Mental Health

Yasmin Qureshi Excerpts

Thursday 16th May 2013 Commons Chamber

[Paul Burstow (Sutton and Cheam) (LD)]

I beg to move,

That this House has considered the matter of mental health.

There can be no health without mental health, and, above all else, I hope that today’s debate communicates that clearly and powerfully in the country and in this House. I start by thanking the Backbench Business Committee for recommending this most important of subjects for a debate, and the Government for finding the time to make it possible. Undoubtedly, there is a lot to debate on mental health, and I am grateful to my two colleagues—one on either side of the House—who have joined me in seeking this debate. I refer to the hon. Members for Bridgend (Mrs Moon) and for Broxbourne (Mr Walker), who hope to catch your eye, Mr Speaker, and contribute as we proceed.

Last year the House had a remarkable, moving debate on mental health, which was very personal for some hon. Members. It demonstrated that mental health is not an issue of “them and us”, but affects all of us. One in four of us may experience a mental health problem at some point.

[Yasmin Qureshi (Bolton South East) (Lab)]

I congratulate the right hon. Gentleman on securing the debate. Recent World Health Organisation figures predict that by 2030, depression will be the leading cause of diseases around the world, physical and mental. People can lose years of their life, as mental illness undermines their physical health too. Would the right hon. Gentleman agree, therefore, that mental health must be at the top of the Government’s agenda?

[Paul Burstow]

I certainly would. The fact that a large number of hon. Members are present, hoping to contribute to the debate, that the Backbench Business Committee advocated the debate, and that the Government have given the time suggests there is cross-party consensus that mental health has for far too long been hidden in the shadows and not awarded sufficient priority. The cost to our society of mental ill health across England, Scotland and Wales amounts to over £116 billion a year, but that does not adequately capture the human cost—the misery—that arises from it. Given that the burden of mental ill health is about 23% of the burden of all disease in our country, it is surprising that for so many years it has not been tackled with the necessary vigour. So I agree absolutely with the hon. Lady.

--- Later in debate ---

[Mr Jones]

That is our great challenge, and not just for the present Government. We did a lot in the last Government to recognise the problem. I pay particular tribute to my right hon. Friend the Member for Leigh (Andy Burnham), who championed IAPT—improving access to psychological therapies—services, for example, but part of the problem is cultural. We do not talk about these issues in this country. I think that is changing—I will come to the stigma in a minute—but for anyone who has suffered from a mental illness or who has a family member who has, there is a sense of shame. There should not be, but there is a sense in which talking about it means that those people are failures, when I would argue the opposite. In many cases it is a sign of strength. With the right support, people can function normally, work perfectly normally and have a perfectly happy and productive family life.

[Yasmin Qureshi]

I congratulate my hon. Friend on being brave and speaking about his situation—as I congratulate the hon. Member for Broxbourne (Mr Walker) on speaking about his—and on highlighting the issue. There is a stigma attached to it, and we should discuss it more. My hon. Friend said that the lady who approached him said that she was able to recover after she was given support. Does he agree that some mental health treatments are often quite costly? There is a funding issue, so should we not also encourage the Government to ensure proper funding for services across the country for everyone who may have problems?

[Mr Jones]

We need to explode the myth that the problem is funding. I do not think it is; I think it is where the funding is spent—a point raised earlier. Indeed, funding that is properly spent on early interventions for people with mental health issues will save the NHS money in the long term, not cost it.

--- Later in debate ---

[Yasmin Qureshi (Bolton South East) (Lab)]

I congratulate the right hon. Member for Sutton and Cheam (Paul Burstow) on securing the debate and thank the Backbench Business Committee for granting it. I also pay tribute to all hon. Members who have spoken today and in the previous debate. They have covered many aspects of mental health, many types of mental health illnesses and many groups of people affected by them.

When many normal members of the public think about people who suffer from mental health problems, they often think about those who go around killing or assaulting people or self-harming, but they are a small minority. The majority of people with mental health problems, as my hon. Friend the Member for North Durham (Mr Jones) said earlier, look very normal; it could be any one of us, or people who look similar to us. Mental health issues do not often result in people self-harming, but there can be problems with depression or with how to relate to families and friends or to the community at large.

