NHS Funding

Debate between Lucy Powell and Stephen Dorrell

Wednesday 12th December 2012 Commons Chamber

[Mr Dorrell]

The right hon. Gentleman knows that I agree that the prime focus of health policy since 2010 should have been on how we can change the way that care is delivered in the health care system and the social care system to ensure that we can meet demand against the very different resource outlook that I have described. However, I say to the right hon. Gentleman, as I have done many times in this Chamber, that he shares some of the responsibility for the two-year trip down memory lane that we have had. It has been comfortable for the Labour party to say that the Tory party does not believe in the health service. We have been reminded numerous times that Tory MPs—all of whom are now dead and most of whom died before most of the current Members of the House of Commons were born—voted against the establishment of the national health service in 1946. We have had reminders from Government Members that the Labour party voted against the establishment of NHS trusts and then went ahead with the policy in office. The Labour party says that it is against choice and competition, but it was that party that established the choice and competition panel to ensure that those influences were brought to bear in health care policy.

We have had a two-year trip down memory lane, in which we have engaged in party political arguments that have avoided the issue that the right hon. Gentleman articulated as Secretary of State: how can we meet rising demand for health and care services against the background of a budget that, as the Select Committee has said repeatedly, is flatlining in real terms? That is why I was so keen earlier to read out the sentence from the Dilnot letter that states that it is

“fair to say that real terms expenditure had changed little over this period.”

The way that I prefer to put it is that if the decimal points are knocked out, real-terms expenditure is running at zero. The question is how to act against the background of a very small growth in resources, which is what the Government are committed to.

What the right hon. Gentleman did not cover in his speech is that the revenue expenditure of the NHS, which is what actually treats patients on a day-by-day basis, has grown modestly in real terms since his last year as Secretary of State. In my view, it will continue to grow modestly in real terms. He is frowning, but it is there in the arithmetic that there has been modest real-terms growth in the revenue expenditure, which is another definition of front-line services. That is the expenditure that funds the delivery of services to patients on a day-by-day basis and that is where the pressure is felt.

[Lucy Powell]

In addition to the point that the right hon. Gentleman is making, has he considered the chronic pressure that is being put on the NHS, which will get much worse from next April with the cuts to adult social care and the desperate cuts to local government? The conversation that we are having has to take into account what the money has to be spent on. The service will decline dramatically from next April.

[Mr Dorrell]

I have made the point more than once that we should look across the traditional divide between the national health service and the social care system towards a health and care system. The only way of responding to the efficiency challenge that the right hon. Member for Leigh was the first Secretary of State to set out—what the Select Committee has described as the Nicholson challenge—is to rethink the way in which services are delivered across the health and social care divide. The National Audit Office, another independent body, has stated that 30% of non-emergency hospital admissions are avoidable—not unnecessary, but avoidable. We need decent community-based services that meet the demand early in the development of the condition to avoid the unnecessary development of acute cases that have to be treated though hospital admission.