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NHS Turnaround Programme

Volume 458: debated on Tuesday 13 March 2007

The estimated expenditure on the turnaround programme to 31 March 2007 is £10 million in central costs and £36 million locally. This is about 3 per cent. of the forecast in-year savings from the programme.

Since the Secretary of State’s visit to Milton Keynes last summer, the Fraser day hospital has closed, along with a 23-bed surgical assessment unit, and there have been cuts to mental health services, oral health services, language therapy services, podiatry services and counselling services—the list goes on—so does she consider the turnaround programme in Milton Keynes a success?

I am surprised that the hon. Gentleman did not mention the fact that in the past three years the budget for the national health service in Milton Keynes has increased by more than £47 million. In the current two years, it will receive a further £55.6 million increase. I congratulate the staff of Milton Keynes primary care trust and others working in the local NHS who have made difficult decisions this year to reduce their deficit, although they will need longer than this year to do so. I suggest that the hon. Gentleman speak to his hon. Friend the Member for South Cambridgeshire (Mr. Lansley), who said in the House yesterday that primary care trusts

“receive a given amount of public expenditure resources.”

He might have said they receive more than every before. He continued:

“They should live within the overall resource envelope.

He said that a PCT

“has a responsibility not to spend more than the resources that are voted to it through the House.”—[Official Report, 12 March 2007; Vol. 458, c. 41.]

Does the hon. Member for North-East Milton Keynes (Mr. Lancaster) agree with that, or not?

My right hon. Friend will know that in its report on NHS deficits the Select Committee on Health said that the fact that the turnaround programme had to be introduced was

“a sad reflection on the quality of much management in the NHS over many years.”

When does she think that the turnaround teams will leave NHS institutions, which will be capable and competent enough to run services themselves?

I congratulate my right hon. Friend on the Health Committee report that was debated yesterday. The scale of achievement by NHS managers and front-line staff, supported by turnaround teams, is indicated by the in-year position of organisations that had a deficit last year. That deficit has been reduced by £600 million, almost all of which—nearly £500 million—can be attributed to the turnaround organisations, which have supplemented the excellent management in many parts of the NHS. It is up to local organisations to decide when they cease to make use of them.

Following the turnaround team’s work in mid-Essex, how will the closure of all three intermediate care wards at St. John’s hospital alleviate the problem of delayed discharges at Broomfield hospital?

The decisions to which the hon. Gentleman refers are, of course, for the local NHS to make. Delayed discharges are a serious problem, and the local primary care trust must satisfy itself that alternative arrangements are in place, including intermediate care in patients’ own homes, to ensure that it does not recur and become worse, as it did when his party was in power.

Turnaround teams are important, because they resolve the problem in the current financial year so that there are not even bigger projected problems in the next financial year, 2007-08. Is it not right that individual trusts live within their means so that other partners and NHS trusts are not disadvantaged?

My hon. Friend is right. It was unfair and unacceptable that in the past a minority of overspending trusts were bailed out, sometimes year after year, when other parts of the NHS—mental health organisations or, more often, underspending trusts in parts of the country, especially the midlands and the north—had even worse health problems. That was not fair and it gave the overspenders no incentive to sort themselves out. I am glad to say that with the fair, transparent and responsible financial system that we have put in place, we are stopping that unfairness at last.

In figures dragged from them last June, Ministers said that the declared central costs of the turnaround programme would be £5 million. Successive freedom of information requests showed that those costs have more than doubled to £11 million, and more recently we managed to extract the information that the local cost of the programme is more than £24 million. The central £11 million plus the £24 million means that the financial incompetence of the Secretary of State has so far cost £35 million, and rising. As the growth deficit of the NHS is forecast to increase this year, will the right hon. Lady tell us what the turnaround teams have delivered, what the final cost of the programme will be, and above all, at what cost to front-line patient care?

Spending on the turnaround teams has been higher than we originally estimated because we found that more organisations had been overspending—some of them for years—and needed to go into the turnaround programme. The investment in the turnaround programme is a very small proportion of the savings that are now being made. The hon. Gentleman might wish to acknowledge that, as we indicated in the most recent financial report, eight out of 10 hospital trusts and seven out of 10 primary care trusts report an improvement on their in-year position. There has been an enormous improvement in the in-year position, and thanks to the difficult decisions that NHS managers and staff have made, the NHS has got a grip on its finances while continuing to improve waiting times, cancer treatment and other key services. By returning to balance at the end of this month, the NHS will be in a far stronger position for the next financial year and able to make further improvements for patients, particularly in cutting waiting times even faster.