Future of the NHS
Baroness Primarolo Excerpts(13 years, 6 months ago)
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Tony Baldry (Banbury) (Con)
The hon. Gentleman is a member of the Health Committee, so one would expect him to be well informed on these matters. I assume that he reads other reports of the House relating to health. I wonder what he would say about the report of the Public Accounts Committee that was recently published, under the chairmanship of one of his right hon. Friends, which says:
“The trend of falling NHS productivity will have to be reversed if the NHS is to deliver, by 2014-15, savings of up to £20 billion each year for reinvestment in healthcare.”
The PAC found that there were serious problems with productivity—
Madam Deputy Speaker (Dawn Primarolo)
Order. Interventions, by their nature, must be brief, particularly when so many Members are waiting to speak.
Grahame M. Morris
I am grateful, Madam Deputy Speaker.
Indeed, that was the point that I wanted to make when the right hon. Member for Charnwood was speaking about the level of the challenge faced by the NHS. Sir David Nicholson rightly pointed out that major efficiency savings have to be made and he identified the figure. However, he did not advocate massive organisational change on top of the drive for efficiencies in the system.
During the 28 sittings of the Public Bill Committee, I raised countless issues and made numerous interventions against the health reforms. Unfortunately, the Secretary of State was unwilling to take them earlier in this debate. I have followed this matter very closely. The hon. Member for Banbury (Tony Baldry) asked if I had read the Bill. As a matter of fact, I have read it inside out and could probably give some lessons to a few Members who are in the Chamber. My conclusion is that the policy has remained basically the same, and that only the public relations strategy and the spin has changed.
Valerie Vaz
I absolutely agree with my hon. Friend.
We were told by Sir David Nicolson that very little work has been done on what will happen in 2013-14. Just for the record, the UK had the second-lowest debt in the G7 in 2007-08, before the global financial crisis. Which Government are out of control with their spending?
Finally, there are many unanswered questions. I have tried to obtain the legal advice on whether EU competition law applies to the provisions of the Bill from the Secretary of State, but apparently, it is in the public interest not to disclose that to the public. However, in a recent article in the British Medical Journal, Rupert Dunbar-Rees, a GP, and Robert McGough, a solicitor, say that
“the technical argument reinforces the logical argument that the reforms further open up the NHS to EU competition law.”
Who will account for the training of doctors, and indeed health care professionals? That cannot be left at a local level. In A and E, an increased percentage of patients wait more than four hours, the maternity service in Maidstone has been closed despite GP opposition—
Madam Deputy Speaker (Dawn Primarolo)
Order. I am very sorry to interrupt the hon. Lady, but the clock is not correct. If she is following that, she will not know that she does not have that much time left—the clock stopped and did not start again. I would advise her to take about another minute and a half only.
Valerie Vaz
At Barts specialist regional cancer care unit, 20% of staff have been cut in two weeks.
An Ipsos MORI poll found that 71% agree that the NHS is the best in the world and that 72% express satisfaction with the NHS, but that was published by the Department only under pressure.
Finally, there have been 6,000 responses to the White Paper. The people of England have given their proposals, but they have not given their verdict on the Bill. They want the Prime Minister to keep his promise. If he does not do so, they will be ready to give their verdict at the next general election.
Madam Deputy Speaker
Order. May I apologise to the hon. Lady for the error with the timing? It was very gracious of her to ensure that she stayed within the time, which allows others to speak, but I think she will find that she got her time anyway.
Madam Deputy Speaker (Dawn Primarolo)
Order. A large number of Members still wish to speak, and we simply will not get everyone in unless I reduce the time limit further, so that is precisely what I am going to do. The time limit for contributions to the debate from Back-Bench Members is now five minutes.
Debbie Abrahams
Does not the hon. Gentleman think that that is why we won the election in Wales?
The savings required are 4%, and if the Government get their way with the new economic regulator Monitor, they could go as high as 7% each year—far more than our NHS is capable of coping with.
