Health

Alun Cairns Excerpts

Monday 9th June 2014 Commons Chamber

[Andy Burnham]

I think that that is exactly the reason. They introduced a reorganisation that nobody wanted, that nobody voted for, that put the wrong values at the heart of the NHS and that has dragged the NHS down, and all the while they are softening it up for accelerating privatisation. That is the record on which they will have to stand before the country in less than 12 months’ time. If the Secretary of State can justify that record and breaking the coalition agreement to his constituents, I would be very surprised indeed.

[Alun Cairns (Vale of Glamorgan) (Con)]

Will the right hon. Gentleman give way?

[Andy Burnham]

No, I am going to make some progress.

On the day of the Gracious Speech, 60 senior NHS leaders wrote to a newspaper to warn

“that the NHS is at the most challenged time of its existence.”

Just when it needs real leadership, it is being offered a period of drift from an increasingly dysfunctional Government and, sadly, the same is true on public health. The Government should have used this moment to regain the initiative and publish regulations on standardised packaging for tobacco and smoking in cars. Ministers announced on 3 April that they would publish the draft regulations on standardised packaging later that month—that was what the Minister responsible for public health, the hon. Member for Battersea (Jane Ellison), said. They have not, and since then almost 40,000 children have taken up smoking.

The public health Minister wrote to my hon. Friend the Member for Liverpool, Wavertree (Luciana Berger), the shadow public health Minister, saying

“we will now push ahead”

with banning smoking in cars following the vote in this House, but we are still waiting. We did not hear anything on public health from the Secretary of State today. When will they show some leadership and set out a timetable for these important measures?

It is not hard to guess the reason for this pre-election period of NHS silence. On every measure that matters to the public, contrary to what the Secretary of State said, the evidence is clear that the NHS has gone downhill under this Government and that it is getting steadily worse.

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[Andy Burnham]

But regulations are needed. If the Minister does not know that—[Interruption.] It was the Opposition who brought forward the vote on smoking in cars and she committed to introduce regulations to implement it. She cannot duck the question. When will she do that? If she does not realise that she is going to introduce regulations, she needs to go back and do a bit more homework.

It is not hard to guess why the Government want a period of silence. On every measure, the evidence is clear that the NHS is getting worse. When the Prime Minister was challenged—

[Alun Cairns]

rose—

[Andy Burnham]

No, I will not give way. When the Prime Minister was challenged on the wisdom of his reorganisation, he said that it should be judged by its effect on waiting times—[Interruption.]

[Alun Cairns]

rose—

[David T. C. Davies]

rose—

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[Andy Burnham]

I think that it would behove Government Members to have a bit more self-reflection and humility. The hon. Lady was not a Member of the House at the time, but she may recall that before 1997 people used to spend years on NHS waiting lists, and some never came off them. Over Labour’s 13 years in government we saw waiting lists come down, and down, and down, to the point that, when we left office, they were at their lowest ever level. I am not claiming that the NHS was perfect and did everything right, but it had the highest ever level of public satisfaction. We must have done something right. A bit of balance and accuracy in this debate is just what the NHS needs.

[Alun Cairns]

rose—

[Mr Sheerman]

rose—

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[Andy Burnham]

What I find surprising is that all over the country plans are being developed to close A and E departments. How can that make sense when we are in the middle of an A and E crisis? In west London my hon. Friend the Member for Hammersmith (Mr Slaughter) has done much work to raise concerns about the changes to hospitals there.

[Alun Cairns]

Will the shadow Secretary of State give way?

[Andy Burnham]

The question I would put to the Secretary of State is this: have the Government looked at the latest evidence? Are they looking at the fact that this year hospital A and E departments have missed his target for 46 weeks? If that is the case, is it safe to proceed with changes on this scale?

[Alun Cairns]

On a point of order, Mr Speaker. I seek your advice. I am trying to raise a relevant point with the shadow Secretary of State. I want to point out that A and E waiting times in Wales have not been hit since 2009—

[Mr Speaker]

Order. The hon. Gentleman must not use an attempted point of order to try to make a point that he would make in the debate if he got the chance to contribute. He said that he wanted my advice. My advice to him is that persistence pays and he should keep at it, as I am sure he will.

--- Later in debate ---

[Andy Burnham]

My shadow responsibilities do not extend to the NHS in Wales, but the Government have spent a year or more running it down. Just a few weeks ago, a Nuffield Trust report said that the picture was more mixed and that there were some areas in which the NHS in Wales was better than the NHS in England and vice versa. The Government need to look at themselves and to be fair to NHS staff, and not constantly repeat the mantra of running down the NHS in Wales and in England.

It was to prevent the NHS from being in this limbo—this silence—that we have brought this debate to the House. Until the Government face up to some of the problems caused by their reorganisation, the NHS will not be able to move forward. In the remainder of my time, I want to focus on two areas—leadership and competition—where uncertainty urgently needs to be removed.

