Education and Health

Lord Lansley Excerpts

Wednesday 2nd June 2010 Commons Chamber

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

It is a great privilege to be able to come to this Dispatch Box for the first time as Secretary of State for Health, after six and a half years as shadow Secretary of State. I thank the right hon. Member for Leigh (Andy Burnham) for his kind words about me and my team. I am very proud of the team that we have at the Department of Health. I was proud when the Prime Minister spoke of us in warm terms today, and we will fulfil the responsibilities that he has placed on us.

Let me say to the right hon. Gentleman, in return, that I thank him, on behalf of the NHS, for his commitment. From the days when he began as a Minister in the Department and then went, as it were, back to the shop floor, I think that nobody has doubted his personal commitment to improving standards in the NHS, nor, indeed, that of his outgoing ministerial team. He is on his own in the shadow health team—[Interruption.] Oh, I beg their pardons. However, he has lost his fellow Ministers. I will not go on at length, but I know that they were all committed to their jobs. I want especially to mention Ann Keen. As a nurse, she showed her personal commitment to the NHS and to nursing as a profession. My colleagues, including the Under-Secretary of State for Health, my hon. Friend the Member for Guildford (Anne Milton), and I will ensure that we continue the work of identifying how we can take nursing forward as a profession. That includes the work that she and the Minister of State, Department of Health, my hon. Friend the Member for Chelmsford (Mr Burns), have done in looking at nursing as a profession for the future.

As Secretary of State, it is my privilege to be able to represent those who work in the national health service. We have reason, all of us, to be grateful to them every day. People in Cumbria, especially today, have reason to be grateful to the north-west ambulance service, to local GPs, and to those who work in North Cumbria University Hospitals NHS Trust, particularly those at West Cumberland hospital, whom I have twice visited. I know the responsibility that they feel, even on a day-to-day basis, for providing hospital care—acute care—to patients across that part of Cumberland, which is at a great distance from other hospital locations. I know that people in Cumbria will be deeply grateful for the service that they have provided to look after them today.

It is a privilege for the shadow Secretary of State and I to respond to this debate, which has included 23 maiden speeches and, indeed, some fine speeches by Members who are not new. Before I respond to those speeches in detail, I want to say that it was very encouraging to hear the commitment to improving quality expressed on both sides of the House.

It was particularly encouraging to hear my right hon. Friend the Secretary of State for Education and other Members on these Benches demonstrate that what we need to achieve that quality is a change from a command-and-control, top-down system of running our schools, hospitals, health care and social care services to one that is built on standards of delivering quality. We need to understand that if we are really going to achieve that, we have to give parents greater choice and control over the education that their children receive. We have to give patients greater information, choice and control over the health care that they receive, and in all the public services that we are talking about, we must provide those who deliver them with a much greater sense of ownership.

It is all very well for the right hon. Member for Leigh to talk about what has been achieved in the NHS over recent years, and I have never been one to diminish what has been achieved. However, many who work in the service, notwithstanding the fact that they are better paid than they were and know that they have had an unprecedented increase in resources to deliver improvements, still feel demoralised and that they are not in control of the service that they provide. They cannot give the care that they want to give, and they know that they are not yet matching the standard of care that they could achieve given the opportunity to do so. It is our responsibility to make that happen and I do not doubt the commitment of Government Members to do so. I visited 62 constituencies during the general election campaign and, without exception, I met candidates who were committed to delivering improvements in health care, not least because in many cases they had personally campaigned for years to deliver improvements in health care services. That is why we will not let Labour’s debt crisis, which we have inherited, mean that we cut the NHS and make the sick pay.

When the right hon. Gentleman was Secretary of State, he commissioned McKinsey to go off and publish a report. It produced a report for him stating that on average, something like 10% of those employed by a provider of health care with 300 staff should be taken away, mostly clinical staff. That was the recommendation given this March to my predecessor as Secretary of State, but that is not the way we should go. We must move towards a change in priorities from a service that was increasing the number of managers three times as fast as the number of nurses to one that deploys clinical staff on the front line to deliver the care that patients need.

[Andy Burnham]

Just for the record, the report was not commissioned by me or by Ministers but by the former director of commissioning in the Department, who left before I arrived.

[Mr Lansley]

Let me put it like this: I inherited a Department in which the report had been produced but not published, so I published it. I published the report on London and will publish all the reports that were prepared before the election, such as the prescription charges review that the Secretary of State commissioned from Professor Ian Gilmore, which was not published before the general election. As far as I am concerned, we are committed to transparency and getting that information out.

I have immense respect for the right hon. Member for Rother Valley (Mr Barron). He and I do not agree about the specific issue of minimum unit pricing on alcohol, and he knows why—I do not believe we have seen the evidence of its benefit compared with cost, particularly for low-income households. However, my hon. Friend the Member for Totnes (Dr Wollaston) is absolutely right that we must do something about the matter. We must acknowledge the scale and severity of the problems resulting from alcohol misuse, and we must tackle supply, pricing and problem drinks. We must ensure that we enforce legislation properly, but we must also recognise that it is not just about restricting the availability of alcohol. We must change our relationship with alcohol as individuals and as a society, and we will address that issue.