My constituent, Peter, was refused a cataract operation, yet his vision was so poor that he was able to see the world only through a haze; as a precision engineer, furthermore, he was not able to do his job and faced the threat of redundancy. In other cases, non-compliance with NICE guidelines—on familial hypercholesterolaemia, for example—is leaving people at extreme risk of untreated cardiovascular disease.
Health professionals have almost without exception castigated the Bill for what it will do to the NHS in completely opening it up to the market, with competition law applying in full and allowing private health care providers to cherry-pick profitable services. A hospital medical director said last week that he did not know how his hospital could continue to provide care for unprofitable patients.
The unprofitable services for most hospitals are elderly care, mental health, paediatrics and maternity, which are essential services for all communities. Instead of service providers and commissioners working together to provide the best quality care they can for their patients, the trend is for hospital trusts to maximise income and compete against each other. We are already seeing that lack of co-operation when PCTs look at alternatives in commissioning. Trusts are reluctant to collaborate when they see that it might reduce their income, even if it improves the quality of patient care. Similarly, the Bill gives GPs a financial interest in restricting or refusing treatment in order to make savings and to get bonus payments from the NHS commissioning board.
Labour wants genuine savings that will enhance patient outcomes rather than produce the diminishing effect that we are currently seeing, and we believe that we can achieve that. We want hospital specialists and GPs to work together to deliver clinical care pathways that improve the quality of patient care and bring care closer to home. One local PCT is trying to introduce the use of drugs that are cheaper—and unlicensed—to treat age-related macular degeneration, but it is under severe pressure from the pharmaceutical industry. That is another way in which we could reduce costs.
There is no doubt in my mind that, unamended, the Bill threatens the founding principles and values of the NHS. It removes the duty to provide a comprehensive health service, and provides an opportunity for the new NHS commissioning board and GP consortia to charge for services. It involves a costly, ideologically driven reorganisation of the NHS that has no mandate from the British people, and no support from health professionals and that will mean the end of the NHS that we know and love. As I have said before, the NHS is not just an organisation that plans and provides our health care; it reflects the values of our society on which this country set such store.
I know that there are many members on this side of the House—
Tony Baldry
No, I am not going to give way as I am conscious that many Members wish to speak, and Madam Deputy Speaker has already told me off this afternoon for taking too long.
Madam Deputy Speaker (Dawn Primarolo)
Order. I was not telling the hon. Gentleman off; rather, I was reminding him of the convention.
Tony Baldry
I can recognise a chastisement when I see it!
GPs want to get on with things, and while it is important that we should pause and have a listening exercise, we also need to give GPs the confidence so that they continue to plan for GP-led commissioning.
The more I listen to the contributions in the debate, the clearer it becomes that each Member has their own agenda of changes that they wish to be made. Much has been made of the 98% vote against my right hon. Friend the Secretary of State by the Royal College of Nursing, but I listened to Peter Carter, chief executive and general secretary of the RCN, on “The World at One”, and I was so struck by what he said that I took down a transcript. Martha Kearney put it to him—
Andrew George (St Ives) (LD)
It is a pleasure to follow the right hon. Member for Holborn and St Pancras (Frank Dobson) and I was glad that his speech contained an element of recognition of the excellent contribution made by my hon. Friend the Member for Southport (John Pugh), who set out far more articulately than I could many of the concerns about the Bill that underpin this evening’s debate. These concerns have been raised by Liberal Democrat Members and I know for a fact that a number of Conservative colleagues feel the same way about aspects of the reform, although that has not been articulated this evening.
I wish to get one piece of rough and tumble out of the way before I commence with the substantive comments I wish to make in the short time available to me. I will not be supporting Labour’s motion this evening because to do so would be to endorse Labour’s history of having introduced the following: independent treatment centres, which wasted hundreds of millions of pounds of taxpayers’ money; alternative providers of medical services enforced through primary care trusts; and many other top-down reorganisations, which Labour Members now pretend they are against. It would also mean endorsing their approach to the whole concept of top-down reorganisations, the billions that Labour wasted on NHS IT systems and Labour’s failure to address the unfair funding formula, which set back my part of the country significantly and left it in significant debt, from which it is still trying to escape.
