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Health and Education

I am delighted to follow the hon. Member for Sevenoaks (Mr. Fallon), who made a thoughtful speech, especially on localism. I pay tribute to my hon. Friend the Member for Warrington, North (Helen Jones)—she is popping out of the Chamber briefly—who made an excellent speech with which I fully concurred. I am grateful for the opportunity to speak in the debate. It has not been long since other hon. Members and I had the opportunity to hold a thorough debate on the NHS. Nevertheless, I welcome the chance to contribute during the Queen’s Speech debate. The major reforms that are now occurring in our constituencies are having substantial—in my view, positive—effects on care, and I welcome that and the fact that the important issues that affect health care in the years to come will continue to be debated in the House. The NHS is both a huge institution employing around 1.3 million people, and a vast array of local institutions in every corner of the United Kingdom. It is important to take opportunities such as the one afforded by the debate to highlight local perspectives on the changes. After all, our constituents experience the NHS through local services. It is also important to ensure that our local experiences are expressed in a wider context. I do not, for instance, think that it is acceptable to complain about service rationalisation in areas that have been allowed to overspend their budgets for many years while simultaneously opposing and criticising the increased investment that the Government have championed. We hear many conflicting arguments from the Opposition. Conservative Members claim that, if ever back in government, they would introduce an independent NHS body to distribute funds; share the proceeds of economic growth between spending and tax cuts; and ensure that wealthy areas that traditionally overspend have all the resources that they desire. Those are obviously conflicting aims. It will always be impossible to create financial discipline in the NHS if we do not ask primary care trusts to keep to their budgets, just as it will be impossible to retain current service levels if public expenditure is cut by £17 billion, as the Conservative party’s policy commission recommends. Whether a formula is used to allocate funds or vast sums are spent on a new independent body to do the job, it will always be important for the constituent parts of the NHS to operate within their means. Our aim should surely be to provide the NHS with generous funding so that it continues to offer a world-class service to its patients, free at the point of use, while ensuring that NHS bodies spend their budgets sensibly, in a way that provides the best health care for the most people, and without compromising the resources available for other areas of the country. The Government must deliver fairer funding in the future by moving PCTs towards their proper share of NHS resources. It is vital that the NHS is brought back into balance to achieve a fairer funding settlement for our constituents. In the past, overspending organisations had no incentive to improve because they knew that they would be bailed out by underspending parts of the NHS. That is unfair. When we examine the matter carefully, it becomes clear that the overspenders are mostly in areas with fewer health problems, while the underspenders are mainly in the north of England and the midlands—generally areas with far greater health needs. If local service rationalisation and reform is necessary to stop overspending in wealthy areas, that must be done. Large organisations with major budget problems will understandably take some time to do that, and the Government have promised support to help them succeed, but they must get back into balance as fast as possible. It is simply wrong to expect the PCTs and the acute trusts that serve my constituents to continue to postpone improvements in care for their patients for the sake of those that continually overspend. Although much has been done, health inequalities in this country remain significant, with residents of the poorest urban areas having the lowest life expectancies. New efforts must be made to tackle those inequalities. My constituency of Denton and Reddish has higher obesity rates, more smoking-related deaths and, consequently, lower life expectancies than the English average. It is my job to ensure that the most vulnerable people in Denton and Reddish get the support that they need and it is unfair to continue to ask the Tameside and Glossop primary care trust, Stockport PCT and my constituents to fund overspends in areas where people can expect to live significantly longer. The money that the Government continue to invest has delivered vast improvements in health care. Stepping Hill and Tameside general hospitals, which serve my constituents, have received good and excellent ratings by the Healthcare Commission in respect of quality of service and use of resources. Those hospitals were two of only 10 health care organisations in the north-west to acquire that positive seal of approval. I want us to ensure that more hospitals in the north-west of England have the same opportunity to reach that level of care for their patients. In particular, I want to ensure that the Tameside general hospital tackles those areas where it still needs to improve its performance. My hon. Friends the Members for Ashton-under-Lyne (David Heyes) and for Stalybridge and Hyde (James Purnell) and I recently raised those problems