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Mr. Ian Austin (Dudley, North) (Lab): The hon. Gentleman is wrong to say that all the new hospitals have been funded through PFI, but I am pleased to say that Russells Hall, the brand new £200 million hospital in Dudley, has been. Is his message to the people of Dudley, who will read whatever he says with great interest when we put it in our leaflet, that the Liberal party is against that investment and would not have supported the development of a brand new hospital, funded through PFI, for my constituents?
Norman Lamb: We have consistently supported the Government on increased investment in the health service, but the over-reliance on PFI has been a mistake. The hon. Gentleman might want to listen to the comments of Bob Ricketts, the head of capacity development at the Department of Health. In June 2005, he said:
I have seen some awfully grand PFI schemes that are starting to give us a real problem in our capacity management. We need a fundamental rethink about how we invest in capital rather than human resources.
The Governments own Department of Health is questioning the over-reliance on PFI. That over-reliance is the responsibility of the Chancellor of the Exchequer, the next Prime Minister, who has at every stage driven PFI in the health service.
The Minister of State, Department of Health (Andy Burnham): The hon. Gentleman may be aware that there has been a lot of controversy about Leeds childrens hospital, which is a proposed PFI development, and that one of his colleagues, the hon. Member for Leeds, North-West (Greg Mulholland), has been pushing hard for it to be built. Under a Liberal Democrat Government, would the hon. Gentleman have to disappoint his colleague by abandoning that scheme?
Norman Lamb: That is a ludicrous suggestion. We oppose over-reliance on PFI, as do the Conservatives. We entirely support the building of that new hospital, but investment in health facilities does not always have to be done using PFIthat is a remarkable argument. Other finance mechanisms can be used.
Mr. Lansley: Does the hon. Gentleman recall that, at the last general election, the Conservative party issued a document about what we would do in Government? It included making resources available from the Department of Health capital budget to support several new childrens hospitals, one of which would have been the Leeds hospital.
Norman Lamb: The hon. Gentleman makes the point that there are other ways of financing new build. Health bonds are another method. To suggest that it is PFI or nothing is ludicrous. The hon. Member for Norwich, North (Dr. Gibson) often criticises PFI plenty of Labour Members criticise the over-reliance on PFI. Not only Liberal Democrats take that view.
Mr. Kevan Jones (North Durham) (Lab): As someone whose constituency is served by two brand new PFI hospitals, let me emphasise that they not only provide good quality health care, but they were built on time and on budget. How would the hon. Gentleman fund the hospital building programme that the Government have achieved?
Norman Lamb: It is remarkable that Labour contributors appear to have swallowed the idea that the only way in which one can invest in capital projects is through PFI. Bonds are a perfectly good way of raising funds for capital investment. It does not have to be done through PFI.
We are in an extraordinary position whereby we have record investment in the NHS, yet there is also a record deficit. How did we get there? Too much investment has been wasted. The Health Committee drew attention to poor financial management, loss of financial control and the PFI obsession.
The failings are the fault not only of the Secretary of State but of successive Ministers. Indeed, the pain of forcing trusts to address their deficits was delayed until after the last general election.
Let us consider the legacy of another Secretary of Statethe current Home Secretary. His legacy includes the GP contract, which ran massively over budget and continues to have an impact on local health economies; the handover of responsibility for out-of-hours care from doctors to PCTs, which the Public Accounts Committee described as shambolic; and the consultants contract, which also ran massively over budget and, according to the National Audit Office, fails to deliver the intended improvements in patient care. There is also his target for cutting MRSA infections, which will be missed by next year as C. difficile cases continue to increase. All those failures continue to afflict the NHS and the Governments reputation.
Let us consider the current Secretary of State. She made a political commitment to sort out NHS finances, and the Government will undoubtedly hail the achievement of a small overall surplus as a victory at the end of the financial year, but at what price? Again, the Health Committee highlighted the impact on soft targets. Funding for voluntary organisations has been cut.
Mr. Deputy Speaker: Order. The hon. Member for North Norfolk (Norman Lamb) has indicated that he will not give way. I also remind the House that time is ticking away and many hon. Members are seeking to catch my eye. That should be borne in mind.
Norman Lamb: There is the threat to so many community hospitals around the country, including in my county of Norfolk. I fully accept that some reconfiguration of acute services is necessary, but in some cases it is driven by financial crisisagain, a point that the Health Committee made.
