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14 Dec 2006 : Column 379WH—continued
Politics cannot be kept out of it, or why would heat maps have been debated? The Government cannot specify the benefits of community care when it is relatively undeveloped and patchy at the moment. Blood testing in one of the hospitals in my
constituency has been moved out of the ward and into a clinic. Fine, but the clinic is at the end of the constituency. In terms of accessibility, it is no better than the hospital was. People find it more difficult to access the blood service than they did when it was at the hospital.
Not all doctors are, like Sir Liam Donaldson, on side or on message. One has only to look at the constant stream of British Medical Association press releases to realise that. Even the argument that lives will be saved rather than lost is a little flaky. One cannot argue, as Dr. Roger Boyle does, that it makes a huge difference that 83 per cent. rather than 38 per cent. of heart patients now receive hospital treatment within30 minutes, and then argue that it makes little difference how long it takes to get to the hospital. The Government cannot have it both ways.
I suggest that, rather than refining the message’s delivery or constructing a better way to present unacceptable policy, the Government should seek to re-examine the message itself. Public instincts on matters as basic as health are rarely far off the mark. Paradoxically, the Government trust the public to choose between hospitals with choose and book, but do not trust them with any voice in how health facilities are configured. That seems to me a fundamental mistake. I believe from some experience of such issues that the public are not stupid. They can grasp what a sensible clinical audit is about. They know that hospital stays are shorter, but they also know that people are getting older all the time. If maternity and geriatric services are stripped out, it does not result in a sharp decline in the acute provision so much vaunted by organisations such as the NHS Confederation.
The public rely on consultants and hospital administrators in some circumstances but know that they are not immune to special pleading and have individual preoccupations—the former with training and professional status and the latter with making the sums add up and pleasing the Department of Health or the SHA. Furthermore, the public really understand any point one wants to make about distance. They are prepared to travel to wherever is necessary when life is at stake, but they do not want to travel miles for triage, basic treatment and competent reassurance.
The public also do not want the health service to be indifferent to the journey that they make to treatment in the first place. To cite another example from my constituency, back in 2003, children’s A and E was moved nine miles out of town. Parents were puzzled as to why when something had happened to a child, it had to be dealt with by making an unnecessary nine-mile trip past an A and E department in an all-singing, all-dancing general hospital, whether the child had fallen on a beach or at school, or whatever, with the mother traumatised by the experience. That decision was not even consistent with Sir George Alberti’s general remit and instructions, and was shored up by duff clinical advice. I can remember standing outside the building in question with a sign saying “Treat children in Southport—20,000 people can’t be wrong”, which was how many people had signed the petition. Those people were not wrong, and that was acknowledged later.
There is no alternative for the Government, unless they go ahead kamikaze-like with their doomed
strategy, to having a real dialogue with the public. That should not involve a lecture to the public or a tutorial, but it should mean genuinely allowing the public into the debate, although not in involvement forums, which are simply not good enough, as sham consultees or even as consultees at all. We should be looking soon to creating a place for the public as decision makers in their own facilities.
5.11 pm
Tim Loughton (East Worthing and Shoreham) (Con): This has been an extraordinary debate, with an extraordinarily confused Minister. At the end of it all, I still do not really know what it was about. The Minister spoke for 71 minutes—at one stage, I thought that he would move seamlessly into the winding-up speeches, and we still have another 10 minutes to come.
What did the Minister come here to show? Why was this debate put on the agenda, with not a single Labour Member being prepared to come and support him? Not even his own Parliamentary Private Secretary came and the Whip abandoned ship halfway through, while no Liberal Democrat Back Benchers were prepared to come and speak up for their constituents on what is probably the most challenging and important issue in all our constituencies. I have never seen a debate like this in Westminster Hall before, in which not a single Member of the governing party, in the Government’s time, was prepared to come and support Minister-no-mates.
The Minister’s contribution, amazingly, was more about the Conservative party, ancient history and accusations against us of scaremongering. My 11 hon. Friends who turned up did not do so to scaremonger, but to represent the genuine fears among our constituents that have filled our postbags for many months now. The Minister then tried to challenge us on the 29 A and E departments that are under threat of closure or downgrading. He confused Truro and Penzance, and could then only come up with Calderdale. It is a long way from Calderdale to Cornwall, but he was not prepared to grant the safety of those other 27 A and E departments on the list, such as in Eastbourne, or at the Conquest hospital, St. Richard’s hospital in Chichester, Worthing and Southlands hospital or the Princess Royal hospital. They are all in constituencies represented by hon. Members who took part in this debate.
The Minister was also very good at recycling, because he gave the same speech that Lord Warner gave a week ago; but Lord Warner was wrong last week and the Minister was wrong again today. The ignorance that the Minister showed was deeply worrying. We never got the difference between clinical and medical explained. At one stage, he clearly did not know the difference between A and E and maternity departments. He also said that liver disease was caused by what people ate. That is a new one on me. If the Minister had had long enough, he might have claimed that statins were invented by him.
