Health and Social Care Bill (Programme) (No. 3)
(Limited Text - Ministerial Extracts only)
Read Full debate16:03 - The House divided: - Ayes: 299 / Noes: 232 - Question accordingly agreed to.
The Minister of State, Department of Health (Mr Simon Burns)
I beg to move,
That the Order of 31 January 2011 (Health and Social Care Bill (Programme)) as supplemented by the Order of 21 June 2011 (Health and Social Care Bill (Programme) (No. 2)) be varied as follows:
1. Paragraphs 5 and 6 of the Order shall be omitted.
2. Proceedings on Consideration shall be taken on the days shown in the first column of the following Table and in the order so shown.
3. Each part of the proceedings shall (so far as not previously concluded) be brought to a conclusion at the time specified in relation to it in the second column of the Table.
TABLE
Proceedings | Time for conclusion of proceedings |
|---|---|
First day New Clauses and New Schedules relating to, and amendments to, Parts 3 and 4 other than: (a) New Clauses, New Schedules and amendments relating to transitional arrangements for NHS foundation trusts, (b) New Clauses, New Schedules and amendments relating to private health care, and (c) amendments providing for commissioning consortia to be known as clinical commissioning groups. | 8.30 pm on the first day. |
New Clauses and New Schedules relating to, and amendments to, Parts 3 and 4, which relate to transitional arrangements for NHS foundation trusts or to private health care; amendments providing for commissioning consortia to be known as clinical commissioning groups. | 10.00 pm on the first day. |
Second day New Clauses, New Schedules and amendments relating to the provision of information, advice or counselling about termination of pregnancy. | One and a half hours after the commencement of proceedings on consideration on the second day. |
Remaining New Clauses and New Schedules relating to, and remaining amendments to, Parts 1, 2 and 5 to 12; remaining proceedings on consideration. | 6.00 pm on the second day. |
4. Proceedings on Third Reading shall (so far as not previously concluded) be brought to a conclusion at 7.00 pm on the second day on which proceedings on consideration are taken.
I will speak briefly to the programme motion, as I am sure that all hon. Members who wish to take part in debate on the Bill would like to make progress and get on to the main core of the amendments before us. As they will see, we have set in train our plan to hold Report and Third Reading over two days, commencing now and continuing until 10 pm tonight, and resuming on Wednesday, after Prime Minister’s questions and any other business that takes place on that day. As is normal, Third Reading will take place an hour before the end of that day.
As we are all aware, we arrive at Report with the Bill having received extensive scrutiny in two House of Commons Committee stages. Our first Committee stage, in February and March this year, lasted 28 sittings. It was the longest Committee stage of any Bill since the Criminal Justice Bill of 2002-03. At the conclusion of proceedings, even the hon. Member for Halton (Derek Twigg), who led for the Opposition in that Committee, acknowledged that
“every inch of the Bill”––[Official Report, Health and Social Care Public Bill Committee, 31 March 2011; c. 1310.]
had been
“scrutinised”.
Following a listening exercise and the work of the Future Forum, the Bill was re-committed to a further Committee stage of 12 sittings. If that had been a stand-alone Committee stage, it would have been the longest for any Bill sponsored by the Department of Health since 2003. All that means that the Bill has been scrutinised for a total of over 100 hours, and has been the subject of 40 Committee sittings—more sittings than there has been for any public Bill between 1997 to 2010. I will dwell on that point for a moment, and remind hon. Members of recent Health Bills that predate this Government.
The Health Act 2009 was scrutinised over eight sittings, as was the Human Fertilisation and Embryology Act 2008. The Bill Committee for the Health and Social Care Act 2008, which among other provisions set up the Care Quality Commission, sat for 12 sittings, a number matched by the Health Act 2006. As the keener mathematicians among us might have realised, the total number of Commons Committee sittings for these four Bills was 40—the same number as for this single Bill. In these 40 sittings we had a great number of debates where the issues were fully debated, sometime more than once.
Having had such substantial debate in Committee, we feel strongly that two days on Report is a thoroughly appropriate length of time. I have heard the calls from certain Opposition Members that more time is needed. I find that intriguing, given the rarity with which two-day Report stages were granted under the previous Government.
Frank Dobson (Holborn and St Pancras) (Lab)
Is it not treating the people who work in the national health service with contempt to expect the House to consider more than 1,000 amendments and new clauses in two days? Is that not a disgrace?
Mr Burns
The right hon. Gentleman’s hyperbole does not match the facts. He mentioned 715 amendments —[Interruption.] Yes, but the right hon. Gentleman mentioned 715 amendments dealing with one issue within the more than 1,000 amendments. May I point out to him that 715 amendments are all technical amendments? They change the name of GP consortia to clinical commissioning groups, following the recommendations made by the Future Forum and others working in the health service, which I would have thought would be welcomed by the Opposition Front Bench team at least. That number bloats and distorts the total number. The other significant number of amendments—121—deal with the continuity of services, which is an issue that the Opposition Front-Bench team implored us to bring before the House, rather than allowing it to be dealt with another place. That is why we have done so.