I set out my position in the Second Reading debate on the Health and Social Care Bill, on 31 January, when I refused to support the Government because of the criticisms and concerns that I raised then. I do not need to repeat them now, but I also made it clear then, as I do now, that I would vote against the Government on Third Reading if the Bill were to look in any way like the measure that we saw come out of the Committee and that will come through to the Report stage. I therefore look forward to the outcome of the listening exercise, and hope that it is a genuine listening exercise and that substantial changes will be made to the Bill. The changes that I wish to see are so substantial that they would take the guts out of the Bill.
To the concept of commissioning proposed in the Bill and the idea of handing all that power to one narrow group of clinicians—GPs—there is, despite what the hon. Member for Banbury (Tony Baldry) said about GPs in his area, at best a resigned reluctance and at worst outright hostility about what GPs are being asked to do. I do not go along with the hon. Gentleman’s view that they are keen to get on with it. They are responsible people and responsible professionals; they recognise when they are being asked to do something and they will get on with it, but I must say that they will not do so with any enthusiasm.
Secondly, the substantial elephant in the room is not the risk of privatisation of the NHS, as the hon. Member for Easington (Grahame M. Morris), who is no longer in his place, described it, but the marketisation of the NHS. My hon. Friend the Member for Southport (John Pugh) put it well: the cherries will be picked by the private sector. Any decisions on commissioning could easily be unscrambled by a process whereby decisions that were intended to try to integrate services could be challenged because they were structured uncompetitively. Those are two fundamental failings in the Bill.
This comes to the heart of what coalitions are about. No one gets their own way, as Labour knows from being in coalition in other places, and it is silly to be childish about that. In a coalition, the parties work together when they agree and seek a compromise where they fail to agree. I would argue that when they cannot come to any kind of agreement or compromise, they should allow Parliament to decide. What I do not like about what is happening is the fact that the Secretary of State is largely implementing this—
Owen Smith (Pontypridd) (Lab)
I am delighted to follow the hon. Member for St Ives (Andrew George) and to hear him say that, were this a Third Reading debate and the Bill had remained as it is, he would vote against it. He should not hold his breath, because we have not heard any indication from those on the Treasury Bench that they propose to listen to the reasoned and substantive opposition that we heard in the Public Bill Committee, of which I was a member and where the Government rejected all 250 to 300 suggested amendments, or to that in the rest of the country, where doctors and all the medical professions are united in opposing the Bill.
Earlier, those of us on the Opposition Benches were admonished for the sound and fury coming from us. Mr Speaker was right to admonish us for shouting, but that sound and fury is not born of cynicism; it comes from three things. The first is our outrage at how the history of what the Labour Government did in office is being rewritten and at the suggestion that this Bill represents an evolution of what we did with the NHS. It is not an evolution, but a revolution.
The second is the shameless way in which the Government are misrepresenting that which sits at the heart of the Bill. They present it as trying to bring about patient focus and GP-led improvements to the NHS, but in truth it is about competition and the Government’s belief that competition in health care, like in telecoms or the energy market, is the best way to drive improvements in the efficient allocation of resources, allowing consumer-driven demand to drive efficiency. We fundamentally contest that. We do not think that it is true in many aspects of life, but it is certainly not true in the NHS, a body built on collectivism, co-operation and integration. Those fundamental ethics—the ethos of the NHS—will be undermined by the Bill.
Thirdly, the Bill is a completely unnecessary intervention. We did not need a top-down reorganisation of the NHS, because we got record patient satisfaction and increased productivity in all the ways that matter, as described earlier by my right hon. Friend the Member for Holborn and St Pancras (Frank Dobson). Crucially, we have a far more efficient and better-resourced system than previously. That prompts the question of why the Government are pursuing this change. They are doing so because they fundamentally believe that the way to drive the NHS forward is an unfettered market and greater deregulation.
