18 March 2009
Mike Penning winds up a debate on health inequalities and supports calls for the acute medical care and public health budgets to be separated so that public health spending doesn't suffer.
Mike Penning (Hemel Hempstead) (Con): I thank the hon. Member for Southport (Dr. Pugh) for cutting his comments short, but we want to hear what the Minister has to say.
I congratulate the hon. Member for Wigan (Mr. Turner) on securing the debate and on making a passionate contribution. He said exactly what I would have said, if I were a Back Bencher, and I agree fully on behalf of my town, which I may mention later.
I wonder whether the hon. Member for Wigan recognises this:
It comes from the report of the Select Committee on Health, published on Sunday. I was a proud member of that Committee for many years, but it is still Labour-dominated, and has a Labour Chairman. Nevertheless, it has released a scathing report into health inequalities. If Members have not yet had the opportunity to read it, I ask them please to do so. Not only does it deal with many of the questions that have been raised today, but it sets out some ways in which we can go forward, which is what we all seek. We all wish to improve the quality of health for all our constituents in this great country. I was fascinated to read the report. In many ways, it follows on from the report on funding formula and deficits, which was published when I was a member of the Committee. That argument will go on and on, and I may touch on it in my short contribution.
The Advisory Committee on Resource Allocation was rightly asked by the Government to look into the way in which health is funded. I was as surprised as the hon. Member for Stockton, South (Ms Taylor) to read that those experts were not capable of working out how to address the inequalities argument. It is not a question of cash flying back and forth. If it were only about cash going into communities, Glasgow would have the best health outcomes and Wokingham the worst. As we know, Glasgow still gets the greatest amount of cash. We heard about the north-south divide, and the north-east gets a huge proportion—some 70 per cent. more in 2009-10 than other parts of the United Kingdom.
I listened intently to the debate on the difference between the north and the south, but those on the Front Benches—I am sure that the Minister has found this when visiting the north-east—know that although they have some fantastic facilities in the north-east, and the area is very well funded, other parts of the country would love to have the same.
Ms Dari Taylor: I hope that hon. Gentleman will put into that into context. We were a long way behind in 1997, and we had a long way to go to get to the average point. Secondly, a great deal of that funding goes into acute medicine; again, I have no problem with that.
Mike Penning: The hon. Lady has raised an important point. My constituency gets disproportionately low funding compared with the midlands, let alone the north. That may be one reason why my acute hospital closed at the weekend—because of the lack of funding, it will close permanently.
I shall touch quickly on the comments of other Members. The right hon. Member for Oxford, East (Mr. Smith) raised the question of funding, and how it can disproportionately affect certain parts of our communities. One part of a community may be relatively affluent and another deprived, but nothing in the formula addresses that problem. That is the cause of real disparity; the poorer seem to get worse treatment. Nothing in the formula, not even the new one, deals with that problem. In my constituency, I have some of the most affluent villages in the south, but I also have three of the most deprived wards in the country. Nothing in the funding formula allows my strategic health authority to allow for that, and the PCTs struggle enormously.
I listened carefully to what the hon. Member for Weaver Vale said about targets. I point him to the devastating report—a statement was made about it a few moment’s ago in the Chamber—on the investigation into Mid Staffordshire NHS Foundation Trust. One of the most striking comments in the report was that at “virtually every stage” of emergency care, targets were being pursued to the detriment of patient care.
Mr. Mike Hall rose—
Mike Penning: Will the hon. Gentleman bear with me, because I am short of time and it is not be possible for me to give way?
Although I understand the ideological issue, we have to address the fact that some of our clinical experts, surgeons and consultants, are looking at the clock. They obviously did so in Staffordshire, rather than looking after the patients. That is something that has to be addressed.
Mr. Hall rose—
Mike Penning: I have only four minutes, and I want to leave 10 minutes for the Minister to respond to the debate.
It cannot be right for our clinicians to be more worried about the tick-boxes of the target culture than they are about treating the patients—the reason why they came into the profession. Those who do not believe me should read the Health Committee report. It is there in black and white. The Healthcare Commission will remain in existence until the end of the month.
Mr. Hall: Will the hon. Gentleman give way?
Mike Penning: No. At the end of the month, the commission will be abolished, and the parliamentary health ombudsman will take over the complaints procedure.
All too often as I go around the country, I see ambulances sitting outside A and E; patients are not being accepted because hospitals are worried about the four-hour target. [Interruption.] The hon. Member for Wigan may not believe me, but I was in Birmingham recently with the West Midlands ambulance service, and the chief executive will confirm that ambulances regularly have to wait outside A and E. I was in London ambulance control centre only two months ago, and there was a capacity problem in Romford; 12 ambulances were stuck outside while I was at the centre. It happens. It may not happen in Wigan, and it may not happen in Stockton, but it is happening elsewhere in the country, and it is affecting the outcome for our constituents. That problem has to be addressed.
I completely agree with something that all hon. Members who have contributed to the debate, including the hon. Member for Southport, have said, namely that we must try to separate the acute medical care and public health budgets. So often, PCTs set up public health budgets, so that they can work on the long-term inequalities within our communities, but when things get tough and money becomes tight—it seems to happen often in the constituencies that we have heard about today—those budgets are raided. If the public health budget is raided this year, the knock-on effect will last for generations, yet it is happening all the time. I believe that that is due partly to the targets—some bodies are 6 or 7 per cent. behind.
Our constituents and patients do not care about that. What they want is treatment as close to home as possible that is safe and free at the point of delivery. That is a commitment that we must all make. Yes, the funding formula has to be changed. Yes, we have to address inequalities within our communities. I urge those who have not yet read the Health Committee’s report to do so. It is not a Conservative-led Committee, but its report into health inequalities is scathing.
