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“We have an impressive track record of achieving national targets and delivering financial balance. The SHA was categorised as ‘high performing’.
We are however the worst funded SHA relative to the national capitation formula which seeks to enable a fair, equitable distribution across the NHS.
Kettering General Hospital for example has a reference cost index of 89. Indeed North Northamptonshire is our most pressurised health community. Northamptonshire Heartlands PCT which covers this population (including Corby with its severe health problems) is 32 million pounds (9.9%) below capitation.”
Mr. Jeremy Hunt (South-West Surrey) (Con): Will my hon. Friend give way?
Mr. Bone: I am afraid that I will not give way, because other hon. Members wish to take part in the debate.
“I am sure you will not be surprised that we believe we cannot deliver both financial and non-financial targets in 2005/06.
It will be a simple and inevitable consequence of a growing gap between our allocated funding and the monies we need (as defined by the national formula) to meet the needs of our population.”
That was Sir Richard Tilt’s view in August 2005.
The crux of the matter is that the Government spend a lot of time, money and effort working out what is a fair level of funding for each PCT based on its needs compared to similar areas across the country. That has been developed so that we have a level playing field across the national health service. As the Secretary of State for Health said in a letter to me and my hon. Friend the Member for Kettering (Mr. Hollobone) on 25 August 2005:
“A weighted capitation formula is used to determine each PCT’s target share of available resources, to enable them to commission similar levels of health service for populations in similar need.”
I agree entirely with the Secretary of State. That is exactly what should happen in our NHS, but it is not happening in north Northamptonshire and, year after year, we are underfunded. There is no end in sight to this underfunding. In a letter to me, the Secretary of State said:
“Northamptonshire Heartlands PCT will be 3.5 per cent. under target by 2007/8.”
While the gap between what we should get and what we actually get is being closed, we will still not receive what the Government say is our fair and equitable funding. In fact, north Northamptonshire will still be £13.2 million short of its fair share. This lack of funding by the Government is causing the crisis in Wellingborough and the surrounding areas.
Let us look at the figures a little more closely and at the funding for north Northamptonshire compared to the national average while bearing in mind that we should be better funded than the national average because of our areas of severe deprivation. Let us just go back three years to 2003-04 when revenue allocations were directly made to primary care trusts for the first time. In 2003-04, the PCT only received 90 per cent. of the funding that it should have had compared with the national average. This was a shortfall of £22.2 million. In 2004-05, we again received only 90 per cent. compared with the national average. This was a shortfall of £24.4 million. Almost unbelievably, in 2005-06, the figure fell to 89 per cent. of the national average, increasing the shortfall to £29.37 million. This year, the shortfall is £20.16 million and, next year, it is predicted to be £15.08 million. This gives a total shortfall since 2003-04 of £11,210,000.
If we had had the funding that the Government said we should have had, there would be no crisis in our local health service. The people of Wellingborough and the surrounding areas have suffered because the Government have not implemented their own policy—a policy to bring fairness and a level playing field to what is supposed to be a national health service, not a postcode lottery health service.
Let me list some of the cuts that Kettering general hospital has been forced to make in recent weeks and months due to the lack of funding. They include reducing nurse levels to the absolute minimum, making 2,100 patients wait a minimum of five months for their operation, delaying planned second operations such as hip replacements and removing patients from the waiting list for low-priority operations. So apparently the answer to waiting lists is not improved patient care, but is just to tell patients that they can no longer have their operations. Further cuts involve redeploying surplus staff into existing vacancies with little regard to suitability, closing a surgical ward, closing an operating theatre, reducing prescriptions on discharge from 28 to seven days, closing a further medical ward, reducing the availability of consultants, making patients wait longer for treatment in audiology, freezing vacancies, reducing maintenance funding, increasing canteen prices and making nurses pay to park at the hospital.
There is, however, one part of Kettering hospital where the patients are not kept waiting, where operations are not delayed and where there is never a complaint about the quality of service. Several months ago, a new day care unit was built in the grounds of the hospital. It has 28 beds, four operating theatres, and a breast cancer screening centre. The unit has never had any adverse statistics recorded against it, and the reason why is that it does not have any patients, doctors or nurses. A brand new unit is sitting empty and the hospital does not know if or when it is going to be able to open it. But there is one part that is open—the typing pool that is paying all the bills to maintain a new, empty, mini-hospital.
What my constituents need and what north Northamptonshire desperately needs is a new hospital in the Wellingborough area. A new hospital with minor accident and emergency facilities would ease the massive burden that Kettering and Northampton hospitals face each and every day.
I have spoken about formulae; I have spoken about cuts. I now want to convey how these actually affect people in my constituency. Last week, Mrs. James and her son came to visit me at my weekly surgery. Mrs. James had written a long letter about the treatment that her husband received in Northampton general hospital. I want to read a few extracts from that letter. Mrs. James writes:
“I repeatedly pointed out that he was not able to eat. This was in part due to him being unaware of when food and drink was available.
“My son, Ian placed a large notice at the back of Colin’s bed stating he could not see and might need help with eating and drinking. Within a short time a nurse came to see us and said the nurses did not have time to feed patients as there were only four of them and they had thirteen patients.”
