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NHS: Value for Money and Efficiency

Volume 648: debated on Tuesday 23 October 2018

Having committed an additional £20 billion in real terms, the Government are asking the NHS to deliver a long-term plan that includes continued improvements in productivity and efficiency, and we are reinvesting the savings in improved patient care.

I congratulate my hon. Friend on his drive to recycle more hospital equipment such as zimmer frames, crutches and wheelchairs, but what steps is his Department taking to encourage more hospitals such as Southport Hospital in my constituency to run recycling programmes to reduce waste in our NHS?

I am keen to work with my hon. Friend to encourage Southport and other trusts to recycle equipment. I know from my family’s experience that it causes significant frustration when people see hospitals not collecting perfectly good medical equipment that could be recycled. I am keen to work with him and with trusts to ensure that we learn from that.

Digitising patient records and removing outdated technologies such as fax machines can improve productivity and patient care across the NHS. What steps is my hon. Friend taking to prepare the NHS for the fourth industrial revolution?

I commend my hon. Friend for his excellent report for the Centre for Policy Studies, which highlights the opportunities provided by technology. I was at a Scan4Safety event last night, looking at how barcodes are being used at six trusts, and at how that could be expanded to deliver 4:1 efficiency savings and improve patient care through the safety it offers.

Does the Minister believe that the practice of cutting funding to hospitals that miss A&E targets helps to improve the patient experience at those hospitals? Will he agree to meet me to discuss how this issue has affected Leighton hospital, which serves my constituents?

The hon. Lady may have missed our recent announcement of significant additional funding, ahead of winter pressure, to assist hospitals. As the Secretary of State announced, the extra £20.5 billion real-terms increase is part of a wider commitment to support our hospitals.

Jack Adcock’s death was a tragedy, but why did the General Medical Council spend £30,000 on getting Dr Hadiza Bawa-Garba struck off, even though she had already faced the consequences of her mistakes in court? Does the Minister think that the GMC needs to sort its act out and that Charlie Massey should resign?

As the right hon. Gentleman will be aware, Professor Norman Williams looked at the circumstances of this case and produced a report on it for the Government. As a part of that, we are looking at a number of factors.

Is the Minister aware that in terms of value for money and efficiency, the Government of India’s integrated health Ministry has half a million ayurvedic doctors and a quarter of a million homeopathic doctors? At a clinic I visited recently in Karnataka province, four fifths of the patients who would have normally gone to see a western doctor were treated by those local doctors. Will he build links with the Indian Ministry of Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homoeopathy?

I pay tribute to my hon. Friend for the longevity and sincerity of his campaigning on these issues. He draws attention to the wider point of how patients presenting with multiple and complex conditions need to be treated in multiple ways, and what he refers to is a part of that wider discussion.

NHS England is being ripped off to the tune of £230 million a year as the price of some off-patent drugs and non-standard preparations, or specials, have been hiked up hundreds of times, for example to over £1,000 for a bottle of pain-relieving mouthwash. In Scotland, specials remain in-house to keep the price down, but a year and a half on from the Health Service Medical Supplies (Costs) Act 2017, why have the Government not used its powers to stop this drug racketeering?

The hon. Lady, very astutely and correctly, identifies the issue, which is how we ensure value for money from specials. Indeed, I commend The Times for highlighting a number of these issues. We are looking at this area. As we commit an extra £20 billion in funding to the NHS, our commitment is to ensure that we derive value for money from that investment. That applies to specials, too.

The healthcare market in NHS England is estimated to cost £5 billion to £10 billion a year and involves 2.5 million nursing hours a week being wasted on non-clinical paperwork. Does the Minister not recognise that this is the biggest inefficiency? Will he commit to reversing the disastrous marketisation of NHS England?

Again, the hon. Lady draws attention to my work on driving productivity improvements within the system, which looks at a range of efficiencies such as sending texts and emails, dealing with missed appointments and the use of green energy. We can implement a whole range of initiatives as a part of that agenda.

As the first port of call for patients with often minor ailments, community pharmacists can really help to improve the efficiency of the NHS by taking pressure off GPs. What plans do the Government have to support and enhance the role of community pharmacists?

My hon. Friend is right to draw attention to the valuable role played by pharmacies. This is part of a wider education campaign within the NHS and increased access to clinicians, such as through 111, is another component of that. We want to ensure that rather than people’s first port of call being a GP, they access the NHS and pharmacies at the appropriate time.

At the end of the last financial year, trusts owed the Department a staggering £11 billion. NHS providers say that this is locking some trusts into

“a vicious circle of inevitable failure”,

and the King’s Fund says that there is no prospect of them ever repaying. Trusts with the biggest debts are forced to pay the highest levels of interest. How can the Minister expect trusts to be efficient when they are paying an interest rate of 6% on debts to his Department?

As it happens, I will be at an event with NHS providers—chief execs—this evening, when I am sure that this will be one of a number of issues that we will discuss. The hon. Gentleman is right to draw attention to the very high private finance initiative costs that many trusts face due to contracts signed under the previous Labour Government. That is a real pressure faced by many trusts.