That brings me to my substantive point. I want to rebut the notion which we have heard repeatedly from the Government that competition will not bite harder on the NHS as a result of the changes. The Government have told us repeatedly that nothing in the Bill says that competition will impact on the NHS to any great extent. As we all know, however, in 100 of the 300 clauses Monitor is established as an Office of Fair Trading-style competition overlord for the NHS, because as soon as the NHS is opened up to multiple entrants in the market and there are multiple providers of health care services in this country, we will no longer be able to argue that it is a state service that ought to be protected and therefore should not be subject to the vagaries of the market and EU competition law. As soon as we allow multiple health providers into the market, we will have to apply EU competition law, and European case law and arguments between lawyers will inevitably lead to the progressive fragmentation of the NHS.
There is one other point with which I want to take issue. Privatisation is a pretty difficult word to bandy about in politics, but I do not shy away from using it in this debate. We are going to see a progressive and creeping privatisation of the NHS. To argue about marketisation and privatisation is to argue about semantics. We will increasingly see many more aspects of the NHS either in the hands of or being delivered through the private sector. Earlier, the Secretary of State asked us to point out where in the Bill it showed that there would be an increased number of private providers in the NHS. My challenge to the Minister of State, Department of Health, the right hon. Member for Chelmsford (Mr Burns), who is now back in his place, is to point out to me where in the Bill it says that we will not see more private providers entering the marketplace. The Bill provides for that to happen and what will arise from that is the break-up, fragmentation and, eventually, privatisation of the NHS. Those on the Government Front Bench know that—
Clive Efford (Eltham) (Lab)
I must confess to being somewhat confused about where we have got to with the Bill. I have been here for 14 years and I cannot recall a Bill being halted after it had been through Committee so that we could go back and consult the public. I will be corrected by Members who have been here longer than me, but I cannot remember anything like this extraordinary situation.
Yesterday, I listened to the Deputy Prime Minister on the “Andrew Marr Show”. He said:
“Let me stress this, it’s not a gimmick, it’s not a PR exercise. We will make changes, we’ll make significant and substantive changes to the legislation”.
We have not heard any of that tonight. No one has got up and said, “We are listening,” or, “We are pausing,” or “We are reflecting and we are going to see substantial changes to this Bill.” The Secretary of State is in his place: I would like him to intervene on me and tell me that in relation to GP commissioning, the full £80 billion will be transferred to GPs, as he has frequently stated it would; that they will be in charge of commissioning and that we will not see that altered in any significant way as a result of the interventions of the Prime Minister or the Deputy Prime Minister. Members of the Government are trying to say that they are listening and that they are not responsible for all this, but I have here the White Paper that was published back in January, the foreword of which was signed by the Prime Minister, the Deputy Prime Minister and the Secretary of State for Health. They all signed up to it, but all of a sudden we are back to pausing, reflecting and listening.
What or who are we listening to? We have heard from the Secretary of State tonight that there are no cuts in the NHS, but let me tell hon. Members the story of Mrs Bell, a constituent of mine who was referred by her GP to a consultant last spring about cataract operations. She received the first operation within 18 weeks, and when she went back for a second consultation about the other eye she was referred for another operation. After 18 weeks, she rang the local health care trust to say that she had been waiting for her cataract operation for 18 weeks, but she was told that that was no longer a deliverable target. She ended up waiting more than 26 weeks for that cataract operation, so no one can tell my constituents or anyone else that we are not seeing cuts to the NHS and longer waiting times for patients.
What is fundamentally wrong with the Bill is that it places the market at the head of commissioning and planning services. The coalition document said that the coalition was going to introduce some element of democracy into primary care trusts, but PCTs got demolished as part of the proposals. My local PCT has been absolutely decimated, because although the Bill has not gone through Parliament yet, people are acting on it: they are voting with their feet and they have all gone. Currently, my area has no one who is responsible for the oversight and planning of our local health care services. Moreover, no one who will ultimately be accountable to local people is responsible for planning local services. All of that has been frittered away; it has disappeared. What we need is some form of democratisation of the commissioning process so that local people can know quite clearly who is accountable and who is not.
