Health and Social Care Bill (Programme) (No. 2)
(Limited Text - Ministerial Extracts only)
Read Full debate18:30 - The House divided: - Ayes: 297 / Noes: 224 - Question accordingly agreed to.
David Wright (Telford) (Lab)
On a point of order, Mr Deputy Speaker. Will you find out from the parliamentary authorities whether the monitors are working throughout the parliamentary estate? Only one Liberal Democrat Back Bencher is present, and, given that the Liberal Democrats have laid claim to significant alterations to the Bill, it is very important that they are in the Chamber.
Mr Burns
I beg to move,
That the following provisions shall apply to the Health and Social Care Bill for the purpose of supplementing the Order of 31 January 2011 (Health and Social Care Bill (Programme)):
Re-committal
1. The Bill shall be re-committed to the Public Bill Committee to which it previously stood committed in respect of the following Clauses and Schedules—
(a) in Part 1, Clauses 1 to 6, 9 to 11, 19 to 24, 28 and 29 and Schedules 1 to 3;
(b) in Part 3, Clauses 55, 56, 58, 59, 63 to 75, 100, 101, 112 to 117 and 147 and Schedules 8 and 9;
(c) in Part 4, Clauses 149, 156, 165, 166 and 176;
(d) in Part 5, Clauses 178 to 180 and 189 to 193 and Schedule 15;
(e) in Part 8, Clause 242;
(f) in Part 9, Clause 265;
(g) in Part 11, Clauses 285 and 286;
(h) in Part 12, Clauses 295, 297 and 298.
2. Proceedings in the Public Bill Committee on re-committal shall (so far as not previously concluded) be brought to a conclusion on Thursday 14 July 2011.
3. The Public Bill Committee shall have leave to sit twice on the first day it meets.
Let me say at the outset that, because of the number of Members who wish to speak in the debate, I will take only a small number of interventions and will respond to them briefly.
The vital importance of our national health service cannot be overstated, nor can the Government’s determination to do all in our power to make it as good as it can be for the patients who depend on it by putting patients at the centre of care and putting outcomes first—outcomes such as survival rates, speed of recovery, and the ability to lead a full and independent life. The Health and Social Care Bill represents a bold evolutionary programme of essential modernisation: a programme—[Interruption.]
Mr Deputy Speaker
Order. I know that passions are running high, but it is important that we hear the Minister.
Mr Kevan Jones (North Durham) (Lab)
On a point of order, Mr Deputy Speaker. I thought we were debating a programme motion, but the speech we are hearing seems to be a rehearsal of the Bill.
Mr Deputy Speaker
Hold on. Keep calm. I am absolutely certain that the Minister is about to move on to the programme motion.
Mr Burns
If Opposition Members were more interested in listening than in trying to be disruptive, they would discover that after setting the scene I will deal precisely with the recommittal and our reasons for proposing it.
We will replace that culture with a bottom-up culture of clinical leadership and patient choice and an unfaltering focus on improving health outcomes.
While there has always been widespread agreement on the principles of modernisation—a fact that even the shadow Secretary of State now accepts—there have been concerns in some quarters that the Bill could support those principles better.
Kevin Brennan (Cardiff West) (Lab)
On a point of order, Mr Deputy Speaker. Some of us wish to talk about the programme motion that we are supposed to be debating, and indeed to intervene on the Minister if he will give way, as he said that he would at the outset. Can the Minister be persuaded to discuss the motion that is before the House?
Mr Deputy Speaker
Several Members wish to participate in this very short debate. It will last for only an hour, and we are already well into that hour. Will the Minister now refer directly to the programme motion?
Mr Burns
Absolutely, Mr Deputy Speaker.
Given our commitment to, and the paramount importance of, the NHS, we decided to take the unprecedented step of pausing at an appropriate point in the legislative process. The independent Future Forum produced its report. We shall be able to make some changes to our plans that will not require legislation, but a number of changes will need to be scrutinised again by a Committee. All our proposed changes will be subject to further detailed parliamentary scrutiny through a further Committee stage and on Report. We propose—
Angela Smith (Penistone and Stocksbridge) (Lab)
I thank the Minister for giving way.
It is not unprecedented for Bills to come back to the House having been changed by the Government, but previously the whole Bill has gone back to Committee. Why are the Government not doing that?
Mr Burns
The hon. Lady might not be too familiar with the past. Two previous Bills have been recommitted, both in 2003, and if she will wait I will put them in the context of what we are doing.
