this issue later.
How have we achieved these improvements in outcomes in the NHS? There are three factors, the first of which, of course, is the money. It is not by chance that these improvements have happened. On listening to some of the contributions from Conservative Members during this debate, one would think that we have somehow magically profited from benign economic circumstances and that, had they been in the same situation, they, too, could have done it. It is our economic policies that have led to this situation, but most importantly, we raised taxes, which Conservative Members opposed, to do it. This is not chance—it is deliberate action.
The second way that we have achieved our outcomes is by setting targets. We have not just thrown money into the system—the Government have sent an extremely clear signal about what we want devolved management to spend that money on. I hope that the Conservative Front-Bench spokesperson will say later which of those targets they would cut, given that they are on record as saying that they would do so. Would they cut our target of a mere 18 weeks from GP referral to actual operation—down from 18 months under the previous Government? Would they cut our target of seeing accident and emergency patients within four hours, which is practically being met, I am proud to say, in my constituency? Would they cut our target to have urgent cancer cases seen by a specialist consultant within two months, which I believe is also largely being met in my constituency? We need the answers to those questions because these are the issues that matter to the public; yet the Conservatives say that targets do not matter to them.
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