Speaker Lunch At The House Of Commons

Mr Lamb thanked the PM Society for inviting him to speak and the opportunity to present his vision for the NHS.

Since his appointment as Shadow Secretary of State for Health in December 2006, Mr Lamb said that he had been on a voyage of discovery, unravelling the enormous complexities of our health system and he was now in a much better position to understand what the key issues were within the health service.

He confirmed that the Liberal Democrats supported the Government’s case for extra investment in the NHS and pointed out that in 1997, the spend (both public and private) on the NHS was a 1/3 lower in the UK compared to the rest of Europe. He stated that in his constituency, waiting times were unacceptable, with a 2-3 year wait for some operations on the NHS. This under investment in the NHS has obviously had consequences.

However, additional spend does not necessarily equal better service. It seems that although we needed the extra investment, now questions are being asked about how this money has been spent. It is clear we need to have a better understanding of where and on what, money should be spent in order to improve the Service. There have been too many botched and expensive reorganisations that have not result in a better and more efficient health service. An example Mr Lamb gave was that in Sedgefield since 1987 one Health Visitor has had 5 different employers - this reorganisation is extremely costly and inefficient.

In his view, the biggest failure has been the Government’s insistence of maintaining command and control from the centre. He pointed out that the NHS is 4 times the size of the Cuban economy and more centralised – illustrating the point that central control is cumbersome and difficult and is not in the best way to ensure an effective and efficient NHS.

His two main areas of concern are as follows:

Care of the Elderly
In a pre budget report, it stated that there had been a 4% increase in spend on the NHS, however only a 1% increase on social care. The question needs to be asked as to why this is? The budget is very constrained and will result in enormous problems. Domiciliary support is down and there are 25% fewer people now receiving domiciliary care. He feels that the pernicious means test must come to an end so that people are given the care they need when they reach old age.

Mental Health
Mr Lamb pointed out that this was a Cinderella service with waiting lists of over 2½ years for the people that need access to specialists most. He strongly questions why are those people who need it most being denied access to treatment and care?

VISION
He then provided an overview of the Liberal Democrats key vision and 4 core principles for the health service.

Value for money
To design a service that provides a high quality service that is efficient and effective.

Fairness/equality
To close the widening gap of health outcomes. In the UK there is a growing gap between the poorest and the wealthiest people. In Sheffield there is a 14-year life expectancy difference between the poorest people and the wealthiest. He added that children are 3 times more likely to die in childhood in deprived areas. He said we need to challenge this accident of birth and provide a more equal society.

Accountability
PCTs have boards that are appointed nationally. They are not accountable to who they represent in the local communities, unlike in countries such as Denmark. We need to be accountable and provide access to treatments. Our provision of cancer and stroke services is behind the rest of Scandinavia and we need to improve on this.

Empowering patients
Patients are not passive beings. We need to recognise this and think how we can empower patients. The Government thinks it is giving choice when it offers a choice of 4 hospitals – this is not choice – patients should be given complete choice of the range of treatments they can have, not just where they can be treated.

An example of how this can work is when patients and/or carers are able to commission the services they need themselves. A woman caring for her husband with Alzheimer’s had been allocated 7 different carers by the local County Council. No relationship with the carers could be built and the situation was extremely difficult. So she campaigned to receive the payments so that a carer could be employed directly by her. She was successful and this has resulted in one carer being directly responsible for her husband who has completely transformed the situation and how he is being cared for. Social care direct payments are much more effective and are an ideal model of care. There is an enormous amount we can do ourselves with the right services and flexibility. We need to empower people in this way.

To summarise, Mr Lamb thanked the Pharmaceutical Industry as a whole and the enormous amount everyone working in the industry does and the value that is bought by pharmaceuticals and the research and development into treatments that can transform lives, although the current system often denies people these new treatments.

A short question session followed where PM Society members were given the opportunity to ask Mr Lamb questions:

Adrian Brown from Scope Medical began by making the point that the NHS is not free and people need to know what it costs. What would the Liberal Democrats do about making things more transparent?