If we are going to be somewhat churlish, let me point out that 100 amendments were tabled by the official Opposition, of which 41 have been selected, and the vast majority of those amendments have been dealt with in Committee in great detail. So in that respect we will be going over well covered ground.
I do not intend to speak for long as I do not wish to detain the House. There is work to be done. This Government have allowed four two-day Report stages in this Session alone. Let me remind the House of one of those rare Government Bills that was granted a two-day Report stage under the previous Government—the Planning Bill in June 2008, with which I know the right hon. Member for Wentworth and Dearne (John Healey) is extremely familiar and probably very fond of. For that Bill the Government of the day thought that two days were appropriate—an interesting judgment, given that they were tabling 29 new clauses and seven new schedules on Report. Indeed, by the end of Report, the Planning Bill had grown by 25%. That compares with the nine new clauses that the Government have tabled on Report for the Health and Social Care (Re-committed) Bill. So that those on the Opposition Benches get the message, that is nine new clauses under this Government, as opposed to 29 new clauses in the right hon. Gentleman’s Bill.
Let us give the Opposition the benefit of the doubt. They might have forgotten what the right hon. Gentleman said when the Planning Bill was, unusually, allowed two days on Report, so let me remind them:
“My reasons for moving this motion were straightforward… It is true that the Bill is wide-ranging and important, which is why we have, unusually, provided two full days for the Report stage… we have departed from the usual by giving two days to this consideration.”—[Official Report, 2 June 2008; Vol. 476, c. 507.]
He established the fact that it is highly unusual. The Health and Social Care Bill has had far more time in Committee than previous Bills, and we are giving an extra day to allow hon. Members the opportunity to contribute to debates, although I must warn my hon. Friends that some of the debates will be a repetition, particularly for those who served on the Committee. It is for those reasons that I urge the House to support the motion.
Liz Kendall (Leicester West) (Lab)
We oppose this programme motion because it fails to give hon. Members enough time to scrutinise one of the most important Bills of this Parliament and, indeed, of the 63 years of the NHS. It is one of the largest Bills of recent times and the largest ever in the history of the NHS, with 420 pages and more than 300 clauses. It is also one of the most controversial. It will force the NHS through a massive reorganisation, which is already happening even though the Bill has not been passed, when it should be focused on meeting the biggest financial challenge of its life and improving patient care. It also seeks to make fundamental changes to the way our NHS is run, driving competition into every part of the system whether or not it is in patients’ best interests.
Labour has led the arguments against the Bill since the autumn, helping to create the widespread opposition that has already forced the Government to pause and amend their plans. However, the Government, far from what the Minister said, refused to give the second Bill Committee enough time to scrutinise properly the changes after their so-called listening exercise. [Interruption.] The Minister tuts from a sedentary position, as is his wont, but 42 Government amendments and two new clauses were not debated in the second Committee due to a lack of time. They have not even bothered to publish the explanatory notes and impact assessment for the post-pause Bill, so the two days on Report that the programme motion proposes would have been insufficient in any case.
Then, on Thursday, three days before this debate, more than 1,000 new Government amendments were tabled, 363 of which are significant. They include a completely new set of proposals on whether local NHS services and, indeed, entire hospitals will be allowed to fail—proposals that could affect every constituency in England. It is a gross discourtesy to this House, not to mention to patients and NHS staff, to produce such important proposals and give such little time for scrutiny. I am sure that Members of the other place will take that into consideration in their deliberations on the Bill.
We are now faced with hundreds of significant new amendments and a series of fundamental questions about the post-pause Bill, and yet we have only two days for debate. Who will have the final say, and who is accountable for vital decisions about the future of local services? What will the Government’s health care market mean for expensive local services that do not make money, such as accident and emergency services and geriatric care, if hospitals lose services that do make money, such as hip and knee operations? How will NHS patients be protected if the private patient cap is abolished and hospitals are forced to take on more patients who pay in order to balance their books? What will be the true cost to taxpayers of the extra red tape and bureaucracy created by the Bill?
The Government’s failure to give the House sufficient time for scrutiny and provide proper answers about their Bill means that many NHS staff and patients remain deeply concerned. Unfortunately, that seems to have passed the Prime Minister by. Two weeks ago, he claimed:
“the whole…profession is on board for what is now being done.”
I wonder whether “the whole profession” includes the British Medical Association, which says—
Liz Kendall
The Minister groans. If he thinks that the body representing doctors in this country is worthy of that response, that is a disgrace. The BMA says that the Bill is still
“an unacceptably high risk to the NHS, threatening its ability to operate effectively and equitably now and in the future”.
It calls for the Bill’s withdrawal
“or at the very least further, significant amendment”.