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The new access fund will also establish at least 150 new GP-run health centres in easily accessible locations, open seven days a week from 8 am to 8 pm.
These will offer bookable appointments, walk-in services and, in some cases, access to physiotherapy, diagnostics and social care services. There will be at least one in each PCT area.
More than a third of GP time is spent dealing with mental health problems, from which one in six people suffer at any one time. Mental illness accounts for 40 per cent. of those on incapacity benefit. Prescription medication provides a successful treatment for many, but we know that psychological therapies work equally well, and often prove to be more effective in the long term. The time has come to do much more to help those with depression and anxiety.
I can announce today—which is, of course, world mental health day—that we will build a groundbreaking psychological therapy service in England. Backed by new investment rising to £170 million by 2010-11, the service will be capable of treating 900,000 additional patients suffering from depression and anxiety over the next three years. Around half are likely to be completely cured, with many fewer people with mental health problems having to depend on sick pay and benefits.
Thirdly, we want an NHS that is innovative. British scientists have been responsible for discovering some of the most important medical breakthroughs in history. In this modern age of rapid medical scientific and technological advance, we must ensure that the NHS remains at the cutting edge of developments in products, processes and procedures.
We will establish a new health innovation council to drive a more innovative NHS, identifying and removing barriers to change. The council will bring together all the splendid work that is going on, from discovery through development to adoption, and ensure that ideas can pass efficiently from the labs to patients without any compromise to patient safety. In addition, we will set up a new £100 million fund for innovation jointly funded with the Wellcome Trust.
We will also expand the single fund for health research to £1.7 billion. In the 18th century, Edward Jenner discovered the smallpox vaccine. In the 19th century, British scientists developed anaesthetics and antiseptics. In the 20th century, Alexander Fleming discovered antibiotics. In the 21st century, we want British scientists to combine to lead in the fight against global killers such as cancer and HIV/AIDS.
Fourthly, we want an NHS that is safe. Health care-acquired infections are a growing problem around the world. Hospital cleanliness should be the last concern of patients and the first duty of everyone in the health service. We have announced that all hospitals will be deep cleaned at least once a year. Isolation wards will be extended wherever possible, and we will empower and encourage matrons and nurses to use their expertise to fight infection on the front line.
The Health and Social Care Bill contained in our draft legislative programme will provide the new health and adult social regulator with tougher powers, backed by fines, to inspect, investigate and intervene in those hospitals that fail to meet hygiene and infection control standards. As Lord Darzi recommended and the CSR provides for, we will invest £130 million to introduce MRSA screening for all admissions, elective and
emergency, over the next three years. We will also put a further £140 million into reducing clostridium difficile infection rates.
To develop an NHS that is clinically led and locally driven we need more local accountability. I have already said that there will be no top-down structural reorganisation of strategic health authorities and primary care trusts for the foreseeable future. Although we must ensure minimum standards, we will not impose a swathe of new targets. We know that future improvements will come from more local ownership, fewer top-down targets and concentration on better health outcomes.
As Lord Darzi has said, any change to NHS services must clear a high clinical bar, based on full engagement with patients and the public. Ensuring that the health service is clinically led will be pivotal to ensuring that the service moves from good to great—world class in all aspects instead of just some. How we match local ownership with greater local accountability will be one of the principal aspects of Lord Darzi’s continuing work.
The historical problem for the health service has been under-investment. The challenge today is to ensure that we maximise the potential of this unprecedented level of increased investment. The public want more money to be spent on the NHS, but they also require it to be spent well. Measuring productivity when quality of care is paramount is not an easy task, as Wanless highlighted recently. The better care, better value indicators, published yesterday, showed that £363 million of productivity improvements were achieved last year. Those first-step savings came from reducing the length of stay and from increasing prescriptions of low-cost generic statins for patients with high cholesterol. Those gains are modest but they point to the potential of what can be achieved without compromising patient care.
We must now look to build on these achievements, systematically and sensibly. Over the course of this spending round, the NHS will deliver average value for money gains of 3 per cent. every year, releasing more than £8 billion a year by 2010-11 to spend on front-line care. There are some obvious areas that can contribute in that difficult task. Improving community-based services so that people with long-term conditions can receive greater support in the community could bring savings of about £500 million a year. Intervening with preventive action, such as regular health check-ups, when someone is at risk of illness could reduce the costs of chronic lifestyle diseases such as diabetes, heart disease or lung cancer. Spreading new technologies and best practice across the health service could lead to savings of £1.5 billion a year. Improving procurement could save £1 billion a year, and by introducing MRSA screening for all admissions we can reduce the risk of huge costs occurring later.
In the face of unprecedented demographic change, it is clear that our social care system needs to respond. The Chancellor has announced that we will develop a Green Paper exploring options for reform, with the aim of increasing dignity and reducing dependency for those who rely on our social care systems. The social care settlement is divided into two parts: local
government grant and direct funding from my Department for social care. The local government support grant will increase by £2.6 billion by 2010-11 and direct funding from the Department of Health for adult social care, which covers, for example, carers, mental health and the social care work force, will increase by an average of 2.3 per cent. a year in real terms, worth £190 million.
