Business of the House

Debate between Lord Lansley and Joan Ruddock

Thursday 25th October 2012 Commons Chamber

[Mr Lansley]

My hon. Friend makes a good point. Although parliamentary time is tight, it is awfully tempting to arrange a debate on the economic figures—on growth, employment, inflation and borrowing. I fear, however, that we might not be able to do so. I reiterate the point made by my hon. Friend the Member for Croydon Central (Gavin Barwell): as the Opposition have time available in the week after next, perhaps they might like to debate the issues.

[Dame Joan Ruddock (Lewisham, Deptford) (Lab)]

Will the Leader of the House join me in congratulating the Clerks and staff of the House, including Hansard, on their enabling us to make a smooth transition to our earlier sitting hours? Will he quash the ugly rumours that this is a mere experiment and confirm there are no plans to review the earlier hours?

[Mr Lansley]

I of course share the right hon. Lady’s appreciation of the way in which the Clerk and staff of the House assist us in our business. The House was invited to make a decision and a decision was made.

Health and Social Care Bill

Debate between Lord Lansley and Joan Ruddock

Tuesday 20th March 2012 Commons Chamber

[Mr Lansley]

The right hon. Gentleman knows perfectly well that in the debate on 22 February we made it clear that we felt that our appeal to the tribunal was justified, and indeed it was, because we won at appeal on the question of the publication of the strategic risk register. The Government’s objection and my objection to the publication of the risk register is precisely that risk registers are not written for publication. They are written in that safe space within which officials give advice to Ministers.

[Dame Joan Ruddock]

Will the right hon. Gentleman give way?

[Mr Lansley]

No.

Risk registers do not represent a balanced view. They are not a prediction of the future. They set out a worst-case scenario to challenge decision making. My hon. Friend the Member for Totnes (Dr Wollaston) captured the understanding of what a risk register is very well. The point is that we have looked precisely at the balanced view in the impact assessment, which captures where the risks and the benefits of the Bill lie. However, publication of the risk register, as my right hon. Friend the Member for Charnwood (Mr Dorrell) made perfectly clear, would prejudice the frankness and integrity of the decision-making processes of government and the Government are opposed to their publication.

As I mentioned, we won on appeal in relation to the strategic risk register, but not on the transition risk register. In the absence of the reasons for those decisions by the tribunal, and given the nature of the overlap between the strategic risk register and the transition risk register, I cannot comment further on that, or indeed on what our response will be to the tribunal’s decisions.

Health and Social Care Bill

Debate between Lord Lansley and Joan Ruddock

Tuesday 13th March 2012 Commons Chamber

[Mr Lansley]

We know that it is necessary for us to reform in order to deliver the improvements that the NHS needs, as well as the sustainability that it needs. We are not even speculating about this; we can demonstrate that it is happening. This is in contrast to what the right hon. Member for Leigh said. He said that he was not scaremongering, then he got up and did just that. He scaremongered all over again. He went to a completely different set of data on the four-hour A and E provision, for example. He went to the faulty monitoring data, which are completely different from the ones that we have always used in the past—namely, the hospital episodes statistics data, which demonstrate that we are continuing to meet the 95% target.

When we look across the range of NHS performance measures, we can see that we have improved performance while maintaining financial control. The monitoring data from the NHS make that absolutely clear, and that is in contrast to what happened when the right hon. Gentleman was a Minister in the Department, when Labour increased the NHS budget and lost financial control. That happened when the hon. Member for Leicester West (Liz Kendall) was a special adviser in the Department. Now, we have financial control across the NHS and we have the NHS in financial surplus.

Let me return to the Labour manifesto—[Interruption.] Labour Members do not like to hear this. It stated:

“Patients requiring elective care will have the right, in law, to choose from any provider who meets NHS standards of quality at NHS costs.”

Yes—choice and any qualified provider are in the Labour manifesto. We are doing what Labour said should be done in its manifesto—and it is now opposing it.