The dentists contract is also a shambles, with people finding it literally impossible in some parts of the country to find an NHS dentist. Primary care trusts throughout the country face deficits in their dental budgets because of the Governments miscalculation of patient fee income.
We then come to junior doctors and the disgraceful shambles of the medical training application serviceMTAS. The judicial review has failed, and the Secretary of State has applied for costs in the case this afternoon against the junior doctors. I understand that the judge awarded costs but asked the Secretary of State to reflect on that. He made the point that she had acknowledged that mistakes had been made and that she will have to work with junior doctors. Would not it be outrageous if she chose to pursue her recovery of costs against the junior doctors who have been the victims of the Governments mismanagement of the system? I urge hershe is trying not to listento announce in her statement tomorrow that she will not pursue the recovery of costs against junior doctors. She could clear up the matter this afternoon, if she chose to do so.
Despite all the warnings that the system had severe problems, the Government ploughed on regardless, displaying a mixture of arrogance and complacency. Clearly, MTAS was not adequately piloted or tested. The statement of Nicholas Greenfield from the Department of Health to the High Court last week revealed that it became clear in April that the software was not working. A paper on 25 April noted that the
allocation algorithm was giving a different allocation from what was expected.
It stated that until the issues were resolved, and the principles agreed, it would not be possible to confirm the feasibility of the allocation rules, to design and develop the allocation software, or to confirm the timetable for making offers to applicants.
By 28 April, the situation was even worse. A report by Beverley Bryant, in the aftermath of the security breaches, concluded that further changes to system functionality were necessary. It stated, however, that making further changes
could further compromise the quality and security of the system which...could be fatal to the programme.
Andrew Stunell: One of my constituents, who is a consultant, drew to my attention last weekend the huge amount of consultant time being spent on trying to get the system back in order. He estimated that 140 hours of consultant time would be spent on the system and on trying to appoint junior doctors. That is a total waste of his effort, and reduces his capacity to give treatment to patients.
Norman Lamb: My hon. Friend makes a good point. The impact has been not just on junior doctors, but on all those who have had to conduct 15,000 extra interviews. There has therefore been an impact on patients, too. What a mess.
A litany of misjudgments, costly mistakes, changes of direction and botched reform has been the responsibility not just of the Secretary of State but of the whole Government. That is an extraordinary record of failure from a Government who warned us back in 1997 that there were 24 hours to save the NHS. Everyone knows that the Secretary of State will go when the new Prime Minister takes over. Is it not ludicrous that the NHS must wait six weeks for that to happen? When so much needs to be done, we have a lame duck Secretary of State. She should go now.
Mr. Graham Stuart: On a point of order, Mr. Deputy Speaker. I am not seeking to catch your eye in this debate, but it occurs to me that little time will be left once the Liberal Democrat Front-Bench spokesman has finished[Hon. Members: He has finished.] He has just finished. What can you do to ensure that Back Benchers who wish to contribute to such debates have time to do so?
Mr. Deputy Speaker: It is true that all three Front-Bench speeches have taken more than half an hour. That is a matter for those on the Front Benches. All I can do is urge hon. Members to make their contributions brief and, before they intervene, to think what they are intervening about and to make their interventions brief. But thenhope springs eternal.
Natascha Engel (North-East Derbyshire) (Lab): I shall try and restrict myself to 10 minutes and take out all the digs at the Tory Front-Bench team, except to say that once again we are having a health debate on an Opposition day, in which I greatly enjoy taking part. I have taken part in almost all of them and I have yet to hear a Tory policy. Perhaps we will hear one later.
The Department of Health is massive and wide ranging. I shall focus on cancer treatment and survival rates. Cancer affects almost every family and every person directly or indirectly. It is terrifying. Most doctors speak of the C-word rather than refer to cancer itself, because it used to be a death sentence. That is no longer necessarily the case. Although cancer is wide ranging and survival rates differ greatly, depending on
the type of cancer, people are still twice as likely to survive if they are diagnosed today than they were 10 years ago.
The reason that we have been so successful in cancer treatment and have such high survival rates is because of early screening, early diagnosis and far better treatment. Almost everyone with suspected cancer who is seen by their GP will be sent to a cancer specialist within two weeks, and 99 per cent. of patients who have been diagnosed with cancer will have had treatment within one month of their diagnosis. These are fantastic statistics.