We propose to recommit 63 of the Bill’s clauses and to add a further five to the Bill. About 35 of those 63 clauses will need to be amended. The remainder will provide context and allow the Committee to have a sensible debate about the revisions. These clauses will cover the key areas of the Bill, including the role of the Secretary of State, clinical commissioning groups, the NHS commissioning board, the role of Monitor, foundation trusts, health and wellbeing boards and HealthWatch. We are demonstrably committed to subjecting the Bill to the full and proper scrutiny of Parliament. The Health and Social Care Bill spent a very long time in Committee, with 28 sittings over seven weeks, which, in fact, is the longest series of sittings of a Committee since we considered the modernisation of this Chamber and the House of Commons. Indeed, the hon. Member for Halton (Derek Twigg), who led for the Opposition in Committee, acknowledged at the time that the Committee had
“scrutinised every inch of the Bill.”––[Official Report, Health and Social Care Public Bill Committee, 31 March 2011; c. 1310.]
However—[Interruption.] However, as the changes we are making are—
Mr Burns
Earlier, Opposition Members complained that I was not discussing why the Bill was being recommitted, yet as I now go through, point by point, why we are doing that they do not seem interested in listening. As I have said, I will not accept interventions frequently, because the House wants to know what we are doing and why are doing it, and that is the right way to proceed.
Mr Dave Watts (St Helens North) (Lab)
I thank the Minister for giving way.
So far today, the Minister has used the precedent of 1983. Will he confirm that when a similar Bill came back in 1983, the whole Bill was recommitted to the House?
Mr Burns
The hon. Gentleman seems a little confused. He is talking about 1983, but if he had been listening he would know that I have already said that two Bills were recommitted in 2003. I also said that if Opposition Members wait, I will explain the context of those Bills vis-à-vis the current situation. I therefore urge them to show patience, as they will then learn something.
Kevin Brennan
On a point of order, Mr Deputy Speaker. In fact, the last Bill to be partially recommitted to a Committee was the Mineral Workings Bill in 1951, some 60 years ago, but the Minister is not referring to that.
Mr Deputy Speaker (Mr Nigel Evans)
That is just an extension of the debate. I reiterate that we have only one hour to debate this programme motion, so may we make progress? May I also ask Members to calm down, because I am finding it difficult to listen to the Minister?
Mr Burns
Thank you, Mr Deputy Speaker, and you can rest assured that I am doing my bit. If only Opposition Members would listen, they would get the plot.
As the changes we are making are substantial and significant, we have decided to recommit relevant parts of the Bill to Committee. I can tell the House that we expect to make around 160 amendments to the Bill, which we will table in good time. We will also go further and publish briefing notes to help explain the amendments to parliamentarians and those who follow our proceedings outside.
Mr Burns
The hon. Lady, from a sedentary position, rather like a Greek chorus that ill-befits her, asks when. The answer is that we expect to table the amendments by 23 June, which, if it helps her, is in two days’ time. That is despite the fact that many previous Bills—[Interruption.] The hon. Member for Islington South and Finsbury (Emily Thornberry) should listen to this because it has some direct relevance that she will not like. We are doing this despite the fact that many previous Bills were not recommitted under the previous Government despite their having undergone significant change. For example, the Local Government and Public Involvement in Health Bill in 2007 had 54 new clauses and three new schedules added by Government amendment, but rather than returning it to Committee the previous Government added them on Report. The Planning Bill of 2007-08 had 29 new clauses and three new schedules added by Government amendment; again, rather than return that Bill to Committee, the previous Government added the clauses on Report. Indeed, a Bill has not been recommitted for eight years since the Planning and Compulsory Purchase Bill in 2003.
No fair-minded person can claim that we are not subjecting the Bill to the closest possible scrutiny. Our recommitting the Bill will give hon. Members additional time to examine parts of the Bill that the Government propose to change. Of course, hon. Members will have further opportunity to scrutinise the entire Bill on Report in the Commons and the Bill will receive full scrutiny in another place. We do not believe that it is necessary for the entire Bill to be recommitted—[Hon. Members: “Why not?”] If hon. Members will listen they will find out why not. We do not believe that it is necessary for the entire Bill to be recommitted in order for proper scrutiny to take place. Indeed, we feel very strongly that that would unnecessarily delay the progress of the Bill to the ultimate detriment of patients. It is now time to give greater clarity and direction to staff and patients. As Professor Steve Field said in the Future Forum report:
“It is time for the pause to end.”
Professor Field is not alone in the opinion that now is the time to move forward and to enable proper and thorough scrutiny of those parts of the Bill that will change but without delaying the Bill’s passage beyond what is absolutely necessary. The Academy of Medical Royal Colleges said in its response to the Future Forum report:
“We hope the Government will now accept the Future Forum’s recommendations in full and move swiftly to make the changes to the Bill and the proposals that are required”.
