NHS Future Forum
Andrew Bridgen Excerpts(13 years, 1 month ago)
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Mr Lansley
The right hon. Gentleman should be aware that the Future Forum has recommended that the powers to be held by the Office of Fair Trading or the Competition Commission should be exercised by Monitor. That is because it believes it to be in the interest of the NHS for them to be exercised by a health service-specific regulator that is sympathetic to and has an understanding of NHS interests.
Andrew Bridgen (North West Leicestershire) (Con)
Primary care trusts and strategic health authorities are part of a top-down management structure that has led to waste and bureaucracy and tolerates poorer patient outcomes. Will my right hon. Friend confirm that they will be abolished, and that the £5 billion that that will save over this Parliament will be ploughed back into front-line medical services?
Mr Lansley
Yes, I am grateful to my hon. Friend; I can do that. It is essential to move to a world where we reduce administration costs, relieve bureaucracy in the service and free those providing services by offering them the resources to deliver improving care without the burden of bureaucracy, cost and waste inflicted by a Labour Government in the past.
Future of the NHS
Andrew Bridgen Excerpts(13 years, 2 months ago)
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Debbie Abrahams (Oldham East and Saddleworth) (Lab)
It is a pleasure to follow the hon. Member for Southport (John Pugh). A lot of water has passed under the bridge since the middle of March, when we last debated the NHS. The Committee tasked with scrutinising the Health and Social Care Bill, on which I served—a baptism of fire—finished its deliberations at the end of March. I believe that it was the longest running Bill Committee since 2002, so it was a marathon stint in which we debated 280 clauses and 600 amendments. During those eight weeks, the Government did not accept a single amendment. Some hon. Members made exceptional speeches, dissecting the Bill in detail and arguing against it. I remember in particular a debate about regional specialist services and how they would be commissioned in future. I am afraid, however, that that was as far as it went when it came to changing the Bill. I was therefore nonplussed when, the day after the Committee finished its proceedings, the Prime Minister and the Deputy Prime Minister expressed their concerns about the Bill and announced a pause in its enactment.
At the same time as the Public Bill Committee was sitting, we saw growing public anxiety about what the Bill would mean to patients and their families. I was contacted by hundreds of my constituents and received a petition signed by nearly 300,000 people from across England. Perhaps that was the motivation for the Government’s change of heart, or was it just political rhetoric with the elections looming? There has certainly been no pause in NHS reorganisation in many areas, including my own, where, as I mentioned the other week, it has actually been brought forward.
The public are beginning to see an erosion of the considerable improvements made in the NHS under Labour, and this is what is fuelling public concern. In Greater Manchester, as Peter Thornborrow, one of my constituents found out to his cost, there are much stricter criteria for cataract surgery, as there are for hip and knee replacements.
Andrew Bridgen (North West Leicestershire) (Con)
Recent OECD research shows that, despite the last Government’s spending splurge on the NHS, Britain still has the eighth worst record of all its members for preventable deaths—we are down there with Poland, the Czech Republic and Mexico. It also shows Britain has the seventh highest potential for efficiency savings in health care—that is, for improving patient outcomes without spending any more money. Is that not a damning indictment of the last Government’s health policy and does it not mean that reform is essential for the future of the NHS and for improving patient outcomes?
Emily Thornberry
I am being heckled already. I do not intend to make a habit of this—the hon. Member for Banbury (Tony Baldry) can heckle as much as he likes—but I will answer on this occasion. There is another draw this afternoon. My right hon. Friend the Member for Doncaster North (Edward Miliband) is speaking, but I understand that my hon. Friends will be coming in a moment.
We have heard a number of interesting and important speeches from Members who have shown great expertise and have been serving the community and the public through their work on Select Committees, including the Health Committee. We heard from my hon. Friends the Members for Easington (Grahame M. Morris), for Walsall South (Valerie Vaz), for Oldham East and Saddleworth (Debbie Abrahams) and for Pontypridd (Owen Smith), and from the hon. Members for Central Suffolk and North Ipswich (Dr Poulter) and for Stafford (Jeremy Lefroy). Listening to their contributions, we have had a taste of the quality of debate that took place in the Health and Social Care Public Bill Committee. It is a shame that the Government did not give an inch as a result of those debates.
We have heard from the Liberal Democrat representatives, including the hon. Member for Southport (John Pugh), who talked about the Jekyll and Hyde drafting of the Bill, and the hon. Member for St Ives (Andrew George), who said that he is likely to vote against it on Third Reading. We heard a characteristically passionate, robust and articulate speech from my right hon. Friend the Member for Holborn and St Pancras (Frank Dobson). My hon. Friend the Member for Eltham (Clive Efford) asked a very simple question that I will repeat in the hope of getting an answer: what changes will be made as a result of the pause?
I hope that the Secretary of State was listening to my hon. Friend the Member for Stockton North (Alex Cunningham) because he brought a dose of reality to the debate by explaining the effect the reorganisation will have on his poor constituency and the redundancies it is suffering.
Andrew Bridgen
Will the hon. Lady not concede, perhaps even reluctantly, that the real reason her party is acting as a roadblock to essential NHS reform is that it pays far more attention to its union backers and paymasters than to NHS patients and taxpayers?