Of course, sometimes those health issues are difficult to identify and assess, and as a result it is sometimes hard to prescribe the right treatment. However, I believe that if enough time and effort is taken to try to identify the problem and support the person fully, it is probably easier to find out what is going on and what the right treatment is.

Members have already touched on how people can be reluctant to talk about their mental health issues because there is still an element of stigma and shame. Although it is great that people are talking about it, we know that it is still not being talked about enough and that there is still stigma. Mental health issues can also affect employment and housing and can lead to rejection by family and friends.

Different communities and groups of people have been mentioned. My hon. Friend the Member for Bridgend (Mrs Moon) quite properly touched on mental health issues in the armed forces, and other hon. Members touched on mental health issues in black and minority ethnic communities. I will mention that as well because, in addition to a number of barriers, such as jobs, stigma and rejection by family and friends, they also face the barrier of accessing appropriate care and treatment that is also culturally sensitive.

Although it is accepted that there is nothing genetically that makes people from black and minority ethnic groups more vulnerable to mental health issues, often those issues are not diagnosed properly. Psychiatry in the United Kingdom, understandably, is based on the western understanding of mental illness and often medical models are used to treat it, but in fact mental health means different things to different people from different cultures and different communities, and they can be affected by many different issues, such as spiritual, religious and background issues. Those might relate, for example, to the countries they have come from. Therefore, a purely medical approach is not necessarily the right one for many people. A more holistic approach that looks at a person’s overall health should be considered.

Contrary to what was said earlier, there are of course problems with resources. We know that mental health issues can be very expensive to deal with, because often it is hard to identify what is happening and the treatment might take months or years and require one-to-one assessment. It is much easier when somebody has a damaged arm or a faulty kidney; such conditions can be expensive to treat, but at least they can be identified and treated. Once the treatment is done, the person recovers. But mental health is unique in that respect, because that does not happen.

We know that drug and alcohol addiction is often linked with mental health issues. In fact, units that deal with addiction are very expensive, so there are funding problems. I know that from my own practical knowledge and experience, having been a criminal law practitioner for 20 years before becoming a Member of Parliament. When clients were charged with various criminal offences, they often had psychiatric problems or problems with drug or alcohol addiction. When they were being sentenced, the pre-sentence report would often require us to look into drug or alcohol rehabilitation units. The first question we used to ask was whether the local authority or social services responsible for the person had the necessary funding. Weeks used to go by while everybody searched around to find the funding so that the person could go into the unit. That is why I raised funding for mental health issues earlier and questioned whether it is sufficient and appropriately applied to the whole country. In parts of the country, there are very good practices and systems, but in many others that is not the case. It is a question of ensuring that the same treatment, facilities and services are available across the whole country.

More treatment centres should be available in the criminal justice system. There should also be more psychologists and psychiatrists. The problem we had in criminal cases was that the person in question often needed to be assessed by a medical expert or psychologist, and it used to take weeks and weeks before that could be done, which then used to take time away from treatment. Six months can elapse between somebody being charged and getting treatment. That is if they even get the treatment, because sometimes the funding authority will not fund it, so they end up in the prison system, which does not help them. That is partly why a large number of people, in comparison with the rest of the population, commit suicide in prison.

Everybody here, including Ministers, I am sure, wants to deal with mental health on a humanitarian level, but there is also an economic and financial case for ensuring that the system is working properly. If we are able to help a person to recover from their mental health problems, it will be better for our country and for society generally. For example, if an adult who cares for children suffers mental health problems and is not treated properly, those children will often be taken away and put into care homes or with foster families. That is an incredibly expensive process. If we are able to support and help the parent, the thousands of pounds that it would cost to deal with the problem will be saved. Everyone talks about the humanitarian case, and we all agree with that, but it makes economic sense as well.

I pay tribute to hon. Members who have mentioned their mental health experiences; it is great that that has happened. I hope there is a debate about this issue in the rest of the country and it is appreciated that many people can experience mental health problems of differing natures. If we recognise that, then medical and social services professionals, and others, can intervene to help. I congratulate the hon. Member for Broxbourne (Mr Walker) and my hon. Friend the Member for North Durham on talking about their experiences. It takes a lot of courage for a public person to mention these issues, and I thank them for what they have said.

