NHS Commissioning Board

Kevin Barron Excerpts

Tuesday 5th March 2013 Commons Chamber

[Norman Lamb]

We will make absolutely sure that the amended regulations meet faithfully the commitments given in the Upper House during the passage of the Bill, and in the letter sent to clinical commissioning groups by the former Secretary of State following the legislation.

[Mr Kevin Barron (Rother Valley) (Lab)]

During the passage of the Health and Social Care Bill, the Government withdrew clauses that promoted competition and replaced them with clauses that would prevent anti-competitive behaviour. I never understood that at the time. Is it not the case that compulsory competitive tendering is the intention of the regulations and the intention of the original Act?

[Norman Lamb]

The right hon. Gentleman’s own Government had guidance in place precisely to address anti-competitive behaviour. Let me again reiterate that these regulations will not introduce compulsory competitive tendering. The amendments that we will table will make it absolutely clear that the power rests with clinical commissioning groups, and not with the Government, Monitor or anyone else.

South London Healthcare NHS Trust

Kevin Barron Excerpts

Thursday 31st January 2013 Commons Chamber

[Mr Hunt]

On the merger, may I gently point out that I want to follow the hon. Lady’s advice if she is against people deciding things from the top down. It is for local trusts to negotiate such things, and they must do so on the basis of what is in the clinical interest of the population they serve. I will not be a Secretary of State who steps in and stops those things happening, unless they amount to a reconfiguration, in which case procedures are in place that require proper democratic support for any changes.

On the changes to maternity provision in Lewisham, we have allocated £36 million to expanding the capacity at those other hospitals that will take on more complex and high-risk births as a result of the proposals, and we will work closely with those trusts to ensure that that capacity is in place. I agree with the hon. Lady that it is extremely important for such work to be done in a meticulous way so that we get the better clinical outcomes we want as a result of what I am announcing today.

[Mr Kevin Barron (Rother Valley) (Lab)]

I sat on the Health and Social Care Bill Committee. The principle in that Bill, which became an Act last year, was that clinicians will be in charge. The lead clinical commissioner has said that this downgrading would pose a huge risk to health outcomes in Lewisham. How does that square with the provisions of that Act passed in this House last year?

[Mr Hunt]

Clinicians and commissioners have been closely involved in these proposals which, as the right hon. Gentleman will know from reading my statement, affect the broader south-east London area covering six clinical commissioning groups. Five of those groups support the proposals. One does not, but it supports the principles behind them, which is that more complex procedures must be carried out on fewer sites. We have had the benefit of the clinical input of senior people such as Sir Bruce Keogh, and many of the royal colleges have been involved in the external clinical advisory group, which had significant input on the proposals. One question I asked Sir Bruce was whether there had been sufficient clinical input, and his conclusion was that yes, there had been.

Oral Answers to Questions

Kevin Barron Excerpts

Tuesday 15th January 2013 Commons Chamber

[Mr Kevin Barron (Rother Valley) (Lab)]

The independent reconfiguration panel has already visited Leeds and I understand that it will visit again before that date. If it decided that both Leeds and Newcastle ought to stay open, would that be agreed?

[Mr Hunt]

I will make my decision when I have the IRP’s final recommendation. Obviously I cannot speculate on what the final decision will be, but let me reassure the right hon. Gentleman, as I did with my hon. Friend the Member for Brigg and Goole (Andrew Percy), that my decision will be taken on the basis of clinical need—in other words, what will save the most lives.

NHS Funding

Kevin Barron Excerpts

Wednesday 12th December 2012 Commons Chamber

[Mr Kevin Barron (Rother Valley) (Lab)]

I am sorry that the Secretary of State is leaving because, before going on to discuss what is happening in my local health community and local hospital, I want to pick up on a couple of the things that have been said. First, I am pleased that this very dry motion has been tabled because I hope that it will concentrate our minds on what is happening in the national health service and, in particular, to spending.

