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