Julian Smith: NHS must supply the best care and value for patients

WHEN the House of Commons debated the NHS Risk Register, I called the Shadow Health Secretary a “scaremongering buffoon”.

I was rightly told to withdraw the comment by the Deputy Speaker. Anyone who knows me will realise how out of character my outburst was but I was angry at the opportunism and hypocrisy of the Labour Party’s attempts to scare those who are concerned about the future of the health service. It was the same with this week’s debate.

What Andy Burnham failed to highlight is that when Labour were in Government, and he was the Secretary of State for Health, he refused to publish the Risk Register as well. It is not because people should not have all the facts; it is because the document itself – as with the reforms in general – needs to be set in context.

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The Health and Social Care Bill has, as the Prime Minister has himself admitted, not always been explained particularly well.

I can completely understand why people are worried but let’s be clear – we believe in the NHS, we guarantee it will always provide treatment free when you need it and the Government are increasing the amount of money spent on it.

That does not mean there should not be change. There has to be as the NHS faces massive and rising cost pressures from an ageing population and new medicines. Just as the organisation looks different than it did when it was set up, it will need to look different in the future. When you ask patients who they turn to and rely on first in the health service, more often than not it is their GP.

GP’s are on the front line of the NHS – they see patients of all ages, with all manner of symptoms and are the gateway to healthcare. Who better to have more of a say on how the NHS is run.

That, at its simplest level, is what the Government’s reforms are intended to provide – more power to doctors and patients. Of course GPs cannot work in isolation and that is why other clinicians such as hospital doctors and nurses have also now been invited to be part of the new decision-making process.

The experience I have seen in my constituency in the past year, as the debate about the future of the NHS has raged, has been in stark contrast to what the national media headlines would lead you to believe.

Groups of GPs in Ripon, Bentham and Craven have come together, formed consortia and are working well together on the challenge of taking control. Each hospital that I have visited has been thinking carefully about what it does best, what it should focus on and what should be left to others. Local councils have been reflecting on how they co-ordinate their responsibilities for social care with health care and how that will mean a more co-ordinated service for patients.

What has also struck me is the strength of leadership and an enthusiasm for the future. These reforms give those on the front line much more of a say rather than managers in York or Leeds or London.

Take the chief executive of Airedale Hospital – a former nurse who has become the person in charge. She is just one example of what I believe these reforms will bring – people with real experience of the National Health Service making decisions about the future of the National Health Service.

Already over the past 18 months, there are 15,000 less administrators and 4,000 more doctors. We need to continue to cut bureaucracy to get more money to the front line.

There is also a lot of focus and misinformation on private involvement in the NHS. Let’s be clear – there is already private involvement in the NHS. Labour’s reforms saw private providers more and more integrated into the National Health Service. Over a quarter of all “NHS walk in health centres” are, for example, privately run. It is a good thing. The involvement of the private sector has improved treatment, reduced waiting times and given patients better choice.

As one of the hospitals admitted when I made a recent visit, it has forced them to improve as well. We should not turn back the clock and we must ensure a level playing but we have to be prepared to accept some services can be provided by those other than the state – competition will help everyone get the best possible treatment as long as it is based on quality and not on price.

It is not just larger companies who can provide innovative solutions, but new start-up providers like Helping Hands of Harrogate, based in Pateley Bridge, who provide personal care for young people and young adults with a range of complex care needs. I hope that with local decision-making comes greater integration of health and care services.

There are many excellent charities, groups and providers in Yorkshire who would not get through the door of the NHS if decisions were being made in London. With these reforms we stand a better chance of having a proper joined up health and care system, with the best people, the best treatments and the best services on offer.

We also need to encourage more links between medical research and the National Health Service to ensure we stay ahead of the game on tackling the biggest diseases. As a country we have some of the best scientists, engineers and medical researchers in the world.

Yet many of them end up producing medical breakthroughs for the United States, India and China meaning residents of those countries get health benefits before they arrive in this country.

We must have a health service with a culture that allows them to stay, to research and innovate here and our leading hospitals must have the opportunity to ensure they can offer the best treatments and the best healthcare in the world. Again this will mean working with both public and private organisations with the NHS benefiting from any breakthroughs that emerge.

This Government is absolutely committed to an NHS free at the point of delivery, funded from general taxation and based on the need and not ability to pay. But with the doubling of people aged 85 and over in the next 20 years, and the cost of medicines rising at £600m a year, we need to continually think about how we get the best value for money and the very best care for patients.