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Andrew Gwynne (Denton and Reddish) (Lab): I am delighted to follow the hon. Member for Sevenoaks (Mr. Fallon), who made a thoughtful speech, especially on localism. I pay tribute to my hon. Friend the Member for Warrington, North (Helen Jones)she is popping out of the Chamber brieflywho made an excellent speech with which I fully concurred.
I am grateful for the opportunity to speak in the debate. It has not been long since other hon. Members and I had the opportunity to hold a thorough debate on the NHS. Nevertheless, I welcome the chance to contribute during the Queens Speech debate.
The major reforms that are now occurring in our constituencies are having substantialin my view, positiveeffects on care, and I welcome that and the fact that the important issues that affect health care in the years to come will continue to be debated in the House.
The NHS is both a huge institution employing around 1.3 million people, and a vast array of local institutions in every corner of the United Kingdom. It is important to take opportunities such as the one afforded by the debate to highlight local perspectives on the changes. After all, our constituents experience the NHS through local services. It is also important to ensure that our local experiences are expressed in a wider context. I do not, for instance, think that it is acceptable to complain about service rationalisation in areas that have been allowed to overspend their budgets for many years while simultaneously opposing and
criticising the increased investment that the Government have championed.
We hear many conflicting arguments from the Opposition. Conservative Members claim that, if ever back in government, they would introduce an independent NHS body to distribute funds; share the proceeds of economic growth between spending and tax cuts; and ensure that wealthy areas that traditionally overspend have all the resources that they desire. Those are obviously conflicting aims. It will always be impossible to create financial discipline in the NHS if we do not ask primary care trusts to keep to their budgets, just as it will be impossible to retain current service levels if public expenditure is cut by £17 billion, as the Conservative partys policy commission recommends.
Whether a formula is used to allocate funds or vast sums are spent on a new independent body to do the job, it will always be important for the constituent parts of the NHS to operate within their means. Our aim should surely be to provide the NHS with generous funding so that it continues to offer a world-class service to its patients, free at the point of use, while ensuring that NHS bodies spend their budgets sensibly, in a way that provides the best health care for the most people, and without compromising the resources available for other areas of the country.
The Government must deliver fairer funding in the future by moving PCTs towards their proper share of NHS resources. It is vital that the NHS is brought back into balance to achieve a fairer funding settlement for our constituents. In the past, overspending organisations had no incentive to improve because they knew that they would be bailed out by underspending parts of the NHS. That is unfair. When we examine the matter carefully, it becomes clear that the overspenders are mostly in areas with fewer health problems, while the underspenders are mainly in the north of England and the midlandsgenerally areas with far greater health needs.
If local service rationalisation and reform is necessary to stop overspending in wealthy areas, that must be done. Large organisations with major budget problems will understandably take some time to do that, and the Government have promised support to help them succeed, but they must get back into balance as fast as possible. It is simply wrong to expect the PCTs and the acute trusts that serve my constituents to continue to postpone improvements in care for their patients for the sake of those that continually overspend.
Although much has been done, health inequalities in this country remain significant, with residents of the poorest urban areas having the lowest life expectancies. New efforts must be made to tackle those inequalities. My constituency of Denton and Reddish has higher obesity rates, more smoking-related deaths and, consequently, lower life expectancies than the English average. It is my job to ensure that the most vulnerable people in Denton and Reddish get the support that they need and it is unfair to continue to ask the Tameside and Glossop primary care trust, Stockport PCT and my constituents to fund overspends in areas where people can expect to live significantly longer.
The money that the Government continue to invest has delivered vast improvements in health care.
Stepping Hill and Tameside general hospitals, which serve my constituents, have received good and excellent ratings by the Healthcare Commission in respect of quality of service and use of resources. Those hospitals were two of only 10 health care organisations in the north-west to acquire that positive seal of approval. I want us to ensure that more hospitals in the north-west of England have the same opportunity to reach that level of care for their patients. In particular, I want to ensure that the Tameside general hospital tackles those areas where it still needs to improve its performance. My hon. Friends the Members for Ashton-under-Lyne (David Heyes) and for Stalybridge and Hyde (James Purnell) and I recently raised those problems with Ministers. There are certainly issues that Tameside general hospital needs to resolve.
Society is changing and hospitals and clinics will have to spend their allocated budgets in a way that addresses the needs of the patients whom they treat, just as Stepping Hill and Tameside hospitals do. Since coming to power, the Government have increased the number of people working in the NHS by 300,000, but increasing staff numbers and keeping large district hospitals open should not be seen as the end goal. Yes, in many cases, keeping staff numbers high and large successful hospitals open are the best ways to achieve NHS aims, but they should not be seen as ends in themselves. The Government must ensure that the best structures are in place to provide health care to all who need it.