Tonight’s vote presents the Liberal Democrats—after we have paused and listened and reflected and after all they have said over the weekend about changes to the legislation—with an opportunity to send a message to the Government. This morning, the hon. Member for North Norfolk (Norman Lamb), the Parliamentary Private Secretary to the Deputy Prime Minister, said on the “Today” programme that there will be significant changes to the Bill. If the Liberal Democrats want to send a message to the Government, they should join the Opposition in the Lobby tonight and send the message that the Bill has to be changed. But I will tell them what will happen when it comes to Third Reading. The Whips will get to them, they will be as spineless as ever and they will go through the Lobby defending the Bill’s Third Reading—
NHS Reorganisation
Baroness Primarolo Excerpts(13 years, 8 months ago)
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Madam Deputy Speaker (Dawn Primarolo)
I advise the House that neither of the amendments has been selected by Mr Speaker. I remind Members that there is a six-minute limit on Back-Bench contributions, and I am sure that when making their opening speeches, both Front-Bench speakers will be conscious of the number of Back Benchers who want to speak in the debate.
Michael Dugher
I might be new to Parliament, but we ask the questions and he is supposed to answer them. The Secretary of State knows full well that patient groups, health charities, doctors and nurses oppose the Bill—even that shower opposite opposed it at their conference. Is it not just arrogance on the part of the Government—
Madam Deputy Speaker (Dawn Primarolo)
Order. The hon. Gentleman needs to moderate his language. I would grateful if he withdrew the word “shower” and thought of another way to make his point that uses parliamentary language.
Michael Dugher
I withdraw “shower”.
Is it not just arrogant for the Government to think that everybody else is wrong and they are right—
Madam Deputy Speaker
Order. It was not an opportunity to ask another question, either.
Mr Lansley
The hon. Gentleman has now learned that, if one is trying to pray somebody in aid, it is best not to insult them at the same time.
We have made it clear that we need to protect the NHS now and for future generations through modernisation. Under the Labour party—
Health and Social Care Bill
Baroness Primarolo Excerpts(13 years, 9 months ago)
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NHS Reorganisation
Baroness Primarolo Excerpts(14 years ago)
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Madam Deputy Speaker (Dawn Primarolo)
Order. Some 15 Members are seeking to participate in the debate. Mr Speaker has therefore decided that there will be a seven-minute time limit on speeches after the Secretary of State has spoken. I remind Members that they do not have to speak for as long as seven minutes; seven minutes is the maximum. If they bear that in mind and are considerate to other Members, it may be possible for everyone to contribute.
Mr Lansley
I am not giving way, so the hon. Lady must sit down. [Interruption.]
Madam Deputy Speaker
Order. The Secretary of State is indicating that he is not giving way, and that is his choice.
Mr Lansley
Not only is it my choice, but it is a necessity. As you said earlier, Madam Deputy Speaker, 15 Members wish to speak in the debate, and they will be allowed only seven minutes. I shall therefore take less time than the shadow Secretary of State did.
The Labour Administration pursued practice-based commissioning. Labour Members now make up numbers about how many GP-led commissioning consortiums there will be, but under practice-based commissioning there are 909 practice-based commissioning consortiums. The Labour Government did not give them any power, but they established them and they all have costs associated with them; there are 152 primary care trusts. Bureaucracy and cost in the system is legion, and we have to take it out; we have to reduce the number of people.
Under the Labour Administration the number of managers and senior managers in the NHS doubled. Where was the corresponding improvement in outcomes? The number of nurses increased by only 27%. That shows the kind of distorted priorities that were at the heart of the previous Government. They said that all NHS trusts should be foundation trusts by December 2008, but they simply did not bring that about; we are going to make it happen. They set up the idea of a right to request for staff in PCTs in provider services to become social enterprises, but we are the ones who are now bringing that about. Yesterday, I was able to announce 32 more social enterprises in the NHS, where staff are taking responsibility and ownership of the service that they provide, representing 15,000 additional staff and more than £500 million of revenue. If the Labour party is now against all the reforms that used to be part of the process of delivering greater empowerment of staff and patients in the NHS, what is it in favour of? I simply cannot find out the answer to that question any more.