Part of the reason for such success is that the NHS has introduced far greater flexibility in the system for cancer treatment and takes account of the needs of individual patients far more. Treatment is carried out in communities wherever possible. Simple chemotherapy treatments can now be given in district hospitals such as the Chesterfield and North Derbyshire Royal hospital, which has developed a chemotherapy suite so that patients do not have to travel all the way to Sheffield if they do not want to. The Chesterfield Royal has been so successful in its chemotherapy treatment that it is massively expanding its operation. It is a tiny district hospital, but the same is happening throughout the country so that patients diagnosed with cancer can receive treatment in a much calmer community-based environment, with their families close by. That is a huge achievement.
Eighty per cent. of women diagnosed with breast cancer will survive for at least five years, compared with 50 per cent. only 30 years agoagain, a massive achievement. Two thirds of women who are newly diagnosed with breast cancer are likely to survive for another 20 years. These sound like random statistics, but about 1,400 people who are alive today would not have been alive 10 years ago.
One of those people is my mother, which is the reason I wanted to take part in the debate. She is over 60, and three years ago had a routine mammogram at the Addenbrookes hospital. She lives in the neighbouring constituency of Huntingdon. The nurses were not entirely happy with the results, sent off for a biopsy on that day, and she was given a positive diagnosis there and then. She was seen and treated within three weeks of that routine appointment, which is staggering. On the day that she had her mammogram, she was given the name and telephone number for a nurse whom she could call day or night if she was worried. That was spectacular. Her experience has been fantastic. There are many other women like her throughout the country. Those cancer rates are fantastic.
Another example concerns a friend of mine who lives in my constituency and who has taken a terrifying but very brave decision. Her family has been blighted by breast cancer. She has lost grandmothers, cousins and aunts to breast cancer. When her mother was 38, she decided that she would have preventive breast surgerya double mastectomyto avoid having to go through with the cancer. She was the first woman in the country to have such a preventive double mastectomy.
Becky, a presenter of a breakfast radio programme on Peak 107 FM, decided at the age of 24 to become the youngest woman in the country to have a double mastectomyan incredibly brave decision for someone
so young. She is beautiful and vivacious and has a very high profile in north-east Derbyshire. It is absolutely amazing. She had an 85 per cent. chance of developing breast cancer in her life. Taking the decision to have both breasts removed at such a young age was brave, but it was, for her, only a liberating experience. She has had breast surgery so she now has even better breasts than she had before. She is still enjoying life.
The point is that modern technology and cosmetic surgery have meant that people like Becky can take blood tests and find out whether they are carrying a faulty gene, which was not possible before. A death sentence has been lifted from this girl and it is so easy to see it when we talk to her about her experiences.
Those are two small examplesalbeit very close-to-home examplesof where breast cancer treatment and survival rates have made a huge difference, not just to my life but to the lives of other people. I hope that we can continue to make a difference. The best chance of continuing to be able to help people with cancer, especially breast cancer, is to maintain a Labour Government, as recent history shows.
Mr. Deputy Speaker: Order. I want to underline the point I made a few moments ago. Everyone can see the number of hon. Members seeking to catch my eye. We shall start the winding-up speeches at about 6.30 or 6.40 pm, so I would be grateful if hon. Members made their contributions as brief as possible in order to allow as many as possible to speak.
If we are discussing the health service, it is important to acknowledge that extra money has been invested and some improvements made, particularly on waiting times. We then have to ask whether the money has been spent sensibly and whether we could get more from it by spending it more productively. One of the dangers of a debate like this is that we quickly descend into our own individual examples of exactly what is happening in our own local health economies and local hospitals. That sometimes misses the broader point, because it is always possible to find one example that proves or disproves a general rule, so I shall leave any comments about local matters until the end.
Accountability within the health service is one of its great problems, despite the amount of money going into it. I suspect that we have all experienced the problem of taking an issue on behalf of a constituent to an acute health trust. It tells us that the matter is not its responsibility, but that of the commissioning agency, the primary care trust, which then says that it is a matter for the strategic health authority, now a regional body. The SHA proceeds to tell us that it is not a matter that it can deal with because the Secretary of State needs to intervene. At that point, we contact the Secretary of State for Health, who tells us that it is a matter for the local health economy[Hon. Members: Absolutely]so we have gone round in a huge circle. It is extremely difficult, in a system that almost deliberately seems to go out of its way to cause such confusion, ever to pin down exactly who is responsible or accountable for what is happening locally.
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