Questions to the Prime Minister
I join the Prime Minister in commemorating the disaster at Aberfan all those years ago when 118 children along with many adults died. Many in that community are still living with that tragedy, and they will live with it for the rest of their days. As a young person growing up at that time, I remember it well, particularly the collections for the disaster fund. The BBC documentary presented by Huw Edwards was brilliant and poignant, and serves to remind us all of what the disaster was about.
One in four of us will suffer a mental health problem. Analysis by the King’s Fund suggests that 40% of our mental health trusts had their budgets cut last year, and six trusts have seen their budgets cut for three years in a row. Is the Prime Minister really confident that we are delivering parity of esteem for mental health?
The Prime Minister
First, like the right hon. Gentleman and my hon. Friend the Member for Wellingborough (Mr Bone), I am of an age when I can remember seeing on television those terrible scenes of what happened in Aberfan. I did not see the whole of Huw Edwards’ documentary, but I thought the bits that I happened to see last night were very poignant, as the right hon. Gentleman said. Interestingly, what it showed again was the issue of those in power not being willing to step up to the plate initially and to accept what had actually happened, but the inquiry was very clear about where the responsibility lay.
It is right that we are introducing parity of esteem for mental health in our national health service. We have waited too long for this, and it is important that it is being done. We are actually investing more in mental health services—an estimated record £11.7 billion. In particular, we are increasing the overall number of children’s beds to the highest number for mental health problems, which I think is important. There is, of course, more for us to do in looking at mental health, but we have made an important start and, as I say, that funding will be there.
I received a letter from Colin, who has a family member with a chronic mental health condition. Many others, like him, have relatives going through a mental health crisis. He says that the
“NHS is so dramatically underfunded”
that too often it is left to the underfunded police forces to deal with the consequences of this crisis. Indeed, the chief constable of Devon and Cornwall has this month threatened legal action against the NHS because he is forced to hold people with mental conditions in police cells because there are not enough NHS beds. I simply ask the Prime Minister this: if the Government are truly committed to parity of esteem, why is this trust and so many others facing an acute financial crisis at the present time?
The Prime Minister
May I first of all say to Colin that I think all of us in this House recognise the difficulties people have when coping with mental health problems? I commend those in this House who have been prepared to stand up and refer to their own mental health problems. I think that has sent a very important signal to people with mental health issues across the country.
The right hon. Gentleman raises the whole question of the interaction between the NHS and police forces. I am very proud of the fact that when I was Home Secretary I actually worked with the Department of Health to bring a change to the way in which police forces dealt with people in mental health crisis. That is why we see those triage pilots out on the streets and better NHS support being given to police forces, so that the number of people who have to be taken to a police cell as a place of safety has come down. Overall, I think it has more than halved, and in some areas it has come down by even more than that. This is a result of the action that this Government have taken.
The reality is that no one with a mental health condition should ever be taken to a police cell. Such people should be supported in the proper way, and I commend the police and crime commissioners who have managed to end the practice in their areas. The reality is, however, that it is not just Devon and Cornwall that are suffering cuts; the Norfolk and Suffolk mental health trust has been cut in every one of the last three years.
I agree with the Prime Minister that it is a very good thing for Members to stand up and openly discuss mental health issues that they have experienced, because we need to end the stigma surrounding mental health conditions throughout the country. However, NHS trusts are in a financial crisis. According to NHS Providers, it seems to be the worst financial crisis in NHS history: 80% of acute hospitals are now in deficit. There was a time, in 2010, when the NHS was in surplus. What has happened?
The Prime Minister
Let me remind the right hon. Gentleman what has happened in relation to NHS funding. We asked the NHS itself to come up with a five-year plan, and we asked the NHS itself to say what extra funding was needed to deliver on that. The NHS came up with its five-year plan, led by Simon Stevens as its chief executive. He said that £8 billion was needed. We are giving £10 billion of extra funding to the NHS. I might also remind the right hon. Gentleman that at the last election, it was not the Conservative party that was refusing to guarantee funding for the NHS; it was the Labour party.
