NHS: Debt

Lord Reid of Cardowan Excerpts

Monday 23rd January 2017 Lords Chamber

[Baroness Boothroyd (CB)]

My Lords—

[Lord Reid of Cardowan (Lab)]

My Lords—

[Baroness Boothroyd]

Order. That is a very good way to begin the week. My question is brief and very much to the point, and concerns the transportation of patients to and from hospitals. We are all aware that many patients often have to go to major hospitals—travelling 20 or 30 miles—on a daily, weekly, fortnightly or thrice-weekly basis. The cost must be horrendous; is this part of it? Can the Minister give any indication of the cost of transporting patients to and from hospitals?

[Lord O'Shaughnessy]

I will write to the noble Baroness with specific details of cost. It is certainly true that if you have to go to or be taken to a distant hospital for care, that is more expensive both in transport and setting terms. Part of the transformation that the NHS needs to make is that more care should be delivered in primary settings and in the community, which by definition will be closer to home.

[Lord Reid of Cardowan]

My Lords, first, I apologise to the noble Baroness; I thought it was the Liberal Benches. Has not the noble Lord missed the point of the Question? In the first sentence of his first answer, he said his first challenge was an ageing population. Is it not now obvious to even the most obstinate that cuts in social care have a knock-on effect on the ageing population in putting pressure on the NHS? It is not just that the deficits have trebled; 27 hospitals have now declared that they cannot provide comprehensive care, and more than 50 hospitals are asking for outside assistance every day of the week. The situation is getting worse every week. Will he not take the advice of my noble friend and urge his colleagues to reverse the cuts to social care in the Budget, which are not only affecting care provision but having a disastrous effect on provision through the National Health Service?

[Lord O'Shaughnessy]

It is certainly the case that one part of the system impacts on the other parts, whether that is primary, secondary or social care. There is no denying that and I do not seek to do so. On the picture the noble Lord paints of worsening deficits, in fact, the picture in 2016-17 is considerably better than it was in 2015-16. It has been helped not least by the sustainability and transformation plans. We are putting £1.8 billion into trusts, 95% of which have accepted control totals to get a hold of that financial sustainability. Extra funding is going in. There is a big increase this year for the NHS budget, which will help, as will the extra money for social care; but of course the challenges are there.

National Health Service: Sustainability

Lord Reid of Cardowan Excerpts

Thursday 9th July 2015 Lords Chamber

[Lord Reid of Cardowan (Lab)]

My Lords, I am speaking in the gap because I was not sure that I would be able to stay for the whole debate. I want to make a very short contribution. First, I thank the noble Lord, Lord Patel, who is, if I may say so, the right person, at the right time. He is the right person, because nobody can in any way doubt his commitment to the National Health Service, and it is the right time, because it is outside what has been probably the longest general election campaign, courtesy of the five-year Parliament. That refers to the point people have made about the National Health Service being used as a political football. I do not think that it will ever be taken out of politics, because politics is a series of moral choices about the commitment of scarce resources to infinite demands. But it can be taken out of party politics, and I think that today’s conversation begins to do that.

Let me make my position very plain. First, like everyone else here, it goes without saying that I am committed to the National Health Service, not just ideologically but, like the noble Lord, Lord Mawhinney, for very practical reasons—it saved my life over 50 years ago. Secondly, I am sure that there are efficiencies that can be carried out in the National Health Service. Some have already been mentioned, but I merely mention the fact that, in procurement, even in non-medical areas, there are more than 40,000 people purchasing for the National Health Service and most of them do not know the price being paid for a particular commodity by the person sitting next to them—the other 40,000. In an age where we can “compare the market” for everything and of one-click purchases through Amazon, it seems to me incredible that that is the position in the National Health Service.

Thirdly, I am not one of those who is opposed to the use of outsourced private services. I think that a diversity of suppliers, where appropriate, is a good thing—again, that is not just ideological, but because it was central to reducing the huge waiting lists, which were mentioned earlier, and waiting times. The provision of that range of services, appropriately used, can be efficacious in removing the pain of people who had to wait in pain for so long. However, I do not believe that the solution lies in an insurance-based system. Witness the fact that 10 years ago, when I was Secretary of State, we were spending 6% or 7% of GDP, going up now to 9%. In the United States, at that time, they were spending 17% or 18% of GDP on the combination of a private-based and supplemented system—it will be even more now with Obamacare—and over 20% of that went on bureaucracy. We have to get the balance right.

Having said all that, the real issue is that the betrayal of the National Health Service does not lie in addressing the fundamental challenges; it lies in ignoring them and hoping that somehow this will go on sustainably and indefinitely, with a hugely increased demand. We all know why that is happening. There is an increased population, people are living longer, diseases and illnesses will become more chronic, and new treatments and technologies will be invented every day, all at a cost and rate that is above inflation. As I say, I believe that if we are committed to the National Health Service, our duty is to address this question in the long run, not to avoid it. That is why the noble Lord, Lord Patel, has opened a conversation today that does us and the National Health Service a service.