Mr Lamb responded by agreeing that the more people understand how much things cost, the better. As a Liberal, he believes in the principle that responsibility goes with freedom. He gave an example of A+E admissions and the fact that we never question whether those admitted on a Friday and Saturday night, heavily under the influence of alcohol should be responsible for the reasons they are there. Do we have a right to charge those people for their care after they have been treated if they are burdening the health service by binge drinking?

Adrian Brown added that people need to understand the numbers (regarding the cost of running the NHS) and they might then change their opinions. He then went on to ask if Mr Lamb had an opinion about the National Programme for IT.

Mr Lamb responded by commenting that the National Programme for IT is a classic example of command and control from the centre. Originally an idea of Tony Blair’s where a commitment was given to deliver a grandiose scheme. It seems unclear whether anyone asked whether a cost benefit analysis was undertaken or the question asked if the IT programme would achieve better outcomes than more or better access to treatment. The scheme has now cost over £20 billion. It does not even link into social care, as there are issues about civil liberties and sharing information. Mr Lamb added he was very critical of the scheme and feels that it needs independent analysis. Elements of it are a good idea such as on screen x-rays and scans, however it is an overly grandiose scheme, which is unproven at the very least.

Jamie Holyer asked if Mr Lamb had a view on the PPRS?

Mr Lamb said that there is a case for looking at how it operates. The model the OFT has come up with is not the final answer and we have a system that is opaque and not transparent enough. He feels that an initiative that capped profits is bizarre; however it does seem to work. He agrees that good deals are ok, but isn’t certain that PPRS is actually working for the benefit of patients.

Mr Lamb provided a summary of his vision with the following points: There should be local democratic accountability, but national entitlement. In Wet Macular Disease (WMD) there are effective treatments available – however people are having to use all their savings to finance treatment or going blind if they cannot pay.

In the mental health arena particularly there should be access to treatments. There are targets to improve areas of physical conditions, but in mental health there are none.

Sandy Thomson, Chair of the PM Society thanked Mr Lamb very much for his very informative talk.

Biography
Norman Lamb is the Liberal Democrat MP for Norfolk North. Before he was elected he was an employment lawyer and has also been a councillor on Norwich City Council. He fought the seat twice, in 1992 and 1997, before finally winning in 2001 by 483 votes. After being elected, he was appointed Liberal Democrat Deputy Spokesperson for International Development; he then moved to become Shadow Treasury Minister in the party's Treasury Team. In January 2003, he was elected to the influential Treasury Select Committee and, later that year, appointed Parliamentary Private Secretary to Charles Kennedy. Following his re-election in 2005, he was promoted to Shadow Secretary of State for Trade and Industry in the Liberal Democrat Shadow Cabinet. Following Sir Menzies Campbell’s election as party leader in March 2006, Norman became his Chief of Staff. In December 2006 he was appointed as Shadow Secretary of State for Health.

Until his election, Norman was a partner in the law firm Steele and Co. He was recognised as a leader in employment law in two national guides to the legal profession: the Legal 500 and in the Chambers Directory. He is also the author of a book on employment law: ‘Remedies in the Employment Tribunal’ (Sweet and Maxwell, 1998), which has been described as an invaluable “aide-memoire for experienced practitioners”.

Although first elected to Parliament in 2001, Norman’s entry into politics was when he gained Nelson Ward on Norwich City Council from the Conservatives. He later became leader of the opposition on Norwich City Council. In 1991, Norman was selected as the prospective parliamentary candidate for North Norfolk Liberal Democrats and has, since then, turned a 15,500 Conservative majority into a Lib Dem majority of 10,606.

He said in his maiden speech in parliament, "We have a duty to make politics much more relevant and to behave in a way that will rebuild people's trust in the political process. It is incumbent on us to modernise the way in which we carry out our business, and to open this place up to young people."

Our next event, the annual Half-Day Conference, is being held on Monday 26th November. The topic for this year’s conference covers the issue of Return on Investment and is entitled ROI or RIP? For further details about this event and an on-line booking form please click here.

Held on: 15/10/2007