Specialist children's hospitals will continue to be funded through local commissioning and specialised commissioning based on payment by results and local contracting while also recognising the specific additional costs of specialist paediatric services.
The Secretary of State will know that his Department has written to specialist children’s hospitals threatening to withdraw the top-up moneys that are recognised as important in treating the most critically ill children. That is outrageous and seems to run counter to the Government’s commitment not to cut funding. Will he go back to his Department and tell his officials that he will not go ahead with the reduction in top-up fees?
I am afraid that I have to correct the hon. Gentleman. We are not withdrawing specialist top-up payments; the Department has acted on the basis of a review conducted by the university of York which was initiated by the Opposition Front Bench team’s predecessors when they were in government. They set up a review on specialist top-ups which said that the payments should go down from 78% to 25%, not that they should be withdrawn completely. We are reviewing that outcome with the specialist children’s hospitals and a meeting is taking place today to consider whether the review’s conclusions were accurate and applicable.
Does the Minister agree with me and the 1999 Shields report that children’s accident and emergency, paediatrics and maternity units should be kept together in one hospital? Will he postpone the move of the Burnley children’s ward to Blackburn until the new GP commissioners are installed and can make an informed decision?
Yes, I entirely understand my hon. Friend’s point and we have discussed this at Burnley. I feel strongly—indeed, I know—that we must continue to apply the tests that I have set out for such issues of configuration, including that they will deliver improving clinical outcomes, be safe for patients and, as he rightly says, reflect the commissioning intentions of local GPs representing local patients.
How can it possibly be right that the world-renowned staff at Great Ormond Street hospital in my constituency face, under this proposition, a reduction of £16 million in the funding of that hospital? NHS funding is supposed to be ring-fenced, but from the point of view of people at Great Ormond Street, it seems to be rather more ringed than fenced.
The right hon. Gentleman must realise that if we had listened to the Labour party in the comprehensive spending review, we would have cut the NHS budget, but we did not. We resisted the Labour party’s proposal, and resources for the NHS will increase in real terms, but there is then the matter of how those resources should be deployed to best effect. The application of the proposal—we have still to agree with children’s hospitals on how it will be applied—would have the overall effect of reducing Great Ormond Street’s total income by less than 2%.
The Secretary of State’s answer simply will not do. He is in government now, not us. He is making decisions to make deep cuts to our specialist children’s hospitals. He is trying to keep the NHS out of the public spotlight, and we will make sure that the public know what his plans for the NHS are.
I have the Secretary of State’s letter. He has not answered my questions and I ask him again to tell the House why, before today, no Minister has made any statement in public or in the House about these big stealth cuts to our children’s hospitals, and how much each one of the 35 specialist children’s hospitals will lose next year in funding to treat some of the most critically ill children in our country.
I welcome the right hon. Gentleman to his place. I hope he enjoys being shadow Secretary of State as much as I did, and that he enjoys an even longer tenure. I explained to his right hon. Friend the Member for Holborn and St Pancras (Frank Dobson) the impact on Great Ormond Street. I do not discount its importance to the hospital, and it is being discussed today with specialist children’s hospitals by a group chaired by the national clinical director, but it represents less than 2% of Great Ormond Street’s total income. This is about specialist top-ups to the tariff where the new tariff has been introduced, which in itself makes differences to the income and the accuracy of costs of services provided by those hospitals. It was all set up by the previous Government. They started the review. They published it on 16 December 2009. It was not our doing; it was their doing.
I thank the right hon. Gentleman for his welcome to me in my job. I have no intention of being in the job for six years, as he was before he came into government. We will have won an election before the end of that period.
Big stealth cuts to our children’s hospitals are not what the public expected to see when they heard the Prime Minister promise to protect the NHS budget. Will the Secretary of State admit that he is double-counting £1 billion a year in the spending review as both money for the NHS and money to paper over the cracks in social care? Will he accept the new House of Commons Library research report, which confirms:
“Including the (social care) funding is critical to the description of the settlement as a ‘real terms increase’; without it, funding for the NHS falls by £500 million—0.54% in real terms.”
When did the Secretary of State tell the Prime Minister that the Government are breaking his promise to protect the NHS budget?
I am afraid the right hon. Gentleman is wrong about that. Even if we did not treat up to £1 billion to support social care through the NHS as NHS money—we should treat it as NHS money, but even if we did not—there would still be an increase in the resources available to the NHS in real terms each year. It is NHS money. The right hon. Gentleman must accept that this year we are spending £70 million on reablement, which has the effect of mitigating need in social care and reducing emergency readmissions to hospital. We will provide NHS money, which in itself supports health gain and social care support.