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Access to NHS Services

Part of Opposition Day — [15th Allotted Day] – in the House of Commons at 4:43 pm on 3rd July 2007.

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Photo of Andrew Lansley Andrew Lansley Shadow Secretary of State for Health 4:43 pm, 3rd July 2007

I share my right hon. Friend's concerns. Furthermore, he represents a part of the country that secures the lowest per capita distribution of resources. The Select Committee on Health made it clear that, as we had argued, there should be a review of the resource allocation formula to make it fairer in distributing resources relative to the burden of disease. It is interesting that the Secretary of State's predecessor handed him one admission of our arguments. Only the week before last, the right hon. Lady said that the Advisory Committee on Resource Allocation should be given Bank of England-style independence. She acknowledged that we were right and that it had been the subject of political interference. In a letter to me on her last day in office, she also accepted our argument that the principal cause of variation in health-related need in the burden of disease is age, so as an urgent measure I look forward to an independent review of resource allocation to deliver a fairer distribution across the country.

The purpose of the debate is partly to set out the things that need to be done. Local services, such as accident and emergency and maternity services, should not be shut down in the absence of evidence of what constitutes safe, accessible and good-quality care. I hope that tomorrow the Secretary of State will say that he will have such a moratorium.

The Prime Minister and the Secretary of State should not be wandering around the country saying that they are going to listen and then overriding things before they happen. We need care closer to home to mean exactly that, and not have services taken away that people have relied upon for a great deal of time. We need to know whether the Prime Minister has any substance to add to what he said in passing at the outset of his leadership campaign, or does he, as it turns out, have hidden shallows to him? Where in the Government amendment is the recognition that they must do better? If that is what the new Prime Minister said in his leadership campaign, why is it not reflected in the Government's self-congratulatory amendment?

Morale in the NHS is at an all-time low. The Health Service Journal asked NHS staff about morale and published the results the week before last. It asked whether morale in the NHS was excellent and 0 per cent. said that it was. Some 4 per cent. said that morale was good and 30 per cent. said that it was moderate. However, 41 per cent. said that it was poor and 25 per cent. that it was very poor. That is nearly two thirds.

The Secretary of State is a former general secretary of a trade union and he must know that relations between the leadership of the NHS and the staff of the NHS are at all-time low. Even in his own Department, morale is low. Direction and leadership are badly needed, and we must have greater autonomy for health care professionals to re-empower and motivate them. We must have accountability to patients exercising choice and a public voice on these issues. We need evidence for the policies that are being pursued rather than simply a slash-and-burn pursuit of the Government's fiscal targets, which are delivering inequitable access to care in too many parts of the country. Not least, we need strong commissioning decisions taken closer to the patients and stronger primary care-led commissioning in urgent care.

We have a clear vision for an NHS that is patient- centred and professionally led. It is a vision of an NHS accountable for its outcomes and not hamstrung by targets, and in which we recognise that access to NHS care, as well the safety of care, is integral to quality services. It is a vision of what is, indeed, a national health service that respects the diversity and needs of patients at every level, and incorporates the essential principles that have stood the NHS in good stead for nearly 60 years, and puts them right at the centre of NHS care.

I hope that this is a starting point from which we and the Secretary of State and his ministerial team can work together positively and constructively to deliver a service that lives up not only to those principles, but to the ambitions of the people who work in the NHS and, not least, of those who depend upon it. I commend the motion to the House.