Mid Staffordshire NHS Foundation Trust

Yasmin Qureshi Excerpts

Tuesday 26th March 2013 Commons Chamber

[Mr Hunt]

I am sure that my hon. Friend’s sentiments are shared on both sides of the House. Indeed, I could have done with such a guide when I started this job last September. I am happy to do as he requests, but from today’s announcement the most important thing that the country should know is that when it comes to failures in care, the buck stops in one place. It will be the chief inspector’s job to identify such failures and shout publicly about them, and that will be an important clarification that the system needs.

[Yasmin Qureshi (Bolton South East) (Lab)]

This is not a debate about private or public, but will the Secretary of State ensure that the duty of candour is applied equally to private providers of NHS services?

[Mr Hunt]

Yes, it will be, as it will to providers in the social care sector.

Regional Pay (NHS)

Yasmin Qureshi Excerpts

Wednesday 7th November 2012 Commons Chamber

[Mr Hunt]

No. Let me just remind the right hon. Gentleman that the budget increase in the NHS that this Government committed to and that this Government announced was something that he said would be “irresponsible”. We have ignored that, and I have been completely clear that the NHS budget went up.

We support recruitment and retention pay—an amount that can be as much as 30% of a person’s salary, and which the Opposition, if they were consistent in their opposition to regional pay, would presumably wish to abolish. We support the London weighting, which is, again, a form of regional pay that we would be planning to abolish if we listened to the Opposition’s arguments today.

[Yasmin Qureshi (Bolton South East) (Lab)]

rose—

[Mr Hunt]

The hon. Lady might want to think about her own constituents before she jumps on that bandwagon. We also support high-cost area supplements. Why should trusts not be able to offer higher packages to lower-paid staff living in expensive areas beyond the capital so that they can live nearer to where they work? If we listened to the Opposition and their trade union sponsors, that, too, would be banned. This Government support the right of local trusts to determine how best to reward their own staff, so they can recruit, retain and motivate the people whom patients rely on every single day. That includes the right of each employer to choose their own terms and conditions or to use national terms and conditions, should they wish.

[Yasmin Qureshi]

I was not in this House when the earlier legislation and policies were being put through, but the question for today is: will someone working in London be paid the same as someone doing the same work in Bolton? Will the Secretary of State reassure us that the fundamental change to that arrangement will not take place?

[Mr Hunt]

May I gently remind the hon. Lady that she stood for election on a manifesto that did not include abolishing the 2003 Act or the Health Act 2006, which gave foundation trusts the freedom to set their own pay and conditions? [Interruption.] I ask Labour Members to let me answer the question. May I also remind her that the previous Government, whom she supported, introduced “Agenda for Change”, which does not pay the same amount throughout the country for the same work? It actually includes a lot of flexibility for regional pay.

--- Later in debate ---

[Kerry McCarthy]

I shall try to move on. When I wrote to the Health Secretary, the response I got back was very ambiguous. It referred mysteriously to when the document was first leaked to the public, rather than saying what the Government were aware of in relation to the consortium.

In the debate earlier today, the Minister definitely said the words, “Yes, we were.” The civil servant behind her was shaking his head and saying, “No, we weren’t. No, we weren’t,” so I hope that we get some clarity on the matter and a firm answer when the Government respond to this debate. To what extent did they know about and encourage the south-west consortium to start?

The consortium, as I indicated, was initially developed in secret but since NHS staff found out about it by accident, I have received hundreds of letters and e-mails from staff who are angry and anxious not just for their own futures, but for their patients. It is shocking that they found out about that only by accident and were not consulted by the consortium.

[Yasmin Qureshi]

Does my hon. Friend agree that we were a bit surprised to hear the Secretary of State say that Labour is asking for national pay and opposing regional pay because the unions are bankrolling us? My hon. Friend said that she had received many e-mails. I am sure that, like me, other Opposition Members have received hundreds of e-mails from people who work in the health service—ordinary people, working people—who say that they do not want regional pay. That has nothing to do with any union.

