Health and Social Care Bill

Debate between Lord Peston and Lord Ribeiro

Tuesday 25th October 2011 Lords Chamber

[Lord Ribeiro]

My Lords, I am grateful to my noble friend Lord Mawhinney for referring to the words, “motherhood and apple pie”, because when I first saw this amendment, that is the way it looked. When one reads proposed subsections (1), (2)—or parts of it— (4), (5) and (6), they seem pretty innocuous. However, in proposed subsection (2), we are talking about high principles, which none of us would disagree with—principles which crop up time and again throughout the Bill. Quality—something that the noble Lord, Lord Darzi, referred to in a speech a few weeks ago —equity, integration, accountability are all points that we will address in the coming weeks, and are fundamental aspects of this Bill. However, the phrase “not the market” is not a principle—it is a mechanism for delivering what one wants.

The noble Lord, Lord Peston, said that any form of market would turn the NHS into a privatised industry. May I remind him that during the time of the previous Administration, we had independent sector treatment centres? What were they if not an example of a market-driven industry? They were introduced—

[Lord Peston]

I was not a Minister in that Government, so I do not have to defend them.

[Lord Ribeiro]

At least the noble Lord recognises that it was something that happened, and that it was a market. It was deliberately introduced by the previous Government. Were it not for the fact that NHS consultants were excluded from working in that area, it achieved the objective it was designed to do, which was to reduce waiting list numbers. However, it was a market, so if we were to accept proposed subsection (2), we would effectively say that we must call an end to all forms of privatised healthcare provision that currently exist in the NHS. I think that noble Lords would agree that this would not be acceptable.

Proposed subsection (3) talks about restructuring and reorganisation. The noble Baroness, Lady Williams, addressed this very effectively when she said that we do not want to encapsulate the NHS in aspic, creating rigidity rather than flexibility. The previous time the House debated the health service, I made reference to the decision that had been made on Chase Farm. It had taken 17 years for it to be made. If we were to accept proposed new subsection (3), effectively every constituent of Chase Farm would have a very good legal reason to challenge why that reorganisation had taken place. While I am fully supportive of the idea in Amendment 52 of having the NHS constitution clearly laid out—we all agree with, understand and support it—I am not in agreement that the five principles as set out in Amendment 1 should be accepted in their present form. If it came to a vote, I would certainly oppose the amendment.