Let us find out what it is that the right hon. Member for Leigh opposes in the Bill. I did not find that out in his speech; I heard generalised distortions, but I genuinely want to know. Let us take some examples. Is it the Secretary of State’s duty in clause 1 to promote a comprehensive health service free of charge, as now? No, he cannot possibly be against that. Is it that the Bill incorporates for the first time a duty on the Secretary of State to act to secure continuous improvement in quality—not just access to an NHS service, but putting quality at the heart of the NHS? Is he against that? No, surely not. Anyway, that approach began with Ara Darzi, and we have strengthened it.

[Dame Joan Ruddock (Lewisham, Deptford) (Lab)]

rose—

[Grahame M. Morris (Easington) (Lab)]

rose—

--- Later in debate ---

[Mr Lansley]

The short answer to that is no. If one wishes to arrive at a place where the clinical commissioning groups have responsibility for budgets and proper accountability—including democratic accountability for what they do—legislation is required to get there. That is why we are putting legislation in place to make it happen.

[Dame Joan Ruddock]

rose—

[Angie Bray (Ealing Central and Acton) (Con)]

rose—

NHS (Private Sector)

Debate between Lord Lansley and Joan Ruddock

Monday 16th January 2012 Commons Chamber

[Mr Lansley]

Let me explain to the hon. Gentleman. The average time that patients waited for in-patient elective procedures in the NHS according to the latest data was 8.4 weeks, which is exactly the same as at the time of the last general election. For out-patients it was 3.9 weeks, compared to 4.3 weeks at the election. For diagnostic tests, despite the fact that the NHS has performed 440,000 more diagnostic tests, the average waiting time is 1.8 weeks, the same as at the election. Long waits? The hon. Gentleman did not say that according to the latest data published the number of patients waiting more than a year for their treatment went down 40%, compared with what we inherited from the Government at the time of the last election.

The motion is all about Labour’s going back to the past. I am staggered. It is almost like revisiting Barbara Castle’s antipathy towards the private sector, or that of the right hon. Member for Holborn and St Pancras (Frank Dobson), the only former Labour Secretary of State now, even including himself, that the right hon. Member for Leigh seems to agree with.

I will ask the House to reject the motion, but in a way I am asking the House to reject those sentiments all over again, because we have been here before with this debate. Far from the House not having had an opportunity to consider issues including the private income cap, I remember having exactly this debate on Report. We were very clear about that. We discussed it when the White Paper was published, we discussed it when the Bill was debated on Second Reading, when it was in Committee and on Report, and it has been debated again in another place. I hope to use this opportunity to trample on some of the myths that the right hon. Member for Leigh and his friends are propagating about the Bill.

[Dame Joan Ruddock (Lewisham, Deptford) (Lab)]

I have received information from inside King’s College Hospital NHS Foundation Trust that priority is being given to private cancer patients in both diagnosis and treatment. Will the Secretary of State either confirm or deny that that is a fact?

[Mr Lansley]

If the right hon. Lady has any such evidence, she should give it to me. Let me explain that at the moment any individual member of NHS staff would be acting contrary to the NHS staff code of conduct if they saw a conflict between private sector and NHS activity and gave priority to private patients to the detriment of NHS patients. Technically speaking, under the legislation we inherited it is not explicitly unlawful for a foundation trust to do that but, as I explained to the right hon. Member for Leigh, a whole series of specific safeguards relating to the relationship between private and NHS activities was introduced into the Bill in another place. It makes it clear that the principal purpose of a foundation trust is to benefit NHS patients and NHS services. To do anything that is to the detriment of NHS patients will be unlawful. There are specific safeguards stating that foundation trusts cannot cross-subsidise between NHS activities and services and private services. If the right hon. Lady has information of a particular instance, she might as well give it to me.

[Dame Joan Ruddock]

I am grateful to the Secretary of State for giving way again. Does he not understand that a person who has this information is terrified of putting it into the public domain—[Interruption.] I am sorry, but he is wrong. We are talking about someone’s job and livelihood. I simply asked him whether this is correct or not. Does he know?

