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23 May 2007 : Column 1377

Meg Hillier: I will be brief. Perhaps the hon. Gentleman should visit constituencies like mine, where the Homerton hospital is a foundation trust made up of members of the public who have joined and created a mutual to help to run and hold the hospital to account. Does he not accept that that is a real achievement—one that we should perhaps see more of?

Grant Shapps: I absolutely agree. We like the idea of foundation trusts and we want to go further and faster with them. We were going in that direction, until it was all reversed for the first half of the decade during which the Government were in power—before we realised the error of their ways.

As I say, it is a problem of accountability. A great example is closing a chemotherapy unit on a temporary basis, when the entire community realises that it is actually being closed permanently. Chemotherapy is a treatment that people want to have close to home, if at all possible, for the simple reason that it is an uncomfortable experience. It is highly undesirable for people who are feeling sick to have to travel miles after their treatment.

I have heard of cases of chemotherapy units being closed on a temporary basis in order to remove the need for the local NHS trust to consult the public on the closure. A temporary closure, unlike a permanent one, requires no consultation. Having temporarily closed the unit, the trust then consults on a permanent closure. The effect has been to close the chemotherapy unit permanently, while calling the closure temporary. The rules have been circumvented by pretending to have a consultation, even though the unit is already closed. That is just another example of the lack of accountability that has found its way, almost systematically, into the health service. The Secretary of State should address that issue.

There are many other issues to address. Week in and week out in the House, we hear about a new top priority in the health service. Just the other week, I was highlighting the problems surrounding in vitro fertilisation in the NHS. In 2002, the then Secretary of State came to the House and said that everyone should be able to get at least one cycle of IVF on the national health service. I was very relieved to hear that. All three of my children were conceived through IVF, and the idea that others would be able to get the treatment through the NHS was to be welcomed.

The trouble was that, after that had been happening for a while, it stopped. The reason for it stopping seemed to be that other priorities had come along and been piled on top of the original priorities set by the Secretary of State, resulting in the first priority being almost entirely lost. That applies to all manner of services. An investigation into audiology services revealed that, despite the 18-week target, the average wait is 42 weeks. In Liverpool, the wait for having a hearing aid refitted is five years—

Andy Burnham: No it is not.

Grant Shapps: I can provide the Minister with the data—

Andy Burnham: Prove it.

Grant Shapps: I will provide the data to the Minister. In fact, I have already provided them to the Secretary
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of State after I issued my report. If the Minister goes to, he will be able to download that report for himself.

The truth is that there is a five-year wait for people trying to transfer from an old-fashioned analogue hearing aid to a digital one. The Government have recently said that their aim is to include audiology services in the 18-week target. That is fine—it is to be welcomed—but there will be a problem if all that that does is pile that target on top of all the previous NHS targets. It is the latest priority in the latest week, and it simply will not work. The Government do not understand that the answer to all the problems in the NHS is not simply to stand up in the House and announce the latest priority, because all that happens is that the previous priority—and the one before, and the one before that—gets trampled on. That is how we end up with so little accountability.

I want to be brief, so I shall simply do what I am sure all hon. Members want to do, which is to refer to a local case. Despite all the promises and pledges, and despite what we heard at Prime Minister’s questions today and in the Secretary of State’s opening comments about how wonderfully rosy everything should be in the NHS, we all have our own examples of how the exact opposite is the case. In my constituency, the Queen Elizabeth II hospital is the place that illustrates that problem.

A consultation is about to get under way into the closure of the accident and emergency unit, of maternity services, of elderly care and of paediatrics, and into ending all elective operations there. This is the proposed wholesale closure of all the acute services at the hospital. The Secretary of State and her Ministers must recognise that when we hear pledges and promises, or talk of the number of extra doctors and nurses, they mean nothing to those who live in a county such as mine, which has more than 1 million people but only two hospitals that are set to remain after this flawed consultation: one in Labour Stevenage, the other in Labour Watford.

6.9 pm

Mr. Eric Martlew (Carlisle) (Lab): I was first elected a member of a health authority in 1974. In 1977, I was appointed chair of Cumbria health authority by a Labour Secretary of State, and in 1979 I was not reappointed by a Conservative Secretary of State. There was something honest about that. There were people chairing health authorities who supported the Government’s views. Now, I am afraid that we have given that away. Now, the Healthcare Commission appoints retired civil servants. In my area it has just appointed a new primary care trust, not one of whose non-executive directors lives in a city or a town. They all live in a rural area, and I suspect that they all come from the middle class.

I do not think we have done very well in that regard, but I will say this. Since 1974, I have worked in one way or another—in the health authority or in Parliament—with every Secretary of State we have had, and I believe that the record of the Secretary of State we have today compares with that of the best of them.

Mr. Graham Stuart: The hon. Gentleman is joking!