That funding will enable social services to do more to give service users and their carers greater choice and control over the way in which their needs are met. In particular, the investment will enable further expansion of care tailored to the individual; it will go into prevention and improving people’s quality of life. It will enable more individuals to live independent lives in their own home. But as the Wanless report on social care identified, we need a radical rethink about how we fund that crucial element for everyone in need, not just the elderly, in the future. The Green Paper will begin that important process.
Those are our concrete plans for future investment in the NHS, which our party created and then rescued from Tory decline. The Opposition promise to spend £2 billion on a tax cut for a wealthy elite, whereas we will spend that money on delivering a better health system for all our people. They have a black hole to fill and a dilemma to fix: either they break their promise on inheritance tax or they break their commitment to match our investment in the NHS.
Lord Darzi and his team of 1,500 clinicians will finalise the NHS next stage review in time for the 60th anniversary of the NHS. This is an exciting time for everyone involved in health care, but as the comprehensive spending review demonstrated, it is patients and the public who will continue to benefit from a national health service that is rising to the challenges of the 21st century. I commend the statement to the House.
Mr. Andrew Lansley (South Cambridgeshire) (Con): I am grateful to the Secretary of State for the opportunity to see the statement in advance. I am sure that the House will be grateful for the opportunity to debate the announcements on health spending that were made yesterday, and indeed Lord Darzi’s interim report, which was mysteriously brought forward to be part of what we have just heard from the Secretary of State—a cobbled-together, pre-election series of announcements, which add up to no vision at all for the future of the national health service.
Where was the reference to patient choice in what the Secretary of State had to say? Where was the reference to a voice for patients, a voice that the Government have persistently taken away from them? Where is the freedom for doctors, nurses and NHS professionals, so that they can deliver the care that they want for their patients, free from top-down targets? Where are the separate public health investment and the dedicated resources for delivering on public health measures, which have failed under the Government in the past decade? Where was the reference to an NHS that is open to new providers, bringing in new investment and new capacity? In contrast, over the past year the Government have cut the national health service’s prospective building budgets.
The Secretary of State talked about Derek Wanless. Let me remind him that last month Derek Wanless reviewed the report that he gave to the Prime Minister. He said,
“what is equally clear from this review is that we are not on course to deliver the sustainable and world class health care system, and ultimately the healthier nation, that we all desire.”
And why? Because none of the three requirements that Wanless set out five years ago—the need to improve productivity, technology and public health—has been met. There was nothing about improving public health in what the Secretary of State had to say. There was nothing about technology or the review, which is absolutely necessary, of the NHS IT programme.
On productivity, we all know, as do people working in the national health service, that what really matters is not just the resources that they receive, but the ability to deliver improving and effective care as a result of them. However, in reality, under this Government there has been bureaucracy, over-regulation, distorting top-down targets and declining productivity. The Office for National Statistics made it clear that there has been a 1.3 per cent. a year reduction in productivity in health care. Just last month, it said that there was a 2.1 per cent. a year reduction in productivity in social care.
The Secretary of State reiterated the numbers from yesterday’s comprehensive spending review statement, but as always with this Government, and in particular with this Prime Minister, one has to look at the small print. The Secretary of State says that there is a 4 per cent. real-terms increase, but in reality, in the Budget in March this year, the then Chancellor of the Exchequer took £2 billion out of the national health service’s planned capital budgets. Yesterday, the Chancellor of the Exchequer said that he would put that £2 billion back in by 2011, but of course, as he had reduced the denominator, he made the percentage increase look larger than it would otherwise have done. If the £2 billion that had been taken out in March was still in planned Department of Health spending, the real-terms increase to 2011 would have been just 3.2 per cent. That is less than half the rate of increase of recent years and, indeed, well below the 4.4 per cent. minimum real-terms increase that Derek Wanless recommended to the then Chancellor five years ago.
The NHS needs certainty. Given that the Government have failed on reform and that the NHS needs a new Conservative Government as soon as possible who will deliver that reform, I make it clear to the House that a Conservative Government will match the Government’s proposed health spending through to 2011. But we will spend the money better. We will not be a Government who cut 8,000 beds as a consequence of financial deficits when patients are contracting hospital-acquired infections because of excessive bed occupancy. We will not be a Government who permit a situation where 14,000 junior doctors apply for training posts and do not attract them in the first round. We will not have a situation where trained nurses, physiotherapists and midwives who are needed in the NHS cannot find jobs. We will be a Government who deliver better productivity.
The Secretary of State said that 1 million more operations were taking place. If the productivity gains before 1997 had continued since then, there would be
2 million more operations taking place in the NHS rather than 1 million, and waiting lists would be a thing of the past.
