here - United Kingdom Parliament

339WH
[Paul Burstow]
Health Care (North Yorkshire and
York)
that the trust should not seek excuses in how the funding
formula works. None the less, we need to look at the
formula.
Equally, it is important to bear in mind that the QIPP
programme in North Yorkshire and York has not delivered.
I understand that it set some ambitious and challenging
plans; the problem was that the implementation has not
been as robust as the plans. I understand that one issue
appears to be a failure to bring on board the full range
of stakeholders to deliver on the improvement plans.
That is a significant failing, because where the PCT is
doing that, the signs are extremely positive. For instance,
local GPs are working with the trust on prescribing
practices—together they are looking to cut costs by
more than £1 million, while protecting quality and
service. I highlight that because it shows the power of
GPs in managing efficiencies, and is a sign of how our
reforms will help in the future.
Perhaps most troubling of all is the fact that the PCT
has slammed the brakes on funding for the voluntary
sector in a way that may have serious consequences for
the future. The PCT may, technically, be within its
rights to give the minimum of notice to providers, but
pulling the plug on small organisations with just a
month’s notice—or in some cases, less—is alien to the
spirit of collaboration and partnership that we want
the NHS to cultivate. As my hon. Friend the Member
for Skipton and Ripon said, it seems to be against the
notion of the compact.
There is an important general point here. As we move
through transition there will be difficult choices, and
the NHS needs to be clear about what it needs to
protect and how best to maintain vital voluntary community
services. Therefore, in response to this debate, I have
asked the NHS chief executive, Sir David Nicholson, to
consider how to ensure that local NHS organisations
act responsibly towards voluntary sector organisations
during any period of retrenchment. My hon. Friend is
right: we need candour and early discussion. Discussions
about where there are cost pressures are in the system,
because, given the opportunity, the voluntary sector can
contribute to managing them.
Reference has been made to the issues of pain relief
injections and of treating chronic back pain. The hon.
Member for Selby and Ainsty (Nigel Adams) asked a
question about the discussions that he has had with the
Secretary of State, as did the hon. Gentleman who
secured this debate. I am not cited in regard to those
discussions, but I will undertake to ensure that we look
very carefully at the issue and come back to both hon.
Members who raised it, to satisfy them and ourselves
that NICE guidance is being followed properly.
1 DECEMBER 2010
However, I believe that the PCT understands that its
decision has affected a significant number of patients
with chronic back pain, and that it has written to a
number of those patients, commissioned a series of
initiative clinics where patients are fully assessed and
given new treatment options to manage their pain.
Nigel Adams: Just on that point, it is worth remarking
that the reason given by the PCT for the withdrawal of
the procedure is not a financial one, which is very
difficult for colleagues to comprehend. Apparently, it is
based on medical advice via the NICE guidelines, but
the PCT seems to be the only one in the country that
has adopted that stance. Does the Minister agree that
that sort of logic is a perfect reason why our reforms
must come through in terms of GP commissioning, so
that decisions can be made by health professionals
rather than bureaucrats?
Paul Burstow: There is no doubt in my mind that
getting clinicians far more engaged in commissioning
will be a key driver to a significant improvement in
quality and outcomes in the system in future. I certainly
undertake to ensure that we have a proper look at this
issue of the guidance, and I will come back to both the
hon. Gentleman and his hon. Friend, the hon. Member
for York Outer, on that point.
I certainly share the belief that those reforms are
needed to ensure that the NHS in north Yorkshire, and
Yorkshire in general, moves in the positive direction
that we all want to see it move in. Our proposals will
bring the right leadership and purpose to sustain and
improve the services that the constituents of the hon.
Member for York Outer, and those of the other hon.
Members who have come to support him in this debate,
expect the NHS to deliver.
Decisions that are made much closer to the patient
will ensure that health care is shaped in the best interests
of the community and the general population. By
introducing greater transparency and democratic
accountability, we will ensure that the local NHS is far
more answerable to the people whom it serves and that
there will be much more scrutiny and community
involvement in the decisions that it takes.
That is something that I am sure all hon. Members
want to see. It is how we can move our NHS forward,
maintaining it as a national treasure but one that really
delivers the best possible outcomes—outcomes that are
among the best in the world. That is what we really
want to see.
Question put and agreed to.
5.27 pm
Sitting adjourned.
Health Care (North Yorkshire and
York)
340WH