[Mr Speaker]

Order. Interventions on both sides should be brief, and rather briefer than that.

--- Later in debate ---

[Yasmin Qureshi]

The hon. Gentleman said that as somebody from the north of the country he accepts that there is already a north-south divide in pay. Does he agree that regional pay would make that even worse?

[John Pugh]

Absolutely.

I was enlarging on the fact that the Minister has to keep peace between sectors of the coalition, and I do not envy him that role. To be fair, many Members from the majority party are also finding this issue uncomfortably irrelevant.

So what can the Minister do, and what can we do? I have a suggestion. The south-west trust was set up by Labour as an independent providers foundation trust with, frankly, pathetic levels of public accountability. Trusts were set up to operate within a market competing with other NHS providers and private providers, and they do not in law have to consider themselves as part of the wider NHS—as part of national bargaining or “Agenda for Change”. Apparently the trusts in the consortium do not to want to so consider themselves and want to ignore national agreements. If they see themselves as independent free agents in competition with other free independent agents, then surely they cannot all form a cartel with a huge share of the health market and conspire collectively to keep wages, and so their costs, down. That is not a free market—it is market abuse. It is not even fair trading. It is the sort of thing that in the United States would lead to a class action as wage fixing.

That is why my colleagues and I are referring this issue to Monitor and the Office of Fair Trading for investigation. This misguided lot in the south-west cannot be allowed to be freebooters when it suits them and freeloaders on the NHS when asked to play by market rules. If the Government are a bit schizophrenic on this issue, the south-west consortium appears to be even more so.

Health and Social Care Bill

Yasmin Qureshi Excerpts

Tuesday 13th March 2012 Commons Chamber

[John Healey]

The hon. Gentleman is right. One of the great tragedies here is that the Government have squandered the good will and confidence of NHS staff that is necessary to make the changes to the NHS that it must make. This health Bill will make making those changes more difficult, not easier.

The Government could have built on the golden legacy and the great improvements that patients saw under 13 years of Labour investment and reform: hundreds of new hospitals and health centres; thousands more doctors, nurses and specialist staff; and millions of patients with the shortest ever waits for tests and treatments. Instead, we have a Tory-led Government, backed by its Lib Dem coalition partners, who have brought in the chaos of the biggest reorganisation in NHS history; wasted billions of pounds on new bureaucracy; and betrayed our NHS with a health Bill that will, in the long run, break up the NHS as a national health service and set it up as a full-blown market ruled, in time—for the first time—by the full force of competition law.

Everything about this NHS reorganisation has been rushed and reckless. This has been a master class in misjudged and mishandled reform—implementing before legislating, and legislating before being forced to call a pause to listen and consult on the plans already in hand. This health Bill was introduced last January. What was a very bad Bill is still a bad Bill. Make no mistake: this legislation will leave the NHS facing more complex bureaucracy and more confusion about who decides what and who accounts for what, and mired in more cuts and wasted costs for years to come.

Risk has been at the heart of the concern about these changes from the outset. There has been a lack of confidence and a lack of evidence, yet the Government are ready to manage the risks of introducing the biggest ever reorganisation in NHS history at the same time as the biggest financial squeeze since the 1950s. These risks were the reason for the growing alarm among the public, professionals and Parliament in the autumn of 2010, when I made my freedom of information request for the release of the transition risk register.

Last Friday the courts dismissed the Government’s efforts to keep secret the risks of their NHS reforms. Apocalyptic arguments were made in court, in defence of the Government, about how releasing the register would lead to the collapse of the Government’s system for managing risk. That did not happen when the Labour Government were forced to release the risk register for the third runway at Heathrow. Nor will it lead to the routine disclosure of Government risk registers, because the tribunal’s decision, like the Information Commissioner’s decision before it—both saw the transition risk register—was based on my argument that the scale and speed of these changes was unprecedented, and therefore that the public interest in their being disclosed was exceptional.

The Government have dragged out their refusal to release this information for 15 months. That is wrong. They have now lost in law twice. This is not a political argument but a legal and constitutional argument. It is about the public’s right to know the risk that the Government are running with our NHS, and about Parliament’s right to know, as we are asked to legislate for these changes.

