Health and Social Care Bill

Baroness Morgan of Cotes Excerpts

Tuesday 13th March 2012 Commons Chamber

[Nicky Morgan (Loughborough) (Con)]

I rise tonight to oppose the motion and the amendment. The motion is clear on the e-petition, on calling on the Government to drop the Health and Social Care Bill, and on declining to support the Bill in its current form. I see no mention of the risk register, yet when we debated it several weeks ago the shadow Secretary of State did not want to talk about it; he wanted to talk about the Bill. I shall come to the very confused position of the Opposition on this issue.

I will obviously not support the amendment—that will come as no great surprise to the hon. Member for St Ives (Andrew George)—but I agree with his reference to patients’ organisations. Such references have been missing from the speeches of Opposition Members. I would prefer a reference to patients and service users, because my first point is that the voice of patients has not been heard. Those are not my words, but those of somebody who gave evidence to the all-party parliamentary group on mental health last week. We have not heard the voices of patients in the debate so far—[Interruption.] Opposition Members are welcome to stand to correct me, but I have heard no mention from them of the words and views of patients.

[Karl Turner]

I am obliged to the hon. Lady for giving way. The mere fact that more than 170,000 people have signed the e-petition surely must speak volumes to her.

[Nicky Morgan]

If the hon. Gentleman wants to talk about maths or numbers—

[Karl Turner]

I am not talking about maths.

[Nicky Morgan]

We could talk about the number of people who have taken part in the Royal Colleges petitions.

[Karl Turner]

I am talking about the 170,000 people who signed the petition. What are you talking about?

[Nicky Morgan]

Well, 175,000 have signed the petition, but there are nigh on 60 million people in this country.

[Madam Deputy Speaker (Dawn Primarolo)]

Order. Mr Turner, do not shout over the Chamber. Either intervene or listen to the points that are being made. You do not have to agree with them; you just have to be quiet.

--- Later in debate ---

[Nicky Morgan]

Thank you, Madam Deputy Speaker. After many, many weeks on the Health and Social Care Bill Committee, there is no danger of the hon. Gentleman agreeing with any of the points that I make, but that will not stop me making them.

My hon. Friend the Member for South West Bedfordshire (Andrew Selous) talked about mental health. Those who spent time on the Public Bill Committee will know that I am particularly involved and interested in mental health, and I hope that we will have a debate on mental health in the Chamber soon, but what has struck me in discussions of the Bill is that mental health service users want to be involved in decisions about the commissioning of their services. They have that opportunity in the Bill through the health and wellbeing board, HealthWatch, the clinical commissioning groups, the involvement of the voluntary sector, and, as hon. Members have said, the integration of health and social care services. The Secretary of State talked about shared decision making. It is incredibly important that that is allowed to flourish under the Bill.

My next point—a damning and depressing one for a Member of Parliament to make—is the misinformation that has been perpetuated about the Bill. Tonight, we heard the shadow Secretary of State say that time is running out for the NHS. An hon. Member said that the shadow Secretary of State spoke in December of our having 72 hours to save the NHS, and another said that their constituents are worried about the services that will be on offer. All that is scaremongering, and it is unfair on those who do not have the time, capacity or inclination to read the Bill. We need to talk about the reality.

[Grahame M. Morris]

On the charges of scaremongering, is the hon. Lady aware that the George Eliot hospital in Nuneaton is engaged in conversations with two private sector providers—Serco and Circle—on taking over that provision? In my 30-odd years involved in the NHS, I have never known that to happen.

[Nicky Morgan]

I thank the hon. Gentleman for his point and the measured way in which he made it. That is welcome in the debate on the Bill. As a midlands MPs, I am aware of what is happening in Nuneaton, but it is not my constituency so I will refrain from saying too much. I will say only that the hospital management have asked in other providers because they are concerned and want to ensure the best possible care. Is that not what we want?

[Grahame M. Morris]

They are private providers.

[Nicky Morgan]

That could be the voluntary sector or the community sector. They are all private. If someone has a physio appointment, it could be with a private provider. At the end of the day, we want the best care for patients and constituents. That is what we all want.

