Managing Risk in the NHS

Debate between Andrew Selous and Andy Burnham

Wednesday 17th July 2013 Commons Chamber

[Andy Burnham]

Promises were made before the reorganisation to my hon. Friend and his colleagues in St Helens, Knowsley and Halton about the future of the hospital, because there was concern that certain commitments would not be honoured by the new organisations. And it came to pass: they were not honoured. My hon. Friend asked whether the Secretary of State had been to an A and E. We know that he did not turn up at one until April, yet he had already stood up and criticised hospitals for “coasting”. How on earth could he make such comments when he had not bothered to get his feet on the ground to see what was happening in the NHS? Unbelievable.

The Government took a huge gamble when they proceeded with the reorganisation at a time of financial stress and in the teeth of opposition from the public and the professions. If the Secretary of State truly believes, as he said yesterday, that transparency is a disinfectant—he is nodding—and if he wants to show leadership from the front from today onwards, should he not now commit to publishing the risk register that accompanied the Government’s reorganisation of the NHS? [Interruption.] He claims again that this was all about the last Government, but let me explain the difference to him. This Government withheld the risk register in defiance of the Information Rights Tribunal and the Appeal Court. Is he proud of that? What message does he think that that sends to the boards of those NHS organisations that he is now asking to act with maximum transparency? I am afraid that it sends absolutely the wrong message. He will not foster the right culture in risk management in the NHS if there is one rule for the Department and another for everybody else.

[Andrew Selous (South West Bedfordshire) (Con)]

What is the right hon. Gentleman’s view of the previous culture of secret board-to-board meetings, at which the boards of a local trust and a strategic health authority met in private to try to deal with issues? In retrospect, does he agree that that was probably not the best way to deal with serious issues, because the very people who were responsible would perhaps not get the blame?

[Andy Burnham]

Let me give the hon. Gentleman a direct answer. One of the things that shocked me most when I received the Francis report, which I commissioned under the previous Government, was the revelation that on receiving foundation trust status, the board of Mid Staffordshire NHS Foundation Trust had begun to hold its meetings in private, rather than in public. It had taken the freedoms, yet decided to become more secretive. That was fundamentally unacceptable, and I made that point loud and clear to the NHS when I received that report. I do not think that there is any difference between us on this. I believe in openness and transparency too. Ours was the Government who brought in the Freedom of Information Act and independent regulation for the NHS. On that matter, we can make common cause.

Accident and Emergency Waiting Times

Debate between Andrew Selous and Andy Burnham

Wednesday 5th June 2013 Commons Chamber

[Andy Burnham]

My hon. Friend is absolutely right. Two-thirds of NHS finance directors have identified social care and its collapse as the single biggest driver of the pressure on A and E. The Government do not like to talk about that because of the record my hon. Friend just outlined, and I will come to that later in my remarks.

The Secretary of State visited his first A and E in April, and NHS England requested action plans only on 9 May, when hospitals had already been battling with the problem for months. It is simply not good enough. The NHS needs leadership and he has not provided it; instead, he has stuck to the spin. He continued to blame the GP contract, even when experts queued up to tell him it was not the cause of the problem. The NHS Confederation, the Royal College of General Practitioners, the King’s Fund and the Foundation Trust Network all told him that the causes lay elsewhere, but he was not listening because it did not suit his argument. When the NHS needed a Secretary of State, it was left with a spin doctor-in-chief.

That brings us to the crux of this debate and the charge that I lay directly at the Secretary of State’s door. By persisting with spin and by diverting attention elsewhere, the real causes of this crisis have been left neglected.

[Andrew Selous (South West Bedfordshire) (Con)]

If the right hon. Gentleman looks at the graph of A and E attendances, he will see that the figure was pretty constant at 14 million until 2003-04, when it rose steadily to 21 million. Why does he think that there was that big rise in A and E attendances at the time of the change to the GP contract?

NHS Funding

Debate between Andrew Selous and Andy Burnham

Wednesday 12th December 2012 Commons Chamber

[Andy Burnham]

This is the reality on the ground, as my hon. Friend says. There is also the mental health budget cut. There has been a mismatch; people see all those things, yet they hear the statements from the Government, and it does not make any sense, but now the truth and the facts about our NHS are being told, and things will begin to make sense to people.

What I find most troubling about all this, and most revealing about the Government’s style and the way that they work, is that even when they are warned by an official watchdog, they just carry on—as they are doing today—as if nothing had happened. When they admitted cutting the NHS in 2011-12 by amending their website, what was the excuse that they offered to Sir Andrew? Labour left plans for a cut; that is what the Prime Minister said at the Dispatch Box last week. It is what the Secretary of State said in a letter replying to Mr Dilnot. Again, that is simply untrue.

According to Treasury statistics, Labour left plans for a 0.7% real-terms increase in the NHS in 2011-12. From then on, we had a spending settlement giving real-terms protection to the NHS budget. It was this Government who slowed spending in 2010-11, who allowed the resulting £1.9 billion underspend to be swiped back by the Treasury, contrary to the Secretary of State’s promise that all savings would be reinvested, and who still have published plans, issued by Her Majesty’s Treasury, for a further 0.3% cut to the NHS in 2013-14 and 2014-15, contrary to the new statement that the Conservatives have just put on their website. The Secretary of State has a lot of explaining to do.

[Andrew Selous (South West Bedfordshire) (Con)]

I should be interested in the right hon. Gentleman’s comments on the statement by John Appleby, the chief economist of the King’s Fund, who said that before the general election, the former Chancellor left plans for 2011-12 and 2012-13 that would see a cut in real terms. What does the right hon. Gentleman say to that?

[Andy Burnham]

I have not seen the quote, but I did the deal with the former Chancellor of the Exchequer just months before the general election, protecting the NHS in real terms. A deal was done for schools and for the Home Office too. Those were the plans. At the election I was arguing for real-terms protection. The Secretary of State was on the hustings calling for real-terms increases. I said it would be irresponsible, yes, to give real-terms increases over and above real-terms protection because the only way he could pay for that would be taking it off councils, hollowing out the social care budget. That is what I said at the election, but the right hon. Gentleman has not even given real-terms protection. He has cut the NHS in real terms, so it beggars belief that he has the nerve to heckle and shout out from the Front Bench, when he has cut the NHS lower than the plans that I had left in place.