The Secretary of State said that spending is related to budgets. He did not respond to the point posed by my right hon. Friend the Member for Leigh (Andy Burnham) that in 2010-11, there was a £1.9 billion underspend in the national health service budget. No use was made of the budget exchange scheme, so none of that money was moved into the following financial year. We can assume that £1.9 billion went back to the Treasury.

In the following year, 2011-12, the underspend was £1.4 billion, and £316 million was carried over into 2012-13. An underspend in the region of £3 billion from the first two years of this Government—including the year they won the general election—has gone back to the Treasury. Those are the facts; I do not know if any Front Bench Member wishes to dispute them.

[The Minister of State, Department of Health (Norman Lamb)]

Does the right hon. Gentleman also acknowledge that the average underspend in the last four years of the Labour Government was £1.9 billion?

[Mr Barron]

I recognise that there has been underspend, but I take this debate, and the debate we had running up to the general election, a bit more seriously. The chairman of the UK Statistics Authority said that there had been an underspend, and what we have just heard is not true. As my right hon. Friend the Member for Leigh (Andy Burnham) said, the Conservative party manifesto stated:

“We will increase health spending in real terms every year.”

[Mr Graham Stuart]

Will the right hon. Gentleman give way?

[Mr Barron]

I will give way in a few minutes. When the Conservative party was in opposition, the current Prime Minister said in 2009:

“With the Conservatives there will no more of the tiresome, meddlesome, top-down re-structures that have dominated the last decade of the NHS.”

I want to keep reminding hon. Members of that because, as my right hon. Friend the Member for Leigh pointed out, we may be able to take £20 billion out of a budget over four years—that is a big ask and has never been done anywhere in the public or private sector—but to do it while we are also having mass reorganisation is creating chaos in the health service. I will refer to what is happening in my local health service in a few minutes.

In 2007 the right hon. Member for South Cambridgeshire (Mr Lansley) was shadow Secretary of State for Health, although he has now moved to Leader of the House. He said that the NHS needed

“no more top-down reorganisations.”

Indeed, in terms of expenditure the coalition agreement stated:

“We will guarantee that health spending increases in real terms, in each year of the Parliament, while recognising the impact this decision will have on other departments.”

It also stated:

“We will stop the top-down re-organisations of the NHS”

so we can take that with a pinch of salt as well.

[Mr Graham Stuart]

rose—

[Mr Barron]

I will give way to the hon. Gentleman before I move on to what is happening to the NHS in the real world.

[Mr Stuart]

Like my right hon. Friend the Member for Charnwood (Mr Dorrell), the right hon. Member for Rother Valley (Mr Barron) is a former distinguished Chairman of the Health Committee. My right hon. Friend rightly said that spending on the NHS is broadly flat, and that the most important question we should be debating, rather than scoring points over 0.1% of spend, is how to use the money most effectively. Does the right hon. Gentleman agree with that, and that we must look at the allocation of spend around the country? I represent a rural area and it does not seem as if funds are fairly allocated now.

[Mr Barron]

The issue of allocation has been looked at by many Select Committees, including by the Health Committee when I chaired it in the last Parliament. We did not find the level of unfairness that people, particularly those from rural areas, used to say there was. We looked for it but we did not find it.

Let us look at what is happening in the real world. My local Rotherham hospital foundation trust is not a bad hospital trust in any way and scores quite well in many areas. It received foundation trust status a number of years ago, and when this Government took office, it is fair to say that the efficiency factor was there already. On 16 March 2011 the trust announced that more than 60 jobs were to be axed at Rotherham general hospital, and confirmed a potential reduction of 62 posts in medical and surgical areas. Earlier this year on 6 March 2012, the local BBC announced that more than 70 NHS staff were facing the threat of redundancy, and the trust is seeking to save about £4 million. On 26 October 2012, an internal report given to the local media stated that the trust now intends to cut 750 jobs—about 20% of its work force—by 2015.

