NHS (Private Sector)

Baroness Keeley Excerpts

Monday 16th January 2012 Commons Chamber

[The Secretary of State for Health (Mr Andrew Lansley)]

We start 2012, and what is the Labour party’s priority? Is it to welcome the NHS improvements in performance, as reported before Christmas—that waiting times are low and stable, that there are now 90% fewer breaches of mixed-sex accommodation standards than at the same time last year, that hospital infections are at their lowest ever levels, or that there are more doctors and fewer managers in the NHS than at the election? No, none of those was Labour’s priority. Was it to welcome the increase next year announced just before Christmas in NHS funding for primary care trusts, or since Christmas an increase in the funding available this year direct to clinical commissioning groups to enable them to meet the needs of their patients? No, it was not that.

[Barbara Keeley (Worsley and Eccles South) (Lab)]

I know that the Secretary of State was at Salford Royal hospital last week, where the abundance that he is describing does not seem to be around. That hospital—he went there to talk about nursing—will have to lose many hundreds of its nurses. It seems strange to us that we do not seem to see the abundance that he talks about and it certainly was not apparent at Salford Royal.

[Mr Lansley]

That is exactly the same question that the hon. Lady asked during oral questions. The Prime Minister and I did indeed go to Salford Royal hospital and we were tremendously impressed by what is being done there but, like other hospitals across the NHS, as part of a process of using resources more effectively and as part of the consequences of a transfer to supporting patients more in the community than in the acute sector, that hospital is changing the way it manages its services, and it is delivering cost improvements. We make no bones about that.

We delivered £4.3 billion of cost improvement in the NHS in the last financial year. We are aiming to do more this year. We delivered £2.5 billion, according to the deputy chief executive of the NHS, in the first two quarters. Every penny saved by reducing costs in the NHS is available to be reinvested in the NHS. That is why we are in a position to improve the performance. The hon. Lady did not talk about how that funding is becoming available through savings on central costs—for example, £150 million extra funding this year announced since Christmas for support for the integration of health and social care.

Was that Labour’s priority? No. Did Labour come to the House and say, “We want to welcome the way the NHS has achieved an increase in the flu vaccine uptake,” or the simple fact that flu activity at this stage is at its lowest level for the past 20 years? No, none of that. The hon. Lady talked about Salford Royal and the way nurses are engaging in some best practice—

[Mr Lansley]

No. I am still answering the previous intervention. Nurses are engaging in best practice to improve the quality of care for patients in Salford Royal. Was that the basis upon which the right hon. Member for Leigh (Andy Burnham) chose to come to the House to talk about the things that matter to patients—the quality of care being delivered to patients? No, it was none of those things.

[Barbara Keeley]

Will the Secretary of State give way?

[Mr Lansley]

No. I answered the hon. Lady’s question.

Labour Members came to the House not to pursue the priorities of patients or of those who work in the NHS, but to pursue Labour’s priorities. They are not in 2012; they are not even in the 21st century. They are back in the past. Talking of the past and somebody who lives in the past, let us listen to the hon. Member for Easington (Grahame M. Morris).

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[Barbara Keeley (Worsley and Eccles South) (Lab)]

I want to speak in support of the motion and argue that NHS hospitals are not private businesses and should not be turned into private businesses, pitted against each other and competing for the most lucrative procedures.

Many of the dangers inherent in the Government’s plans have been displayed in the saga about PIP implants. In that case, tens of thousands of women have been left worried sick about implants received in surgery in private clinics. There are, of course, serious questions about regulation of the products used in private clinics on those tens of thousands of women. Indeed, it has emerged that the PIP implants were effectively counterfeit goods below medical grade, and I understand that some of the gel used in them is designed for use in mattresses.

On 23 December, the Health Secretary’s initial response to the scare affecting tens of thousands of women was that his current advice was that there was

“no need to routinely remove these PIP breast implants. In the meantime we would recommend that all patients who have questions about their PIP breast implants should seek advice from their implanting surgeon.”

