NHS Commissioning Board (Mandate)

Andy Burnham Excerpts

Tuesday 13th November 2012 Commons Chamber

[Andy Burnham (Leigh) (Lab)]

The Secretary of State has just reeled off an impressive wish list, but people across the NHS will be asking a simple question: how on earth can he ask the NHS to do more, when we learn today that 61,000 jobs have been lost or are at risk in the NHS? His statements are dangerously at odds with the reality on the ground and risk raising unrealistic expectations. Across England, services are under severe pressure with ambulances queuing outside A and E, patients left on trolleys in corridors for hours on end, and increasing numbers of A and E and ward closures. No wonder nurses’ leaders today warn that the NHS is “sleepwalking into a crisis.” To listen to the Secretary of State, however, it is as if none of that is happening.

A toxic mix of reorganisation and real-terms cuts risks plunging the NHS into a tailspin. Today, people will have been hoping for a mandate for common sense to restore sanity to an NHS that is in danger of losing the plot, and for instructions to protect the front line. Well, they will have been disappointed.

The Secretary of State glosses over finance, but let me give the House the facts. He and his predecessor promised to reinvest all efficiency savings in the NHS front line—[Interruption.] Yes, they say, yet we learn that £3 billion of NHS money has been swiped back by the Treasury. When will the Secretary of State stand up to the Treasury and keep promises that the Government have made to the NHS? While the NHS front line takes a battering, the Government keep throwing money at a back-office reorganisation that nobody wanted. A full £1 billion has been spent on redundancy packages for managers, more than 1,000 of whom have received six-figure payouts while 6,000 nurses get P45s. That is the scandalous reality of the coalition Government NHS.

Will the Secretary of State confirm that a single payoff of £324,000 was made to the former chief executive of NHS Bolton? How would he care to justify that to NHS staff in Bolton who are losing their jobs? There could be no clearer illustration of a Government whose priorities are completely wrong.

Let me turn to some of the specific points set out by the Secretary of State. First, he makes welcome commitments on care for older people. If that is his priority, however, why are there no instructions in this mandate to stop commissioners from imposing restrictions on essential operations for older people? Last year, there were 12,000 fewer cataract operations than in 2009-10. Older people were told that they could have an operation in one eye but not in two. The Government boast about shorter waiting lists, but that is because people cannot get on those lists in the first place. A postcode lottery is running riot and there is nothing in this mandate to stop it.

The Secretary of State’s promises on dementia will be nothing more than hollow words until he faces up to the crisis in council budgets for adult social care. Across England, older people and carers are facing a desperate struggle as council services such as home helps are cut to the bone. Millions of people are facing ever higher care charges—cruel coalition dementia taxes—as councils are forced to put up the cost of meals on wheels and other services. If the Secretary of State really wants to help people with dementia, when will he act to stop this scandal?

Let me turn to mortality rates. Over the past decade, the deaths from heart attacks fell by 50% in men and 53% in women, and the NHS achieved the biggest drop in cancer deaths among the 10 most developed nations. It is widely accepted that the clinical networks established by the previous Government played a significant role in that success. Indeed, the NHS medical director, Professor Sir Bruce Keogh, called them “an NHS success story”. Why, then, is the Secretary of State proceeding with brutal cuts to cancer, heart and stroke networks? Surely the best way to meet the ambitions he has set out is to build on that track record of success, not destroy it.

The Secretary of State promises to implement the Labour amendment to the Health and Social Care Act 2012 to ensure “parity of esteem” between physical and mental health. However, the opposite is happening as the NHS reverts to its default position and places mental health services first in line for cuts. Will he confirm that mental health spending was cut in real terms last year, and what will he do to reverse that? He says he wants a transparency revolution, but across the country local people are being shut out of crucial decisions affecting local NHS services. If he believes in “No decision about me without me,” will he today commit to consult Greater Manchester patients with long-term conditions on whether they want ambulance services to be run by a bus company? Will he act to stop details of contracts under his “any qualified provider” regime from being kept secret from local people under “commercial confidentiality”? The truth is that patients are being shut out as his friends in the private sector fill their boots.

In the weekend’s papers, this mandate was called the first contract with the NHS—the new language of the coalition NHS, in which competition and contracts replace care and compassion. Yes, the Secretary of State has today published a new mandate, but we needed a change of direction. The Government have put the NHS on a fast track to fragmentation. Today, they have unfairly and unrealistically raised expectations on a battered NHS, thinking they have cleverly contracted out responsibility to the national Commissioning Board. I have news for them. The chaos in the NHS starts and ends with the guilty men and women on the Government Benches. We will hound them and hold them to account for the damage they are doing.

[Mr Hunt]

This is an incredibly important document for the NHS, and I think that we were all expecting a bit more than the same old hollow rhetoric from the right hon. Gentleman.

There could be no greater commitment to the NHS than to protect its budget at a time of unprecedented austerity. This Government have protected the NHS budget; the right hon. Gentleman said that that would be irresponsible. The Government take action; he uses words. The picture he paints of the NHS in crisis is not the picture recognised by thousands of doctors and nurses up and down the country. Of course, with an ageing population, the NHS is doing more than ever before. Nearly 1 million more people every year are in A and E than when he was Health Secretary, but it is meeting all its waiting times targets and has virtually eliminated mixed-sex wards, and hospital-acquired infections are going down. This NHS is performing exceptionally well.

Let me address some of the points that the right hon. Gentleman made. On finance, in the figures he gave, I think he was alluding to the fact that, in the first year the coalition was in power, it worked to Labour’s NHS budgets. There was an underspend in that year, as there was in each of the last four years that Labour was in control. In three of those four years, the underspend was higher than it was when my right hon. Friend the Leader of the House was Health Secretary. Let us talk about redundancy payments. The reforms introduced by my right hon. Friend will save the NHS—[Interruption.]