I have that rather sad sign with me. Mrs. James continues:
“Having lost approximately a third of his body weight and being severely weakened through lack of food and the dehydration tablets, his poor body could not stand against three infections.
“He begged us to take him out and told us and at least one nurse that he felt he had been dropped into a pit and left to rot. The outcome seems to be not far from this.”
Mr. James died four hours after coming home, as a result of three infections he contracted on the ward.
The people in my constituency and in north Northamptonshire deserve a fairer share of the national cake. I am not asking for more than our fair share, just what the Government say we should be getting, but are not. Why should my constituents suffer? This is meant to be a national health service, not a postcode lottery health service. I have two suggestions to improve health care provision in north Northamptonshire and to make it fairer for my constituents. First, I want a guarantee from the Secretary of State for Health that there will be an investigation into the provision of a new hospital in my constituency to coincide with the massive growth in population in the area. Secondly, and perhaps more importantly, I urge Northamptonshire PCT, and Kettering general and Northampton general hospitals to put patient care first, not Government accountants. I urge them to cease making cuts to patient care and to spend the £111 million that we should have received from the Government through their own capitation formula. The Government have said that we should have had that money for health care in north Northamptonshire. Let us use this funding for better health care provision for the people of my constituency. I challenge the PCT and the local hospitals to stand up against the Government and put the health care of patients first instead of satisfying the accountants in Whitehall. If they do that, they will have my full support.
9.22 pm
Mr. Brooks Newmark (Braintree) (Con): After seven hours of patience, I am pleased to be able to participate in the final day of the Queen’s Speech debate. I hope to abide by the principle that ought to apply to both regulation and legislation: less is more. The meat, or should I say the gristle, of this year’s Gracious Speech is the Statistics and Registration Service Bill. As the Treasury Committee, on which I serve, discovered in its investigation of the independence of statistics before the summer break, there are some deep misgivings about the Government’s proposals. Some of those misgivings, although happily not all, are reflected in the Bill that was published last Wednesday.
The quality of, and ease of access to, statistics forms the bedrock of administrative oversight and parliamentary scrutiny. When questioned about the structure and powers of an independent board, Lord Moser told our Committee that
“if one needs one word, it is ‘scrutiny’; it is advising the public, advising Parliament.”
We might be forgiven for thinking that the principle of economy, which ought to apply to regulation and legislation, ought not to apply to statistics, because a wealth of material is always to our benefit. However, less can be more when it comes to statistics, too. The Bill does not explicitly address the burdens associated with the collection of and access to statistical information. A study by the British Chambers of Commerce, published earlier this month and entitled “Red Tape: The Real Story”, tackles exactly that issue. It contains a number of case studies drawn from real business. One of the first studies concerns the impact of Government statistics on business.
The real problem is that the proposed Bill is introspective, which is symptomatic of what is happening across the Government. Legislation is proposed without a clear view of the effect that it will have after it has passed through its parliamentary stages and gone into force in
the wide world. The Treasury wants to make a splash in the press by overhauling the treatment of statistics, which is all well and good. However, we will no doubt have something to say about the details of the proposals when the Bill is debated in the House.
It is clear that irrelevant and inappropriate statistics are as burdensome on business and the economy as a whole as unnecessary legislation and even regulation. Chris Harrod, the chief executive of a sports equipment company, said in the British Chambers of Commerce study:
“as a small businessman I am regularly required to fill out forms by the Office for National Statistics. Many of the forms we are asked to fill out, like the Business Register Survey and the Monthly Enquiry into Production ask for the same information.”
“should either share data across departments as a matter of course or they should look at including default information. At the moment I spend hours of my time which should be devoted to other areas of my business filling in these forms.”
The sharing of data has in itself become a minefield. Our Committee examined the problem in detail and the Government’s response welcomed our recommendations on the sharing of data and the safeguards that must be in place before that can safely take place. I fear that the complex interactions among the Freedom of Information Act 2000, the Data Protection Act 1998 and the need to share administrative data will hamstring the Bill and add to the complexity faced by both the successor to the Office for National Statistics and business.
The British Chambers of Commerce annual burdens barometer has identified the cost to business of major regulations approved since 1998 as exceeding £50 billion and climbing well into the stratosphere. Some of us would have been present earlier this year when the hon. Member for Wolverhampton, South-West (Rob Marris) was good enough to introduce show and tell to the Chamber by unfurling the whole document and offering a line-by-line commentary of it. By happy coincidence, the subject of the first entry on the burdens barometer was the cost of the Data Protection Act, which has exceeded £6 billion since 1998. The hon. Gentleman said that the regulation
“Could be good, or could be bad.”—[ Official Report, 24 April 2006; Vol. 445, c. 414.]
By equivocating, I assume that he meant that the intention behind the regulation might have been good, but that its implementation had been less than satisfactory.
The operation of the Data Protection Act is the subject of a further British Chambers of Commerce case study, in which another business man says:
“The DPA is a worthwhile piece of legislation but the process of registration is both futile for Government and time consuming for business. I do not see how registration assists government other than the revenue they take in initial notification fees and annual renewal fees.”