First, on leadership, one of the major flaws of the Health and Social Care Act is that it has created confusion on that most fundamental question of all: who is in charge? Ever since the Act was passed, I have been told of continued tension between Ministers and NHS England. Ministers have repeatedly tried to instruct and overrule, ignoring the independence of NHS England for which they legislated. The problem is that thousands of NHS staff are left receiving mixed messages as to who is in charge.

I want to illustrate that point with reference to the growing crisis in mental health services, which the Secretary of State did not mention once. There are reports of growing problems in accessing mental health care and, in particular, a dangerous shortage of crisis beds. Despite that, NHS England has made a decision on the tariff which will lead to even deeper cuts to mental health care than to the rest of the NHS. This takes the NHS into new territory, because for the first time, as far as I can see, there is a direct contradiction between Department of Health policy and NHS England policy. The Government claim to support parity between mental and physical health, but their NHS policy is actively widening the disparity.

Therefore, in mental health—a policy of growing importance—we have complete confusion. People still look to Ministers to sort it out, but they have legislated themselves into the position of bystanders, shouting on the sidelines with the rest. The care Minister took to Twitter, no less, to vent his disgust at the “outrageous decision” by NHS England. People up and down the land will see that and say, “You’re the Minister! Don’t just tweet—do something about it!” The fact is that Ministers should have the power to enforce their own policy of parity, but in the interim NHS England should reconsider the decision to inflict cuts on a mental health system that is already in severe distress.

In the end, the answer to this uncertainty is simple: the Government should be legislating in this Gracious Speech to correct the flaws of the Health and Social Care Act and restore the Secretary of State’s duty to provide a comprehensive universal service. At a stroke, everyone would know where they stand and who is in charge, restoring grip and leadership in the NHS when it faces one of the most uncertain periods in its history.

The second area about which there is still considerable confusion is that of competition policy. When the Health and Social Care Act was going through, the Government’s mantra was that GPs would decide how best to organise care, but that is not what has happened in practice. Section 75 regulations are forcing commissioners to put services out to competitive tender when they do not think it necessary. That is leading to protracted legal disputes and millions spent on competition lawyers.

The nonsense that the Health and Social Care Act has inflicted on the NHS was plain for all to see last year when the then Competition Commission intervened in the NHS for the first time in its history to prevent collaboration between two NHS hospitals on the grounds that it was “anti-competitive”. What nonsense this is. It was succinctly summed up by the chief executive of the NHS, who said that

“you’ve got competition lawyers all over the place…We are getting bogged down in a morass of competition law causing significant cost in the system and great frustration for people in the service about making change happen. In which case, to make integration happen, we will need to change the law.”

That is precisely what this Gracious Speech should have done: change the law to help the NHS get on and make the changes it needs to make and remove the competition policy, which is fragmenting the NHS, not integrating it. That is the challenge the Government have ducked completely. The problem is that if they stay on this path, the NHS will head in the wrong direction. This Government and their Health and Social Care Act have placed the NHS on a fast track to fragmentation and privatisation when the future demands the integration of care.

The Opposition are clear that the market is not the answer to 21st-century care. The NHS now needs solutions of scale to rise to the increasing challenges that it faces. The NHS needed such leadership in this Queen’s Speech, but it was offered nothing. Instead, this Queen’s Speech leaves it lumbered with a Health and Social Care Act that puts competition before collaboration and the NHS on the wrong path for the future. The NHS urgently needs a Government who want to talk about the issues it faces and to get on with the job of securing its future. Let there therefore be no doubt that the next Labour Queen’s Speech will repeal the 2012 Act and pave the way for the full integration of health and social care.

I am coming to the end of my speech—I need only a couple more moments—but I will give way to the hon. Member for Vale of Glamorgan (Alun Cairns), as I promised.

[Alun Cairns]

I appreciate that some light-hearted comments have been made on both sides of the House, but my constituents have to wait longer for treatment, particularly for cancer care, as they do not have access to a cancer drugs fund. Will the right hon. Gentleman use all his influence with the Welsh Health Minister to get him to look at introducing such a fund so that my constituents have the same access as people in England?

[Andy Burnham]

That is obviously a matter for the Welsh Government, but let me provide some clarity on the issue of cancer care. In Wales, 92% of people start their cancer care treatment within 62 days, compared with just 86% in England. I ask the Conservative party to think about that, given that it has constantly run down the NHS in the hon. Gentleman’s own country and constituency, and has misrepresented the outstanding job it does to treat patients with cancer.

We will legislate for an NHS that has the right values back at its heart: collaboration before competition, people before profits. We will ask the NHS to lift standards in social care, working to bring an end to the culture of 15-minute visits. We will make sure that people can access care closer to their homes, giving patients clear rights, such as the right to see a GP within 48 hours. This is a plan to put the NHS back on track, and it shows why a Labour Government cannot come a moment too soon for the NHS.