If NHS money is best spent caring for people in their own homes, rather than in hospital beds, that is what should be done. If money is better spent on small specialist units, rather than on large general hospitals, that is also what should be done. Similarly, if money is better spent on new services at general hospitals, as with the new, improved accident and emergency department at the Tameside that is part of the £80 million private finance initiative at the hospital, or the newly rebuilt Stepping Hill hospital, that is what should be done.
The Government are putting unprecedented levels of funding into the NHS. Investment has doubled since 1997 and it will have trebled by 2008 to more than £90 billion. That will bring it up to the European average for health care spending, but such an unprecedented level of taxpayers money has not been injected into the NHS to keep it standing still. It has not been invested to retain services for their own sake. It has been invested so that if more efficient ways of providing health care exist, the NHS can afford to pay for them.
If we value the way in which the NHS is structured today or was structured 60 years ago more than we value its core values, we will let our patients and constituents down. The NHS is not a museum for outdated methods, but an institution that must be continually reformed as new demands are placed on it. To ensure that the NHS continues to deliver high-quality care, it must respond to changes in patient needs and developments in medical technologies.
By 2025, the number of British people above the age of 85 will be up by two thirds, with the average 85-year-old costing the NHS five times more than the average 16 to 44-year-old. With an ageing population such as ours, more resources will have to be directed to helping people in their own homes, rather than
admitting them to hospitals for long stays. With new technologies to support care at home, it will simply become more efficient to treat patients in that manner.
GPs in Denton and Reddish are increasingly providing minor surgery. Community matrons are working in Tameside and Stockport to help people better manage their long-term health conditions such as asthma, heart disease and diabetes. That will improve peoples health and avoid unnecessary hospital admissions. When people do have to be admitted to Stepping Hill or Tameside general hospital, more procedures are being carried out as day cases. Also, better drugs and rehabilitation mean that the number of days that my constituents have to spend in hospital will continue to decrease.
Committed, highly trained staff have been integral to the success of both Stepping Hill and Tameside general hospital, just as they are integral to the overall success of the NHS. As I mentioned earlier, there are now about 300,000 extra staff working in the NHS than there were in 1997, including 85,000 more nurses and 32,000 extra doctors. In the north-west of England alone, there has been an increase of nearly 49,000 staff. The extra money put into the NHS has allowed the Government to invest more than £1 billion in improving pay and working conditions across the NHS.
The minimum hourly pay for all staff is now up by 35 per cent. in real terms since 1997. The starting pay for newly qualified nurses is now £19,166, up from £12,385. Qualified nurses now earn on average £30,890, up from £20,760, and nurse consultants can earn up to £60,000. Front-line midwives can now earn up to £31,000, up from about £19,000 in 1997. In addition, all staff get a minimum of 35 days holiday, which is up from 30 days. The Government have also improved access to flexible working and affordable childcare.
When we debated the issue in October, some Opposition Members called current NHS productivity into question. Indeed, the shadow Health Secretary did so today. Conservative Members deplored the fact that new investment money had gone on substantial pay increases for front-line staff and argued that those pay increases had not been matched by increased activity. I would argue that, given the indefensibly low wages that NHS staff received before 1997, it was the Labour Governments duty to increase rates of pay. NHS staff deserve the pay increases that they have received since 1997, and it is right to take pride in the numbers of new NHS staff and the fair wages that they now receive.
Productivity per pound is simply not a useful indicator when assessing NHS wages. In view of wage rates in 1997, it can only be concluded that many nurses were committed to working for their communities in spite of their salaries rather than for them. It may be considered good management by some to get nursing care for the cheapest possible price, but my hon. Friends find that simply unethical.
Mr. Burns: I have been listening to the hon. Gentlemans sanctimonious mutterings, so will he comment on the fact that the nurses pay increase this year was lower than the rate of inflation? Does not that amount to getting them on the cheap?
Andrew Gwynne: I said what needed to be said about pay in the NHS. Investment has been put into salaries and I recall Conservative Members bemoaning the fact on their Opposition-day debate in the previous Session. I have to say that, at the end of the day, NHS staff are doing a brilliant job and we should not forget that.
It is also our responsibility to ensure that we do not take part in scaremongering for political gain. Redundancies are simply not taking place across the country at the rate that the Conservative party claims.
Mike Penning: I thank the hon. Gentleman for being so generous. At this present moment there is a meeting at West Hertfordshire NHS Hospitals Trust to decide to close Hemel Hempstead hospitalthe trust has already put that out in the public domainand 750 doctors, nurses and technicians as well as porters and other unskilled staff are to be made redundant. That is a fact; it is not something we have made up. What is the point of going on about the money that they are going to get when they are to be made redundant this afternoon?
Andrew Gwynne: I am very sorry to hear about that case in the hon. Gentlemans constituency. I do not know the bigger picture of the reconfiguration of health care in his region, but I do know that in the south-east or south-central areas there are very few compulsory redundancies in comparison with the numbers claimed in the Conservative partys press releases. That is a fact also, even if the hon. Gentleman does not like it.