[Mr Lansley]

I have no knowledge of what the right hon. Lady describes. Let me remind her that those working in the NHS have a responsibility to disclose anything that that they think is to the detriment of their patients’ interests, and under legislation on public interest disclosure they have protection. I announced just before Christmas that in the latest contract for an enhanced advice line there should be a whistleblower advice line.

National Health Service

Debate between Lord Lansley and Joan Ruddock

Wednesday 26th October 2011 Commons Chamber

[Mr Lansley]

The second reason the House should reject the motion is that it fails to pay tribute to the hard-working staff of the NHS. I participated in many debates such as this when I was shadow Secretary of State and I thought that they provided an incredibly good opportunity for Members to raise issues relating to their own constituencies. I hope that that happens in this debate, as it is important. Every one of us has in our constituencies thousands of committed and hard-working NHS staff who want to know that we recognise it. I do not see any of that in the motion.

[Joan Ruddock]

rose—

--- Later in debate ---

[Mr Lansley]

No, as I need to conclude my speech. [Interruption.] I am sure what the hon. Lady says is true.

The NHS in Wales is not cutting its budget because everything is going well. Labour Members are fond of citing waiting times, but the latest figures on waiting times show that in England 90.4% of admitted patients and 97.3% of non-admitted patients were referred to treatment within 18 weeks, whereas the figures for Wales are 67.6% and only 74% respectively.

Let me tell the House about infection rates. In 2007, the clostridium difficile mortality rates in England and Wales were similar—in fact, the rate was slightly higher in England. However, in the latest year for which figures are available there were 23.4 deaths per million for men and 23.5 deaths per million for women in England, whereas the figures for Wales were 54.9 deaths per million for men and 59.5 deaths per million for women, so the level in Wales is more than twice that in England. In four years, the gap has widened to the point where Wales has double the number of deaths from C. diff infections relative to England. Less money, less innovation and less good care is what has been happening in Wales under a Labour Government.

I must make it clear that we are going to put patients at the heart of the NHS. We are going to focus on the NHS delivering excellent care every time. Labour focused on the targets and the averages, and never got to the place of really caring about the specifics. A patient about to go into hospital for knee replacement surgery does not want to know about the national figure; they want to know about their hospital, their ward and what will happen to them. The same is true for mixed-sex accommodation. Labour turned a blind eye to variation in performance. We are going to open it up to clinical and public scrutiny, so that we can reward and celebrate achievement and excellence across the service, and shine a light on poor performance.

[Joan Ruddock]

Two weeks ago, I had an operation in Guy’s hospital. Because of possible complications, I had to ask my consultant directly, “Would you advise me to go ahead or not?” He advised me to do so, and I had complete trust in him. He was not thinking about whether he had to fulfil a quota, whether there was competitiveness in his hospital or his department, or whether a private patient would be preferred in the bed that I was to occupy. He was someone I could trust. In the health service that the Secretary of State proposes in his Bill, I could never have that confidence. I ask him please to abandon this Bill.

[Mr Lansley]

The right hon. Lady is simply wrong. There is nothing in the legislation that will do anything other than support clinicians to exercise their judgments in order to deliver the best care for their patients. It was under her Government, when people were told to pursue 18-week targets, that managers were literally walking in to speak to consultants who were about to do waiting lists and surgery lists and telling them that, because of the 18-week target, they had to treat a certain patient rather than another whose interests would mean that they would be seen first. So I will not take any lectures about that. We are going to put clinicians at the heart of delivering care and put patients at the heart of the service that is delivered.

The Labour motion does not reflect reality. It is based on a misleading set of interpretations and representations. Labour Members have a very short memory, but I am afraid that they have left us a shocking legacy. The motion contains no appreciation of the challenges the NHS faces, no appreciation of the care the NHS has provided to patients day in, day out over the past year, and no vision of how the NHS can be better in the future. Modernisation of the NHS will deliver an NHS that we can rely on for future generations, that is based on need, not ability to pay, and that is able to deliver the best outcomes for patients. I urge the House to reject the motion.

