NHS Reform

Baroness Thornton Excerpts

Monday 4th April 2011 Lords Chamber

[Baroness Thornton]

My Lords, I start by thanking the noble Earl for repeating the Statement. I have to confess that this is a very puzzling moment. I do not recall a Statement in the middle of the proceedings of a Bill—a Bill that has only just finished in Standing Committee in the Commons. I would be grateful if the noble Earl could tell me whether there has ever been a Statement announcing a break, natural or otherwise, in the middle of the passage of a Bill. I wonder what might happen in this natural break, whatever that is. Perhaps the Minister can define this new parliamentary term. How long will it be? Why is it really necessary? What is likely to take place during that period? What exactly are the Government intending to do during that period? It seems to me that the things that the Government have said that they are going to do during that period should have happened anyway before the Bill was introduced and that they should have been ongoing. This should not be necessary.

However, I welcome the recognition in this Statement of the concerns that people have about the speed of change. I question the use of the word “continue” in the Statement in the context of listening and engaging. Frankly, if Mr Lansley had been listening and engaging, this Statement would probably not have been necessary. However, if it means that the Secretary of State really is going into listening mode, I welcome that and look forward to seeing it.

I welcome the fact that the Statement touches on the areas that are of concern to people. I also welcome the recognition in the Statement of the 10 years or so of investment by my Labour Government, which is why the NHS is as successful as it is today. However, I also note that the Statement, just like Andrew Lansley’s Second Reading speech when the Bill was introduced in another place, elides the question of Part 3, which gives great powers to a utility regulator—the new economic regulator, Monitor. Therein lie many of Mr Lansley’s problems, because people have worked out what the implications of that part of the Bill are for the NHS. When will Mr Lansley start to listen to the concerns that have been expressed by the Health Select Committee, all the royal colleges, the health regulators, all the bodies representing employees and staff in the NHS, including the BMA, the patients’ organisations, his partners in this Government, the Liberal Democrats, many of the voluntary organisations involved in health—those concerned with diabetes, heart disease, cancer, asthma and dementia, for example—and, in particular, organisations concerned with long-term conditions?

We can build a picture of what has happened in the past week or so. First, the Prime Minister was wrong-footed by Ed Miliband on 16 March on whether the health service would now be subject to European Union competition law. It seems to me that he went away, found out about it and confirmed that that was the case. Will the Minister confirm that? There has been a stream of media stories reflecting serious concerns about the Health and Social Care Bill. Most recently, in the Daily Telegraph, Sarah Wollaston MP urged her party to drop plans for the radical reorganisation. On 1 April, Elizabeth Rigby, chief political correspondent of the Financial Times, reported concerns about the rapidity of change.

On 2 April, the Telegraph said that the Prime Minister was drawing up key changes to the Bill and planning amendments. This article is remarkably detailed about meetings at Downing Street with David Nicholson, the head of the NHS, and Mr Lansley. It says that Mr Lansley was not for compromising and that reforms had gone too far to be undone, which was the subject of a question that I asked in Oral Questions only today. I ask the noble Earl to confirm whether that is the case.

The Statement also reflects the fact that Mr Lansley is very firm about the Government’s intentions for the NHS, but it is not consistent with the stories in the media about the activities at No. 10 Downing Street. Will the noble Earl tell us who is correct about these matters? I will draw a veil over what the noble Lords, Lord Owen and Lord Tebbit, have said about this matter in the past few days.

I am concerned about exactly what will happen during this natural break, which brings me to my final questions. My concern is that this break is being taken in order to strike a deal. I can just imagine a possible conversation between Nick Clegg and the Prime Minister. Nick Clegg says to the Prime Minister, “We want local accountability strengthened”, which I think many of us here would agree with. The Prime Minister then says to Nick Clegg, “Okay, but your people in the Lords must deliver Part 3 of this Bill to establish the economic regulator, Monitor, without dilution of its powers”. There is no doubt that that would be the prize for the Conservatives. It has been recognised by the noble Lords, Lord Owen and Lord Tebbit, and by the noble Baroness, Lady Williams. I fear that this is about keeping the coalition together rather than any assessment of what the NHS might need at this moment. The past few days have seen David Cameron conceding that he and the Health Secretary have failed to get their message across. There have also been anonymous briefings from No. 10, to which I have referred.

I am further concerned that this is about playing politics with the NHS. Will the Minister reassure the House that that is not the case? This is too important to be used as a political football or to see decisions taken about the NHS simply to save David Cameron’s face or Nick Clegg’s face. What is required now is a rethink, a pause in the legislation and some root-and-branch changes.