NHS: Reform — House of Lords, 2015-07-16
Topic: Health
David Prior (Conservative, Centre-right): My Lords, I thank the noble Lord and the noble Baroness for their comments. I was quite depressed listening to the noble Lord opposite. We had a debate in this House last week and we talked about a sense of political consensus on the NHS. I start by saying—rather personally—that, having listened briefly this morning to his right honourable friend Andy Burnham in the other place misquote me out of context from the debate that we had last week, I thought that there was no hope of a non-partisan approach to the NHS. For the avoidance of any doubt from anybody, and as I think I made pretty clear in last week’s debate, I believe fundamentally and passionately in a universal, tax-funded healthcare system—the NHS—that is free at the point of delivery and based on clinical need, not ability to pay. Having looked back on it, I do not remember uttering a word in that debate that would question that statement. Therefore, I hope the noble Lord opposite might have a word with his right honourable friend in the other place to make it absolutely clear that playing cheap party politics has no place in our discussions about the NHS Turning to the comments about my right honourable friend the Secretary of State for Health’s Statement today, seven-day services are in many ways at the heart of it. Thousands of people are dying because we do not provide seven-day services in hospitals. We cannot carry on with a system with thousands of people dying. It is not just that thousands of people are dying. The health of thousands of people is deteriorating in our hospitals over the weekend This is an anecdote, which may be unfair. However, two years ago, I met a radiologist walking down the corridor in an NHS hospital on a Friday morning. His wife had been admitted through A&E. She had abdominal pains. He could not get her a scan. She was going to have to wait in that hospital until Monday. Had it been a bank holiday, she would have had to wait in that hospital until the following Tuesday before she had that scan. That is an anecdote, but we know that it is happening all the time. It is unacceptable So I ask the noble Lord opposite to be more enthusiastic about this. Of course it will be difficult. This Government are putting in £8 billion of new money. This is more money than his party was prepared to offer before the election. It is the same amount of money that the noble Baroness’s party was offering to put in. This is £8 billion of additional money that we are putting into the NHS. It is a critical part of our strategy. It was laid out in our manifesto and is in the NHS Five Year Forward View that we would make seven-day services a main plank of these reforms. For those people who think that this cannot be afforded, put yourself in the position of a chief executive of an NHS hospital that works four and a half days a week because theatres stop work at lunchtime on Friday. Often, they do not start again until Monday lunchtime because every bed is taken up when they come in to work on Monday morning. Across the country, thousands of consultant surgeons, theatre staff and anaesthetists are hanging about on Mondays because they cannot start their work. This is because there is not a bed in the hospital because the flow of patients through that hospital came to a grinding halt on Friday. The noble Baroness is right that this is not just a hospital issue but about joined-up care. You cannot get the discharges out of the hospital unless social care, the physios and the OTs are working—the whole system needs to be working. Seven-day working is not only right for patients but will enable our hospitals to work much more efficiently I will pick up a few other issues. I remember when the 2003 contract was voted on by consultants. In my view, it was a disastrous contract, which deprofessionalised many professional consultants. They voted against it the first time and voted for it, grudgingly, only the second time. They voted for it because their pay went up by 28% as a result of it and they could opt out of providing care over weekends and outside normal hours—of course they voted for it. Looking back on it, some of the noble Lords and Baronesses opposite will maybe accept that it was a disastrous contract. It deprofessionalised a deeply vocational profession and fundamentally changed the culture of the NHS—a culture that we are now trying to change once again I welcome the comments of the noble Lord and the noble Baroness about Sir Robert Francis’s report on whistleblowing. We want an open culture, in which whistleblowing is a thing of the past. I agree with the noble Baroness that whistleblowing is not a great name. It would be great if we never heard about whistleblowing ever again because people felt able to raise their concerns in a proper, central and safe way and knew they could raise them without fear of any detriment to their employment prospects. The proposals put forward by the Public Administration Select Committee, which have been taken up by the Secretary of State for Health, are absolutely right. We need a safe place for when things go wrong I turn to the Rose report. Leadership is fundamental. Around a hospital, one ward will be doing well and one will not because there is a good ward sister in the first one; one hospital will be doing well and one will not because of good local leadership in the former. Leadership is absolutely fundamental, and I subscribe to all the comments that my noble friend Lord Rose has made in his report The noble Lord’s comments about the TDA and Monitor are harsh. David Bennett and others in those organisations have done a very good job in very difficult circumstances. We are fundamentally changing the roles of TDA and Monitor. Together, they are now, as the name suggests, an improvement agency first and a regulator second. The new role of the TDA and Monitor in NHS improvement will fundamentally change the way we approach performance management and improvement. The Secretary of State for Health alluded to the contract that the TDA recently signed with Virginia Mason, one of the safest hospitals in the world, which is one way of bringing best world practice into the NHS I will conclude on the context. Times are difficult in the NHS and we should not pretend differently. This Government are absolutely committed to seeing this transformation programme through. The noble Lord opposite said he did not know anybody who thought that we could achieve the £22 billion in savings that are set out in the NHS Five Year Forward View—he knows me.