In the past eight years, under this Government, the health improvement outcomes in heart disease and cancer, for instance, have not been as good as they were in the previous eight years. The improvement has been gradual over many years; it has not been brought about
by the Government. The Minister produced no evidence at all to back the reconfiguration proposals that his henchmen in the SHAs and PCTs are now undertaking.
The biggest insult of all was on small maternity units, where there is no evidence to suggest higher rates of perinatal mortality. It is an insult to all the dedicated staff who work in those smaller maternity units in our hospitals throughout the country to suggest that there is a higher rate, but the Minister came here without a shred of evidence to back up that claim. This is a Minister who is in denial, and he is from a Health Department in denial about the real damage that it is causing—not our scaremongering—by its refusal to hold public consultations out in the open, to engage people properly and then to listen to them properly. That is where the scaremongering is going on.
We are not against change, but we are against change that is based on a false premise, not on evidence, and that is clearly driven by financial expediency caused by the complete mess of the NHS’s finances that the Government have brought about at a time of record investment in the NHS.
When we came to this debate was it to be told about the Health Committee’s report to which my hon. Friend the Member for Hemel Hempstead (Mike Penning) referred? That report said that the problems in the NHS were down to
“the contribution of the funding formula, the effect of Government policies, poor management by the Department of Health and poor local financial management.”
Were we supposed to have explained to us the gross financial deficit in the NHS, which is forecast to be £1.2 billion this year, following the £1.3 billion last year? Well, we did not get that. Was the Minister going to tell us about changes to the financing formula? Again, no. He was completely in denial about the extra costs associated with older people, which is the very reason why we have such a problem with deficits in our part of the world.
Did the Minister come here to respond to the charges that we have made about maternity units, which are that one in six maternity units faces closure, downgrading or transfer? He did not get on to the list of 49 units at all—again, no safety was granted to any of those, and no evidence based on any research was presented.
The Minister also said nothing about public health, which has been a cause for changes over recent years and on which the Government’s record has been an absolute disaster. There was no mention of mental health or health inequalities, which have worsened under the Government and which are always a reason that he and his colleagues give for the variations in the funding formula that Militate against people in the south-east. He knows that he has failed to do anything about health inequalities.
I should like in the few minutes that I have left to return to my part of the world. It is not unusual that seven of my hon. Friends who represent Sussex constituencies have been present during this debate, because the entire health economy and NHS in West Sussex and East Sussex faces an onslaught. Again, is it not noticeable that there are no Labour MPs from constituencies in Brighton and Hove, whose Royal
Sussex county hospital stands to gain patients if we lose our department? There are no hon. Members here from Hastings, who stand to gain if Eastbourne is a victim of the cuts in that trust.
Peter Bottomley: My hon. Friend may not have noticed yet, but the primary care trust in question put out a press notice today with a photograph of the Minister of State, Department of Health, the hon. Member for Don Valley (Caroline Flint), with one of the only Labour MPs in Sussex looking at some initiative, rather than dealing with what we are dealing with.
Tim Loughton: Absolutely. It is also noticeable that the Minister of State visited Crawley earlier this week and that the Secretary of State visited Brighton a few weeks ago, but neither the Secretary of State nor any of her team at the Health Department have visited any other hospital in Sussex, Hertfordshire or my hon. Friend’s constituency, despite the fact that we are the most under threat. The Secretary of State has also refused to meet my hon. Friend and me; we wanted to deliver hundreds of Christmas cards, sent with the good will of the people of Worthing and the rest of West Sussex, to send her Christmas wishes and ask her to ensure that our hospitals are safe. She will not even receive those from our constituents. Ministers are in denial and blind to the problems that the NHS faces in our part of the world.
It is for those reasons that the public have taken to the streets in unprecedented numbers, in Worthing, in Chichester and at the Princess Royal hospital—as my hon. Friend the Member for Arundel and South Downs (Nick Herbert) said, my hon. Friend the Member for Mid-Sussex (Mr. Soames) would have been here today. It is for those reasons that the local media—Splash FM radio station in Worthing, the Worthing Herald, Meridian TV and BBC South—have been at the forefront of the campaign, day in, day out. They have not been inventing scaremongering stories, but reacting to the real fears of their listeners and our constituents. Thousands have taken to the streets; the “Nurse Sunshine” campaign in Worthing and mid-Sussex has caught people’s imaginations.
Worthing is the largest town in Sussex, with a population of more than 100,000. It will have many more people in the next few years because of the house building targets imposed on us by central Government. Ten years ago, the last Conservative Government greatly expanded Worthing hospital; it is ironic that this Labour Government threaten to be the one to downsize our hospital in the largest town in Sussex, and possibly close Southlands hospital altogether.
