What a pleasure it has been to listen to so many excellent speeches. In particular, I want to say how much I value the contribution of the former Secretary of State for Health, my right hon. Friend the Member for South West Surrey (Jeremy Hunt)—I am sure that Ministers will have listened to what he said. I thank everybody who has tabled amendments, which are very thoughtful and well considered. I am particularly grateful for the amendment on patient safety, and again, I am sure that Ministers will have heard what has been said on that issue.
It is a pleasure to speak in a debate where we are not politicising something that matters so much to our constituents and where we are coming together to contribute our experiences, either in our constituencies or professionally. For that reason, I am delighted to be speaking.
I do not support the amendments, however well intentioned, well formulated and well thought out many of them are. However, I would like to speak to the amendment on capital budgets because there are some learning opportunities for the Government in how they spend significant capital investment on hospitals, upgrades and reconfigurations of hospital services. Those upgrades and reconfigurations are indeed happening now, as was set out in the manifesto, but they were also happening before that. My constituency and the county of Shropshire have experienced significant capital investment, but there has been a very difficult, painful and protracted process in trying to bring that forward as something that will benefit the whole community and improve patient care across the county.
I raise that issue because I hope that Ministers will take away from that experience the fact that it is fundamentally wrong to have significant capital investment where local communities are pitched against one another, as has happened in Shropshire. We saw local CCGs propose that Telford should lose all its acute services and be stripped of its A&E and women and children’s services, with them being transferred to another community some 20 miles away that is significantly more affluent and has better health outcomes. In addition, it was intended that that community would also receive £312 million of capital investment in new facilities. I am sure that hon. Members can imagine how that would make our community feel, particularly when it is disadvantaged in many respects. It is a growing new town that will have 200,000 residents in the next 10 years. We have to provide services with equal access for all, because as this Government have said, they are about one thing: levelling up. They are about narrowing health inequalities and
ensuring that there is equality of access to health services across our communities. Of course, the NHS has always been about need. Funding in the NHS should follow need.
I will not delay the House too much with further discussion of the situation in my constituency because I believe that my CCGs, after six years of debating this issue, have had another thought about how they might resolve the problem. It will require more Government funding, but they have already made it clear that the proposal that is currently on the table will also require more Government funding. It will provide a fantastic opportunity for us to resolve this situation, which has been ongoing for so long. So, if the Minister is listening to pleas for more capital funding, may I ask that we complete the proposal in Telford, which will be of such value to our community?
There are other learning points that come from the capital investment programme. CCGs and health trusts have a duty—indeed, the Secretary of State has a statutory duty—to narrow health inequalities. We see that across the country where there have been controversial reconfigurations of local hospital trusts and hospital builds. It is not just in Shropshire either; many MPs on both sides of the House have spoken of the need to narrow health inequalities and to ensure that more affluent communities do not benefit at the expense of more disadvantaged ones. This new Government could not tolerate that continuing in areas of disadvantage.
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My third and final point is another that many colleagues on both sides of the House have made already. The CCGs, which make these decisions on behalf of communities, are accountable to no one and, regrettably, take no notice of what local communities say. They might conduct a consultation, as with the Shropshire reconfiguration, but they take no notice of what local people say. They certainly take no notice of local representatives—of the MPs and local councils—and sometimes they appear disinclined to take much notice of the Secretary of State. I am very grateful to him for spending a great deal of time trying to resolve this issue, although the CCG was not particularly impressed with his proposal, which I thought was excellent and would have benefited my community.
CCGs often operate as if they were directors of a FTSE 100 company, with all the trimmings but without the checks and balances that shareholders provide. Without accountability we see abuses of power, conflicts of interest and a failure to serve local communities. It is almost impossible to remove a non-performing chief executive or board, and in any event they just pop up somewhere else with their golden handshake and gold-plated pension still intact.
I genuinely believe that we now have a window of opportunity to solve the Shropshire reconfiguration, and I deeply hope that Ministers can help us to bring it to a long overdue conclusion. If we can learn anything from our experience, it is that we have a decision-making structure in the NHS that does not serve the communities it is intended to serve and which is not accountable to us, and if it is not unaccountable to MPs, to local councils or to individual residents and patients, there is a problem. We need a full examination to ensure that what has happened in Shropshire does not happen
again. I am hopeful for my constituents and neighbouring Shropshire MPs that there is a solution on the horizon, and one that would be a positive outcome for all our communities.
That said, our communities should not have had to resort to crowdfunding a legal action against the CCG or the Government, or to protests, marches and petitions, and they should not have had to endure six years of uncertainty or to write thousands of letters to their MP. As the Government embark on this welcome capital expenditure programme—a truly historic investment programme that we all welcome on both sides of the House—I hope they will look at what has happened in the NHS Future Fit process in Shropshire and learn the lessons of that experience so that those mistakes are not repeated.
To conclude, I reiterate what a pleasure it is to take part in a debate where everybody is trying to get the best outcome for their constituents, the country and the NHS in terms of the service it delivers to all our constituents.