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333WH
Health Care (North Yorkshire and
York)
constituency is that North Yorkshire and York PCT’s
way of dealing with voluntary organisations in the past
few months has been a disgrace, breaching the voluntary
compact between those organisations and the PCT. It
has caused problems for those important parts of the
big society that have been operating in North Yorkshire
for so long.
Julian Sturdy: Absolutely. I agree entirely with my
hon. Friend. The time limit given by the PCT to those
voluntary organisations is despicable, and it has caused
fear and concern in the sector. Not only that, if the
organisations lose funding for six months, which might
be seen as only a short period, the problem is that they
might not start up again. That is my concern, and I will
go on to discuss it in more detail.
Local residents have good reasons to believe that a
huge range of treatments will be withdrawn, as I said. If
the truth be told, the status quo is not only unacceptable
but frightening, particularly for the most vulnerable
members of our communities. Even describing the current
situation as a postcode lottery is too generous. I fear
that our patch is in danger of becoming an area of
health deprivation.
Several different factors require deep consideration
as we piece together this somewhat depressing picture.
First, we must accept that the region has to some extent
been underfunded in the past. Before 2008, the North
Yorkshire and York PCT did not exist. Instead, four
separate PCTs covered the area. Nevertheless, for the
purposes of this debate, I have amalgamated funding
data to show the PCT’s current funding allocation and
the annual figures stretching back to 2003-04. For 2010-11,
our region’s PCT received just over £1.1 billion, an
allocation that places it in the lowly position of 140th
out of 152 PCTs. From a starting point of 127th in
2003-04, it has dropped down the funding table each
year. The current funding level is the lowest allocation
per head of all Yorkshire and Humber PCTs.
PCT funding is currently allocated according to a
complex funding formula, often referred to as the weighted
capitation formula. In essence, the formula determines
the target share of resources to which PCTs should
theoretically be entitled, based on a broad range of
criteria including population, the local cost of health
care provision and the level of need and health inequality
in the area. Unfortunately, most PCTs never receive an
allocation equal to their deemed target share according
to the formula. Rather, they move towards it over time,
some faster than others.
Personally, I am slightly critical of the current formula.
It often results in greater funding disparities between
different regions, which provoke a profound sense of
unfairness. Less deprived areas often seem to get a
certain tag as well. For example, according to the formula,
North Yorkshire and York does not have adequate need
for additional resources, particularly compared to the
needs of more urban areas such as Hull. I am not
convinced that approaching regional health funding
consideration with that mentality—judging whether areas
are deprived enough—is a sufficiently robust methodology
in current circumstances. We must look more deeply at
the funding stream.
I agree that the funding shortfall has increased the
strain on our local PCT and its ability to deliver the best
possible health outcomes and equity access for local
1 DECEMBER 2010
Health Care (North Yorkshire and
York)
334WH
residents. I would appreciate the Minister’s comments
on whether the coalition Government will review the
funding formula at some future date. However, I also
suggest that excusing our health care failings in our
region on past funding alone would be somewhat naïve.
Over the past few years, North Yorkshire and York PCT
has accumulated an overspend of some £17.9 million.
Thus, despite the coalition’s welcome commitment to
protect the wider health budget, services are being cut
in our region to pay for the fiscal irresponsibility of the
PCT. Moreover, the PCT seems to be intent on resolving
this deficit immediately because the previous Government
imposed a statutory obligation on all primary care
trusts to break even by the beginning of 2011. Such a
target-focused piece of bureaucracy has now resulted in
the PCT cutting too many services too quickly, possibly
leading to a diminished health care package for our
local residents.
I have already listed some of the services that are
under threat of withdrawal. My hon. Friend the Member
for Skipton and Ripon (Julian Smith) has named the
services in the voluntary sector as well. I shall expand
on a few examples. First, there is the withdrawal of the
pain relief injections. As Members from neighbouring
constituencies know—my hon. Friend the Member for
Selby and Ainsty (Nigel Adams) has campaigned with
me on this—the PCT’s decision to restrict the provision
of back pain relief injections has provoked a huge
reaction from both patients and health care professionals
alike.
Nigel Adams (Selby and Ainsty) (Con): I, too,
congratulate my hon. Friend on securing this debate. I
am not sure whether I should declare an interest, having
received several back pain relief injections in the past.
The injections are a big issue in the north Yorkshire
area, as evidenced by the huge postbags that my hon.
Friend and I receive, and we have spoken to the Secretary
of State on the matter. Can my hon. Friend recall a
discussion with the Secretary of State in which he said
that one of his officials would look into the York PCT’s
interpretation of the NICE guidelines on back pain
relief injections? Has he received any notification
of those discussions or heard from the Secretary of
State’s office?
Julian Sturdy: My hon. Friend makes a valid point.
We did indeed meet, and I have not yet received a
response from the Secretary of State. I hope that the
Minister will hear our message here and chase up that
response, because it is important that we get an answer
to our question.
My hon. Friend mentioned the back pain relief
injections, and the issue is causing real concern among
our constituents. Members of the public came to my
last surgery to discuss the matter. The PCT, as my
hon. Friend said, based its decision to cut back pain
injections on its interpretation of the NICE guidelines.
Unfortunately, almost every other PCT interprets the
same guidelines in a different way. As such, countless
local people are being forced to suffer enormous and
unnecessary levels of pain.
Alongside other hon. Members from the region, I
have lobbied the Secretary of State. Campaign groups
such as York and District Pain Management Support
Group have been leading the way on this as well. I have