Mr. Martlew: Certainly my right hon. Friend’s record compares very well with that of the right hon. Member
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for Charnwood (Mr. Dorrell). I was a Member of Parliament during his time as Secretary of State.

I think that the Secretary of State would agree that she has been greatly assisted by dedicated staff, and also by record funding from a Labour Government. As we have heard today, the NHS has been transformed. We have heard about the experience of patients, as opposed to that of politicians or the general public: we have heard that 90 per cent. are pleased with the treatment that they have received, which is excellent.

We have slashed waiting times. Members who have been here for a while will remember when their postbags were full of letters and their surgeries were full of walking sticks, because people were waiting for hip replacements or elective surgery. They were not waiting for 18 weeks or for 18 months; some were waiting for two or three years. As Members know, that does not happen any more. The hon. Member for Scarborough and Whitby (Mr. Goodwill) is waving a piece of paper. I would like to think it was his resignation, but I suspect that it is not.

Deaths from cancer and coronary disease have declined, but it would be wrong of me to waste this short opportunity by saying that everything in the garden is rosy. Sorry, Rosie! I mean, I apologise to the Minister of State, Department of Health, my right hon. Friend the Member for Doncaster, Central (Ms Winterton).

Mistakes have been made. I happen to believe that the reorganisation of Cumbria PCT was wrong. It needed to be reorganised because it was ridiculous to have three PCTs for 40,000 people, but the creation of a unitary PCT for the whole of Cumbria was entirely wrong, because it has made the PCT too remote. I only hope that we do not make the same mistake in the local government reorganisation and end up with a unitary Cumbria.

At first there was great concern about clinics run by community action teams, but when we met the Minister of State he gave us assurances that the CATs would be tailor-made for rural areas like Cumbria, and would not take resources away. I hope that in the near future it will be announced not only that CATs will be complementary to services in Cumbria, but that one will be based at Cumberland Infirmary.

The out-of-hours service in my constituency is not satisfactory. We have an out-of-hours organisation called CueDoc, with a surgery at the top of the highest hill in Carlisle. As there is no public transport, I cannot imagine how the elderly and the sick manage to get there, especially in the middle of the night, but that could be altered.

However, let us compare that with how things used to be. My area had the first private finance initiative hospital in the country. I advise Members never to want to be the first at anything, because being at the cutting edge has its problems. My hospital had its problems, but they are being sorted out. However, the fact is that we had waited 40 years for that new hospital. The Conservatives cancelled it on four occasions. The previous hospital had been built a long time ago—during the time of Lloyd George—and the maternity service was dangerous because the district general hospital was three miles away from the maternity hospital and the consultants could not get to
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the maternity hospital and children were dying. That has now all been sorted out.

Finally, I shall talk about the dentistry service in Cumbria. In 2005, because of how NHS dentists felt about contracts, the vast majority of those in Carlisle opted out of the service. There were long queues in the streets of Carlisle—which was embarrassing and made the national news—as one dentist said that if people did not sign up immediately they would not get a dentist at all. Last week, it was revealed in The Cumberland News that we have provided 23,000 places for patients in Carlisle, and that there was no waiting list for dentistry there. When the Minister—my right hon. Friend the Member for Doncaster, Central—visited and we went to a surgery, we came across people who had not been to a dentist for 10 or 15 years. Under the current Secretary of State, we have cured the problems of dentistry in north Cumbria, and they can be cured throughout the country.

That is not all that should be said on this matter. A headline in today’s News and Star reads, “Smile! New dentists will treat extra 7,000”. That is not about my constituency; it is a story about the market town of Penrith, where there will also be no waiting list.

It is wrong to say that the Secretary of State has failed. She has had a difficult task, but we are getting things right. One thing that we must do is ensure that the Conservatives never get another chance to decimate the NHS. They have never believed in it—they voted against it—and they still do not believe in it. Many of them do not even use it, so why should we trust them with it?

6.17 pm

Mr. Stephen Dorrell (Charnwood) (Con): First, I shall respond to the closing comments of the hon. Member for Carlisle (Mr. Martlew) by referring to what the Secretary of State said in her speech. She began by saying that being Secretary of State for Health is a great privilege—and she was generous enough to say that it was felt to be so not only by Labour Secretaries of State but by Conservative Secretaries of State as well. I did not agree with very much else of what she said, but I do agree that it is a great privilege to hold her office.

However, when someone is granted a privilege it behoves them to ask what is expected of them in return. Given that this Secretary of State and her three Labour predecessors have been the beneficiaries of an unprecedented increase in national health service funding—increases that the Conservatives support—we can legitimately expect from her in return a commitment from the top of the national health service to deliver the best possible outcome for those increased resources. The charge that sticks against the Secretary of State is not that she is not committed to the national health service and its ideals—of course she is committed to them—but that she has not delivered the level of competence that the taxpayers and patients of this country are entitled to expect in return for the investment provided by her colleagues in the Treasury.

