Speaking in the debate on the Queen’s Speech, Sir George said that, until the Government reviewed the formula it used to allocate NHS money to Hampshire, the local NHS would never be able to afford the quality of service his constituents were entitled to expect.
The text of Sir George’s speech, in which he drew attention to the poor quality of the buildings in Andover hospital and the problems of finding a GP and an NHS dentist, follows.
Sir George Young (North-West Hampshire) (Con): It is a pleasure to follow the thoughtful and courageous, if not career-building, speech by the hon. Member for Birmingham, Northfield (Richard Burden). I am sure that he was right to say that the Government will suffer a loss of public confidence if they pursue their policy on top-up fees, as that policy sits very uneasily with the commitment in their manifesto. However, I hope that the hon. Gentleman and the House will forgive me if, in the short time available, I focus my remarks on the Opposition amendment to the Loyal Address, which relates to the health service.
I welcome to the Front Bench my hon. Friends the Members for South Suffolk (Mr. Yeo) and for South Cambridgeshire (Mr. Lansley), who now have responsibility for health service matters. I can think of no two people better able to dismiss the absurd allegations made by Labour Members from time to time about Opposition policy on the NHS.
When the Conservative Government were elected in 1979, we were able to stick to the spending levels that we inherited from the previous Labour Govt. At a stroke, that demolished some of the absurd claims made before that election. I hope that we will be able to do the same again. I hope that our policy will be to stick to the core values of the NHS and to build on its strengths but address its weaknesses.
I confess to having, from time to time, a moment of sympathy for the Secretary of State for Health. He has extracted record sums for the NHS from the Treasury, and yet he finds himself besieged by colleagues highlighting areas in which the NHS could do better. However, the moment of sympathy passes quite quickly. Ministers must largely bear responsibility for the frustration, because they have let the rhetoric run ahead of reality, stifled the initiative and skills of those who work in the NHS, and overwhelmed it with endless and misguided legislative reforms. People are less interested in new laws than in what is actually happening. I want to spend a moment looking at what is happening.
I recognise that the problem of declining NHS dentistry precedes the advent of this Government in 1997. This Government said, however, that they were going to address it. Six years on, people who have had NHS dentistry all their lives are now losing it. I received an e-mail on 19 November from Mr. Cull of Tadley:
"I have recently been told by my local Dental Practice . . . that they no longer accept NHS patients . . . If it were possible, I would now choose to opt out of paying tax and national insurance, and pay for any services as and when my wife and I need them. I want the Government of the day to recognise that those who pay are entitled to something back!"
Another constituent wrote on 18 November:
"I discovered yesterday that my family has been taken off the NHS register at our local dental surgery and my children cannot get treated unless we the parents register as private patients."
And that is happening under a Government who accuse us of having a secret agenda to promote private medicine.
A third constituent was told that he had to join Denplan at £14 a month. He wrote:
"Both myself and my wife are in our 70s and we find that we cannot afford this level of charge from our pensions. We both only have nine teeth remaining and therefore find this situation is very poor. Can anything be done so that pensioners are not faced with these excessive charges in the future?"
At £18 per tooth per year, those are expensive possessions for them to insure. Some people feel betrayed on NHS dentistry.
The situation with general practitioners in Andover, the main town in my constituency, is not much better. A member of my staff recently moved to Andover. All the GP lists near where she lives are closed. Another constituent e-mailed me on this subject on Monday to say they had attempted to get onto books throughout Andover, but had been informed that the only surgery available is somewhere else. My constituent wrote:
"I would invite your comments on the current state of medical provisions in your constituency when, despite Andover being chosen as an area for expansion, 99 per cent. of all surgeries have closed their books."
There is therefore real pressure not only on NHS dentistry but on primary care and GPs.
Moving upwards to hospitals, we have a popular hospital in Andover with dedicated staff struggling to provide modern services. The building in which the out-patients department is located, however, is straight from "Carry on Nurse" in the 1950s, with people standing in long queues waiting for blood tests on a Monday morning. I ask the Secretary of State, who is chuntering away on the Front Bench, why that is happening and why it is tolerated. In a nutshell, it is because Hampshire gets about £85 per person for every £100 that the rest of the country gets. That is simply inadequate to provide the quality of service that my constituents expect.
We just have to look at the accounts for one of the two three-star hospitals that serve my constituency for the year ended in March to see the pressures. It brought forward an underlying deficit of £3.5 million, and had unfunded commitments of £3.9 million, a cut in primary care trust income of £1.4 million and unfunded cost pressures of £600,000, leading to a deficit of £8.6 million. Of that, £6.1 million was found by savings and income plans—code for increasing car park charges and looking hard at service provision. The balance of £2.5 million was found from the strategic health authority.
Like most of the NHS in south-east England, the local primary care trust has similar structural problems. It had a deficit of £1.5 million last year, made good by capital-to-revenue transfers. In the current year, it can only balance the books by either land sales or capital-to-revenue transfers of £2 million. If we go on transferring from capital to revenue, the position that I have just described at Andover hospital will remain.
I know what the Secretary of State will say—that he has given a record cash increase this year. Yes, the trust that runs the largest hospital in my constituency has had a 9 per cent. cash increase this year over last year. I asked it how much of that was swallowed up by increases over which it has no control. The answer was 6.5 per cent.—national insurance, nurses' pay, doctors' hours and pharmaceutical prices. Therefore, 6.5 per cent. out of 9 per cent. disappeared. Of the 2.5 per cent. remaining, 1.5 per cent. was applied to the deficit that was brought forward, and the 1 per cent. of growth was ring-fenced for a number of specific services. Therefore, virtually no money was left over to develop all the other services that were not ring-fenced.
That pressure feeds through to individual constituents. Mr. S of Andover saw his GP in January and was referred to a neurologist. The appointment was on 10 June. He was told that he needed a brain scan. He wrote:
"After two months, I had not heard so I phoned Southampton Hospital; imagine my anxiety when I was told my scan was classed as routine. My appointment would be in June 2004".
I had a letter on 19 November from Southampton university hospitals NHS trust about this case with more bad news:
"At present our wait is now 8 to 9 months, but unfortunately this waiting time is currently rising as we are suffering staff shortages due to a scarcity of trained radiographers nationwide."
An eight-year-old boy in the village where I live has been assessed and approved for a cochlear implant in Southampton. His parents tell me:
"Unfortunately due to the NHS allocation of funds for this year having already been exhausted, the operation is currently delayed until April next year at the earliest."
Until the formula for allocating resources is changed, the position in Hampshire and other counties in the south-east will always be difficult. The problem is compounded this year by revenue support grant pressures on social services. Education money has been passported through, leaving social services to take the strain of a difficult settlement. Since 1998–99, three nursing homes have closed, with the loss of 88 nursing beds, and five residential care homes have closed, with the loss of 90 residential care beds. During that time, only one home has opened, offering 60 beds, none of them available at the Hampshire rate.
To address the problem, Conservative-controlled Hampshire county council plans to develop an extra 4,500 nursing home beds in the county to help to overcome the shortage—a much more constructive response, dare I say it, than the Community Care (Delayed Discharges etc.) Act 2003. However, Hampshire county council is threatened with capping if it attempts to deliver the quality of service that the Government want.
My advice to the Secretary of State is this: first, stop constantly interfering; secondly, moderate the rhetoric; thirdly, allocate resources fairly. If he does all that, he will begin to bridge the gap between expectation and reality in Hampshire.