[Dan Byles (North Warwickshire) (Con)]

The hon. Member for Easington (Grahame M. Morris) will be aware that the George Eliot hospital is on the edge of my constituency and serves my constituents. There are six people on the shortlist of people it is talking to—six people who have asked to be spoken to. It is wrong to imply that the George Eliot has gone out and spoken to only two private providers. The rest are all NHS providers.

[Nicky Morgan]

I am grateful to my hon. Friend for clarifying that.

The shadow Secretary of State talked about trying to be constructive. I am unclear whether he supports his own motion. Is he calling for the Bill to be dropped or for a conversation? This reflects the position of the Royal College of General Practitioners, which says that it now wants to work with the Government to implement the Bill, having previously opposed it. That is because the people in the NHS are beginning to recognise that implementation is critical if we really care about patient care and service users. There has been talk about how people in the House have stopped listening. I suggest that it is the Opposition who have stopped listening. I am fed up with receiving repeat e-mails. When I reply, making this point and trying to engage in a debate, all I get is another standard e-mail telling me about privatisation and how the NHS will not exist in its current form. That is not correct and not fair on the patients who rely on the NHS.

As my hon. Friend the Member for South West Bedfordshire said, implementation is already happening in many parts of the country, and that is to be welcomed. In Leicestershire, I have three excellent clinical commissioning groups and a health and wellbeing board being set up. I salute the public health professionals in Leicestershire who are working hard on implementation, the secondary care providers, the patient participation groups and everybody else who has taken part. The trouble is that implementation is being hampered by this ongoing political debate. I have a real feeling of groundhog day every time I come in and speak on this. We are going round and round in circles, and I repeat that the people who are missing out are patients and service users. Loughborough has taken the difficult decision to move our walk-in centre, but the GPs have taken that decision, and although I did not agree with it, they are clear that it will result in better urgent care services, and they are spending more money on them. I am willing to trust their judgment.

Members want to talk about the vote of the RCGP. It is interesting to note that out of 97,000 professionals, only 4,700 have taken part in the debate on the Bill. That should tell us something. We need to get on with the Bill now.

--- Later in debate ---

[Ms Diane Abbott (Hackney North and Stoke Newington) (Lab)]

The British public, as I think everyone here acknowledges, have a great care and concern for the national health service. That is not an idle superstition, as Conservative Members sometimes imply, but probably arises because we all interact with the health service when we are at our most vulnerable and at pivotal moments of our lives. Perhaps it happens when we are having our children or when a parent is dying or when we are ill and frightened. It is therefore unfortunate, to put it mildly, that no Government Members have been prepared seriously to engage with the depth of public concern about this Bill.

Let me quote a joint editorial, written by the editors of the British Medical Journal, the Health Service Journal and Nursing Times—publications that originally supported this Bill, to which fact I draw the Secretary of State’s attention. They describe the Bill as

“poorly conceived, badly communicated, and a dangerous distraction at a time when the NHS is required to make unprecedented savings.”

That is the consensus within the NHS. Ministers talk about the GPs involved in clinical commissioning groups. Of course GPs are moving forward and trying to engage with the changes—because they want what is best for their patients, not because most of them support the Bill in principle.

I have spoken about opinion within the NHS. As some Members know, my mother was a woman who gave her life to the NHS. She came to this country in the 1950s as a pupil nurse, and she ended her career working in a mental hospital just outside Huddersfield in West Yorkshire. She was part of that generation of men and women who built our NHS in the years after the second world war. In preparing for this debate and thinking about how to cut through the bluster, allegations, counter-allegations and politicking, I thought to myself, “Perhaps I should say what my mother would want me to say”. She was not a politician; she was not the head of a royal college; she was not a manager; she did not work for a glitzy Westminster think-tank: she was just an ordinary woman who was very proud indeed to say that she worked for the British NHS. My mother would have wanted me to say that the NHS is special and that from its earliest years it has been about change and adaptability. She would have wanted me to say, too, that politicians should handle it with thoughtfulness, not engage in party political games, but give the debate the care and thought that she always gave her patients.

I have to reinforce the point about the specialness of the NHS because part of the Secretary of State’s narrative, as this year has worn on, is that the NHS is somehow broken, and only his Bill can fix it. Well, we have heard that the Commonwealth Fund says that the NHS is one of the world’s leading health care systems for quality and value for money, and we know that it had the highest satisfaction ratings ever at 72%. Even the Secretary of State said on Second Reading that on a number of indicators,

“including mortality rates from accidents and self-harm, equity and access to health care—the NHS leads the world”.—[Official Report, 31 January 2011; Vol. 522, c. 606.]