What have we heard from the Secretary of State? He has given us re-announcements—I have the details here, should hon. Members wish to see them. In January 2006, the previous Secretary of State said that the Government were going to remedy the failures of their own general practitioner contract and secure more GPs in deprived areas. Two years ago, we were told that that would be done with immediate effect—that did not happen. In January 2006, we were told that there would be extended opening hours for GPs, but that has not happened and the Government are re-announcing the measure now.
The Secretary of State said that there will now be money for screening for admissions to hospital. Does he not know that such a provision is already in the published code of practice, which was debated in this House, but it just has not been implemented? He is now borrowing our policies. In our manifesto for the last general election, we made it clear that we would provide additional resources for the rapid screening of patients for hospital-acquired infections. It has taken two and a half years for the Government even to catch up with our policies.
The Government’s latest announcements contain a U-turn in respect of individual budgets that embrace both health care and social care. We have recommended that. If the Secretary of State were to think back to January 2006 and the White Paper, he would recall that when I challenged his predecessor to do precisely that, she and the Government said that they would not do so. They have now had to do a U-turn and accept Conservative policies.
On social care, the Government have failed time and again. The Secretary of State talks about a partnership model, but the King’s Fund report made it clear that Kent county council, a Conservative local authority, had undertaken a pilot project on a partnership model and wanted to do further analysis. What did the report say? It stated:
“In the end, Kent County Council found there was no appetite from either the Department of Health or the Treasury to fund further modelling on how such a scheme could be implemented, each department wanting the other to sponsor the work.”
The Government cannot join up the work of Departments—in fact, there is not even a joined-up approach inside the Department of Health.
Today’s social care announcements are for a 1 per cent. real-terms increase in social care budgets in local authorities, the effect of which will be to create additional charges for adult social services in local authorities across the country and to force an increase in council taxes. Those will be the consequences, but what we need are individual budgets and the greater efficiency that will come from them.
I welcome the Secretary of State’s comments about support for talking therapies and mental health services. Professor Layard and my colleagues have been asking for just that. Is the Secretary of State confident that the thousands of additional counsellors and therapists needed to make that happen will be available? Does he see this as reflecting the pilot in Newham, which has an integrated model with other agencies, or is it closer to the one in Doncaster?
What we have heard today contains no vision, but it does contain re-announcements of things that the Government have said before and policies stolen from the Conservative party. The Government are flagrantly unwilling to apologise for the cuts and closures that are happening in the NHS across the country because of their failed management. We have a Secretary of State who has no ideas of his own, a Government who have no chance of delivering change and a Labour party that has no hope at an election now or in the future.
Alan Johnson: That was very disappointing. The hon. Gentleman has been on the Front Bench since 2003, but nothing in his contribution takes us any further forward on health policies.
Let me deal with the first point, because it shows how pathetic the Opposition are getting. We have heard criticisms, the first of which was that we brought the Darzi report forward—another was that the Prime Minister opened a hospital twice. On the first point, I must point out to the hon. Gentleman that on 4 July I said in this House that Darzi’s interim report would be presented in three months—it was presented on 4 October, which was exactly three months later—and that it would come before the comprehensive spending review.
On the hospital, I must admit that I was rather crushed when I visited that splendid new facility in Basildon, of which we should all be proud, where some £60 million has been invested in cardiothoracic surgery. It was so exciting that I asked whether I could open it. I was told by the people running it, “No, we have asked the Prime Minister or the Queen to do it.” That put me in my place. Indeed, they wrote in early July to ask the Prime Minister to open it in October. Unless the Conservative party has been so long out of government that they have forgotten that many buildings open and then are officially opened some time afterwards, it is a strange —
Mr. Graham Stuart (Beverley and Holderness) (Con): Say something of substance.
Alan Johnson: The hon. Gentleman asks me to say something of substance. Well, I could mention the new community hospital being built in Beverley, which he curiously never mentions in any debate on health.
The hon. Member for South Cambridgeshire (Mr. Lansley) also said that we have somehow abandoned choice and abandoned new providers. The Minister of State, Department of Health, my hon. Friend the Member for Exeter (Mr. Bradshaw), has been talking all morning to the independent sector about precisely the announcement that I have made about introducing these new, state-of-the-art facilities, which will be open from 8 am to 8 pm, seven days a week, into 150 PCTs around the country. We are talking to the independent sector all the time. I have made it clear in the House that we will judge the use of the independent sector on whether it can add to capacity, whether it provides value for money and whether it can improve the service.
The hon. Member for South Cambridgeshire also mentioned Wanless. I shall make it clear what his report said:
“The funding increase has helped to deliver some clear and notable improvements—more staff and equipment; improved infrastructure; significantly reduced waiting times and better access to care; and improved care in coronary heart disease, cancer, stroke and mental health.”
“the direction of health care policy now being pursued by the government”
“correct to address the key challenges identified in the 2002 review.”
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