The NHS trust said that it needed a smaller hospital with substantially fewer beds and a smaller work force to save £50 million over the next four years. The internal report—aptly named, “Creating Certainty in an Uncertain World”—said that it was necessary to save £50 million from the £220 million budget before 2015 to meet Government targets. That was confirmed by the trust in a press release.

On 5 November 2012, the chief executive of the trust said that it would show staff the plans and invite them to come back with alternative views on how things might be done differently. The trust stated:

“We’ve made it very clear that there may have to be redundancies, but to be honest with you until we have gone through the process, I don’t know how many we will be able to lose through natural turnover and how many will have to be made redundant.”

What type of planning is there in any of this when we have such a situation in a district general hospital on which about 80% of my constituents rely if they have to go into secondary care?

On 20 November 2012, the chief executive announced his retirement. On 3 December 2012, the hospital announced that staff will be informed about the decision to postpone the formal consultation launch into work force restructuring. It went on:

“We realise this an anxious time for all members of staff, but it is imperative that we do what is right for the Trust, our staff and our patients. This means that we need to take more time to ensure our workforce proposal is exactly what the Trust requires and we anticipate the launch to take place later in the month.”

On 7 December 2012—last Friday—a headline in the local newspaper stated that the trust had recently engaged the services of a director of transformation on a time-limited basis. The acting chief executive said:

“It is important that the trust acts quickly to take the action required to safeguard the future clinical and financial sustainability of the Trust. This appointment, which was made after a competitive process, is required to provide additional expertise and impetus to the changes we need to make, whilst allowing others to remain focused on delivering the healthcare services that the people of Rotherham need and deserve.”

I do not stand here and support the way the NHS has been structured now or in the past, and I have been critical about many areas of that. I agree with the chief executive of the NHS, David Nicholson, who said at the NHS confederation conference this year:

“We need to change the model of care to one which supports patients and focuses more on preventing ill health from happening in the first place...and move away from the default position of getting someone into a hospital bed.”

At the same conference the then Health Secretary said that closure decisions were not an issue for national politicians, and my right hon. Friend the Member for Leigh said that the current Health Secretary said very much the same thing—“It’s nothing to do with me, guv.”

Let me say to the Minister, and other hon. Members who have made relevant interventions, that if changes and reconfigurations inside the national health service are getting better care to more patients, that is fine. However, the chaos in my local health service is about cutting back and saving money. I have played an active role in health care in my constituency over many years and, as far as I know, there has been no debate with local Members of Parliament, patients, patient groups, local doctors or people engaged in health provision in Rotherham. There have been no discussions whatever about reconfiguring the district general hospital to improve the position of patients and of the people of Rotherham and the surrounding area. Instead there is a drive to save money, which is creating chaos in my local health service.

[Norman Lamb]

Does that not demonstrate a complete failure at local level to address the real problems that we are trying to grapple with? There is therefore a case for a changed system whereby a health and wellbeing board brings all the parts of the system together to debate such issues.

[Mr Barron]

The events of the past two months suggest to me that the people in whom the Minister has faith to reorganise health care in Rotherham do not know what they are doing. They have brought in new systems and produced a report inside the hospital, which I understand was given to the trade unions. It ended up on the front page of a local newspaper and was countered by a press release by the hospital itself. Where is the debate about improving health care for my constituents and others? It is absent.

I say to the Minister that it was wholly wrong for the previous and current Secretaries of State—he is not the Secretary of State himself, but we never know, he may be one day—to say “These are not matters for Ministers”. I have not been consulted about them. The three local MPs had an appointment with the chief executive of the trust about two weeks ago, but it was cancelled because he had announced his retirement the week before. That is not acceptable.

The hard reality on the ground is that no matter what we would like to happen in health care, trusts are charging into cutting budgets. They are cutting jobs, because that is where the major expenditure is in health care, and that is creating the chaos that I have described. It is not acceptable. My constituents pay their taxes to pay for health care—it does not come out of the budget down here in Westminster—and they deserve better than what they are getting at the moment.

