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NHS Trust Deficits

Volume 462: debated on Tuesday 26 June 2007

I meet the chief executive of the East of England strategic health authority on a quarterly basis to discuss finance and other topics. For 2007-08, all PCTs in East Anglia and the east of England are forecasting financial balance.

Can the Minister explain why he and his ministerial colleagues allowed the new Norfolk PCT to start operating with a £50 million deficit? Is he aware of the widespread concern in East Anglia that a number of accident and emergency units are under threat, and can he confirm that there will be no linkage between strategic health authority deficits and the closure of A and E units?

As I said a moment ago, the health economy of which the hon. Gentleman’s PCT is a part is forecasting financial balance this year. In addition, it will make progress on our 18-week target, effectively bringing an end to waiting and to waiting lists. All PCTs in the country have to plan for their own local services and get services in the right places that are convenient for the population. I wish that the hon. Gentleman and his colleagues would stop trying to perpetuate the myth that financial pressures are causing cuts to services such as A and E, because it is simply not true.

The East of England strategic health authority figures show that even though Cambridgeshire PCT has the highest funding allocation per head, it was the biggest overspender in the eastern region. My own PCT has successfully managed down its own modest deficit, but the strategic health authority took some of our money to bail out Cambridgeshire. Will my hon. Friend tell me when we will get it back?

My hon. Friend has just put his finger on the unfairness of a health funding system that allowed overspending to continue, thereby taking money from other parts of the country that needed the resources to improve the health of the population. I pay tribute to his PCT, which moved from an in-year deficit in 2005-06 to a surplus last year. If his PCT has got its house in order, others can do so too.

As the Minister reflects on how those trusts are struggling to cope with deficits and to deal with a substantial programme of reform at the same time, is he minded to agree with the chief executive of the NHS, who said:

“How can you drive through this degree and nature of change from the centre? The answer is that you can’t”?

Does he agree that the current structure is hopelessly over-centralised and that independence, as proposed by the Conservatives, will not change that at all? What we need is local, democratic accountability for local health services.

If I can decode what the hon. Gentleman said, he wants to retreat to a comfort zone where we tolerate practices that allow overspending to continue. Parts of the reform programme, however, have shone a spotlight on areas where inefficiency has been tolerated for far too long, and the tariff system has made people ask questions of their own operation so that they can achieve more efficiency. Our 18-week target is hammering out unnecessary delays in the patient journey, and making sure that there is better and more productive use of resources. The reform measures that we have put in place therefore do not contradict at all the goal of financial balance. In fact, they help trusts to achieve it.