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6.27 pm
Mr. Peter Bone (Wellingborough) (Con): It is a great pleasure to follow the hon. Member for South Swindon (Anne Snelgrove), who made her points very powerfully. I will help her, I hope, with the points that I want to make.
I should like to concentrate on the final part of the motion on access to NHS services, which urges the House to call
“on the Government to ensure the fair allocation of resources, relative to burden”.
First, however, I pay tribute to the consultants, doctors, nurses and other professionals who work in our health service. They are a tremendous asset to the country, and their dedication, professionalism and care know no bounds. Many nurses and doctors work longer than required to put patient care first, but they are often unrewarded financially for doing so. They are an asset to the country, and were it not for them, the NHS would be in crisis.
Unfortunately, in past years and months, and even in the past few weeks, I have had to attend a number of NHS hospitals across the country. The one thing that all the staff wanted me to say in the House of Commons when they found out that I was a Member of Parliament was that morale is at rock bottom. I did not know before today’s debate that my hon. Friend the Member for South Cambridgeshire (Mr. Lansley) had the figures from a survey to prove that, but that was just what they told me. Wherever I was, they said that morale was at rock bottom. When I asked why, they said that the main reason was that the Government set them priorities and targets. They head in that direction for six months, but then the Government change the priorities and targets, and they head off in the opposite direction. They thought that clinical judgment was not appreciated, and was not being used. A very senior consultant—one of the top cancer care specialists in the country—said that the book and choose system has had an adverse effect. He said that part of every surgery must be reserved for people using that system. He said that as a result he sees people who could be seen by a junior doctor rather than people who are seriously ill whom he should see. That is because of direct Government intervention on his clinical judgment.
The hon. Member for South Swindon made a powerful speech about how well things are going in her area and how much extra investment there is. That highlights an aspect of my argument: the situation is not the same across the country. The national capitation formula is supposed to produce fair play across the whole of the NHS, but north Northamptonshire does not get a fair deal. By the Government’s own figures, over the past five years north Northamptonshire has been underfunded by £111 million. If we in north Northamptonshire had £111 million extra, we would not be denying patients access to certain treatments. I want to highlight such patients to give a few examples of what underfunding actually means. I am not trying to claim that the Government do not want to invest; I do not believe that
the Government want what is happening to happen, but because of how they have run the NHS—top-down, in a Stalinist manner—it is happening.
A 92-year-old constituent of mine has gone deaf. He currently manages to live on his own, but he cannot make do without a hearing aid. The waiting time to receive a hearing aid for that 92-year-old is 15 months, and yet they can, of course, be bought off the shelf. He has been let down; access to that has been denied him. There is also the case of a lady who needed a hysterectomy. My primary care trust has introduced a minimum five-and-a-half-month wait. When she eventually got into hospital, she was gowned up and had done all the tests when she was told at 5 o’clock in the evening, “Sorry, we can’t do it because the doctor’s run out of hours,” so she had to go back into the queue again.
There is also the issue of cancelled operations. I sat in a mixed ward and witnessed a consultant telling a patient on the other side of the room, “I’m sorry that we had to cancel your operation that was scheduled for six months ago. Unfortunately, your cancer has now got worse and the operation will be much more complicated.” That patient did not survive; he died on the operating table.
Let me give another example of a lady in my constituency who is almost 80 years of age. She went to hospital; it was not the local hospital as there is no hospital in my constituency, so she had to go to one in a neighbouring constituency. She was told that she was going blind and had macular degeneration and that the only way to fix it was to have injections of a drug called Avastin. The consultant told her that it was not available on the NHS but that if she went to the place down the road, she could have it done for £3,300. It is incredible that although we are supposed to have a national health service with access for everyone—and with great facilities in South Swindon—I have a constituent who will go blind unless her family finds £3,300. That cannot be the basis on which to run the NHS. It cannot be right that patients in my constituency can go blind because people in Whitehall will not fund the treatment they need.
6.34 pm
Mary Creagh (Wakefield) (Lab): I wish to speak briefly about the health care system in Wakefield, which presents a challenge, not least because we have to provide health care for two prisons. We have to provide mental health care, drugs and alcohol support and primary care in a women’s prison, a young offenders institution and in Wakefield prison, which is high security. A remote electrocardiogram system is now in place in Wakefield prison so that prisoners who might be having a heart attack can be remotely assessed by hospital clinicians, thereby avoiding the security risks involved in transporting prisoners to and from hospital, such as opportunities for escape.
According to the latest statistics, Wakefield has a positive first set of figures for the number of people waiting no more than 18 weeks to receive their treatment. At my local hospital, Pinderfields general hospital, 54 per cent. of patients received their treatment within 18 weeks. In a specialty such as gastroenterology, the proportion was more than 90 per cent. and in cardiology it was more than 70 per cent.