My hon. Friend the Member for Milton Keynes North (Mark Lancaster) knows that I am committed to maternity services there and to helping them deliver the quality that his constituents expect. The hon. Member for Hackney South and Shoreditch (Meg Hillier) said that what works in Surrey Heath may not work in Hackney. Exactly—that is the point. When we devolve decision making inside the education and health services, as we intend to do, things happen differently in different places. That is precisely why those services should be empowered to respond in different ways in different places, and that is our intention.

There have been some fabulous maiden speeches today. I say to my hon. Friend the Member for Harlow (Robert Halfon) that I appreciate the 10 years that he has been fighting for the people of Harlow. He showed today his absolute commitment to maintaining exactly that support for the people whom he represents.

It is good to see the hon. Member for Liverpool, West Derby (Stephen Twigg) back, and to those of us who entered the House at the same time as him, it feels as though he had not gone away. I understand exactly what he says about Alder Hey, and the same is true of Broadgreen. I visited Alder Hey shortly before the election, and it tells us a lot when families are crammed together on a ward, but all they want to do is say how wonderful the care that they are receiving is. However, we have a responsibility to ensure that terrific care is provided in physical circumstances that reflect it. We cannot make announcements about the Royal Liverpool and Broadgreen, or about Monitor in relation in Alder Hey as a foundation trust, but I hope that we will be able to do so soon.

The hon. Member for Chippenham (Duncan Hames) and others talked about the importance of community hospitals. I hope that he will have heard the Prime Minister say this afternoon that they are supported and valued. That is absolutely the case, and I know Chippenham hospital from visiting it in the past. The hon. Member for Luton South (Gavin Shuker) said that there is more to life than politics. That is very wise, very true and very good advice for those in the Labour party at the moment. The hon. Member for Wolverhampton North East (Emma Reynolds) has obviously learnt her politics well, because she mentioned the Express & Star, which is very sensible. She also talked about New Cross hospital, which I have visited, as she will know.

We must provide the public with the information required to enable them to support the driving up of standards through the exercise of control and choice, but also sometimes just through holding people to account publicly for the quality of the service that they provide. New Cross is a great example: there has not been a case of MRSA there since June 2009. That is terrific. The former Secretary of State will say, “Haven’t we done well in reducing infections?” However, that is from a terribly high base. What will drive down infections is a constant focus on places that achieve the best results, and New Cross—as I know from personal experience—does extraordinarily well.

My hon. Friend the Member for Bristol North West (Charlotte Leslie) and others talked about the pupil premium and the health premium, how we can reduce health and education inequalities and how we can achieve a greater sense of equality in our society. Notwithstanding some of the correct arguments about the wider social determinants of health and education, if we tackle both as communities and as a society, we can do a great deal to reduce those underlying inequalities at the same time as we tackle economic inequality.

My hon. Friend the Member for Croydon Central (Gavin Barwell) and I go back a long way—20 years—and it was a delight to hear him talking about Croydon and, in particular, about leadership, because that is important. Many other hon. Members also talked about that issue, and rightly so. I heard no references to traffic lights from the hon. Member for Streatham (Mr Umunna), but I used to live in Balham and it was a delight to learn more about the area. I never knew that I was walking the longest high street in western Europe. The hon. Member for Liverpool, Wavertree (Luciana Berger) managed to tell us about the world’s first integrated sewer system and Meccano, so the debate this evening has been very educational.

I do not want to leave anybody out, and I was delighted to hear the hon. Member for Kilmarnock and Loudoun (Cathy Jamieson), who talked about mutualism and social enterprise, which are terrifically important. We will do more to give employers in public services ownership of the services that they provide. The hon. Member for Bradford East (Mr Ward) will know that examples such as Born in Bradford will be part of how we approach our public health strategies. Everyone seemed to mention academies this evening, but my hon. Friend the Member for South Derbyshire (Heather Wheeler) was the only one to mention a golf academy.

My hon. Friend the Member for Blackpool North and Cleveleys (Paul Maynard) made the important point that we must deliver improving long-term care that allies health and social care together. We will do that and we will reform adult social care—and we will not wait until 2015-16 as proposed. We will press on and examine how we can do that in a matter of months, not of years.

The hon. Members for Norwich South (Simon Wright) and for Walthamstow (Stella Creasy) gave us further visions of how they will achieve their objectives for their constituencies, as did my hon. Friend the Member for Sittingbourne and Sheppey (Gordon Henderson) and the hon. Member for Pontypridd (Owen Smith). They are robust advocates in speaking up for their constituencies and explaining their convictions.

In conclusion, I am committed, as is my right hon. Friend the Secretary of State for Education, to putting in place sustainable, stable reforms that achieve our vision of delivering health and educational outcomes that are as good as anywhere in the world, based on principles of equity, excellence and delivering greater efficiency in the services that we represent, but most of all based on empowerment of people.