NHS and Social Care Funding — House of Commons, 2017-01-11
Topic: Health
Owen Smith (Labour, Centre-left): I do not intend to take too long, because I am mindful of the fact that the motion refers largely to NHS England, but I am goaded to speak by the repeated references by the current Secretary of State, the previous Prime Minister and the current Prime Minister to the relative performance of the NHS in Wales. I want to take a few minutes to set the record straight and give a clearer illustration of the relative performance of the two NHS systems Before I do that, I want to reflect on the interesting, thoughtful speech that the Prime Minister gave earlier this week about her desire to create a "shared society", as she put it, in Britain. I read the speech, as many Members did, and felt that it set out precisely what all Governments ought to be doing at all times. In one passage, the Prime Minister said: "That is why I believe that…the central challenge of our times is to overcome division and bring our country together." She said that she wanted to create "a society that respects the bonds that we share as a union of people and nations." I completely agree with her about that, but I find it impossible to reconcile that stated objective and rhetoric with how she and, in particular, her predecessor have sought to divide this country on the NHS. They have illegitimately demeaned the performance of the NHS in Wales, demoralised its staff and destroyed confidence and faith in it among Welsh citizens. With a few statistics, I hope to illustrate how misleading some of the representations in recent years have been The first statistic is that the previous Prime Minister referred to the NHS in Wales in a disparaging fashion 37 times, on every occasion as a political attempt to militate against criticism of the NHS in England. That broke the important bonds between different parts of the UK. I will state a few of the facts. The entire budget for Wales is about £15 billion per annum, and £7.1 billion of that is spent on the NHS. That is 48% of all spending by the Government in Wales. The difference between that and the situation in England is enormous. In England, the NHS budget is £120 billion, and the entire budget of the country is about £750 billion, so 16% of the budget is spent on the NHS in England and 48% in Wales. The Welsh Government’s headroom to expand spending on the NHS instead of other areas is therefore dramatically less than in England. That is the first illegitimate way in which the Government have manipulated statistics on the issue Secondly, over the past six years, the Government have repeatedly referred to the lesser spending on the NHS in Wales than in England per head or in percentage terms. We have heard that three times today already. The truth is that in 2010 the Welsh Government, with the lower headroom that I have mentioned, chose to reduce spending on the NHS by 1% compared with the previous year. In England, there was flat cash spending. That 1% reduction was made to increase and prioritise spending on education in Wales. Since then, we have seen successive rounds of investment by the Welsh Government: £80 million was announced this week for a new treatment fund; last week, there was £40 million for capital spending. It is now broadly comparable in percentage terms. In fact, last year in Wales we spent £2,026 per head, while England spent £2,028. The difference is negligible. If we add health and social care together, we find that Wales spent 6% more per head than England. These are the realities of the comparative spending What has this given us in outputs? There are some things that the Welsh NHS does worse. In Wales, we wait longer for some diagnostic treatment. There is a need to spend more on more MRI scanners and CT scanners. Part of the issue, however, relates to an older and sicker post-industrial population, rural sparsity and a lesser ability to attract people to some of the more far-flung hospitals—all perfectly explicable and reasonable. In England, over the past nine months, we have seen the biggest rise in waiting lists for nine years In other areas, Wales does well. On the crucial eight-minute ambulance response time, 77% of calls meet it in Wales, against only 67% in England. Most would agree that the 62-day cancer treatment target is vital, but in England it is consistently missed. In England, on average, 81% of people are treated within the target time; in Wales, the figure is currently 86%. There are other areas I could turn to. A&E is the crucial area we are looking at today. In Wales, 83% of patients are currently seen within the four-hour target. In England, the figure is 88%. There are 150 A& E departments in England and only six or seven in Wales, so this is another completely ludicrous and, in many respects, meaningless statistical comparison. Thirty seven of the 150 A&E departments in England are below the Welsh average. Several of the Welsh trusts are up at the 95% or 98% mark. This is a further illustration of how meaningless, misleading and frankly abusive it has been of the Tories to use the Welsh NHS as a stick to score political points In conclusion, the truth about the Welsh NHS is that it performs excellently in some areas and that it could be improved in others. As the OECD said, in a 10-year study of all the healthcare systems across the country, no one part of Britain performs demonstrably better or worse than any other. That is the truth about the differences between our NHS in this country. The Minister, the Prime Minister and the Secretary of State need to remember that they are Ministers for the whole United Kingdom, not just England. Their duty is to increase the bonds of solidary, not destroy them.