Therefore, it is clear that targets are driving down waiting times, and it is vital that we keep them in order to improve patient care. Nationally, targets have resulted in 50,000 extra lives being saved from cancer and 150,000 lives saved from heart disease. That is also linked to our target to treat people in accident and emergency units within four hours. Anybody who had to wait in an accident and emergency unit 10 or 15 years ago with a sick child, a relative or a friend in pain, wondering when they were going to be seen—as many Members must have done—will welcome that maximum four-hour waiting target. It simply did not exist 10 years ago.
I also wish to address accessibility to GP surgeries for people in wheelchairs and those with sight and mobility problems. Last year, I visited Kirkburton health centre in my constituency. It has a fantastic new centre, which was built under the LIFT—local improvement finance trust—scheme. It is fully compliant with disability and discrimination legislation, unlike some of the terraced housing that was all too prevalent under the Conservative years of NHS underfunding.
In Wakefield we have had a problem with access to dental surgeries. I am delighted that that has been greatly relieved by the opening of a new dental practice in Queen street, which last year took on 8,000 new patients and is this year due to take on another 8,000 patients—a total of 16,000 people, most of them my constituents, who have never had access to dental care, or who have not had that for many years. I visited the surgery on Friday; goodie bags were being given to children, containing little toothbrushes that could stand up, little balloons that carried the message,
“Twice a day for two minutes”,
and a special egg-timer—because we all know that it is not just about encouraging children to brush their teeth, but encouraging them to do so for a considerable period of time and many young children do not have the patience to do that. Wakefield is seeing its share of the £400 million national investment in dentistry.
Like other areas, our local primary care trust has been underfunded. However, I am delighted that no PCT will be more than 3.7 per cent. below its target by the end of this financial year. There have been huge real-terms cash increases for our PCT, and in terms of our secondary and acute sector it was announced today—the celebrations are taking place—that Mid Yorkshire Hospitals NHS Trust’s £340 million private finance initiative to build new hospitals on the Pinderfield and Pontefract sites has been signed, sealed and delivered. I pay tribute to John Parkes, the former chief executive, Julia Squire, the current chief executive and Sir Hugh Sykes, the chair of the trust board, for reducing the in-year deficit of one of our hospitals from £30 million two years ago to £13 million this year. The projection is that balance will be achieved by October this year.
I am also delighted that we have finally got £1 million transferred from the PCT to the acute hospitals to improve the hearing aid services for my constituents. My constituency is in an old industrial area where many people were involved in mining and there is a clear link between such heavy industry and drilling activities and hearing loss. As for the rhetoric about digital hearing aids, may I say, as a former hearing aid user, that people suffering hearing loss are not
necessarily always best served by a digital hearing aid? Analogue hearing aids can provide required levels of volume and clarity without the long waits that are associated with the fitting of new digital hearing aids.
To pick up on the points made by the hon. Member for North Norfolk (Norman Lamb), there are health inequality issues in Wakefield. People in my constituency live on average one year less than the national average life expectancy and seven years less than those with the highest life expectancy in Britain. Some 25 per cent. of the adult population are obese and we need to look at placing a statutory duty on primary care trusts to reduce those types of health inequalities.
In terms of access to health care, the new NHS choices website that was launched a couple of weeks ago provides patients with a great deal of information about what their local hospitals provide. For example, pregnant women in my constituency can look up Pontefract general infirmary and see vital information such as the number of women who knew their midwife in labour—in Pontefract it was 45 per cent. compared to an average of 22 per cent. They can also see if their local hospital has a neonatal intensive care unit or a special care baby unit, or a dedicated obstetric anaesthetist, which is related to my earlier intervention about waiting for an epidural. Crucially, women can discover whether, post-birth, they will have access to breastfeeding support—something that every mother would like to know. As we roll out choice and achieve greater transparency, we will see waiting lists and times coming down further.
The Conservatives will the ends but not the means when it comes to health care access. They voted against the national insurance increase that saw a huge cash injection for the NHS. They talk about abolishing targets that have been crucial in driving down waiting lists and tackling the scourge of hospital-acquired infections. I am delighted that the hon. Member for Wellingborough (Mr. Bone) is in his place. He did not mention his Cornerstone document, although some of the case studies that he mentioned came from it. He wants people to take out health insurance to cover all their family’s medical expenses. That would be
“set at a level to cover all your family’s medical expenses greater than 5 per cent. of your family’s income.”
That challenging new system would
“cover all serious medical conditions which could require significant costs.”
But the real driver of the document is in this sentence:
“An added bonus of this shift in policy would be a massive cut in taxation without penalising public services.”
The second part of that sentence is highly debatable. As in so many instances, the Conservatives offer warm words, but lying beneath them is cold comfort for families and patients in my constituency. We need to put our money where our mouth is, invest in the modern facilities that people deserve, and ensure that our NHS is safe as it approaches its 60th birthday and safe for the next 60 years.
