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NHS Funding Bill

Part of the debate – in the House of Commons at 9:04 pm on 27th January 2020.

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Photo of Bob Seely Bob Seely Conservative, Isle of Wight 9:04 pm, 27th January 2020

I have spoken at length in this Chamber before about the prospects of an Island deal on the Isle of Wight, and I was delighted when on 25 September last year the Prime Minister spoke of the Island deal that we will do. I would like to come to that, but first I want to come to the crux of the Bill.

I very much welcome the Bill. I feel a little guilty about barracking Ministers earlier today about Huawei, so I want to go out of my way to congratulate Ministers, and indeed the entire Health Front-Bench team, who I have a great deal of time for, on putting together this Bill. I thank in particular the Minister present, my hon. Friend Edward Argar, because he and I have talked on various different occasions about the Isle of Wight, and I apologise for that; he is extremely knowledgeable not only about his constituency, but about many others as well, and I know he does his job.

I like the levelling up idea behind a lot of what the Government are going to do, because, just as we have heard from my hon. Friend Richard Drax, my patch has also lost out in funding in many different ways in the past 10 or 15 years. I spoke briefly with the Secretary of State last week about some concerns in relation to the Isle of Wight NHS Trust. We have an increase in serious incident reporting, which was reported by the Health Service Journal under freedom of information requests last week, and I congratulate the journalist responsible for that work. I have to say that in part the increase in reporting is because that was encouraged by the new management, and I am very supportive of the new management, which is trying to turn things around in the hospital.

Sadly, our staff morale tends to be at the bottom of the NHS staff morale charts, and we have issues about recruitment, somewhat because we are an Island, and that feeds into morale issues and the use of locums, and there is less time for patient treatment.

We are now graded as requiring improvement rather than in special measures. When I was talking with the Secretary of State last week, he specifically said, “Focus on the management,” and I said “You’re absolutely right, Secretary of State, to focus on management issues and how we need to support the management team on the Isle of Wight and all our senior doctors—our consultants—as well as all the NHS staff.” But there is also an issue of funding, which I would like to remind my hon. Friend the Minister of in the couple of minutes I have left.

My hon. Friend knows about this, as I have talked to him about it, and I have spoken to the Secretary of State, who admitted in July that the Isle of Wight is

“unique in its health geography, and that there are places in this country—almost certainly including the Isle of Wight—where healthcare costs are higher”.—[Official Report, 1 July 2019; Vol. 662, c. 943.]

I just want to remind the Minister of that and say that I wrote to the Prime Minister and forwarded the letter to the Department of Health and others.

Working with the Isle of Wight NHS Trust, we estimate that the additional cost of providing NHS services on the island to the same standard as on the mainland is approximately £11 million. There are many academic studies, both internationally and nationally, to do with Scotland and to do with England that show that the costs of providing public services are greater specifically on islands, because there is severance by sea. Academics give various sophisticated names to that—such as diseconomies of scale and island factors. Basically however, it means that on the Isle of Wight we have a district general hospital—I thank all the staff who work there; they do a great job in sometimes difficult circumstances—but we have only half the population base of district general hospitals, so we do not get the same tariffs, and as a result of that everything costs more; it is very difficult to get the same efficiencies and economies of scale. We estimate that the additional cost of providing the same standard of acute care on the Island as against the mainland is £8.9 million a year. It would be great to meet with either the Minister or the Secretary of State to discuss that. The additional cost of providing an ambulance service, which includes a coastguard helicopter ambulance, is about £1.5 million, and we need to add to that the cost of patient travel by ferry—which can be uncomfortable and difficult for those going for repeated treatment on the mainland, such as to Southampton for cancer care—which works out at about £560,000 a year.

The Secretary of State is right that there has been a management issue, and we are trying to confront it, and that has fed into lots of other problems with HR, low morale and difficulty in recruiting consultants, but we are in a vicious financial cycle as well. If we cancel an operation due to lack of beds, we do not receive the tariff from that operation, and we have doctors, and consultants and senior doctors, who are not using their talents for the greater good. I will leave that point there, because I know that we need to wrap up, but I remind my hon. Friend the Minister and those on the Front Bench of the additional costs, which we have worked out and presented to the Government, of providing NHS care to the same standard as on the mainland. I am not asking for golden elephants or anything over and above what my excellent hon. Friends on this side of the House or Members on the other side receive, but we estimate that providing us with the same standards costs us an additional £11 million a year.