Andy Burnham: The hon. Gentleman’s time is up.
Tim Loughton: It is pretty ironic for the Minister to call time, given that he spoke for 71 minutes. The Government are already in negotiations with a property management company to take over the site of Southlands hospital. Will he comment on that as well?
The consultants at Worthing hospital have made it absolutely clear that they believe that the proposals will
cost the lives of people in our town. They have said that the closure of acute services at Worthing hospital will result in patient deaths as a result of the inter-hospital transfer of sick patients. Do the Government care? We have had little evidence of that. When the excellent Tom Wye—the mayor of Worthing, who heads the KWASH campaign—wrote to the Prime Minister, the Prime Minister’s office wrote back to say that the matter had been referred to the Department for Transport.
The Government are in denial and out of touch. If the Minister will not listen to us today, for goodness’ sake he should answer the letters, come down, see the petitions and listen to the people.
5.21 pm
Andy Burnham: Contrary to what the hon. Member for East Worthing and Shoreham (Tim Loughton) said, I think that we have had a good debate about an important issue that is real for many of us in our constituencies. The hon. Member for Arundel and South Downs (Nick Herbert) said that I was patronising people with talk about getting out placards. I was not; I realise that the issues are real.
The hon. Member for Arundel and South Downs asked about a real issue that affects his constituents. I understand that and know that there is strength of feeling; I accept that from the hon. Member for East Worthing and Shoreham too. There is real feeling because the consultations and changes are real and will affect the hon. Gentlemen’s constituents. I understand the strength of feeling today.
However, I make a distinction between that and scaremongering, a phrase that all Opposition Members here have used. Yes, I make a distinction between real proposals—real, live, happening consultations—and other suggestions made for party political gain. The hon. Member for East Worthing and Shoreham asked about 29 A and E departments. His people may not have spoken to the NHS, but we have. He asked for more examples. I shall give them: Buckinghamshire hospitals trust, Calderdale and Huddersfield foundation trust, George Eliot hospital trust, Good Hope hospital trust, Gloucestershire hospitals trust, Oxford Radcliffe hospitals trust, Royal Cornwall hospitals trust, Royal Free Hampstead trust, South Tees hospitals trust, South Warwickshire general hospitals trust and Whittington hospitals trust. They all categorically deny what the Conservative party said in its material last week. In my book, that was scaremongering. I draw a distinction between that rubbish and the real proposals affecting Opposition Members, who have spoken fairly, passionately and rightly about real changes in their constituencies.
The Liberal Democrats are not exempt. They know—perhaps other Opposition Members do—that such rumours and scare stories can win parliamentary seats. That is why they created a rumour about the Christie hospital in Greater Manchester before the last general election. That was groundless, but done to generate political support.
Gregory Barker: Will the Minister give way?
Sadly, that tactic was successful. People should not play politics in that way with such issues.
Opposition Members sought to get going another rumour, about Penzance, during this debate. There has been speculation, but the trust has reinforced the point that it is only speculation and that there are no plans or procedures in place for changes in casualty cover to occur. Will those hon. Members please stop generating groundless rumours designed to cause anxiety among the general public? It is high time that they dropped that, and sharpish.
I turn to funding figures, as lots of Opposition Members spoke about the funding formula—rightly, because it is an important issue. This financial year—[Interruption.] The hon. Member for Hemel Hempstead (Mike Penning) is waving a booklet at me. Let me tell him this: average per-head funding in the NHS this year is £1,274. That cannot be denied; it is a fact.
Let me read out some figures for some of the constituencies of Members here today. This financial year, the PCT serving Worthing is funded at £1,389 per head, above the national average. The PCT for Bexhill and Rother has £1,445 per head, significantly more than the national average and close to the highest per-head funding in the country. The hon. Member for South Cambridgeshire (Mr. Lansley) said that there were real health needs in his constituency. That is a fair point, and I accept it. His PCT gets £1,432 per head this financial year, compared with a national average of £1,274.
I am afraid that bleating about the health funding formula will simply not wash. The hon. Gentlemen should read the facts and figures before they head into large, sweeping statements.
Mr. Tyrie: Will the Minister give way?
Andy Burnham: I will not; I have other points to answer.
Denial has nothing to do with it; those are the facts and figures. The hon. Gentlemen should read them before coming to debates such as this and making large claims for which there is no basis.
The hon. Member for Worthing, West (Peter Bottomley) raised questions about the resource allocation budget formula. That is a fair point. We have said that we will look again at the case for reversing the impact of past RAB reductions. That will be done only on delivery of financial balance in the NHS in 2006-07. No funding will be allowed to do that immediately. To respond to another point, yes, the NHS will achieve financial balance this year. It will balance overall, and at that point we can consider what steps can be taken on the application of RAB.
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