As we have heard since, however, some women who had that surgery could not even contact their original surgeon and many clinics demanded hundreds of pounds even for a scan—money that the women involved just might not have. Last week, many private clinics said that patients must pay in cash to have the implants removed.

I did not feel that the initial advice would reassure the women involved, who were left with all their fears and concerns over Christmas and new year, so I asked fellow members of the Health Select Committee to consider an inquiry into the saga and the issues of regulation that it raised, and I am glad that Committee members agreed and that there will now be an inquiry. We have to remember, however, that reviews and inquiries move slowly for people worried sick about their health. I believe that the NHS should stand by these women, which it reluctantly now seems to be agreeing to do.

The Medicines and Healthcare products Regulatory Agency passed the products despite their being substandard or, as I said last week and previously, effectively counterfeit. I thought that the point was well made in an article by the health writer and commentator Roy Lilley. He wrote that

“women who have PIP made breast implants are the victims of a crime”,

having

“spent fortunes on enhancements that have turned out to be counterfeit and possibly…injurious to their health… The NHS would not turn away a patient convulsing from consuming counterfeit vodka. Neither should it turn these women away.”

This saga raises many issues about not only the quality of implants but regulation—or the lack of it—in private medicine. That is key to this debate. More issues have been raised in recent days about the ability of surgeons who practise cosmetic surgery in private clinics. Apparently, they are not always trained or skilled enough to apply to be consultants or even to practise in the NHS without supervision, but they are skilled enough to operate alone in cosmetic surgery and private clinics. To what standard do those private clinics operate? What about the many other products implanted in surgery—hips, knees and heart valves, for example? How well regulated are those products and how can we be sure of their quality? I hope that the Health Committee inquiry can tackle some of those regulatory issues.

The concerns raised recently about the cosmetic surgery industry prompt many questions about where we will be if the Government continue with their Health and Social Care Bill. Last week in a letter to The Times, 14 consultants, general practitioners and public health experts wrote:

“The government proposes a vast increase in private provision of health care just as we are told that existing private providers are unable to supply adequate records of what they have been doing and are charging exorbitant sums to consult their records for those women seeking information on what happened to them.”

They continue to warn that the Health and Social Care Bill, now in the other place,

“provides much less protection for patients should their provider fail than is available to people booking package holidays.”

We have to think about that, because the implications are frightening for the future of the NHS.

The other major area of decline is waiting lists—this has been touched on in the debate—which are already getting longer, to the detriment of NHS patients. We must question what will happen when up to half of hospital beds are being used for private patients. In 1997, this country had a Conservative Government and NHS waiting lists were shockingly long. I was out campaigning in the 1997 election with my right hon. Friend the Member for Wythenshawe and Sale East (Paul Goggins), and I met a man who had been told that he would wait two years for vital heart surgery. He was worried that he would die while on the waiting list. That was the reality of the NHS then.

After 13 years of a Labour Government and while campaigning in my constituency in 2010, I met a man who told me about a totally different experience of the NHS. He visited his GP on Monday and was sent for blood tests. On Tuesday, he was told that he could have serious problems and was admitted to a north Manchester hospital for further investigation. They had a specialist surgeon there who operated on him on Thursday and told him that the surgery had saved his life—four days to save a life in the NHS after a Labour Government had run it for 13 years versus a desperate two-year wait back in 1997 under a Conservative-run Government.

The Health and Social Care Bill challenges the NHS’s founding principle that access to services should be based on need, not ability to pay. I know that my constituents do not want these changes. Many of them have asked me to be here for this debate and to vote for the motion. I am happy to do so.

In conclusion, I join my hon. Friend the Member for Easington (Grahame M. Morris) in mentioning the brave participation of Dr Clive Peedell and David Wilson in running 160 miles in six days to draw attention to the growing campaign to drop the Health and Social Care Bill. It is time the Government listened.