NHS Future Forum

Debate between Lord Lansley and Joan Ruddock

Tuesday 14th June 2011 Commons Chamber

[Mr Lansley]

My hon. Friend is absolutely right. We will legislate to stop precisely that distortion and that favouritism to the private sector. The private sector must know that it will have to provide additional services to the NHS on the basis of quality, not on the basis of any preferential system, as under the previous Government.

[Joan Ruddock (Lewisham, Deptford) (Lab)]

I remember that under the previous Conservative Government people died while on waiting lists. [Hon. Members: “Oh!”] It is a fact. I was a Member of Parliament at the time and it happened. Labour’s targets transformed that. The Secretary of State has been forced today to retake responsibility for the delivery of the NHS. He has talked about what has been happening. Will he make a specific promise today about the future waiting lists under his jurisdiction?

[Mr Lansley]

I will make clear to the right hon. Lady, as the Prime Minister has made clear, that we will not let waiting times rise. We will continue to maintain downward pressure, but it is very important that we do not treat waiting times in the NHS as the only measure of performance. It is more than that: it is the quality of care that is provided, not just the access to care.

NHS Reform

Debate between Lord Lansley and Joan Ruddock

Monday 4th April 2011 Commons Chamber

[Mr Lansley]

Yes, my hon. Friend is absolutely right. Locally, he can see how that is happening as GP leaders—including Dr Howard Stoate, whom Members will fondly remember, as the chair of the clinical cabinet in Bexley—are coming together to look at issues that the previous Government never dealt with, including those relating to the South London Healthcare NHS Trust and to Queen Mary’s hospital in Sidcup. They are coming forward with proposals to improve services for local people, and I applaud that kind of clinical leadership.

[Joan Ruddock (Lewisham, Deptford) (Lab)]

Before the general election, the right hon. Member for Witney (Mr Cameron) promised an extra 3,000 midwives. Has the Secretary of State noted the alarming rise in preventable maternal mortality? Would the Secretary of State not do better to deliver on his Prime Minister’s promises and abandon his reckless reorganisation?

[Mr Lansley]

The right hon. Lady must know that we continue to have a record number of midwives in training, and that the number of midwives in the health service has continued to increase since the election. In the financial year that is just starting, the number of commissions for training will continue to be at a record level.

NHS Reorganisation

Debate between Lord Lansley and Joan Ruddock

Wednesday 16th March 2011 Commons Chamber

[Joan Ruddock (Lewisham, Deptford) (Lab)]

Will the right hon. Gentleman give way?

[Mr Lansley]

In a moment.

Only yesterday, the Public Accounts Committee said that over the past 10 years the productivity of NHS hospitals had been in almost continuous decline, and that taxpayers were getting less for every pound invested in the NHS: Labour, leaving us to sort out the mess. The truth of the matter is that the NHS needs to change to meet the rising demand for and cost of health care.

The changes that the NHS needs are simple: more investment, less waste, power to front-line doctors, nurses and health professionals, and to put patients first.

[Mr Lansley]

No. I will give way to the right hon. Member for Lewisham, Deptford (Joan Ruddock) first.

[Joan Ruddock]

The right hon. Gentleman speaks of the respect that patients have for their GPs, and that is certainly the case in my area, where GPs do an incredibly difficult and demanding job. How does he think, therefore, patients and the doctors themselves regard the pressure being put on them to become managers, to adopt skills that they do not have, and being forced to do it, when they say to me that the plans are untested, potentially divisive and will take them away from their patients? Those things are actually happening. Does he think that it is ethical to pay GPs £300,000 to cut services to patients?

[Mr Lansley]

The Royal College of General Practitioners has said that it believes that there should be more clinician-led commissioning, and yesterday the British Medical Association reasserted its view that general practice-led commissioning is the right way forward. The Labour Government set up practice-based commissioning but, as the shadow Health Minister, the hon. Member for Leicester West (Liz Kendall), said, GPs were not given the power, responsibility and opportunity to do it. I am afraid that the right hon. Member for Lewisham, Deptford is speaking against the evidence and the experience of GPs all over the country.