What does represent a radical departure from the past is the fact that we are pressing ahead with the reforms with purpose and pace. I make no apology for the fact that we are going to achieve the changes required in the NHS more rapidly than anything that the Labour party did in the past—because not to do so would prejudice the opportunity to deliver resources to the front line, choice for patients and clinical responsibility for leaders across the NHS.
Rosie Cooper
Nobody could disagree with that.
The NHS will be one where the area and street where people live will determine whether they have access to certain drug treatment, because of the weakening of NICE and a shift back to value-based pricing, placing drug companies back in control, and a return to postcode prescribing—an NHS where people may or may not get certain operations. Already in my area, across Lancashire, primary care trusts are reviewing funding for 70 procedures, so if patients require an endoscopic procedure for their knee or back, or a hysterectomy, those may no longer be available.
How far people travel to their hospital depends on whether they have a hospital close by that offers the treatment that they need. On 26 October at the Select Committee, various witnesses gave evidence that hospital closures will be necessary to release moneys back into the wider health service. How many patients would agree that such a state of affairs is part of a patient-led NHS? Not many, I bet.
Improving health care outcomes was the Secretary of State’s second aim. It seems highly unlikely, given that the ability to deliver improved outcomes is reliant on front-line services and the availability of the staff to deliver them. The Royal College of Nursing expects to lose 27,000 front-line jobs. That is the equivalent of losing nine Alder Hey children’s hospitals. The work of the RCN suggests that under the guise of 45% management cuts, the NHS will lose health care assistants, nurses and medical staff—front-line cuts by stealth.
All this must be set in the context of what was said to be the lowest financial settlement since the 1950s, reputed to be 0.1%—as we heard today, that is already disputed—together with massive pressure on NHS budgets from increased VAT costs—[Interruption.]—redundancy payments, budget short-falls and hospitals having tariffs frozen—[Interruption.]
Madam Deputy Speaker
Order. The Secretary of State does not need to shout across the Chamber. He has had his time.
Rosie Cooper
It would help if I could hear the right hon. Gentleman, but never mind.
The difficulties are topped up with increasing demand for services, an ageing population, an increase in the number of people with complex illnesses and the rising cost of treatment. That is all very worrying.
At the Select Committee the Secretary of State spoke about increasing autonomy and accountability in the NHS. I have raised that with him on a number of occasions and I tried to intervene today. It is a further example of the two health policies of the Administration, one mythological and the other the reality. Perpetuating the myth, the Secretary of State said at the Select Committee that
“the conclusion that we reached was that we could achieve democratic accountability more effectively by creating a stronger strategic relationship between the general practice-led consortia and the local authority.”
We might imagine that that meant patients and elected representatives at the heart of decision-making, and that the consortiums would operate with councillors on the board, who would be able to vote, but no. Scrutiny will come from well-being boards, which means that patients and councillors will not be there offering their opinions and able to vote. Well-being boards, like the current NHS overview and scrutiny arrangements, may as well not exist because they will be nothing more than a focus group.
I said at the Select Committee that those arrangements were nothing short of throwing snowballs at a moving truck—they would make little or no difference. The Government are giving a budget of more than £80 billion to GPs who just want to practise medicine and not get involved in the experiment.
Rosie Cooper
We need to get more GPs to do that, and I think that is what the Secretary of State is trying to say.
The Government plan no testing or pilots, just a big bang, using consortiums as a shield to deflect criticism from them, rather as they currently use the Liberal Democrats.
The fourth aim was promoting public health. Everybody agrees that prevention is key to easing the cost burdens further down the health pathway, so if we were serious, we would be doing more about promoting public health. Simply allocating 4% of the NHS budget and giving it to cash-strapped local authorities does not seem the best and most effective way of promoting public health. We await more detail, although that might be as difficult to follow as the Department of Health’s £1 billion allocation to social care.
