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The service is worse than it was 25 years ago, and I am sure that the Minister will want to apply that to the whole service, because 25 years ago if people needed a doctor in the night, they could get one. Then, we had a domiciliary calling service. Try that today. On dentistry, 25 years ago, I never had complaints that people could not get on the list of an NHS dentist, but now, of the 14 dental practices in Suffolk, Coastal, only one is taking on new NHS customers. So, I wrote to the Minister’s predecessor, who did something that I do
not think this Minister would do—he wrote me rather a nasty letter saying that I could have found out about that myself by getting in touch with NHS Direct.
I had written about a constituent in Felixstowe who was unable to get on a list for an NHS dentist. That Minister sent me a list of eight NHS dentists who were, he said, within 10 miles of my constituent’s home. Four were within 10 miles and they were indeed NHS dentists, but none was taking on new patients, at least for the moment. I looked with enthusiasm to the other four, only to find that they were all in Frinton.
NHS Direct does not realise that there is a river between Felixstowe and Frinton or that it is some 50 miles to Frinton and 50 miles back. Unless people can swim, they cannot get an NHS dentist in Felixstowe. This Minister has to bear the brunt of the fact that we in my part of the country do not believe that NHS Direct understands.
What makes the difference? Why do we not get the money? Why have our community hospitals not had any of that £300 million? Why are our community hospitals closed? Why are other community hospitals kept open? Could it be that the one thing that distinguishes most constituencies in Suffolk is their political representation?
I was chairman of the Conservative party, and during my chairmanship I would neither have asked, nor been allowed, to play any part in the decisions on the closure of hospitals. I have talked to my colleagues who have been chairman of the Conservative party and they assure me that the same was true of them.
I spent some eight or nine years as a Cabinet Minister. As Secretary of State for the Environment, I would no more have allowed a political person to come in and decide how I would work out the money for local authorities than I would fly. The same was true of deciding whether to close or open MAFF offices when I was Minister of Agriculture, Fisheries and Food. I would have considered that dishonourable and wholly unacceptable.
Indeed, when I was making decisions on supermarkets and out-of-town development, I remember insisting that my officials remove the names of the supermarket companies, because one naturally had those that one liked and those that one did not. I believed it proper always to make those decisions at arm’s length.
I am not in any way criticising the Minister, but when we discover that hospital closures are discussed by Ministers in the presence of the chairman of the Labour party, the right hon. Member for Salford (Hazel Blears), we must think seriously about a connection between political representation and the closure or opening of community hospitals. That connection has been made clearer by the list produced by The Times. Surely it is not a matter of accident that all the closures have been in Conservative-held seats, except for a small number in Liberal Democrat-held seats. As I understand it, none of the closures so far has been in a Labour-held seat. I hope that the Minister will tell us how much of the £300 million is earmarked for Hartismere and Aldeburgh, the two community hospitals left in central and eastern Suffolk.
What is the effect of all that on the confidence of my constituents? We have an older population than almost anybody else, and we get less money. We have a more expensive service than almost anybody else—that is on the Government figures—and we get less money. We have a real problem with one-person households over the age of 65, and we get less money. All our PCTs and hospitals have gone into the red and have historic debts to pay off. The Government have taken no responsibility for that at all. All they have done is make our situation worse by fining Waveney, which had got itself into the right position, and, as far as the rest of us are concerned, by forcing people to pay back the money in a single year.
I therefore have five simple questions to put to the Minister. First, of the four community hospitals, Beccles, Lowestoft, Halesworth and Southwold, none of which is currently threatened, two are in the constituency of Suffolk, Coastal held by the Conservatives, and two are in the marginal constituency of Waveney, which will not be held by the Conservatives until after the next election. Does he therefore accept that we will watch carefully to see that all four remain open and that a choice is not made on the basis of political representation or the nature of marginal seats?
Secondly, will the Minister agree to go back, look at the debts and recognise that the local PCTs are underfunded? To enable them to return from their current terrible base to some kind of service that equates with what was there 25 years ago, and certainly that equates with what the Labour Government would no doubt say they are proud to have achieved in other parts of the country, does he agree that those debts will either be cancelled, as has happened in a number of cases, or paid without penalties over the next five years?
Thirdly, the Minister of State, Department of Health, the right hon. Member for Doncaster, Central (Ms Winterton) told the strategic health authority that the old services would not be closed before the new services were in place. In front of me and the hon. Member for Ipswich, who was present on that occasion, she said clearly that that was what should happen, and the SHA said that it could not happen, because it did not have the money. Does the Minister therefore accept that the services will not be closed until working replacements are in place throughout the county of Suffolk?
Fourthly, will the Minister consider the appalling position of midwives? It will now be almost impossible for women to have babies at home in many rural parts of Suffolk because of cuts, reduction in grading and the fact that that is another area in which savings can be made.
Finally, will the Minister promise me that he will talk to Suffolk county council about the pressures that are now being exerted on its social services department? The department is already hugely overspent, and has already been cut because of the Government’s pusillanimous post-election arrangements for the county council. Will he promise to sit down with members of the county council and establish what extra help it can be given to deal with the situation with which it has been left after the closure of so much of Suffolk’s heath provision?
