NHS Reorganisation

Lyn Brown Excerpts

Wednesday 17th November 2010 Commons Chamber

[Paul Blomfield (Sheffield Central) (Lab)]

I want to focus on one specific part of the Government’s plans, which has already been mentioned by a couple of my hon. Friends and by the former Secretary of State for Health, my right hon. Friend the Member for Holborn and St Pancras (Frank Dobson). It is the funding of our children’s hospitals.

I am fortunate enough to have at the heart of my constituency Sheffield children’s hospital, which is a centre of excellence for the region and for the country. It offers pioneering services in trauma and orthopaedics, it is a regional centre for the whole of the north of England for burns injuries and the principal treatment centre for South Yorkshire for childhood cancers, and its metabolic bone service is accessed from across the UK. It does a superb job treating some of our most critically ill children and I want to use one example to bring to light the importance of its work.

A young girl was left unconscious on the streets of Derbyshire with devastating brain injuries after being hit by a car. She was 13 years old. She was transferred to the hospital’s intensive care unit, where a scan revealed the full extent of her head injuries. She was seen to have diffuse axonal injury, one of the most devastating types of traumatic brain injury and, as the Secretary of State will know, a major cause of long-term unconsciousness. She was moved to the children’s hospital’s neurosciences unit, which has specialist equipment to support her rehabilitation and expert consultant neurosurgeons—these are crucial points. Her mother said:

“The doctors and nurses were wonderful and really did go above the call of duty to provide the very best care and treatment. The ward manager was like a second mum to her. The team cared for her like a member of their own family. She is now back at home, relearning simple things such as walking and talking. There is a long road ahead, but if it was not for the Children’s Hospital she wouldn’t be here.”

Such cases involve staff from many disciplines and services to ensure that the patient makes the best recovery possible. Neurosciences are one of the trust’s flagship services, treating children who have suffered brain injuries or who have other brain conditions, spinal cord conditions, diseases such as meningitis or conditions such as epilepsy. The intensive care unit is part of the hospital’s state-of-the-art critical care facility for children and is situated alongside high-dependency and neonatal surgical units, meaning that all the critical care services are in close proximity.

Such services come at a cost, however, and I have always understood that that is why we have had a top-up tariff to pay for the extra staff and the additional support needed to provide that specialist care to very young patients. We now understand that the Government plan—they might be in discussions, but we understand that this is the plan—to cut the tariff to less than a third of its current value.

[Lyn Brown (West Ham) (Lab)]

Does my hon. Friend agree that that puts a whole new slant on the saying, “Women and children first”?

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[Rosie Cooper (West Lancashire) (Lab)]

I often comment that when I became an MP I did not get two items that would have made life so much easier—tarot cards and a crystal ball. In considering the coalition Government’s health policy, they would be essential tools for the job, because before the general election, the statements of the Leader of the Opposition—now the Prime Minister—gave us the impression of a future for the NHS that was completely different from the one we now face. He said:

“We are the only party committed to protecting NHS spending…I’ll cut the deficit, not the NHS.”

He spoke about a period of organisational stability in the NHS. Those were broken promise No. 1 and broken promise No. 2. Instead, we are faced with a vision from the Secretary of State which could set us back 20 years. I say so not as political rhetoric, but from 30 years’ direct involvement in the NHS, including 10 years as chair of a hospital.

The press seems to share that pessimistic view—“extraordinary gamble,” “cocktail of instability,” “accident waiting to happen”—hardly a ringing endorsement of the Government’s health policy. For me, it is a recipe for disaster: one part reduced financial resources, two parts structural reform and three parts break-neck speed—

[Lyn Brown]

Does my hon. Friend agree that the estimated cost of £2 billion to £3 billion for the reorganisation could be far better spent on outcomes for our citizens and treatments for our children?

[Rosie Cooper]

Absolutely. I am sure the Secretary of State will give due cognisance to the comments being made, especially about putting resources right there on the front line, delivering for the very people who are paying the wages.

