I am pleased to follow my hon. Friend the Member for Bradford South (Judith Cummins), who spoke with great feeling about her constituents’ needs, as she always does.
If my constituents were here and saw the estimates, they might be a bit disappointed. A few weeks ago, we had an interesting public meeting. They said to me, “Helen, it’s marvellous: because of Brexit, we’re going to get £350 million extra for the NHS every week, and our A&E department can be reopened.” There seems to be no mention of that in the estimates.
Under our local sustainability and transformation plan, there is a proposal to close the A&E department at Darlington hospital, which would be an unutterable disaster for my constituents. We are continually told that the purpose of the STP is to improve services, but I really wish the local NHS managers would stop pretending. They have also told us that by 2020 there is going to be a funding shortfall of £281 million, so nobody believes it is about improving services; everybody believes it is about managing on limited resources.
I appreciate that pressures on the health service are increasing because of the ageing population, but this level of austerity in the health service is unnecessary. The British economy is bigger now than it has ever been; it is 14% bigger than it was in 2010. Other hon. Members have pointed to the disparity between spend in the UK, which is $3,235 per capita per year, and in Germany, which is $4,800 per capita per year. In the UK, there are 2.8 hospital beds per 1,000 people, whereas in Germany, the figure is 8.3. It does not need to be like that.
I wish to focus on the needs of rural communities, which we have not spoken about this evening. Were the A&E department in Darlington to close, it would be an extremely serious problem for the people to the west of Darlington, and at the top of Teesdale. People are already travelling 30 miles to get to hospital. The response times of the North East ambulance service are not what they should be. People often wait 20 or 30 minutes for an ambulance to arrive, which means that it could be an hour before they get into the hospital.
One of my local councillors has done an absolutely brilliant piece of analysis, looking at the journey times that would be needed were people to have to go to the James Cook university hospital in Middlesbrough. At the moment, someone living in Bishop Auckland would take 25 minutes to get to hospital. It would go up to 39 minutes. If they live right up in the top of the dale, the journey time is 39 minutes. That would go up to 64 minutes. The STP managers running the review say that they want to treat cardio-vascular and trauma patients in specialist centres where a critical mass of staff can maintain their skills. That sounds reasonable enough, but my constituent, Judy Sutherland, asked them, “What proportion of emergency journeys are not cardio-vascular or trauma cases?” The answer was 94%. So, for acute asthma, adrenal crisis, anaphylactic shock, appendicitis, diabetic coma, meningitis and renal failure—the list goes on—there would be no benefit to being in a specialist centre.
The extra mortality from the longer travel time goes up quite dramatically. In Bishop Auckland, it goes up by 2.4%, Barnard Castle by 3%, and in Middleton in Teesdale by 3.2%. That is why the pretence that this is about improving the quality of healthcare is not believed by my constituents. They are tired of being told that services should be nearer to home when, in fact, they are being pushed further and further away. There is a question mark over the Richardson community hospital in Barnard Castle. The A&E and the maternity services have been taken out of the hospital at Bishop Auckland. When that was done, we were told that it would be absolutely fine, because people would be able to go to the Darlington A&E, but now that A&E is under threat. People in rural communities are facing this constant process of attrition.
I have similar challenges in my rural constituency of North Devon. The STP is looking at the same issues that the hon. Lady is raising, and they, too, will lead to long travel distances. As Ministers know, that is something that I have raised with them and brought up in this House on a number of occasions. Does the hon. Lady agree that the challenges that the STP is trying to address have not happened in the past 18 months or the past six years; they have built up over many years and over many different Governments?
The proposal to close Darlington A&E has come up only under this Government. It was not proposed under the coalition Government or the previous Labour Government. This Government must take responsibility for what is happening now.
On Saturday, I went to Alston in Cumbria. The people there are also running a campaign to stop their local hospital closing, because they will then have to go to Carlisle, which is 34 miles away. That is a long way, especially in Cumbria, where the weather is absolutely terrible and the road is often blocked. Ministers need to take more account of this big rural issue. People in Alston are also worried that there will be a cynical saving—the hospital in Copeland—and that they will face even bigger cuts. Perhaps the Minister will give us an assurance about that. The interaction between health and social care is well understood. We all know that cuts to social care mean a worse quality of care and less time for individuals.
Will the hon. Lady give way?
I would rather not because of the speaking limit.
Cuts also mean pressure on the NHS. Durham has faced really big cuts to social care. Between 2011 and 2017, it has had to make £186 million of savings. Child and adult care services comprise 63% of the total budget in the area, and adult social care cuts have been £55 million. The much vaunted precept only raises £4 million, and we have another £40 million of cuts to come. Even taking into account the better care funding, cuts by 2019-20 will come to £170 million. That means that there will be no social care in whole villages in my constituency. We are told that the Chancellor is minded to do something about it. Will he make up the full £4.6 billion that was cut in the last Parliament?
We have discussed the long term, which we do need to think about. The discussion about social insurance is important and significant, but we should also think about which institutions we would be asking people to put their money and their savings into. A lot of private sector organisations are, frankly, ripping people off with fees of £600 and £900 per week, even in my constituency in the north, where costs are not the highest. With fees like that, we do not even see highly trained people with expertise in dementia, but the same workers on minimum wages with low levels of training. We need to look at a stronger mutual approach and cut exploitative private sector contractors out of adult social care.