3.49 pm
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Mike Penning (Hemel Hempstead) (Con): I thank the hon. Member for Southport (Dr. Pugh) for cutting his comments short, but we want to hear what the Minister has to say.
I congratulate the hon. Member for Wigan (Mr. Turner) on securing the debate and on making a passionate contribution. He said exactly what I would have said, if I were a Back Bencher, and I agree fully on behalf of my town, which I may mention later.
I wonder whether the hon. Member for Wigan recognises this:
“Healthy Towns has all the failings of previous policies, indicating that the Government has learnt nothing from the past mistakes.”
It comes from the report of the Select Committee on Health, published on Sunday. I was a proud member of that Committee for many years, but it is still Labour-dominated, and has a Labour Chairman. Nevertheless, it has released a scathing report into health inequalities. If Members have not yet had the opportunity to read it, I ask them please to do so. Not only does it deal with many of the questions that have been raised today, but it sets out some ways in which we can go forward, which is what we all seek. We all wish to improve the quality of health for all our constituents in this great country. I was fascinated to read the report. In many ways, it follows on from the report on funding formula and deficits, which was published when I was a member of the Committee. That argument will go on and on, and I may touch on it in my short contribution.
The Advisory Committee on Resource Allocation was rightly asked by the Government to look into the way in which health is funded. I was as surprised as the hon. Member for Stockton, South (Ms Taylor) to read that those experts were not capable of working out how to address the inequalities argument. It is not a question of cash flying back and forth. If it were only about cash going into communities, Glasgow would have the best health outcomes and Wokingham the worst. As we know, Glasgow still gets the greatest amount of cash. We heard about the north-south divide, and the north-east gets a huge proportion—some 70 per cent. more in 2009-10 than other parts of the United Kingdom.
I listened intently to the debate on the difference between the north and the south, but those on the Front Benches—I am sure that the Minister has found this when visiting the north-east—know that although they have some fantastic facilities in the north-east, and the area is very well funded, other parts of the country would love to have the same.
Ms Dari Taylor: I hope that hon. Gentleman will put into that into context. We were a long way behind in 1997, and we had a long way to go to get to the average point. Secondly, a great deal of that funding goes into acute medicine; again, I have no problem with that.
Mike Penning: The hon. Lady has raised an important point. My constituency gets disproportionately low funding compared with the midlands, let alone the north. That may be one reason why my acute hospital closed at the weekend—because of the lack of funding, it will close permanently.
I shall touch quickly on the comments of other Members. The right hon. Member for Oxford, East (Mr. Smith) raised the question of funding, and how it can disproportionately affect certain parts of our communities. One part of a community may be relatively affluent and another deprived, but nothing in the formula addresses that problem. That is the cause of real disparity; the poorer seem to get worse treatment. Nothing in the formula, not even the new one, deals with that problem. In my constituency, I have some of the most affluent villages in the south, but I also have three of the most deprived wards in the country. Nothing in the funding formula allows my strategic health authority to allow for that, and the PCTs struggle enormously.
I listened carefully to what the hon. Member for Weaver Vale said about targets. I point him to the devastating report—a statement was made about it a few moment’s ago in the Chamber—on the investigation into Mid Staffordshire NHS Foundation Trust. One of the most striking comments in the report was that at “virtually every stage” of emergency care, targets were being pursued to the detriment of patient care.
Mr. Mike Hall rose—
Mike Penning: Will the hon. Gentleman bear with me, because I am short of time and it is not be possible for me to give way?
Although I understand the ideological issue, we have to address the fact that some of our clinical experts, surgeons and consultants, are looking at the clock. They obviously did so in Staffordshire, rather than looking after the patients. That is something that has to be addressed.
Mr. Hall rose—
Mike Penning: I have only four minutes, and I want to leave 10 minutes for the Minister to respond to the debate.
It cannot be right for our clinicians to be more worried about the tick-boxes of the target culture than they are about treating the patients—the reason why they came into the profession. Those who do not believe me should read the Health Committee report. It is there in black and white. The Healthcare Commission will remain in existence until the end of the month.
Mr. Hall: Will the hon. Gentleman give way?
Mike Penning: No. At the end of the month, the commission will be abolished, and the parliamentary health ombudsman will take over the complaints procedure.
All too often as I go around the country, I see ambulances sitting outside A and E; patients are not being accepted because hospitals are worried about the four-hour target. [Interruption.] The hon. Member for Wigan may not believe me, but I was in Birmingham recently with the West Midlands ambulance service, and the chief executive will confirm that ambulances regularly have to wait outside A and E. I was in London ambulance control centre only two months ago, and there was a capacity problem in Romford; 12 ambulances were stuck outside while I was at the centre. It happens. It may not happen in Wigan, and it may not happen in Stockton, but it is happening elsewhere in the country, and it is affecting the outcome for our constituents. That problem has to be addressed.
I completely agree with something that all hon. Members who have contributed to the debate, including the hon. Member for Southport, have said, namely that we must try to separate the acute medical care and public health budgets. So often, PCTs set up public health budgets, so that they can work on the long-term inequalities within our communities, but when things get tough and money becomes tight—it seems to happen often in the constituencies that we have heard about today—those budgets are raided. If the public health budget is raided this year, the knock-on effect will last for generations, yet it is happening all the time. I believe that that is due partly to the targets—some bodies are 6 or 7 per cent. behind.
Our constituents and patients do not care about that. What they want is treatment as close to home as possible that is safe and free at the point of delivery. That is a commitment that we must all make. Yes, the funding formula has to be changed. Yes, we have to address inequalities within our communities. I urge those who have not yet read the Health Committee’s report to do so. It is not a Conservative-led Committee, but its report into health inequalities is scathing.
3.49 pm
| Hansard
