It is a pleasure to serve under your chairmanship, Mr Bailey. I congratulate my friend from the Public Accounts Committee, Meg Hillier, on securing this debate, which is welcome. To start on a positive note, we are having this debate because the NHS has been a great success. Life expectancy in England is now approaching 81, which would have been unimaginable when the service first started. Treatments in today’s hospitals would have been seen only in “Star Trek” in the late 1980s. So, to be positive, the story is about how we deal with a challenge created by the greatest success.
I remember my time in local government. Other former councillors in the room may have seen the same graph showing that emptying bins and disposing of rubbish and social care would be the only thing left that councils would be able to afford to provide due to the predicted rise in the cost of social care as demand increased. We have heard a lot today about the possibility of integrating services. I can certainly reflect on the challenges that my hon. Friend David Mackintosh faced in terms of different budgets and different organisations.
In Torbay we have an integrated care organisation that is fairly successful in removing barriers. It has certainly helped contribute to one of the lowest levels, if not the lowest level, of delayed discharges over winter, yet now we are having to discuss how the risk-share agreement is structured, because the NHS organisations still need to comply with budgetary rules for them as individual organisations. It is not about the amount of money in the system overall; it is not about the spending of taxpayer pounds; it is about how that is divvied up in terms of a risk-share agreement. That is the exact opposite of what we want to see when we look at integrated care.
The issue is also the pace of some of the changes. Paignton Hospital is will stop taking inpatients on
There is a long-term debate. We have touched on pensions and—let us be blunt—there was an element of cross-party agreement when the pension age for my generation was increased to 68. It can be tempting to talk about the amnesia of opposition. We need to discuss long-term solutions. The Budget was welcome, but it has to be seen as a short-term measure. We need a long-term schedule that will last for more than one Parliament and more than one Government.