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NHS Efficiency Savings

Volume 598: debated on Tuesday 7 July 2015

8. Whether he expects that the efficiency savings identified in NHS England’s most recent “Five Year Forward View” will entail a reduction in staff numbers. (900783)

The “Five Year Forward View” is about meeting increasing demand through new models of care, not cutting staff numbers. In fact, we are planning an additional 10,000 staff in primary and community settings, including around 5,000 doctors.

The Secretary of State will be aware that Sir Robert Francis specifically recommended that the National Institute for Health and Care Excellence provide guidance on safe staffing levels because it is independent and can establish guidance based on the needs of patients. The Government’s decision to suspend that work and transfer responsibility to NHS England has been met with criticism from patients’ groups right across the NHS. Will the Secretary of State please explain why he thinks NHS England is better placed than NICE to carry out that vital work?

The important thing is that that work happens. NICE did a very good job in delivering safe staffing guidance for acute wards. It is important to recognise that that guidance was interpreted as being about simply getting numbers into wards, but the amount of time that doctors and nurses have with patients is as important. The work will continue and we are proud of the fact that we are dealing with the issue of badly staffed wards. We will continue to make progress.

In trying to reduce waste as part of the drive for efficiency savings identified in the “Five Year Forward View”, the Secretary of State spoke recently about the possibility of putting a price label on high-value items in prescriptions alongside a label saying that they are paid for by the taxpayer. Will he reassure the House that such a measure would be carefully piloted and evaluated first, so that we can avoid any unintended consequences for those who might consider discontinuing very important medication?

We will look at all the evidence. The evidence we have seen from other countries is very encouraging. Apart from ensuring that NHS patients and the public understand the cost of NHS care, one of the main reasons why we want to do that is to improve adherence to drug regimes by making people understand just how expensive the drugs are that they have been prescribed. We will of course look at all the international evidence.

16. NHS England consulted in the last Parliament not just once but twice on downgrading the economic deprivation part of the funding formula, which would have had the effect of taking some £230 million per year out of the primary care budget for the north-east and Cumbria. Will the Secretary of State give the House a commitment—we got one from the Minister in the last Parliament—that he will not downgrade the economic deprivation part of the funding formula? (900791)

I give an absolute commitment that economic deprivation will be a very important part of the funding formula, but the right hon. Gentleman will appreciate that things such as the number of older people in a particular area is as important in determining levels of funding. We are committed to reducing health inequalities, but that also means making sure that similar levels of care are available in similar parts of the country. That has not always been the case.

Does my right hon. Friend agree that the efficiency savings our Government are introducing have led to the lower waiting lists and the better access to cancer drugs for patients in England that are the envy of my patients in Wales? What can I tell them about how we can get greater access and better standards in Wales while the NHS in Wales is run by Labour?

My hon. Friend can tell them that when Labour Members opposed the Health and Social Care Act 2012, we were doing the right thing for patients, with 18,000 fewer managers, 9,000 more doctors and 8,500 more nurses, whereas the Labour party was posturing. We can see the results of that posturing in Wales, where more people wait for A&E, more people wait for their cancer operation, and 10 times more people are waiting for any kind of operation.

The Secretary of State talks about having similar levels of care, but we do not have similar levels of safe staffing around the country. Peter Carter has said about the decision on NICE:

“If staffing levels are not based on evidence there is a danger they will be based on cost.”

Is my hon. Friend the Member for Wirral West (Margaret Greenwood) not right? NHS England should reverse that decision and let the independent body be the judge of safe staffing levels.

I gently say to the hon. Lady that we will not take any lessons in safe staffing from the party that left us with the tragedy of Mid Staffs. We have recruited 8,000 more nurses into our hospitals because we have learned the lessons of the Francis report. The important lesson in the report is that it is not simply about the number of nurses; it is about the culture in hospitals and making sure that nurses are supported to give the best care. We want to learn those lessons as well.

In reference to the “Five Year Forward View”, the Secretary of State talked about new modes of working. A very simple thing that could be done is for women’s smear test results to refer to the fact that it is not a test for ovarian cancer, and to then list the symptoms of that cancer. That would not cost any money, but it would save lives.

I am very happy to look into that. The general direction of travel my hon. Friend is talking about is right. We need to empower patients. We need patients to become expert patients, so that they take responsibility for their own healthcare. That means giving them much more information to help them to make the right decisions.

The Secretary of State is trying to avoid the question asked by my hon. Friend the Member for Wirral West (Margaret Greenwood). It was a key recommendation of the Francis review into Mid Staffs that safe staffing guidelines should be drawn up independently from Government and NHS managers to make sure people are confident that they are based on what is best for patients, not budgets. Why has he gone against Francis? What was wrong with what NICE was doing? He has published no new criteria for NHS England and no process or timetable for action. Will he now commit to doing that, so that patients, staff and Members of this House can be confident that this is not just a cover for cuts?

We will not take any lessons from the Labour party about what needs to be learned from Mid Staffs. Labour Members should be ashamed of the state of hospital care they left behind. There are 8,000 more nurses in our hospitals as a result of the changes that this Government have made. They should welcome that, not criticise it.