This is far from a health care system that is broken.

My Labour Front-Bench colleagues and I need no reminding of how special the health service is and how we should respect the people who work in it at every level. We have spent the past year going up and down the country, shadowing workers in the NHS. We have met radiotherapists in Wirral, physiotherapists in Northumbria, ambulance crew in Cambridge, mental health nurses in Rochdale, cancer nurses in Birmingham, hospital porters in Leeds, paediatricians in Bristol and midwives in London. These were different people working at different places at different levels, but from every visit, we heard the same abiding message—“Our NHS is not for sale.”.

The second point that I am sure my mother would have wanted me to make is that from its earliest years the NHS has always been open to change and improvement, as I said. Workers are not opposed to change. Why would workers in the NHS be opposed to change? It is a service where people and science interact. Of course people are different first thing in the morning from how they are when they go to bed. Of course NHS workers are able to deal with change. No one needs to tell a nurse’s daughter that there have always been things in the NHS that could have been improved.

The Labour party is not opposed to change. It was our willingness to change and reform that drove down waiting times to unprecedentedly low levels. Some of the things we tried were so radical that some of us could not vote for them, but it is no discredit to my right hon. and hon. Friends that they were willing to try every lever they could to bring down waiting times and provide a service for the people who voted us here.

[Nicky Morgan]

Will the hon. Lady give way?

[Ms Abbott]

Time is against me, I am afraid.

The final thing that ordinary health service workers would wish me to say is that if anything has exemplified the unfortunate practice of politicians of saying one thing and doing another, it is the frequency and vehemence with which the Government decried top-down reorganisations when they were in opposition. In 2006, the right hon. Member for Witney (Mr Cameron), then Leader of the Opposition said:

“So I make this commitment to the NHS and all who work in it. No more pointless reorganisations.”

In 2007, the then shadow Health Secretary said:

“The NHS needs no more pointless organisational upheaval”.

In 2009, still as Leader of the Opposition, the right hon. Member for Witney said:

“But first I want to tell you what we’re not going to do. There will be no more of those pointless re-organisations”.

Then, the coalition agreement of 2010—I do not want to touch on private grief here for Liberal Democrat Members—said:

“We will stop the top-down reorganisations of the NHS that have got in the way of patient care.”

We are thus presented with a Bill that is based on a bizarre sort of life support—the arrogance of the coalition leadership.

Now we know that the doctors, the nurses, the midwives, the health visitors, the paramedics, the cleaners, the porters, and the scientific and technical workers will do their very best with this Bill if it becomes law. That is what Clare Gerada was saying this morning: if it becomes law, they will do their very best, but why should they have to see an already discredited Bill on the statute book? Why should they have to see more bureaucracy, which is what the Bill will mean, and why should they have to see billions of pounds wasted at a time when the health service is under unprecedented financial pressure? Government Members have sought to denigrate those who oppose the Bill by saying that their opposition is merely party-political. Of course it is not: we are proud to be part of a coalition of concern about the Bill.

My right hon. Friend the Member for South Shields (David Miliband), my hon. Friend the Member for Stalybridge and Hyde (Jonathan Reynolds), my right hon. Friend the Member for Manchester, Gorton (Sir Gerald Kaufman), my hon. Friends the Members for Stoke-on-Trent North (Joan Walley) and for Worsley and Eccles South (Barbara Keeley), my right hon. Friend the Member for Wentworth and Dearne (John Healey) and my hon. Friend the Member for Bethnal Green and Bow (Rushanara Ali) spelt out our concern about the Bill. It is extraordinary that we can proceed while the Government are still refusing to reveal the risk register. There is concern throughout the NHS about the fragmentation that will result from the Bill. Government Members say that we are scaremongering—[Hon. Members: “You are.”]—but private sector companies such as Humana and Capita are already advertising their willingness to take over GPs’ commissioning powers on their websites.

The NHS does not belong to the Secretary of State, and it does not belong to the Deputy Prime Minister. It belongs to the people of Britain who built it after the war. The NHS is not for sale, and I urge the House to support the motion.