6.42 pm
Tony Baldry (Banbury) (Con):
Geography is not convenient: the Horton general hospital in my constituency serves a large part of north and west Oxfordshire, south
Warwickshire and south Northamptonshire. It has been a general hospital for more than 100 years, but it is now facing the prospect of a serious downgrading of hospital services, including the removal of 24/7 paediatric care.
That level of paediatric care at Horton came about because of the death of a child. In 1974, Barbara Castle, then Secretary of State for Health, ordered an independent public inquiry, which ruled that there should be 24/7 paediatric care at the Horton. As a consequence of losing that care, we have the prospect of losing the special care baby unit and consultant-led obstetric and midwife maternity services.
When the Oxford Radcliffe NHS trust made those proposals, 86 GPs made a joint statement saying that they were unsafe and inhumane. As a consequence, the trust took its proposals off the table and set up two clinical working groups, which—slightly bizarrely—met and worked in secret. Many of us thought that their purpose was to wear down GP opposition to the proposals. Indeed, several GPs now say that although they are very unhappy about what is proposed, they consider it to be—and we should take note of this sentence’s construction—the least worst option. I do not want an NHS in my constituency that is the least worst option. Nor do I believe that Ministers want that.
The trust also set up a stakeholders’ group, with many members, including Labour councillors Surinder Dhesi, George Parish and Dr. Peter Fisher, who for many years was a consultant physician at the Horton and a Labour county councillor. The group has published a unanimous report, a bit like a Select Committee report, in which it expresses concerns. It says that
“health services must be designed in the best interests of patients and education and training should support that objective. Instead in Oxfordshire and other parts of England educational concerns are leading decisions about the pattern of healthcare with patient needs coming second. The position in maternity services is particularly acute as we understand that many more units across the country may be threatened by these changes to medical education and working hours.”
The group request that the trust
“raise this matter at a national level”.
I am glad that I have the opportunity to do so in the House today.
The group’s document also states that
“instead of being asked to consider a positive vision for the future we have found ourselves being asked to choose between the lesser of two evils—on the one hand there are the clinical risks inherent in the current service arrangements; on the other there are the proposals that by addressing the clinical risk will worsen access to services for local people. Both ‘evils’ are being driven by national policy changes which should be challenged...None of us believe that they”—
“are desirable.”
I have two questions for Ministers. First, how are any of us to explain to people that a substantial downgrading of NHS services is an improvement? I would welcome any Minister who wished to come to Banbury for a rational debate—this is not a partisan issue. As I say, the chair of the “Keep the Horton General” campaign is a Labour district councillor and the campaign has broad support across the community.
How can we explain that we are going back to pre-Barbara Castle days and that that is in some way an improvement?
My second question is what will Ministers do to protect smaller general hospitals, or are they content to see them downgraded? The stakeholder group concluded:
“The proposals that the clinical working groups have put forward may be a ‘least worst’ scenario but they represent a significant downgrading of access to services and a worsening of choice for women and children in the Banbury area.”
I cannot imagine that Ministers, or anyone, want to see a downgrading of access to the NHS for women and children.
Ministers should be concerned, because the Oxford Radcliffe trust seemed to suggest that the Royal College of Obstetricians and Gynaecologists had said that a maternity unit is not viable unless it has 2,500 births a year. The group points out that the college’s document, “Safer Childbirth: Minimum Standards for Service Provision and Care in Labour”, published in November 2006, actually says that units such as the Horton with fewer than 2,500 births should
“continually review staffing to ensure it is adequate based on local needs”.
“This does not seem to be saying that 2,500 is the minimum figure for births in an obstetric-led unit. Rather it seems to suggest that fewer hours consultant support would be required for this number of babies and that staffing levels should be determined locally.”
I would hope that Ministers would feel able to try to work out how health care provision in smaller general hospitals can be protected.
Sir Ian Kennedy, the chairman of the Healthcare Commission, in a recent speech, observed that
“it is terribly important that services and particularly maternity services, in the light of recent proposals from government and professional groups, keep their eye on the ball of safety as they go through the forthcoming period of change and development.”
I do not believe that making expectant mothers travel 26 miles, or more than an hour, to Oxford will necessarily enhance safety.
I hope that Ministers will hear what I have said and accept that it was not intended to be a partisan speech. Instead, I was making a genuine plea that they get a grip on what is happening in the NHS. They need to find ways to protect the services provided by smaller general hospitals, because people do not accept that the substantial downgrading of services in NHS hospitals is a way to improve the health service.
6.50 pm
Mr. Quentin Davies (Grantham and Stamford) (Lab): I wholeheartedly agree with a number of the ideas that have been thrown around this afternoon. First, it would be excellent to have elections to the boards of NHS hospital trusts, and the introduction of such elections would be thoroughly consistent with the spirit of the Prime Minister’s announcement this afternoon.
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