[Yasmin Qureshi (Bolton South East) (Lab)]

Will my right hon. Friend give way?

[John Healey]

I will not, as I have less than a minute left.

Release of the transition risk register is now urgent, in the last week before the Bill passes through Parliament. It will also be important in the two or three years ahead, as this reorganisation is forced through the NHS. I say to Ministers this evening: do the right thing. Respect the law, accept the court’s judgment and release the register immediately and in full, so that people and Parliament can judge for themselves.

NHS Risk Register

Yasmin Qureshi Excerpts

Wednesday 22nd February 2012 Commons Chamber

[Chris Skidmore]

Yes, the situation has moved on. We have had the listening exercise under Steve Field and various Select Committee on Health reports. The name of the commissioning bodies, which were called consortia, has changed. Nurses have been added and we have opened things up so it is not just about GP commissioning.

[Yasmin Qureshi (Bolton South East) (Lab)]

If the register is as irrelevant as the hon. Gentleman says, why not publish it?

[Chris Skidmore]

The Opposition are asking—[Interruption.] The shadow Secretary of State has already said that risk registers should not be published because they are confidential documents that must be used by policy makers. The Opposition are asking for a risk register that is out of date when what we should have been discussing today was reform of the NHS and how we can deal with an ageing population at the same time as dealing with a rise in chronic diseases.

I thought that it was striking that the shadow Secretary of State said at the end of his remarks that he would put the NHS first, without any mention of the patients. That is what these reforms are here for. They are allowing patients to be put in the driving seat and to sit down with their doctor, to understand what treatments they need and to have a choice of treatment through the opening up of providers. We could have had that debate—we could have spent six hours discussing that instead of this irrelevant document that you want to have a look at, which is out of date and from November 2010 when it is now February 2012. You are two years out of date, you are out of time and you are out of touch. I urge everyone to vote down the motion, simply because it falls outside the point.

--- Later in debate ---

[Charlotte Leslie (Bristol North West) (Con)]

Will the hon. Gentleman give way?

[Yasmin Qureshi]

Will my hon. Friend give way?

[Grahame M. Morris]

I am only going to give way twice, so I shall give way to the hon. Lady.

Breast Implants

Yasmin Qureshi Excerpts

Wednesday 11th January 2012 Commons Chamber

[Mr Lansley]

I will do so to an extent. It depends on the nature of the legal contract between a woman and her private provider. I hope that in many cases the legal obligations derived under that contract or under sale of goods and services legislation will clearly mean that the woman will get redress from her private providers or her insurers. If the NHS becomes involved, there may be compensation through the injury costs recovery scheme, so if the NHS incurs costs, we can go on to seek to recover them.

[Yasmin Qureshi (Bolton South East) (Lab)]

I thank the Secretary of State for his statement. As has been said, most of the cosmetic surgery industry is not regulated. What time frame are he and his staff working towards?

[Mr Lansley]

Given the nature of the work I am asking Sir Bruce Keogh and his group to undertake, it will take them some time to look at the range of cosmetic interventions and make any recommendations. They are coming together as rapidly as they can. Many of them have given up a great deal of time over the past two weeks to help us in this work. We must recognise that there are things we need to do rapidly to ensure that there is support and reassurance for any woman affected by PIP implants, and we are acting rapidly. There are lessons and wider implications to be learned. This particular area of cosmetic surgery was not without regulation. The question is to what extent things were properly regulated with surveillance and enforcement over a number of years.

NHS Reorganisation

Yasmin Qureshi Excerpts

Wednesday 17th November 2010 Commons Chamber

[Yasmin Qureshi (Bolton South East) (Lab)]

Thank you, Madam Deputy Speaker, for giving me the opportunity to speak in this debate. I want to take up a few of the points made by the Secretary of State. First, he talked as if the previous Labour Government had done nothing for the NHS and had shown no concern about how people were treated. It is worth reminding the House what Labour inherited in 1997 after a number of years of Conservative mismanagement. We used to have waiting lists of more than two years. Now, waiting lists are down to less than six months. A record number of nurses, doctors and porters have come into the hospital system. Many hospitals have been built and many others have been refurbished. Therefore, we will not listen to the Government telling us that we did nothing or that we did not take care of the NHS. We spent more than £80 billion on the NHS, which benefited many people. The Government state that they will protect the NHS and will not reduce the funding. That is just not correct. They talk about billions of pounds going into the NHS, but the money will actually go to the social care fund, which does not directly benefit people in hospitals. In real terms, there will be a 17.5% cut over four years. There is a decrease in the budget and services will be affected.