Care and Support

Kevin Barron Excerpts

Wednesday 11th July 2012 Commons Chamber

[Mr Lansley]

My hon. Friend makes an important point. We want people who move from England to Wales or from Wales to England to have continuity of care, so I will make it clear to my counterpart in Wales that I am entirely open to discussions about that. Given that it is a devolved matter, it is better in a sense if the initiative for those discussions comes from Wales, because I do not want to be interpreted as trying to impose any solution on Wales, but if the Welsh Government look for such discussions I will be open to them.

[Mr Kevin Barron (Rother Valley) (Lab)]

In response to the White Paper, the NHS Confederation has said that people are

“staying in hospital longer…because the right services are not in place to allow them to go home when they are medically fit to do so.”

Given that it is estimated that delayed discharges from our hospitals cost some £18 million a month, what action are the Government taking to get rid of that waste of public money?

[Mr Lansley]

The total number of delayed discharges is broadly the same as it was last year and, I believe, from memory, the year before—I will correct the record if not. Some 29% of the delays in discharge from hospital are due to the inability to access social care. Most of them arise because people are awaiting further assessment or treatment in the NHS. We have all the details of delayed discharges and are working actively to reduce them.

NHS Annual Report and Care Objectives

Kevin Barron Excerpts

Wednesday 4th July 2012 Commons Chamber

[Mr Lansley]

I am grateful to my hon. Friend. There are many ways in which we can improve the control that patients can exercise, including greater opportunities for patients to exercise choice. In my announcement today, that includes the opportunity for patients to choose alternative providers of NHS care if, for example, the standard of 18 weeks that the constitution sets is not met. I might say that, at the last election, 209,000 patients were waiting for treatment beyond 18 weeks. That number has been brought down to 160,000.

My hon. Friend makes an important point about the exercise of control on the part of patients, who have an opportunity to access clinically appropriate care through the NHS. We will make sure that that is available and, as he knows, in relation to homeopathic treatments, for example, we have maintained clinicians’ ability across the service to make such treatments available through the NHS when they think that it is appropriate to do so.

[Mr Kevin Barron (Rother Valley) (Lab)]

I have not been able to read the annual report in the last few minutes, but may I ask the Secretary of State for Health whether it gives any information on the benefits of high-street pharmacy companies taking over the running of hospital pharmacies?

[Mr Lansley]

No, the annual report makes no reference to that. It refers—I hope, for the first time—in detail to the performance of the NHS over the past year. If the right hon. Gentleman wishes to raise any issues about that, I shall be glad to respond to him separately.

Cigarette Packaging

Kevin Barron Excerpts

Tuesday 17th April 2012 Commons Chamber

[Mr Robinson]

I agree entirely with the hon. Gentleman, and I am very pleased to say so. He mentions some of the advertising gimmicks and marketing subterfuges to which the industry has stooped. The evidence that this is achieving success lies in the fact that two thirds of those currently smoking started when they were younger than 18. That is why we have to deal with this matter and take measures to deal more effectively with the counterfeiting problem.

[Mr Kevin Barron (Rother Valley) (Lab)]

Will my hon. Friend give way on that point?

[Mr Robinson]

For the very last time.

[Mr Barron]

I congratulate my hon. Friend on securing this debate. Some countries have managed to deal with counterfeiting quite well. There are barcodes on all cigarette packages; the problem is the policing of them. Counterfeit cigarettes are not all sold out of car boots, as they are sold in some retail outlets, too. We need enforcement in those areas and to confiscate any smuggled cigarettes.

[Mr Robinson]

I agree entirely that the barcoding and other anti-illicit sales measures are not being policed readily enough, which brings me back to the need for Government action at the local level in enforcing the required measures. That can be done only when the group of agencies that I mentioned work together with that sole purpose in a truly linked-up manner. It will not work on any other basis.