with Ministers. There are certainly issues that Tameside general hospital needs to resolve. Society is changing and hospitals and clinics will have to spend their allocated budgets in a way that addresses the needs of the patients whom they treat, just as Stepping Hill and Tameside hospitals do. Since coming to power, the Government have increased the number of people working in the NHS by 300,000, but increasing staff numbers and keeping large district hospitals open should not be seen as the end goal. Yes, in many cases, keeping staff numbers high and large successful hospitals open are the best ways to achieve NHS aims, but they should not be seen as ends in themselves. The Government must ensure that the best structures are in place to provide health care to all who need it. If NHS money is best spent caring for people in their own homes, rather than in hospital beds, that is what should be done. If money is better spent on small specialist units, rather than on large general hospitals, that is also what should be done. Similarly, if money is better spent on new services at general hospitals, as with the new, improved accident and emergency department at the Tameside that is part of the £80 million private finance initiative at the hospital, or the newly rebuilt Stepping Hill hospital, that is what should be done. The Government are putting unprecedented levels of funding into the NHS. Investment has doubled since 1997 and it will have trebled by 2008 to more than £90 billion. That will bring it up to the European average for health care spending, but such an unprecedented level of taxpayers’ money has not been injected into the NHS to keep it standing still. It has not been invested to retain services for their own sake. It has been invested so that if more efficient ways of providing health care exist, the NHS can afford to pay for them. If we value the way in which the NHS is structured today or was structured 60 years ago more than we value its core values, we will let our patients and constituents down. The NHS is not a museum for outdated methods, but an institution that must be continually reformed as new demands are placed on it. To ensure that the NHS continues to deliver high-quality care, it must respond to changes in patient needs and developments in medical technologies. By 2025, the number of British people above the age of 85 will be up by two thirds, with the average 85-year-old costing the NHS five times more than the average 16 to 44-year-old. With an ageing population such as ours, more resources will have to be directed to helping people in their own homes, rather than admitting them to hospitals for long stays. With new technologies to support care at home, it will simply become more efficient to treat patients in that manner. GPs in Denton and Reddish are increasingly providing minor surgery. Community matrons are working in Tameside and Stockport to help people better manage their long-term health conditions such as asthma, heart disease and diabetes. That will improve people’s health and avoid unnecessary hospital admissions. When people do have to be admitted to Stepping Hill or Tameside general hospital, more procedures are being carried out as day cases. Also, better drugs and rehabilitation mean that the number of days that my constituents have to spend in hospital will continue to decrease. Committed, highly trained staff have been integral to the success of both Stepping Hill and Tameside general hospital, just as they are integral to the overall success of the NHS. As I mentioned earlier, there are now about 300,000 extra staff working in the NHS than there were in 1997, including 85,000 more nurses and 32,000 extra doctors. In the north-west of England alone, there has been an increase of nearly 49,000 staff. The extra money put into the NHS has allowed the Government to invest more than £1 billion in improving pay and working conditions across the NHS. The minimum hourly pay for all staff is now up by 35 per cent. in real terms since 1997. The starting pay for newly qualified nurses is now £19,166, up from £12,385. Qualified nurses now earn on average £30,890, up from £20,760, and nurse consultants can earn up to £60,000. Front-line midwives can now earn up to £31,000, up from about £19,000 in 1997. In addition, all staff get a minimum of 35 days holiday, which is up from 30 days. The Government have also improved access to flexible working and affordable childcare. When we debated the issue in October, some Opposition Members called current NHS productivity into question. Indeed, the shadow Health Secretary did so today. Conservative Members deplored the fact that new investment money had gone on substantial pay increases for front-line staff and argued that those pay increases had not been matched by increased activity. I would argue that, given the indefensibly low wages that NHS staff received before 1997, it was the Labour Government’s duty to increase rates of pay. NHS staff deserve the pay increases that they have received since 1997, and it is right to take pride in the numbers of new NHS staff and the fair wages that they now receive. Productivity per pound is simply not a useful indicator when assessing NHS wages. In view of wage rates in 1997, it can only be concluded that many nurses were committed to working for their communities in spite of their salaries rather than for them. It may be considered good management by some to get nursing care for the cheapest possible price, but my hon. Friends find that simply unethical.