[Henry Smith (Crawley) (Con)]

I am grateful to be called, Mr Deputy Speaker. I had three reasons for writing to Mr Speaker requesting to take part in this debate. The first is that I genuinely wanted to hear, in this Opposition day debate on the NHS, what the Opposition’s plans really are for the future of our health service. The second reason is that I want to describe the experience that my constituents went through, over 13 years of a Labour Administration. Finally, I want to talk about how already, in anticipation of the Health and Social Care Bill becoming law, clinicians in Crawley are working to deliver a better national health service.

I do not mind telling the House that I am forgoing an invitation to a dinner this evening, so great was my desire to hear exactly the official Opposition’s view on the NHS. What I have heard this evening is incredible—or, so that I am not misunderstood, not credible. It is amazing that a party that massively increased the PFI programme during its tenure, spending billions of pounds of taxpayers’ money in an inefficient way through the national health service, should come to the House this evening and try to claim that what we are trying to achieve in the Health and Social Care Bill will somehow privatise the national health service. Let us be quite clear: this Government are committed to providing a national health service that is available regardless of the ability to pay. The difference, I contend, between Government Members and Opposition Members is that they are ruled by some sort of centralist dogma that says that if the Department of Health has not willed it, it cannot happen, whereas the Government are trying to introduce a pragmatic approach, in which outcomes are far more important than the strict processes that a dogmatic system for delivering health care should produce.

I said that I wanted briefly to mention the experience of the NHS during what we are often led to believe were the golden years of the health service, under the previous Government. Those years were not so golden for my constituents, because in 2001—a decade ago—we regrettably saw the downgrading of maternity services at Crawley hospital. Crawley is a growing town; indeed, its motto is, “I grow and I rejoice”. However, there was not much rejoicing when its maternity services were taken away and transferred almost 10 miles up the road to East Surrey hospital, where there is now increased pressure on maternity services, as it is having to cope with the increased number of people from not only east Surrey, but the north-east of West Sussex.

To add insult to injury, in 2005 Crawley hospital saw its accident and emergency department closed. Again, it was moved miles up the road to East Surrey hospital, even though there is little public transport between that hospital and Crawley—a growing and ageing town, with increasing health needs and major transportation links, not least the nation’s second biggest airport, London Gatwick—and single-carriageway roads. At best, that is inconvenient for patients and for families wishing to visit them in hospital; at worst, it is potentially fatal. That is my constituents’ experience.

[Barbara Keeley]

The hon. Gentleman is making a defence of A and E and maternity services, but does he not recognise that, despite the promises made by the current Secretary of State during the election campaign, many hospitals have, for clinical reasons, done the very same thing? They include Salford Royal, which has lost its maternity services, and others in the north-west, even though the Secretary of State promised that that would not happen to them. Does the hon. Gentleman not see that those things are going on now?

[Henry Smith]

The principal reason behind the closure of the accident and emergency unit at my local hospital was the European working time directive, which had a massive impact across the national health service. The NHS as an institution will of course evolve, the better to serve patients up and down the country. That is absolutely right.

That brings me to the third point that I wanted to make: the opportunity that the Health and Social Care Bill will provide for greater localisation in decision making on the future of health care services. I am delighted that the clinicians and GPs in Crawley have already come together to form a GP commissioning body, which is very ably chaired by Dr Amit Bhargava. It is brimming with ideas for innovative ways in which patients can be provided with much better services. For the first time in many years, decisions about the future of health care in Crawley are being made by Crawley clinicians, in conjunction with their patients and in the light of their patients’ needs. The group is working in conjunction with the local authorities—West Sussex county council and Crawley borough council—which, incidentally, will be providing oversight of some of the private sector contracts in the national health service, as envisaged in the Bill. The provision of that democratic oversight for the first time will achieve a localisation of services that is more relevant to the needs of the local communities, as well as a far greater degree of oversight.

I reject the motion before us, and I welcome the Health and Social Care Bill. It will be better for patients and better for democratic oversight. Ultimately, we should be talking about, and delivering, better outcomes for health care in this country, not remaining wedded to an outdated dogma which does not deliver services as efficiently as it could and should deliver them.