That brings me to the fifth aim of the White Paper. Following the publication yesterday of “A Vision for Adult Social Care” by the Department, the foreword gives us a sense of where we are heading with the Government’s policy. Under the third value, responsibility, it states:
“Social care is not solely the responsibility of the state. Communities and wider civil society must be set free to run innovative local schemes and build local networks of support.”
I wonder whether that is code for “We’ve got no real money to invest. Local authorities are not going to be able to meet the demand. Oh well, you’d better get on with it yourself.”
It is no use the document quoting Frederick Seebohm from 1968, as that might not reflect the world of today. As an ideal, it is great, but not every family and every individual can offer the help and support that are required. There are incredible strains on hard-working families and individuals trying to make ends meet while struggling to provide care for ill and elderly relatives—
David Tredinnick (Bosworth) (Con)
I support the Opposition’s motion in one respect: their call on the Secretary of State
“to listen to the warnings from patients’ groups, health professionals and NHS experts”.
I want to address particularly the issues affecting those in integrated health care. I speak as the chair of the integrated health care group—the old complementary medicine group—and as someone who has the honour of serving under my right hon. Friend the Member for Charnwood (Mr Dorrell) on the Health Committee. I wish to look at the regulation of herbal medicine, the possibility of complementary medicine leading to cost reductions in the health service and the choice of services.
As my right hon. Friend the Secretary of State knows, we will have a problem next year with the implementation of the traditional herbal medicines directive, about which many colleagues have been approached by constituents. From April, practitioners will no longer be regulated under section 68 of the Health Act 2009, so my first plea to my right hon. Friend is to come up with a solution to this problem ahead of time—ahead of Christmas, I hope. Otherwise, from April, practitioners will be unable to prescribe the herbs they have been prescribing under the section 68 derogation. The best course of action is the Health Professions Council, because that is the only body—
Madam Deputy Speaker
Order. I should remind the hon. Gentleman that we are not discussing the directive, amendments to the directive or herbal medicine. We are discussing the reorganisation of the health service, to which he needs to direct his points to make them relevant to the motion.
David Tredinnick
Thank you, Madam Deputy Speaker. What I am talking about is relevant to cost savings, choice and the use of existing practitioners. I hope that my right hon. Friend will deal with that issue; otherwise it will cause him major problems next year. I will now move on.
The other, related problem is that, under this arrangement, unless my right hon. Friend acts, we will lose many available products from the shelves, which will affect health service costs and what practitioners can do. Yesterday, I went to Brussels to discuss the issue as it affects health service, which we are discussing, and related cost savings. I spoke to Elena Antonescu, a Member of the European Parliament, who advised me that if the health service is to continue with traditional Chinese and Ayurvedic medicines, the Secretary of State will have to lobby Members of the European Parliament to go to the Commission to produce a report that they first proposed in 2008.
Madam Deputy Speaker
Order. The hon. Gentleman is pushing at the margins. We are not discussing European directives; we are talking about reorganisation of the health service in line with the White Paper. He must put his comments in that context.
David Tredinnick
I am most grateful to you, Madam Deputy Speaker, for your help. I have made my point about Europe having to be involved.
I also want to comment on the points made by my hon. Friend the Member for Basildon and Billericay (Mr Baron) and others about cancer care. Cancer patients can be much helped by integrated health care practitioners. I could cite many different hospitals, but I shall mention just one—Royal Surrey County hospital, which is a national health care award-winning hospital. It includes St Luke’s cancer centre, which offers a wide range of complementary therapies in support of the health service. I want to see such choice widened. If herbal and nutritional medicines are used, that will reduce the costs of the health service referred to in the motion. Many institutions abroad, such as Australia’s National Institute of Complementary Medicine, have shown Governments the way and enabled them to restructure services and provide cost savings.