In six years, the NHS has gone from surplus to the worst crisis in its history. A total of £3 billion was wasted on a top-down reorganisation that no one wanted, and Simon Stevens made it very clear to the Select Committee yesterday that he did not believe that NHS England had enough money to get through the crisis that it is facing.
May I offer an analysis from the Care Quality Commission, which seems to have quite a good grasp of what is going on? It says that cuts in adult social care are
“translating to increased A&E attendances, emergency admissions and delays to people leaving hospital, which in turn is affecting the ability of a growing number of trusts to meet their performance and financial targets.”
Will the Prime Minister also address the reckless and counterproductive adult social care cuts that were made by her predecessor?
The Prime Minister
The right hon. Gentleman quoted what had been said by Simon Stevens, the chief executive of NHS England. At the time of the autumn statement last November, he said that
“our case for the NHS has been heard and actively supported.”
The right hon. Gentleman also raised the question of social care, and the interaction between healthcare and social care. More than £5 billion extra was put into the better care fund in order to deal with precisely those issues, and local authorities are able to raise 2% of council tax to deal with the social care costs that they face. What is important, however, is for the health service and local authorities to work together to ensure that they deliver the best possible service to people who require that social care. I saw a very good example of that at Salford Royal on Monday, and I want to see more examples throughout the National Health Service, delivering for patients. We have put in the funding, which the right hon. Gentleman’s party would not have done, so that the NHS will receive better care for patients.
We all want local government and the NHS to work closely together, but the problem is that local government funding has been cut, and 400,000 fewer people are receiving publicly funded social care as a result. The NHS is having difficulty coping with the crisis that it is in, and unfortunately there is bed-blocking. Acute patients cannot leave, because no social care is available for them somewhere down the line. The issue is a funding crisis in both the NHS and local government. Figures published by NHS trusts show that the total deficit is £2.45 billion, but the chief executive of NHS Providers says that the figure may be even bigger. The Government are disguising the extent of the crisis through temporary bailouts. [Interruption.] They are bailing out trusts in a crisis. That is, of course, a good thing, but why are the trusts in a crisis in the first place?
Next month, sustainability and transformation plans are going to be published. Many people across the country are quite alarmed by this because of the threat to accident and emergency departments. Will the Prime Minister deal with this issue now by quite simply saying there will be no downgrades and no closures of A&E departments in the statement coming out next month?
The Prime Minister
I say to the right hon. Gentleman that over the course of this Parliament, the Government will be spending over half a trillion pounds on the National Health Service. That is a record level of investment in our national health service. There is a key difference between the way the right hon. Gentleman approaches this and how I approach it: Conservative Members believe that people at a local level should be able to make decisions about the national health service, and that decisions about the national health service should be led by clinicians—it should not be a top-down approach, which is typical of the Labour party.
Wow! Well, top-down was what we got. It cost £3 billion for a reorganisation that nobody wanted at all.
I started by asking the Prime Minister about parity of esteem. All this Government have produced is parity of failure—failing mental health patients; failing elderly people who need social care; failing the 4 million on NHS waiting lists; failing the five times as many people who are waiting more than four hours at A&E departments—and another winter crisis is looming. The Society for Acute Medicine has it right when it says that this funding crisis and the local government funding crisis are leaving the NHS “on its knees”.
The Prime Minister
What has happened in the NHS over the past six years? More patients being treated, more calls to the ambulance service, more operations, more doctors, more nurses—that is what has been happening in the NHS. But let us just look at the right hon. Gentleman’s party’s approach to the National Health Service: a former shadow Health Secretary said that it would be “irresponsible” to put more money into the National Health Service; and a former leader of the Labour party wanted to “weaponise” the national health service. At every election the Labour party claims that the Conservatives will cut NHS spending; after every election we increase NHS spending. At every election Labour claims the Tories will privatise the NHS; after every election when we have been in government we have protected the NHS. There is only one party that has cut funding for the NHS: the Labour party in Wales.