I have said all that without going into the detail of the appalling cuts affecting those who are least able to defend themselves—the mentally handicapped in my constituency and elsewhere. I must tell the Minister that I cannot think of a circumstance in all my years as a Member of Parliament in which I have seen a national service that is much prized, much loved and much depended on destroyed by an accounting system that is manifestly bent away from the needy in Suffolk.
5.51 pm
Mr. Richard Spring (West Suffolk) (Con): I congratulate my right hon. Friend the Member for Suffolk, Coastal (Mr. Gummer). I hope that the Minister heard the genuine passion in his speech. It is shared by the other Conservative Members in the county, all of whom face the same huge problem.
Let me take this opportunity to pay tribute to the staff of the NHS in Suffolk. My right hon. Friend talked of the staff cuts at Ipswich hospital. My hon. Friend the Member for Bury St. Edmunds (Mr. Ruffley) knows from his constituency what is happening at West Suffolk hospital. I can tell the Minister that the collapse in morale among wonderful, caring professional people—our nurses, doctors, ancillary workers and community nurses: all those who make the NHS work—is devastating. They come up to us in the street, sign petitions and take part in marches. They simply cannot understand that in this country, the fourth richest in the world, we are seeing the decimation of something that is of great value and cherished by the people of this country: our national health service.
I think the Minister will agree that the clergy are not always ready to come forward on issues that may be controversial. I have lived in the county of Suffolk for a long time, and I am sure that my right hon. Friend finds the same. The clergy in the western part of Suffolk were so horrified by what was happening to the health service that, as a result of pressure from parishioners who approached them expressing concern about the decimation of services, a petition was organised throughout western Suffolk and signed by more than 1,000 people. I believe that that is unprecedented in the history of our county.
I became a Suffolk Member of Parliament in 1992. At the time there was a discussion about reorganisation, and I witnessed the disappearance of West Suffolk health authority. I was told that it was necessary for reasons of economies of scale, procurement and all the other things that would benefit a larger, pan-Suffolk health authority. Not many years ago, against the professional advice of people in the NHS and the county and, indeed Members of Parliament, five primary care trusts were created—all with their chief executives, staff and headquarters, and with all the attendant costs—allegedly to bring health services closer to the people whom they served. Well, of course, we then landed up with three PCTs. Now guess what: we are back to square one and to having only one PCT. Why? It is because creating services allegedly close to the people somehow has not worked. We are now back to large-scale procurement, economies of scale, cheaper purchasing and all the rest of it.
Mr. Spring: I will come on to the question, you bet, of new offices.
My right hon. Friend the Member for Suffolk, Coastal talked about the funding formula. I happen to have been a member of the Health Committee before 1997, and I think I have understood something about the funding formula for the NHS. When there was a change of Government and the funding formula was modified, my hon. Friends the Members for Bury St. Edmunds (Mr. Ruffley) and for South Suffolk (Mr. Yeo) went to see the then Secretary of State for Health to point out the very issue that my right hon. Friend has talked about—the impact that the funding formula would have in areas where the age profile of the population was older than in many parts of the country. He gave the assurance that it would be monitored and since then, as the Minister will confirm, there have been many changes which have further enhanced the gap between the so-called deprivation index and the age profile. This is at the heart of the problem.
In 2007-08 in my constituency the per capita spend on the NHS will be £1,156. In the Prime Minister’s constituency it will be £1,576. That is a £420 difference, up from £391 in the current year. The figure in my constituency is comparable to that of my right hon. Friend the Member for Suffolk, Coastal and my hon. Friend the Member for Bury St. Edmunds and is well below the national average, for the reasons that my right hon. Friend described. Of course, that is at the heart of the problem. The funding formula is skewed in a way that has made the adequate funding of the NHS in Suffolk well nigh impossible.
We have heard something about the strategic health authority. I invited members of the SHA in the first instance to come to London to talk about what very obviously two years ago was going to be a crisis in our county. They came, and I well remember the meeting because there was definitely an atmosphere of “You Members of Parliament are being hysterical. We are carefully watching the situation.” They showed the most extraordinary complacency. However, something must have dropped—the penny or whatever—because only a few weeks later the chairman and chief executive resigned. Perhaps they had begun what they should have done, which was to look at the figures for what was going on in the county, and they did not want to be around when something started hitting the fan.
We had another meeting subsequent to that, with the new chief executive. I remember the atmosphere there as well. It was extremely aggressive. “We are sorting this out”, they told us. They had recovery plans. The idea that there would be massive deficits was a huge exaggeration, because the authority had the matter under control. That simply was untrue. At the most recent meeting there was an admission of total despair and an acceptance that everything that we had forecast to the SHA had materialised. If a strategic health authority could not look at the figures from all the PCTs in the then three counties under its control and see what was so screamingly obvious to the Members of Parliament and which it should have picked up—that a crisis was developing—I have no understanding of what SHAs exist for. They simply have not been doing their job. That is exactly why they should have no right to exist. They are now conducting
an exercise to look at the future of our acute care services in the region. I simply dread to think what they will do, given the performance that we have suffered from these people in the past.