In his evidence to the Select Committee on 20 July, the Health Secretary set out five aims of the White Paper, and he went through them here today. I shall review some of those in the light of the dribbles of information that we have received, and see how they stand up. The first aim was creating a patient-led NHS. Let us start with the Secretary of State’s glib catch-phrase, “No decision about me without me”—

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[Diana Johnson (Kingston upon Hull North) (Lab)]

I am delighted to have an opportunity to say a few words in this debate.

Labour’s investment in health care over the past 13 years has produced huge strides. When we think about the position in 1997, with long waiting lists and hospitals in desperate need of refurbishment, we realise that we have come a very long way. I am disappointed that the new coalition Government, instead of deciding to build on the very successful investment over the past 13 years, are now engaged in an ideological approach to the NHS to bring in the private sector and to destroy a lot of the very good work that has been done.

I pay tribute to all NHS staff, clinical, non-clinical and administrative, who do their best and work very hard for patients. One of the most upsetting things I have heard since May is Government Front Benchers’ denigration of our NHS managers and administrators. That is very wrong.

My main starting point is to look at whether the coalition’s proposals will improve the health of my constituents in Hull. I do not think they will. I am absolutely appalled that the Government are to spend £3 billion on reorganisation when there is such a tight financial settlement for the NHS. Their focus should be on ensuring that patient care is maintained over the next few years, not on reorganisation.

Hull has a very good primary care trust. I pay tribute to the excellent and innovative work of Chris Long, the chief executive, and of Wendy Richardson, the jointly appointed director of public health with the local authority. As a spearhead PCT, Hull received additional money under the previous Government. It introduced projects such as the health trainers who have done so much in working with communities that have high levels of health inequality, for which different ways of working must be adopted. It has also done work on domestic violence and worked with its perpetrators.

The reason I am such a fan of Hull PCT is that, unfortunately, we have a Liberal Democrat-controlled council that does not seem to have any focus on its responsibilities for public health. The previous Labour council introduced free healthy school meals in all the city’s primary and special schools, rather than wait for an evaluation after three years of the pilot project, but the Lib Dems came in and scrapped it. The project was trying to do something about the high levels of obesity and poor performance in schools—to get to our youngsters early to ensure that they eat well. When that Lib Dem council is given the agenda for public health, I do not have much faith in it taking it seriously.

Hon. Members will recall the introduction of the free swimming initiative in the previous Parliament, which got our young people active through swimming and engaged our councils. Of course, Lib Dem-controlled Hull city council said, no, it was not going to get involved, and at the same time it put up the costs to our youngsters of attending sports clubs in the city. I am therefore very sceptical about the proposed public health agenda being taken on by Lib Dem local authorities.

[Lyn Brown]

My hon. Friend will know about the health needs in Newham, where the incidence of TB is rising and the rate of HIV is very high. The people who have helped me and my constituents most in managing these health needs have been the people at the PCT, who have been very responsive to my requests and requirements. Has she found the same in Hull?

[Diana Johnson]

Absolutely. Although not all PCTs have operated as we would like, there is good practice throughout the country. We should focus on that and see what we can learn.

I am concerned about the coalition Government’s approach to public health, because the junk food industry seems to be helping them to make policy, as some of our national media have reported in the past few days.

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[Mr John Baron (Basildon and Billericay) (Con)]

The Government’s refresh of the cancer strategy, announced within two months of their taking office, and their commitment to the cancer drugs fund, clearly illustrate their commitment to improving cancer services in this country. As chairman of the all-party group on cancer, I very much welcome that.

May I suggest that the Government’s focus on outcomes is long overdue? Cancer survival rates in this country have been improving steadily for the past 30 years, but it remains scandalous that the UK is still floundering in the lower divisions of the international cancer league. Part of the problem is that for too long, the NHS has been focused on process-based targets. We need greater focus on outcomes to put the spotlight on just how well the NHS treats patients, not just on how quickly they are seen. That focus will be very important to patients, and particularly to cancer patients.