We have registration processes that are futile, compliance that is time consuming and, most worryingly of all, regulation being used as a revenue-raising tool, rather than a way of preventing abuses. That is the story of red tape. Such things are the hallmarks of the Chancellor’s marriage to stealthy taxation and unwieldy bureaucracy, which is paid for by the cost of falling productivity and crumbling competitiveness. The opportunity to chart our relentless decline through the medium of newly independent yet sketchy statistics is not much compensation.
Disentangling statistics from the Chancellor’s coat tails is only the first step in ensuring that, in his words,
“fiscal decisions are fully transparent and accountable.”—[ Official Report, 10 July 2003; Vol. 408, c. 1404.]
Independent statistics make fiscal decisions transparent, but they do not matter a jot to a Government who are not willing to see themselves as accountable.
Several years ago, the Chancellor called the private finance initiative
“a cynical distortion of public finance”.
However, in the past 18 months or so, his own cynical PFI distortions have been unravelled by the ONS: £1.25 billion was added in August 2005; £5 billion was added in February 2006; and £4.95 billion was added in September 2006. Will the newly independent successor to the ONS continue to add piecemeal to the Government’s balance sheet—a billion here, a billion there—or will there be a clean sweep for statistics and the Child Support Agency following this year’s Gracious Speech?
The Chancellor’s £5 billion annual raid on pensions has cost pensioners £100 billion. How will the independent board force the Government to confront the looming crisis of their own creation? The Government’s spending on consultants reached £2.4 billion by 2005, over £2 billion more than when Labour came into government. How will the new board force the Chancellor to admit that results must follow investment?
How will the independent studies reduce the burdens placed on the most vulnerable in our society? The public sector is expanding and unelected quangos are blossoming while families and businesses alike are simply withering under the tax burden. What teeth will the new board have to deal with those problems? That is what we know without the benefit of truly independent statistics.
9.30 pm
Mr. Philip Hammond (Runnymede and Weybridge) (Con): We come to the end of the final day of debate on what will be the Prime Minister’s final legislative programme. I am glad to see the Secretary of State for Work and Pensions in his place; I am sorry that he could not join us for more of the debate. There is a certain poignancy in his winding up this debate, because he is probably the most ultra-Blairite member of the Cabinet. Depending on which way one looks at it, he is either the most honest in expressing his view or the least nimble at repositioning himself for life under the clunking fist regime coming soon.
The good news for the Secretary of State is that I have calculated that if he can hang on to his job for another 22 days, until the House rises, he will have surpassed the career average of his four immediate predecessors. The bad news is that no one is betting on his luck lasting much beyond that. Things have come to something when Conservative Members are wary of quoting a Cabinet Minister’s description of the Chancellor for fear of being rebuked for the use of unparliamentary language.
We have had what can be described as a wide-ranging and extensive debate this evening, the highlight of which was the first outing of the big clunking fist since its baptism by the Prime Minister the week before last. It clattered in like a medieval war engine, and my
impression was more of clunking than of fist. It looked like a bit of a primitive weapon against the rapier that my hon. Friend the Member for Tatton (Mr. Osborne) plunged into the Chancellor’s record.
The Prime Minister has been promising welfare reform since 1997. The Bill that has carried over into this Session is the first sign of any serious attempt to deliver on that promise, so I will not be complaining, as some of my colleagues have had cause to do from this Bench over the last few days, of a sense of déjà vu surrounding the measure—quite the opposite.
I cannot say the same about the child support Bill. We do not yet know the detail of the Government’s proposals, but we do know that they amount to an admission of failure of the 2003 reforms, in which the Government have squandered £500,000 of taxpayers’ money on a failed computer system. There are now 1.4 million families trapped in the misery of the Child Support Agency, and every Member of the House knows exactly what that means from their constituency experiences. If the Secretary of State is looking for cross-party support on CSA reform, his proposals will have to address the plight of those already in the system as well as new claimants, because we will not support any solution that denies a just and fair outcome to those 1.4 million families.
We have supported and will continue to support the Government’s objectives in the Welfare Reform Bill. I hope that the Secretary of State, when he winds up the debate, will acknowledge the constructive contribution from my hon. Friends in the Committee proceedings on that Bill, which are ongoing. Similarly, we welcome the key changes to the state pension system which we expect to be introduced in the pensions Bill when it is published—tomorrow, I believe. We welcome the re-establishment of the earnings link, a policy on which we fought the last election, and the changes to the contribution rules and caring credits, which will address the unfairness suffered by women pensioners in the present system. All of that will be paid for by asking people to work until they are 68.
Both those measures—and, indeed, the reform of the child support system—have the potential to contribute significantly to the anti-poverty agenda, but both require the creation of significant numbers of net new jobs, because both aim to achieve their objectives through a focus on work. That is the right focus for the British economy and for a sustainable and permanent reduction in poverty. An effective attack on poverty requires an attack on the causes of poverty and, for those who can work, work is the sustainable route out of poverty.
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