A small number of jobs have been lost, but nowhere near as many as the number suggested by the figures that the shadow Health Secretary quoted. Strategic health authorities have reported 903 compulsory redundancies between April and September this year, but eight out of every 10 of those redundancies will have been among non-clinical staff. In the north-west, there were only four compulsory redundancies among clinical staff during that period. Change can be difficult, but when society changes, in both age and expectation, that change is vital.
The NHS continues to improve for patients and staff. It is important not to see every job loss as a sign of failure. No hon. Member likes to see redundancies, but the number of jobs that have been lost in the NHS is small when compared with the increase in overall manpower since 1997. The hard work and dedication of NHS staff, backed by Labours investment and reform, are transforming patient care year on year. Let us be clear: without the staff, none of what has been achieved by the NHS would have been possible.
Her Majestys Gracious Speech declared that a new mental health Bill would be introduced in this Session. That was a Labour party manifesto commitment and I very much welcome the news. New legislation will do much substantially to bolster the Governments commitment to patients rights and public safety. The mental health Bill will address concerns about public safety and keep pace with the growth of community-based treatments. Increased supervised treatment in the community will ensure that treatment regimes are kept to and will help prevent deterioration in patients health. I very much welcome the Bill. If the community is the best place to treat an individuals mental illness, it is vital both to ensure that the patient receives the care that they require and to build confidence among the public that the individual will be properly supervised.
The Bill is in addition to the massive improvements that have affected my constituency, along with the whole country. New reforms will ensure that improvements on the same scale continue in the future. Virtually no one waits more than six months for an operation now, with the average wait for an operation being only 7.6 weeks. Patients can now expect a maximum 13-week wait for an out-patient appointment, with the average wait being only eight weeks. More than 99 per cent. of people with suspected cancer are seen by a specialist within two weeks of being referred urgently by their GP. Nearly 99 per cent. of people with cancer are treated within 31 days of diagnosis and more than 91 per cent. of people are treated within 62 days of being urgently referred by their GP. Some 19 out of 20 patients are seen, treated and discharged from accident and emergency within four hours. More lives are being saved. Deaths from the big killers, such as cancer and coronary heart disease, are now falling ahead of target.
Reform will bring even more improvement to NHS care. The Government are working towards their goal of 18 weeks between GP referral and operation. Choice will be a major driver to deliver that radical improvement. My constituents want more choice about when and where they receive treatments. They want more care in their local communities and at home. The choices that they will make will demonstrate that our collective public services can meet their personal needs and aspirations.
Choice and reform are integral to improvement, whether we are discussing the hard-working single parent who wants to be treated in a fast and efficient way in a treatment centre near their work, rather than at home, or diabetes patients who want to access their medical records online in order to take them to a different GP, as the patients of Haughton Green medical centre in my constituency now can. Choice and freedom will lead to improvement. If we give patients the medical services that they want, rather than the ones that Whitehall thinks that they want, money will be saved, fewer appointments will be missed and my busy and hard-working constituents will receive the treatments that they need, when and where it is convenient for them.
Our goal must be to deliver the best possible care for patients and the best possible value for money for taxpayers. The values of the NHS must remain the same. It is those values that will ensure that future generations can receive free health care at the point of
use, just as their relatives received it 60 years ago. It is those values that must be protected. It is through careful reform that they will be protected by this Labour Government.
Mr. Simon Burns (West Chelmsford) (Con): I am delighted that a day of the debate on the Queens Speech has been allocated to health and education. Both are close to the hearts of all our constituents, and both suffer from considerable problems, as well as enjoy successes.
As the hon. Member for Denton and Reddish (Andrew Gwynne) said towards the end of his speech, we share a common philosophy and principle about the health service. We share a strong belief that the health service should be free at the point of use for all those who are entitled to use it, with the exception of those aspects of the health service thatdating back to the days of Hugh Gaitskell, Nye Bevan, Harold Wilson and John Freemanhave traditionally not been 100 per cent. free, such as prescriptions.
I was interested to hear the Government give a commitment in the Queens Speech to introduce legislation to provide a better framework for those suffering from mental illness. The recent history of attempts to introduce legislation to update, modernise and make more relevant the Mental Health Act 1983which was the last major piece of legislation governing the way in which we treat and look after people suffering from mental illnesshas been long and chequered. The proposals have received pre-legislative scrutiny and there has been a draft Bill, which has aroused a considerable amount of controversy in certain quarters. The Government have considered the legislation and Opposition parties of all complexions have voiced their concerns and support where appropriate.
I am delighted that the Minister of State, Department of Health, the right hon. Member for Doncaster, Central (Ms Winterton) is in her place. However, I do not wish to devote my speech to the ins and outs of the Bill, which is published today, except to say that the overriding desire must be to help to provide the finest treatment possible to those suffering from mental illness, rather than getting the balance wrong and looking at the issue too much in the context of the criminal justice system. However, I accept that there are aspects of mental health care and treatment that will inevitably involve the criminal justice system. We must not lose sight of that.
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