The King’s Fund has also emphasised the need to avoid unnecessary delay. It said:
“The ‘pause’ has served the NHS, its staff and patients well”—
Ian Lucas (Wrexham) (Lab)
On a point of order, Mr Deputy Speaker. I tabled a named day question to the Minister, of which he is aware, in which he made it very clear that the changes to the Bill that he says relate to the recommendations of the Future Forum were in fact—
Mr Deputy Speaker (Mr Nigel Evans)
Order. Please resume your seat. That is not a matter for the Chair; it is an extension of the debate. Yet again I reiterate that we are now 13 minutes into a one-hour debate and we have yet to hear from the shadow Minister and a number of Back Benchers who wish to participate, so, please, could we restrain bogus points of order—that is No. 1 —and could we also have more quiet?
Mr Burns
As I was saying, although the pause may have ended, we will never stop listening. [Laughter.] That is why a team of top health experts will continue to provide independent advice to the Government. [Interruption.] It is extraordinary, Mr Deputy Speaker, that hon. Members giggle and scream hysterically when they do not like what they hear. What they will not accept is that we did listen through the independent forum—we listened, we strengthened the Bill and they do not like it that more people and more organisations outside the House now believe that the plans that my right hon. Friend the Secretary of State introduced have been strengthened and will meet the needs of a modernised health service. That is the problem. That is why they are behaving in that way.
Of course, we need to give right hon. and hon. Members ample opportunity to examine the amendments in detail, but unnecessary delays will only cause harm for patients and add to the pressure on hospitals and commissioners as they make their modernisation plans. They will prevent clinicians on the ground from making the changes they believe will help to improve and save people’s lives. That is why we can have proper scrutiny through the recommittal of the parts of the Bill we are changing, as outlined in the motion, and I urge my hon. Friends and the House to accept it.
John Healey
My hon. Friend is right. We know that the Prime Minister is a PR man. We know that he was forced to call the pause and that, when he did, he was looking for a PR solution. The answer that my hon. Friend flushed out of the Government stands that up clearly.
To return to the motion before the House and the question whether the Bill requires, as we argue, recommittal in full, parliamentary precedent demands this, proper parliamentary scrutiny demands this and, above all, our responsibility to NHS patients to try to get the legislation right demands this. The parliamentary precedent is clear, as my hon. Friend the Member for Cardiff West (Kevin Brennan) said. The House of Commons Library tells me that the last time a Bill was recommitted in part was 60 years ago. In response to a point of order, the Health Minister cited the Planning and Compulsory Purchase Bill of 2003 as a precedent. The Labour Government recommitted that Bill in full and gave Committee members the whole of the summer recess to examine the detailed amendments before the Committee sat again. Why are the Government not acting as they should and as Labour acted in government with that Bill?
The NHS, the legislation and the changes to the changes announced last week are all complex, and the House cannot do its proper job unless the Government’s changes to one clause can be considered alongside the consequences for other parts of the Bill and for the health service. How can the promised changes to Monitor’s role be considered without looking at all 29 clauses dealing with its licensing powers? The House cannot do its proper job unless all the areas that the Government say they will change are recommitted.
Why are the clauses on the failure and designation regime for hospitals, which the Government say they will change, not covered in the recommittal motion? The House cannot do its proper job, and organisations cannot give proper evidence to the Bill Committee, unless all the amendments are tabled in good time, so why will there be only two full working days between the tabling of amendments and the Committee sitting? The House cannot do its proper job unless the Bill Committee has sufficient time for scrutiny.
The 64 clauses in the recommittal motion took 45 hours of debate in Committee last time. The Government are now cutting that time in half. The Minister said that he expects 160 amendments in Committee. That allows less than 10 minutes for each amendment that the Government table, and that is before the Opposition table our own amendments and before taking into account the six schedules that are being recommitted.
Mr Simon Burns
As a former Minister, the right hon. Gentleman knows about taking legislation through Committee. Given that a number of the 160 amendments will be technical and drafting amendments, will he please tell the House how many minutes he needs for each technical and drafting amendment to be debated in Committee?
John Healey
The Minister, his colleagues and the Prime Minister have broken their word so often so far on the NHS that we cannot take at face value what the Minister says. We will wait to see and we will judge what he does when we see the detail of the amendments that he tables.
Chris Bryant
Because there was no opportunity to have a debate last night. It would have been nice to be able to expose the problems with the way the Government are dealing with the Bill, but unfortunately such an opportunity was unavailable to us. It is a disgrace that there is no opportunity for amendment. It is also a disgrace that the whole Bill is not being recommitted. We have seen none of the amendments. The Government are basically saying, “We’ve decided where we want to change the Bill, and only those bits shall be available for discussion by the Committee.” That is a completely inappropriate abrogation of the powers of this House to the Crown. The person who should be most disgraced by that is the Deputy Leader of the House, because he has said so many times that he believes in better scrutiny and yet is now abandoning that.
The Parliamentary Secretary, Office of the Leader of the House of Commons (Mr David Heath)
Will the hon. Gentleman give way?