The Secretary of State responds to that charge by setting out all the improvements that have been delivered in the NHS over the past 10 years, and I do not dispute that there have been big improvements in
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some aspects of the service it delivers. Conservative politicians who say that the NHS has got worse since 1997 are simply wrong. That defies the evidence and the experience of those who use the health service. As my hon. Friend the shadow Secretary of State made clear, the charge against the Secretary of State is not that things have not got better. They have got better under this Secretary of State as they have under all her predecessors going back to 1948. There are endless statistics that my predecessors and I could quote on the improvements that were delivered by the NHS. Such improvements have been delivered throughout its history and my hon. Friend was good enough to cite some of the statistics on cancer mortality this afternoon.

The charge against the Secretary of State is that, in the old words of the school report, she has been too easily satisfied with her own work. We criticise her for losing the opportunity to deliver even bigger benefits for the resources that have been provided to the NHS.

John Bercow: Given that the advances in medical science mean that whenever one devises a new cure, one effectively creates a new queue, does my right hon. Friend agree that uppermost in ministerial minds at all times should be the priority of increasing productivity in the NHS?

Mr. Dorrell: Yes, I do, as long as it is understood that we are looking for the maximum possible health gain for the resources that are provided to the NHS and, in particular, the delivery of the stated objectives that Ministers, under both Labour and Tory Governments, have set out for the NHS. I wish to focus on one of those objectives, because if we conduct the health debate—as is often the temptation—purely in terms of the structure of health care delivered to particular communities, we miss the point of what the NHS exists for and what patients expect us to deliver through its structures.

It has been said by every Health Secretary that one of the purposes of the NHS is to reduce health inequalities around the country. So one of the challenges for the Secretary of State is why, despite the huge increase in resources over the past 10 years, health inequalities in Britain have got worse. In my intervention in the speech by my hon. Friend the Member for South Cambridgeshire (Mr. Lansley), I said that we should look not only at the record on cancer mortality or infant mortality for this country now as compared with 10 years ago, but at the health outcome measures in comparison with other, comparable countries. We should challenge ourselves with the fact that although cancer mortality rates are better here now than they were 10 years, they are significantly—not merely statistically—worse in Britain than in France, Germany, Italy and Spain. The latter is possibly the most telling, because that country’s national income is significantly lower than ours.

We should not simply trade often meaningless party political anecdotes about health improvement, as we heard from the Secretary of State this afternoon: we should address the real consequences of the failure to
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use the resources supplied to her—she is now back in her place—that were not available to her predecessors.

I shall not detain the House with the catalogue of mismanagement that has already been discussed, including the record on MTAS or the huge increases in resources for primary care that have somehow delivered a diminution in the quality of out-of-hours care. As for the Secretary of State’s record on mixed-sex wards, I am tempted to say that that is a subject on which she may regard imitation as the sincerest form of flattery, because she has made the speeches about how dreadful they are, as I did, and her record is exactly the same as mine. Mixed-sex wards still exist in the health service, and there is no effective plan to remove them.

The Secretary of State cannot conceivably be proud of the record on IT. In April, the Select Committee on Public Accounts published a report that stated:

Most extraordinary of all—just listen to this, Mr. Deputy Speaker—it added:

What is an investment appraisal about, if not demonstrating that benefits exceed costs? It beggars belief that we can be launching a £12 billion programme on the basis of an investment appraisal that did not set out to compare costs with benefits and show that benefits exceeded costs.

I promised to be brief. The charge against the Secretary of State is not that she does not care or that she is not committed, but that she has not delivered. That is the basis on which we Conservatives have used the device of this debate to demonstrate our belief that she should resign.

6.26 pm

Mr. Ian Austin (Dudley, North) (Lab): I am delighted to speak in this debate, which gives us the opportunity to set out some of the dividing lines between the parties on the health service, to examine some of the choices that the British people will face at the next election and to consider the Government’s record on some of the issues.

The hon. Member for Welwyn Hatfield (Grant Shapps) said that he did not want to talk about his constituency, but I want to talk a little about mine because some of the things that we have seen in Dudley demonstrate well some of the wider improvements of the health service across the country. It is fair to say at the outset that none of the improvements in Dudley would have been possible without the leadership of the Secretary of State and her colleagues. That is why I am speaking against the Opposition motion today.

Dudley primary care trust has undertaken wide-ranging reforms to services in the community in the past few years. As a result, my constituents now receive in their own homes personalised, individual care that would previously have been found only in hospitals. New ways of working introduced by this Government mean that care is tailored more than ever to meet the specific needs of the individual patient.

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