Let me deal with the extent of the deficits. The county of Suffolk has some 650,000 residents. It seems to me as we look at the figures that the current deficit in the county is about £64.5 million—the cost of the creation of the new PCT. That includes the health trusts and the hospitals. We know, for example, that Suffolk West PCT has passed on a deficit of £16.1 million to the new PCT; and we know that in the east of Suffolk, the PCTs have passed on a total deficit of—
It being Six o’clock, the motion for the Adjournment of the House lapsed, without Question put.
Motion made, and Question proposed, That this House do now adjourn .—[Mr. Heppell.]
Mr. Spring: The deficit in east Suffolk is £35.4 million, with the deficit in the West Suffolk hospital trust at £14.4 million, leaving a total of about £50 million. We understand—and my right hon. Friend the Member for Suffolk, Coastal will know that the information has been checked and published—that the shortfall in the Ipswich hospital may reach something approaching £50 million in the course of next year. We are therefore talking about a huge emerging deficit on top of the existing one and the possibility of some so-called user charge of 10 per cent. That would mean a staggering deficit in the region of £100 million.
I shall put a further point to the Minister. We hear about savings, but it is rather like putting something that costs £1 up to £1.50, then reducing it to £1.40 with an announcement of a 10p saving. That is exactly the logic of the situation. There have indeed been attempts to make savings, but the pattern of deficits—both current and, in particular, historic—has continued to rise.
We have had some discussion of rehabilitation beds and I must say that I took some comfort from the Secretary of State’s remarks that community hospitals should not close on short-term financial grounds. Newmarket hospital in my constituency, for example—a 10-year-old hospital that is much valued and cherished by the local community—is in danger of losing its rehabilitation beds. The bed spaces have to be used because of the repeated crises happening at the West Suffolk PCT and at Addenbrooke’s—almost constantly on black and red alerts. In those circumstances, they have to move people into the bed space simply to accommodate individuals.
In respect of the Newmarket hospital, 1,000 people marched in protest at the removal of these beds and a massive petition was organised. The problem is well known to everyone who works in the hospital, where morale is, of course, extremely low. As my right hon. Friend rightly said, if the beds go, it is a fantasy to suggest that there are appropriate support structures in the local community. There are already not enough carers and the idea that somehow this is all about modernising care or bringing it into the 21st century with all its support structures is simply untrue. We have heard the warnings from Lord Bruce-Lockhart about the pressures on social care budgets all over the country
in the forthcoming year. Why has all this happened? It is partly to do with the funding formula, but it is difficult to get proper and adequate information about the real extent of the deficit. The proof of the pudding lies in the cuts in services and the sackings of staff.
We now have a new Suffolk PCT and the first thing that it did was to create a new headquarters—an interesting decision. If a family is in great difficulties, it does not move house, but makes do. I make that point very simply and we look forward to a meeting with the new chief executive of the new PCT, at which a whole series of important questions will be asked.
In conclusion, the Minister should recognise that it is a truly extraordinary situation when people who believed that the health service would protect them find that it is being demolished in front of their eyes. Of course there have been some improvements in aspects of primary care and I accept that there have been improvements in other spheres, but our acute care services are under threat and it now looks as if our community beds are very much under threat. The deficit and the debts come together to create an impossible situation. Ultimately, the problem comes down to fairness. It is about fairness to people living in Suffolk who are watching what is happening to their health service and who look at other places where the funding formula does not have such a negative effect. They feel that they are being treated extremely unfairly.
Mr. Deputy Speaker (Sir Alan Haselhurst): Order. Before I call the next speaker, I ask Members to recognise that the Minister may need a little extra time to reply to the right hon. Member for Suffolk, Coastal (Mr. Gummer), who initiated the debate.
6.5 pm
Chris Mole (Ipswich) (Lab): Thank you, Mr. Deputy Speaker. As you may gather, it was not my intention to intervene in the debate, but given the length of time available I want to address some of the issues that have been raised.
I am particularly concerned about the co-ordinated attack that has been made, because I was the victim of such an attack from Conservative Members when I was the leader of Suffolk county council. They cloned a debate from Kent, in which the county council had been attacked by Kent Tory MPs, so it is a pity that such an attack has been made again today.
The comments of the right hon. Member for Suffolk, Coastal (Mr. Gummer) were unfortunate, especially because, as a constituency MP, I have regularly engaged with my health trusts—the Ipswich primary care trust, which was the predecessor to the Suffolk East PCTs, the Ipswich Hospital NHS Trust and the Suffolk Mental Health Partnership NHS Trust—and my understanding is that until some of the events described, the right hon. Gentleman had not set foot in Ipswich hospital for some years. The partisan comments we have heard this evening are regrettable; they have avoided a balanced look at developments in our local health economy.
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