Diane speaks on NHS services in Essex

15 Mar 2011

Ms Diane Abbott (Hackney North and Stoke Newington) (Lab): The hon. Lady has spoken at some length and with real passion about money being poured into the appointment of bureaucrats and managers. In her mind's eye, a hospital bureaucrat is a man in a bowler hat with a brief case, but is she aware that many people who are dubbed managers in the health service are actually 

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former senior nurses, such as her colleague, the Minister, who bring much of their clinical background and expertise to bear on their role? Nurses in particular get a little pained when politicians talk about managers and discount the fact that many of them are people with a very solid clinical background.

Priti Patel: I recognise that NHS managers have a range of health care backgrounds and bring a number of skills to the table. Of concern to my constituents though is the fact that we are dominated by managers who tend to have administrative rather than clinical backgrounds, and they are making key decisions about patient treatment, and even about medical care and access to drugs. None the less, I thank the hon. Lady for her comments and her valid point.

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Ms Diane Abbott (Hackney North and Stoke Newington) (Lab): The hon. Member for Witham (Priti Patel) is to be congratulated on obtaining the debate. Many of my constituents move to Essex as a kind of upward trajectory, so I listened with great interest to what she had to say about a part of the world with which I am not as familiar as I probably should be. The week after the Lib Dems have turned savagely against the Conservative-led coalition's health care policies-the British Medical Association is debating them today and, as we know, doctors are very worried about what is proposed-hon. Members will expect me to touch on the health reforms generally and how they will affect the people of Essex.

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I listened with some sympathy to the complaints of the hon. Member for Witham about bureaucracy. As I have been a Member of Parliament for 20 years, I have tangled with more bureaucrats than I care to remember. However, I always like to stop short of sounding as if I am dismissing people who work for the health service as a whole. My mother was a nurse. She was one of that generation of West Indian women who helped to build the health service after the war. We have to remember that however frustrating it is as Members of Parliament or even as members of the community to deal with bureaucrats in the health service or elsewhere, there are thousands and thousands of people without whom the health service could not work or function. They will tell us that they have survived more reorganisations than they care to remember. They are still there, getting their heads down and trying to provide a service for our constituents.

The hon. Member for Witham made an important point about the proportion of elderly people in our population. We do not have time to deal with that matter fully, but people are living longer and they are suffering from ailments such as Alzheimer's and other things. Elderly people make up an increasing proportion of the population. A few weeks ago, I went to a nursing conference and a senior nurse said to me that, when she was on the wards, the mean age of elderly patients was about 80. The mean age of elderly patients is now 90 or 100. Elderly people now pose very different problems from those that the elderly posed a few years ago. It is important that we consider the question of how we secure high-quality care-I am reminded of that awful ombudsman report that was published a few weeks ago-how we pay for it and how health care interconnects with the issues of public health and social care. I hope that we will have a chance to return to those matters.

I remind the hon. Lady that, despite her letters to bureaucrats and her undoubted frustrations on behalf of her constituents, when my party left office, satisfaction with the health service was the highest it has ever been. Hon. Members can say that the population was deluded on that, but I do not think that that is correct. We are talking about massive MORI polls. People's satisfaction was higher than ever. There had also been massive levels of investment, not least in Essex. She will be aware of the new unit at Colchester general hospital, which includes an updated children's ward. It is fully open and operational, and that £20 million project marks the biggest investment in the hospital's facilities since it opened in 1985.

Apart from general frustration with bureaucracy, there are specific issues in relation to health care in Essex that are worth mentioning in this short debate. The hon. Lady mentioned Broomfield hospital. She will be aware that, just a few weeks ago, it was highlighted that although the hospital takes more than £1 million a year in car parking charges, its car parks still lose money because it is spending £1.2 million on running costs, including on CCTV, attendants and capital investment-they must be extremely well paid attendants. We also know that the hospital's move into its £148 million PFI wing was delayed twice before finally opening in late 2010. The opening day was pushed back because staff were trapped in faulty lifts. We also know that the same hospital spent £400,000 on art for its new wing, which was commissioned as part of the development and funded through PFI. PFI is expensive enough-we may 

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debate that at another time. To spend the money on art, when we know how ridiculously expensive PFI can be, seems quite strange.

There have been all sorts of care warnings about hospitals in Essex, such as Queen's hospital in Romford. We know that the Romford project will be the first of a number of pilot reviews of PFI contracts to see if the costs can be brought down, and anyone who cares about the health service must welcome that. We know that the Braintree community hospital has defended itself after paying out nearly £20 million in damages for clinical negligence. If we are focusing on bureaucracy, we have to focus on how those things happen. We know that the Southend University Hospital NHS Foundation Trust, with which hon. Members will be familiar, has had to respond to concerns about safety, which were raised by the Care Quality Commission. We know that the West Essex primary care trust risks not being able to give an 18-week referral-to-treatment time. We know that NHS South West Essex has a very large overspend-its deficit has been improved, but it still has an overspend-in relation not to bureaucrats, but to acute hospital activity.

We also know, which I find alarming, that the Basildon and Thurrock University Hospitals NHS Foundation Trust is now trying to make savings by allowing waiting lists to extend. That implies a 14-week wait on first appointment, which is why an hon. Member on the Government side said that, when ordinary residents and voters are told that money on the health service is being ring-fenced, it rings rather hollow. Up and down the country, not just in Essex, they can see waiting times lengthening, and new hospitals and new health care facilities that have been promised being delayed. It is for the Government, who have made much of their protection of health care spending, to explain that. The real issue is this. The hon. Member for Witham spoke glowingly about the reforms, but sadly I have news for her. She seems to believe that those reforms will help with the issues that she has raised. As she would know, however, if she had followed the Health Committee, there is a real challenge involved in trying to introduce those reforms, whatever we think of them, while at the same trying to achieve unprecedented savings in health care. The Health Committee doubts whether that can be done.

No one argues with the notion that GPs could have a lot to offer in the commissioning of care, but as the president of the Royal College of General Practitioners has said, there are other ways to do that without subjecting the health service to a top-down reorganisation. I do not want to be unpleasant, but the Government promised, all through their time in opposition, that they would not subject the health service to any top-down reorganisations.

Priti Patel: Will the hon. Lady give way?

Ms Abbott: Time is against me, because I want to give the Minister plenty of time to respond. That is what we were promised-no more top-down reorganisations. As for waste of money, one problem with letting all those PCT bureaucrats go is that they have to be paid redundancy. The hon. Lady said that she hopes that they will not be paid big redundancy packages. I am afraid that they will be, and many will be re-employed. GPs will be less accountable to patients and the danger that many people, 

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including GPs, see is that the big American health maintenance organisations will be able to get inside and act as commissioners for GPs, who, after all, joined the health service to heal and not to be managers.

I feel sorry for Government Back Benchers. They believe that the issues that they find so challenging about bureaucracy, cuts and patient accountability will be solved by the reorganisation. I can say with complete confidence that, if anything, the reorganisation, which is too fast and at the wrong time, will make those problems worse. It gives me no pleasure to say that, but anyone who has analysed the so-called reforms can see that they are a car crash in slow motion.

12.14 pm


To see the full debate please click here:  http://www.publications.parliament.uk/pa/cm201011/cmhansrd/cm110315/halltext/110315h0001.htm#11031560000284



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