It is a pleasure to follow my hon. Friend the Member for Sevenoaks (Laura Trott), not least because her last sentence is what the next 10 minutes of my speech are about. [Interruption.] I am sure many Members probably want me to sit down now, but I will continue none the less.
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May I welcome the Bill in general before dealing with the amendments I wish to speak about? It provides useful and good clarity for all the hospitals around the country, which need to ensure that they have appropriate funding in the coming years. I also welcome the clarity on the revenue side for hospitals such as Chesterfield Royal Hospital, which serves my constituency. It is looking for additional support on not only the revenue side, but the capital side, although I know that this is not the debate for that. I will not be supporting amendment 3, but there was a lot of merit in it, if only to ensure that if we do get our urgent care village at Chesterfield Royal Hospital, we could thus ensure that the money is in place and is ploughed into proper capital upgrades for the hospital in the future, for the benefit of everybody in north Derbyshire and my constituency.
I also welcome the Government’s commitment in recent months to the output point that my hon. Friend the Member for Sevenoaks outlined. That was done to some extent during the general election campaign, and I look forward to the continuation and extension of that in the coming months and years. I am pleased that we are in a debate on the NHS and healthcare that, as my hon. Friend the Member for Telford (Lucy Allan) said, has been relatively friendly and has come away from the usual histrionic fireworks that sometimes accompany this issue. It is helpful for us occasionally to step back and have this kind of debate on the NHS, given that we are all committed to improving healthcare in our constituencies.
I wish to discuss two of the amendments briefly, picking up on this point about outputs. The hon. Member for Ellesmere Port and Neston (Justin Madders), speaking from the Opposition Front Bench, was right about the need for accountability and the need to ensure that the money being committed in this Bill is spent wisely and
appropriately, as was my right hon. Friend the Member for South West Surrey (Jeremy Hunt), who is no longer in his place but who talked about this not just being about money, and my hon. Friend the Member for Newton Abbot (Anne Marie Morris), who is also no longer in her place but who was also keen to highlight the importance of outputs. For reasons I will talk about if I have time at the end, it is particularly important for me, on a personal level, that we focus on outputs.
First, let me turn to new clause 4, which I am keen to examine. I congratulate the Opposition Front-Bench team on beginning the long road back to sense—I hope they do not mind my describing it as such—with their welcome return to an interest in healthcare outputs rather than solely in inputs or methods. That is something to welcome, but the problem, and the reason I cannot support these proposals tonight, is that the Opposition continue to mix up the point about targets and outputs. Targets are not ends in themselves. Targets are indicative, much as we wish them to be hit and important as they are, to ensure that they give us good guides as to what is happening in our hospitals and healthcare system. They are different from outputs. In time, I would be keen to see Opposition Front Benchers moving further down that metaphorical road towards recognising that the outputs are the most important thing: people getting well, staying well for longer; going home and living longer and more meaningful lives with their families and within their communities.
The new clause also slightly misses the point. I infer, as clearly one can, that it starts from a position of directly relating the requests made to set out things from the perspective of money. I do not doubt that money is vital in this discussion, which is why we are bringing forward this Bill, but it does slightly become a blunt instrument. An opportunity is missed to recognise that this is not simply about money. The inputs into our healthcare system are incredibly important, but so are the structure, the model, the operations, the behaviour within it, the technology and the prioritisation chosen by all that vast behemoth of bureaucracy around the NHS. We have to ensure that there is a recognition of the importance of that, and that there is a real effect on the output at the end and on making sure that people stay better for longer. On that basis, I cannot support new clause 4.
New clause 11 is a similar attempt by the Opposition to ensure annual reviews of the adequacy of the financial movement forward. My challenge is that there is a definitional problem. The new clause would require the consideration of
“an assessment of the extent to which changes in the costs of…service delivery”
affect outcomes. There is an interesting question about the definition of “service delivery”, whether it is a rather narrow assessment or could encompass everything that the NHS ever does, and whether that would provide any benefit to the House or anybody who used the assessments. There is also a question about the complexity of analysis of service delivery in the first instance and how that can be defined and assessed. As a former management consultant, I am all in favour of complex analyses, but ultimately they have to provide a utility appropriate to what we are trying to do and to the ultimate objective and end point.
Although I again compliment the Opposition on moving closer towards output-based consideration, new clause 11 also starts from the position that money alone is the ultimate arbiter of whether our healthcare system is successful. Again, it is not just about money, as important as that money is; it is about organisation, people, motivation, workforce, demand, prioritisation, processes and how technology and innovation are changing things. If we do not recognise that, we are missing out a substantial portion of the debate that will be vital in the next 20 years to ensure that our healthcare system is fit for purpose.
Ultimately, why does this all matter? Why does speaking at a relatively technical level about outputs, structure or processes matter as much as inputs and money? Because, as other people have said, this is about real people—it is about making sure that people live for longer. We have all seen examples, when people come to see us at our surgeries, of where the NHS works wonderfully, but in our heart of hearts we all know examples of where the NHS has worked less well. That focus is sometimes as important as the money.
Let me give the House a personal example. My family, including myself, have had three occasions or reasons to get involved in the NHS over the past few years—indeed, over many years. The NHS saved my life on multiple occasions when I was growing up, and it also saved my father’s life when he had a double heart bypass around 10 years ago. It did less well with my mum when, a few months after I came to this place in September 2017, she was diagnosed with ovarian cancer, about which I have spoken in Westminster Hall. That was an error, errors happen—there are humans in the process—and we have not taken it any further because of that. My mum is still here and I am very happy about that, but ultimately my mum did not have a good experience. If we just focus on money, we miss out on cases such as my mum’s.
We have been lucky in my family, but ultimately there will be constituents of ours who are not lucky. That is the point: I am grateful for the money that is going in, but it has to be well spent. If this place does not consider the outputs—if this place does not understand where the money is going and how it is used—there will be people who do not get through it in the way that we want them to. We all want to stop that, which is why it is really important that we focus on outputs as much as inputs.