NHS Reorganisation

I echo the sentiments that were ably expressed by my hon. Friend the Member for Eddisbury (Mr. O’Brien) in saying that the NHS is of course a patient-centred organisation—he paid tribute, as I do, to the wonderful work that is done by the nurses, doctors and ancillary workers in our hospitals. I myself spent some time working as a porter in West Suffolk hospital, and I saw the professionalism and good humour of those who work magnificently in our NHS. I emphasise that point because people who work so ably and selflessly in the NHS in Suffolk are under massive pressure and subject to great anxiety because of a crisis in funding and an implosion in some of the services. Before I became a Member of Parliament in 1992, there was a West Suffolk health authority. We were told that a pan-Suffolk health authority was essential on the grounds of economies of scale, procurement, minimising overlapping and so on. Somehow it was deemed to be the right way to go. A few years ago, we were told that that was all wrong and that we had to have primary care trusts because decisions had to be made more locally and be more attuned to the circumstances of the area. They had to be made closer to the patient.However, a huge error was made. In a county the size of Suffolk, which has a population of only 683,000, no fewer than five PCTs were created, all with expensive chief executives and staff, despite the opposition of Members of Parliament, councillors and health professionals. The Government ignored all their advice. The PCTs were introduced in 2002 and we were told that it would take 18 months to assimilate the reforms. We were supposed to experience the benefits only 18 months afterwards. I say with great regret that there have been few benefits. The new proposals go full circle, back to a pan-Suffolk health authority. Goodness knows the amount of taxpayers’ money that has been wasted in getting back to the future, but the problem is not organisational. As we know from the consultation process, which has elicited responses from throughout the county, the problem is the operation of the funding formula. The Under-Secretary shakes his head, so I shall spell out the matter clearly. After the first change was made in 1998, I went to the then Secretary of State for Health and pointed out its likely effect on rural areas, especially those with an ageing population. Since 2001, no fewer than four changes have taken place. Suffolk West PCT has the third worst audited deficit in the country and is £13.7 million in debt. West Suffolk hospital, the biggest hospital in the area, is running a deficit of £11.3 million this financial year. The total deficit in the county of Suffolk is £35 million. For the strategic health authority area, it is a gargantuan £85 million. That is the heart of the problem and it springs substantially from the change in the formula for NHS per capita spending, which has discriminated against an essentially rural area with an ageing population. No organisational changes in the county will remedy that. If the figures sound abstract, I point out that, even in the midst of the consultation process, no fewer than 55 beds have been removed from the West Suffolk hospital in the past few months and 260 staff—15 per cent. of the total—have lost their jobs. Hospitals throughout the county—in Ipswich, Bury St. Edmunds or, indeed, Addenbrookes hospital—are permanently on red or black alert. The position is therefore serious. We held a meeting here with the strategic health authority—the body that is charged with overseeing the finances of the PCTs—at the beginning of 2005. There was complete complacency in that meeting. The Members of Parliament present understood what was going on, but the SHA representatives seemed to have no grip of the situation. How could that be? Their function was inexplicable to all of us. By June, the SHA had a new chief executive because the previous one resigned, as did the chairman. When its representatives came up to the House of Commons, their attitude was that we Members of Parliament were being somewhat hysterical, and that the problem that concerned us so much did not exist. However, they had changed their tune when we had another meeting last month. There was a sense of desperation in the SHA management, amid concerns that it might not be possible for Suffolk’s NHS trusts even to meet their national insurance and tax liabilities. As the SHA has overseen the development of such problems, my colleagues on the Front Bench are right that it should be abolished. It has no clear function whatsoever. The SHA’s chief executive earns £145,000 a year, and the directors of performance and of service modernisation—what a wonderful euphemism—both earn more than £100,000. Its clinical director gets £150,000 and the chief executive of the work force development confederation £100,000. If those people are being paid such sums to look after three counties, goodness knows what will happen if their responsibilities extend to six. Will they get a proportionate increase in pay? It is no wonder that people feel that the NHS is being undermined by a level of expensive bureaucracy that is not appropriate for its task. Suffolk is a rural county, and my constituency of West Suffolk gets £1,156 per capita in health service funding. The Prime Minister’s constituency gets £1,576, and the Secretary of State’s Leicester, West constituency gets £1,428. The Minister of State’s constituency, Doncaster, Central, gets £1,489, while the national average is £1,388. If the county of Suffolk received even the national average, we would not be facing the current crisis. The same is true right across the south and south-east of the country. Of course I accept that there have been medical improvements and huge technological advances over the past few years. That has happened continuously since the NHS was created after the war, but the cuts being made are unprecedented. The White Paper mentions various much cherished and valuable community services but they are now under threat, with rehabilitation beds already being closed down. The Minister who is to wind up the debate may think that I am exaggerating, but I can tell him that the clergy in and around my constituency have been organising petitions. They are anxious about NHS provision in the area and about the stories that their parishioners tell them. The state of the health service is such that they feel compelled to place petitions about it in their churches and places of worship. The situation is terrible. Amalgamation may offer some managerial advantage, but the Government must address the problem of funding and deal with the dead hand of the SHAs by abolishing them. Unless those steps are taken, the NHS will never deliver proper value. That will have consequences for the people in our communities who want the service to work and to succeed, and who are hugely disappointed that it is failing to do so in wide swathes of the country.