I have given way many times, but I know that our debate is restricted to half an hour. I am sure that we will have occasion in future to debate the issue more fully on the Floor of the House almost certainly at the end of the consultation period. I look forward to those debates and to my participation in them. Let me make my own position clear, as all right hon. and hon. Members, the Government, the Opposition and other parties will have to do the same. On balance, I believe that plain packaging would help to reduce smoking, which we desperately need to do. Indeed, I would go further and say that plain packaging could be an important milestone in making cigarettes and their brands pariah products—a status that is richly deserved.

Oral Answers to Questions

Kevin Barron Excerpts

Tuesday 27th March 2012 Commons Chamber

[Paul Burstow]

There is not a nationally mandated programme of walk-in centres; rather, it will be for local commissioners to make decisions based on the evidence and their evaluation, and ensuring that they fulfil their contractual obligations.

[Mr Kevin Barron (Rother Valley) (Lab)]

Is it not the case that the walk-in centre that opened in Rotherham a few years ago has given communities that are higher on bad health indices access to health care 12 hours a day, seven days a week? Getting rid of it—it was opposed by some local doctors, because it threatened their business—would be a backwards step. Can we expect the new commissioning groups to start commissioning GPs in areas such as mine, which are higher on bad health indices and do not have enough general practitioners?

[Paul Burstow]

I am grateful to the right hon. Gentleman for his question, because he outlines the need to reduce health inequalities—something that the party of which he is a member failed to do in government. I can assure him that the Bill, which has now gone through all its parliamentary stages, will place a duty on clinical commissioning groups to seek to reduce health inequalities —something that his Government never did.

Health and Social Care Bill

Kevin Barron Excerpts

Tuesday 28th February 2012 Commons Chamber

[Mr Lansley]

I am grateful to my right hon. Friend and thank him for his positive remarks about my noble Friend Earl Howe. I attach to that my appreciation to Baroness Northover for the work she has been doing in another place and to the Minister of State, Department of Health, my hon. Friend the Member for Sutton and Cheam (Paul Burstow), who is responsible for care services, who has been heavily engaged in discussing some of the amendments. I recall that nearly a year ago there was a clear expression of interest from the Liberal Democrats, as a party, on how they felt the Bill should be improved. I was pleased that we were able to bring forward changes that reflected virtually all those. Indeed, they are reflected directly in what my right hon. Friend the Deputy Prime Minister said in his letter yesterday.

[Mr Kevin Barron (Rother Valley) (Lab)]

If the competition in the Bill is just an extension of what the previous Government did by introducing independent sector treatment centres and everything else, why are more than 90 clauses writing into the law of the land that competition policy should run the NHS, not the NHS, as has been the case in the past?

[Mr Lansley]

I would not characterise this as an extension of the independent sector treatment centres programme. That is precisely what we do not need to do with the private sector. Under the Labour Government, the private sector was paid 11% more than the NHS, which was wrong, and in another place there is a legislative provision that will prevent discrimination in favour of the private sector. The Bill will carry forward exactly the principles and rules of co-operation and competition, as reflected in the panel set up under the previous Government. As NHS Future Forum set out, the reason for having that in the Bill, with Monitor exercising those responsibilities, is so that there will be a health sector regulator, rather than that being done without health expertise by the Office of Fair Trading.

Oral Answers to Questions

Kevin Barron Excerpts

Tuesday 21st February 2012 Commons Chamber

[Mr Burns]

My hon. Friend is absolutely right, because we need to drive up the quality of care. What we are doing with the Health and Social Care Bill is closing a loophole so that there can be no favouritism towards the private sector, so the travesty introduced under the previous Government, including the right hon. Member for Leigh (Andy Burnham), whereby independent treatment centres had an advantage that put the NHS at a disadvantage in providing care, and were paid more than the NHS, will stop, because it is unacceptable.

[Mr Kevin Barron (Rother Valley) (Lab)]

Part 3 of the Health and Social Care Bill will introduce competition policy to the NHS by law for the first time in its history. Does the Minister think that that is likely to lead to more private care in this country or less?

[Mr Burns]

I am sorry, but the right hon. Gentleman, who always asks this question, is wrong. We have not introduced competition into the NHS; it was there under the previous Administration.