Last year, our all-party group set up an inquiry, which reported at the end of the year, on cancer inequalities. The evidence clearly showed that patients who survive one year stand as much chance of reaching the five-year point as cancer patients in other countries. However, where this country lets itself down is that our figures are poor compared with other countries when it comes to the one-year survival rates. That suggests that the NHS is as good as, if not better than, any other health service when it comes to treating cancer once it is detected, but falls down badly in detecting the cancer in the first place. That was why the all-party group’s report recommended the introduction of a one-year cancer survival rate measure, to encourage earlier diagnosis. Late diagnosis makes for poor one-year figures, hence our recommendations. I was therefore delighted that the Government picked up on that point and introduced one-year cancer survival rates as well as five-year survival rates in the White Paper.

[Lyn Brown]

I am following the hon. Gentleman’s excellent speech with care, and I totally agree with what he has said so far, especially about early diagnosis. In poorer areas, early diagnosis does not occur so often, for myriad reasons. In his view, what is set out in the reorganisation White Paper that will make early detection of cancer easier in areas such as mine?

[Mr Baron]

The answer to the hon. Lady’s question was supplied by my right hon. Friend the Secretary of State in answer to my question earlier. The one and five-year cancer survival rate figures will be published and presented, although how that will happen is in the melting pot. I very much welcome the work of the Office for National Statistics, the National Cancer Intelligence Network and the London School of Hygiene and Tropical Medicine. Whatever form the figures take, they will be in a performance table, not a league table, to ensure that all PCTs and then GP consortiums are tasked with improving performance, irrespective of how they compare with others. That will obviously include PCTs in deprived areas across the country.

I suggest to my right hon. Friend the Secretary of State that the focus on outcomes must include patient experience measures and longer-term quality of life measures, such as whether patients are able to return to work. That, too, is very important from the point of view of cancer patients.

As an aside, I suggest that there is a question mark about process-based targets such as waiting times in general. To return to the point made by the hon. Member for West Ham (Lyn Brown), the real problem when it comes to late diagnosis is not whether it takes one, two or four weeks for a patient to see a cancer specialist. It is how long it takes for the suspicion to be raised that cancer exists in that patient in the first place. Perhaps we should incentivise GPs to detect cancer earlier.

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[Yasmin Qureshi (Bolton South East) (Lab)]

Thank you, Madam Deputy Speaker, for giving me the opportunity to speak in this debate. I want to take up a few of the points made by the Secretary of State. First, he talked as if the previous Labour Government had done nothing for the NHS and had shown no concern about how people were treated. It is worth reminding the House what Labour inherited in 1997 after a number of years of Conservative mismanagement. We used to have waiting lists of more than two years. Now, waiting lists are down to less than six months. A record number of nurses, doctors and porters have come into the hospital system. Many hospitals have been built and many others have been refurbished. Therefore, we will not listen to the Government telling us that we did nothing or that we did not take care of the NHS. We spent more than £80 billion on the NHS, which benefited many people. The Government state that they will protect the NHS and will not reduce the funding. That is just not correct. They talk about billions of pounds going into the NHS, but the money will actually go to the social care fund, which does not directly benefit people in hospitals. In real terms, there will be a 17.5% cut over four years. There is a decrease in the budget and services will be affected.

[Lyn Brown]

My hon. Friend must have noticed the chuntering taking place on the Government Front Bench. The same happened during the speeches of a number of other Opposition Members. Does she not think that that is really poor form, especially when the Secretary of State did not seem able to take interventions when it was his turn?

[Madam Deputy Speaker]

Order. That is a matter for me to control. The hon. Lady will continue with her speech. I am sure that all Members of this House, including those on both Front Benches, will behave appropriately in this debate.