[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.

[Lisa Nandy]

In my constituency of Wigan, despite the extreme and visible progress that we have made in the past 13 years of Labour Government, there are still significant health inequalities. In fact 129 per 100,000 people in my constituency die of coronary heart disease, compared to 90 nationally. I know that my hon. Friend shares my concerns, but does she agree that, at a time when we should be addressing those health inequalities and continuing to invest in the NHS, it is an absolute scandal that we are spending the amount of money that she suggests?

[Yasmin Qureshi]

I entirely agree with my hon. Friend. She and I have almost adjoining constituencies, and many of the issues and problems of her constituents are very similar to those in my area. When we were in power, £345 million was set aside for disabled children, for respite and all-night breaks. All of those children will now suffer because the White Paper makes no mention of funding for disabled children after March 2011. Yet, we have £3 billion to pay for reorganisation. On 2 November 2009, the Prime Minister, then Leader of the Opposition, told the Royal College of Pathologists that under the Conservatives, there would be no more restructuring of the NHS.

On 20 May, the coalition Government said:

“We will stop the top-down reorganisations of the NHS that got in the way of patient care.”

What are they doing? They are carrying out exactly that reorganisation. If the Government want to make some real improvements to the NHS, the principle of “no decision about me without me” should be considered. The Health Secretary should reconsider the NHS reorganisation and try to think of a better way to use that money for patients.

[Jonathan Reynolds (Stalybridge and Hyde) (Lab/Co-op)]

My hon. Friend says that the reorganisation is ideologically driven. Is not it the case that when one intends to spend up to £3 billion, one needs an evidence base and proof that that spending—whatever it is on—will be money well spent? As my hon. Friend the Member for Kingston upon Hull North (Diana Johnson) said, there have been no trial programmes or pathfinders. The money could be spent without a shred of evidence that it will make one bit of difference.

[Yasmin Qureshi]

I agree. I was about to discuss the impact of the reforms, with GP consortiums replacing PCTs. We know that there will be huge differences in the arrangements for health care in different areas. With the formation of up to 500 GP consortiums, all free to set their own priorities, a highly visible two-tier service will develop. Patients will be forced to move GPs or be reallocated to another area to get the care that they need.

The financial success of each consortium will also affect the service that patients receive. It will influence the type of care provided and how long it lasts. Some patients who need hospital treatment will inevitably be told by their GP, “Sorry, you’ll have to wait until next year.” Evidence has shown that making providers compete for patients and providing more choice to patients has done little to improve quality. Most people who are offered a choice of hospitals opt for their local provider. Choice may be important, but for patients, it comes below the quality, speed and accessibility of care.

The proposals do not make it clear whether the patients of the commissioning GP do the choosing. However, the GPs’ new contract will have a powerful incentive to hit commissioning targets. How, therefore, do patients know whether they are being prescribed the best or just the cheapest treatment going?

Again, there is no evidence to show that the restructuring would reduce the bureaucratic load. Hospitals alone will have at least three times the number of commissioners with whom to communicate and contract. Five hundred GP consortiums, each with its own set-up and administrative costs, will replace the current 150 PCTs. Huge differences in the arrangements for health care will emerge between areas. A postcode lottery will develop.

[Yvonne Fovargue (Makerfield) (Lab)]

Does my hon. Friend agree that the description of a consortium of GPs—a loose affinity of people with whom they get on rather than a geographical boundary—and the loss of co-terminosity will affect patients? Indeed, it will not simply be a postcode lottery, but, across the board, a matter of whom a patient is registered with.

[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—

[Madam Deputy Speaker]

Order. I am sorry, but time is up.