With those remarks, I very much hope that my right hon. Friend the Secretary of State looks with care at what I have said about these benefits.
Madam Deputy Speaker
Order. The hon. Gentleman, who is a very experienced Member of this House, has been pretty close to not being in order. I take it that he has now resumed his seat, and I will move on to the next contribution.
Lyn Brown
My hon. Friend must have noticed the chuntering taking place on the Government Front Bench. The same happened during the speeches of a number of other Opposition Members. Does she not think that that is really poor form, especially when the Secretary of State did not seem able to take interventions when it was his turn?
Madam Deputy Speaker
Order. That is a matter for me to control. The hon. Lady will continue with her speech. I am sure that all Members of this House, including those on both Front Benches, will behave appropriately in this debate.
Yasmin Qureshi
We are told by the Government that the reorganisation is not ideologically driven, but is somehow a way of maximising efficiency and making the systems better. At a time when we are being told that there is not enough money, commentators and experts are saying that this reorganisation will cost at least £3 billion. We are not talking about a small amount of money; we are talking about £3 billion.
Yasmin Qureshi
I thank my hon. Friend for that intervention. Some years ago, when that sort of process was introduced in the legal system, with solicitors able to apply for franchises, the big firms benefited and the smaller, local firms went bust. A similar thing will happen. Some GPs, who run small surgeries in the heart of a community, will not be able to form consortiums. What happens to them? Does it mean that people in parts of Kearsley in my constituency will have to travel seven miles to go to a big GP consortium rather than being able to walk down the street and speak to their GPs, as they currently do?
The reform means that private patients will have a chance to pay for faster care in the NHS. Now that the restriction on the income that can be made from private patients is being lifted, cash-strapped hospitals will find it difficult to resist that income stream. Patients could routinely be offered that route to faster treatment. Thus wealthier people can queue jump, while NHS patients will linger on a lengthening waiting list.
I know that the Secretary of State—
Contaminated Blood and Blood Products
Baroness Primarolo Excerpts(14 years, 1 month ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Madam Deputy Speaker (Dawn Primarolo)
As Members will have noticed—I shall remind the House again—Mr Speaker has not selected the amendment.
Madam Deputy Speaker
Order. May I remind hon. Members that Mr Speaker has set a time limit on speeches of five minutes? That does not mean that every Member has to take all their five minutes. Some 24 or more Members wish to participate in this important debate, so I ask you all to help your colleagues out by making your points succinctly, so that we can get in as many speakers as possible.
Mr Tom Clarke (Coatbridge, Chryston and Bellshill) (Lab)
On a point of order, Madam Deputy Speaker. Will you confirm that if Members take interventions during those five minutes, they will be given penalty time?
Madam Deputy Speaker
I can confirm that the normal procedure for interventions and compensation time apply to those five minutes. I hope that that is clear.
Mr Geoffrey Robinson
On that point, if the Government intend to do what they have outlined in their written statement, why did they not table an amendment to that effect? Why did they squirrel the information away in a statement in the Library? The right hon. Member for Charnwood (Mr Dorrell) is long enough in the tooth to know that they have not deliberately done it like this, but had they tabled such an amendment, incorporating their statement, we would have been very inclined to vote for it—
Madam Deputy Speaker
Order. Interventions must be interventions; the hon. Gentleman must not make another speech.
Mr Clarke
I feel that there ought to be more humility on both sides of the House as we debate this matter, and I hope that I shall be able to exercise some myself. This issue has not been properly dealt with by Governments of all shades for a quarter of a century. It is amazing, but this is our first debate on the subject in a quarter of a century. I welcome the debate, and as the motion tabled by my hon. Friend the Member for Coventry North West is the only practical proposal before the House, I shall take pride in voting for it. I have held a number of responsibilities myself, including that of shadow spokesperson on disability. The hon. Member for Bristol North West (Charlotte Leslie) asked earlier what had been done so far, and the answer is: not enough.
Madam Deputy Speaker (Dawn Primarolo)
Order. I am sorry, but the time limit has been reached.