Mr Richard Bacon (South Norfolk) (Con): It is a pleasure to speak in this debate and I congratulate my hon. Friend the Member for Witham (Priti Patel) on securing it. The national health service includes many people with different callings, and thank goodness for that.
Some have a calling to look down microscopes and to do scientific experiments to figure out how to solve the problem of cancer. Some have a calling to work with people with mental health problems and to help them return to stability, productivity and a flourishing life. Some have a calling to help at the roadside those who are in critical danger following dreadful accidents and those of us who are unfortunate enough to face near death.
Imagine what it must be like to have that calling, to feel that one’s life purpose and work is to help such people, to have the training of a practitioner in emergency medicine, but to have to hold someone who is dying because an ambulance trust does not work properly and those higher up let down the practitioners. What would be the reaction?
There would come a point when people would say, “I can’t stand this any longer. I can’t stand coming to work and failing people because those above me are failing me.” That is exactly what has happened. It is absolutely clear, as my hon. Friend the Member for Harlow (Robert Halfon) said when quoting from the Marsh report, that it is not about money. The problem is about leadership and accountability. I will draw out some brief points from that report. It says that
“critical decision making has ceased in some areas. The trust has lost focus of the strategic objectives, which may partly be due to the board not fully understanding the purpose of the business.”
“The management structure is overly layered and appears heavy…The trust seems to demonstrate limited urgency and pace in moving forward.”
It also states:
“Leadership does not come from Board level”.
What are they doing, and why are they still there after that damning report?
As a member of the Public Accounts Committee, I have spent 12 years studying slow-motion disasters in various areas of Government and I have read many National Audit Office reports across the whole swathe of Government activity and public expenditure, but I have rarely read words as damning as those. Yet the people who are responsible, who, as my hon. Friend the Member for Harlow said, have so badly failed those whose job it is to serve us and our constituents, are still in post. That is something I cannot understand, and I very much hope that the Minister will address it. If it is not addressed, there will come a point when people will start asking the Department of Health why it has not been addressed, because the matter is so serious.
This did not use to happen. I have been the Member of Parliament for South Norfolk in the east of England for 12 years, and until the last year or two I do not recall people regularly writing to me with complaints about ambulance delays. I do not remember regularly turning up at meetings in the House where there were 15 paramedics talking to the Minister, Earl Howe, facilitated by east of England MPs, because there was no possibility of their having a sensible conversation with the management of their own organisation. This is an extraordinary state of affairs and it requires radical reform.
There is not time in this debate to talk about the wider issues of the NHS culture, but reference has been made to revolving doors and how people lose jobs in one place and gain them in another—I have seen a lot of that myself. In addition there is the issue of confidentiality clauses and the way in which the guidance against using them has been weakened. In 1999, it was stated that confidentiality clauses had no place in NHS contracts; by 2004, it was apparently okay if the guidance was studied carefully.
In the limited time available I want to make a point about size. The ambulance trust in the east of England covers Hertfordshire, which is practically outer London, and Bedfordshire, which is also practically outer London and highly urbanised, as well as places as far away as Cromer in north Norfolk, Great Yarmouth, Southwold in the constituency of my hon. Friend the Member for Suffolk Coastal (Dr Coffey) and Lowestoft in the constituency of my hon. Friend the Member for Waveney (Peter Aldous). It is simply too big, and that is obvious to everyone.
In my rural constituency, ambulances are not just dragged away from the rural areas to Norwich. I accept the point made by the hon. Member for Cambridge (Dr Huppert), who is no longer in his place, that it is not just a rural problem; it is a rural and an urban problem. When I find that ambulances are being dragged away to Bedford and Luton, which are one hour 20 minutes, one hour 25 minutes or one hour and 30 minutes from my constituency, I know that something is fundamentally wrong. We must stop thinking so much about economies of scale and start thinking about the economy of flow—removing the blockages that stop things working properly.