HC Deb 18 November 1997 vol 301 cc165-7 4.27 pm
Mr. Andrew George (St. Ives)

I beg to move, That leave be given to bring in a Bill to set up an independent National Health Service Funding Advisory Body charged with the task of ensuring an equitable formula for the funding of local health authorities. The Bill is relevant to hon. Members from across the country, because its purpose is to deal with the recognised failings of the current formula. Although I support initial ministerial proposals to establish an advisory body that would report next autumn, my Bill would go further by providing a continuing statutory requirement for such a body. Many health authorities—for example, in Cornwall and in Lincolnshire—face unnecessary funding crises, and hon. Members on both sides of the House know that such a crisis could occur in any place and at any time.

I tabled my Bill because of recent proposals—which are a consequence of projections for a budget-driven crisis for next year and subsequent years—to slash Cornwall's health services. The Cornwall and Isles of Scilly Health Authority must make a £5 million year-on-year saving. The need for such cuts has not only sent a shock wave through the Cornish community and been widely and justifiably derided: it has brought into sharp focus the very funding formula used by the Government in deciding local health authorities' apportionment of NHS funding. Last week, the formula was used in Lancashire, and, in the weeks and months ahead, it will affect other places.

For the benefit of hon. Members, I should perhaps explain a little about Cornwall and its people. Historically, we have had not only the lowest wages in the United Kingdom but very high levels of unemployment, a high cost of living, the highest water rates, and pressure on our housing stock from second and holiday homes. It is a difficult place in which to be poor.

This summer, even after the suffering caused by factory closures, job losses and the failure to obtain adequate investment in Cornwall's economic infrastructure, Cornish people would probably say philosophically, "Well, at least we've got our health." They might also say, "At least we have the national health service," but serious doubts now exist that many parts of Cornwall even have that.

Hospitals in small towns, which have raised hundreds of thousands of pounds for specialist and essential equipment, are destined to close. Under the proposals, four non-acute community hospitals would close. Up to 130 beds would be axed, and 400 people would lose their jobs. Essential casualty services would be downgraded. If the House thinks that I am angry, it is wrong—I am very, very angry. I am angry with my people for being so good about the cuts, for never wanting to make a fuss and always being grateful. They do not want to complain, and, until now, they have never properly expressed the deep injustice they all feel.

Before hon. Members make the often felt but rarely stated assumption that we should not complain because we live in a beautiful environment in Cornwall, I ask them to stop and think. The beauty of a rural or any other environment should not mean that its people are a soft touch for hard decisions.

The hard decisions we face in Cornwall would involve, in some places, the complete removal of health services that most other parts of the country take for granted. They would mean damage to the health, well-being and care of many vulnerable people, especially older people and their carers, and the needless loss of life.

I shall explain. One of the proposals would involve the serious downgrading of casualty services in the small general acute hospital in Penzance in my constituency. I must declare an interest, because my wife is a nurse there. However, she does not work in the casualty service, in which an average of 18,000 to 20,000 new cases are seen each year.

Every year, there are many cardiac arrests, approximately 30 cases of cardiac arrhythmia, 10 road traffic accidents—after which, following triage by paramedics, patients are admitted for emergency treatment—10 ruptured aortic aneurysms, and 30 cases of peritonitis with septicaemia. While some of those cases might make it to the only casualty service left, which is nearly 30 miles to the east, higher mortality rates will inevitably result. That will mean more deaths.

Yes, people will die as a result of the cuts, and no one should be in any doubt about that. What good will a beautiful environment be to those who die because their local casualty service has been taken away? I am sure that hon. Members will understand that that is a serious matter. I want local people to get angry, and to get even. They should get angry about the threat to local services, and get an even deal from the funding mechanism.

The present formula does not take proper account of the heavy pressure from holidaymakers who use accident and emergency services in the area. It fails to recognise that the market forces mechanism cannot cope with the problems of a low wage area. Above all, it fails to recognise the special geographical problems in places such as Cornwall. If one looks for a hospital or health service to the north, one finds sea. To the south, it is the same. In my constituency, in west Cornwall, one would need to go to Newfoundland to find a hospital to the west and, as we all know, Cornish people are not keen on going east into England.

I fully appreciate and accept that there is no such thing as a perfect and objective formula waiting to be miraculously discovered, but I know that hon. Members will agree that it could be greatly improved. Frankly, we have gone in the wrong direction, in response to an increasingly litigious society. We have seen more paper, more patients charters, more visions, more performance tables, more missions, more business plans. What has all that created?

All we have achieved is a more remote, out-of-touch and unaccountable system. For all its inhumanity, it should have created efficiencies, but we all know that it did not. Incidentally, I welcome the Government's efforts to remove the absurd purchaser-provider split from the health service. It has created a self-perpetuating culture of centralised management. The corollary is a distaste for and private derision of community facilities and values, and the treatment of patients as human beings rather than as statistics.

It is time to challenge the trend towards treating patients as remote tamagochi pets. It is time to fight back, as we are doing in Cornwall. It is time for a funding formula that recognises the wide diversity of communities, geography and needs across the land. That is all I ask, and I do not think it is too much.

Question put and agreed to.

Bill ordered to be brought in by Mr. Andrew George, Mr. Simon Hughes, Dr. Jenny Tonge, Mr. John Hayes, Mr. Paul Tyler, Mr. Colin Breed, Mr. Matthew Taylor, Dr. Evan Harris, Dr. Peter Brand, Mr. Paul Burstow, Mr. Bob Russell and Mr. John Burnett.