Emily Thornberry
The great strength of being in opposition, in many ways, is the opportunity it gives us to listen to interested groups of every type, including representatives of the work force, experts and the public, and to hear their concerns about the Bill. Those concerns translated into more than 300 amendments that we tabled in Committee and more than 100 votes. As I have said, the Government considered it wise not to give an inch. However, on the day after the Committee finished its considerations, the Government decided that there ought to be a pause so that they could think again. The very fact that they decided to think again tends to encourage us to think that we might have been right in the first place. What a shame it was that they did not listen to us earlier.
For the Health Secretary, it must seem a lifetime since the Prime Minister said about him:
“He is probably the Health Secretary in the last 20 years who has the greatest understanding and greatest passion for the NHS.”
His Deputy Prime Minister stated in the foreword to the NHS White Paper that the reforms were
“rooted in the coalition’s core beliefs”.
Patient groups, professional bodies and health experts gave the underlying principles of the White Paper a cautious welcome, but I ought to explain to the Secretary of State that there is a difference between giving a cautious welcome to the underlying principles of a White Paper or Bill and reading the Bill and realising that it will not deliver on those underlying core principles. That is why there has been an increasing chorus of opposition. Our difficulty is that, although there were more than 6,000 responses to the White Paper, those concerns were largely ignored. When the Bill was published, those concerns increased to alarm and the criticism became less diplomatic, less polite and more forthright, and yet the Secretary of State continues not to listen. More people began to join the Opposition’s side of the argument. Although at the beginning the Secretary of State might have felt encouraged that he had many people in his “liberate the NHS” team, as more people realised just what the Bill was about, more and more of them decided that they had been on the wrong side of the argument and that the Bill was wrong and so crossed the room.
I pray in aid the comments made by the hon. Member for Totnes (Dr Wollaston), who talked about throwing a hand grenade into the NHS, and those of the Royal College of Nursing, which passed a vote of no confidence in the Secretary of State, with 98% of the vote. Its general secretary said that the Bill
“could well turn out to be the biggest disaster in the history of our public services”.
The British Medical Association called for
“a halt to the proposed top-down reorganisation of the NHS”.
When I listened recently to the hon. Member for North Norfolk (Norman Lamb), I was reminded of Luke 15.7 —there shall be more joy in heaven over one sinner who repenteth than over 99 just persons who do not need to repent. The number of people who are moving over to our side of the argument are becoming a flock. They say they realise that the Bill is not what they had first thought it was, that it needs to be fundamentally changed, and that if it is not fundamentally changed it needs to be scrapped.
Lord Owen has said:
“The coalition unexpectedly and inexplicably forged ahead with legislation for NHS reforms of staggering ineptitude.”
Lord Tebbit, who I believe is the Secretary of State’s former boss, has said:
“What worries me about the reforms, however, is the difficulty of organising fair competition between the state-owned hospitals and those in the private sector.”
I could go on. Michael Portillo has said of the Tories:
“They didn’t believe they could win an election if they told you what they were going to do because people are so wedded to the National Health Service.”
The whole of the Liberal Democrats have also crossed the room. Evan Harris has talked about the Bill being “disastrous”. Although I heard the right hon. Member for Charnwood (Mr Dorrell) say encouragingly that the Bill would give
“a holistic basis—a structure for the health service, going forward”,
the Health Committee’s report has not been so enthusiastic, if indeed what he said today could be characterised as enthusiastic. Lady Williams has said that the Bill is “completely misconceived”, and the right hon. Member for Bermondsey and Old Southwark (Simon Hughes) has said that it needs “fundamental change”.
The Health Secretary must be feeling increasingly lonely. Perhaps the most deadly time was when the Chancellor of the Exchequer stated:
“I want changes too, and so does David Cameron”.
I appreciate that the Health Secretary has the Minister of State, the right hon. Member for Chelmsford (Mr Burns) and the Under-Secretary of State, the hon. Member for Guildford (Anne Milton) on his side, along with the hon. Member for Banbury (Tony Baldry). I respectfully suggest to the Health Secretary that he holds very tightly to the hand of the Minister of State, the hon. Member for Sutton and Cheam (Paul Burstow). It must seem a very long time ago that the Prime Minister said:
“I have been involved in designing these changes way back into opposition with Andrew Lansley. I take absolute responsibility with him for all the changes we are making.”
We will see just how long it is that the Prime Minister stands shoulder to shoulder with his Secretary of State.
There has been great excitement in SW1 bubble land on what effects the NHS reforms will have on the coalition and what the Lib Dems will do next, but the fundamental point is that it really does not matter what happens in SW1; what matters is what happens to our national health service. The Bill is a threat to our national health service. Leaving aside the political shenanigans and the saving of the Deputy Prime Minister or the Liberal Democrats’ soul, what is important is what happens to our national health service. We should be looking at the fundamental principles in relation to that. Everything else is just words, words, words. We are told that we must not rush GPs into consortia, but the majority of them have already been rushed into consortia and their PCTs are being abolished. If that is the extent of the fundamental reforms that the Liberal Democrats want, that would be very disappointing.
We in the Opposition have five tests: delete part 3 of the Bill; keep waiting time guarantees; ensure that consortia are not too small, involve wider expertise and require openness and accountability; ban GP bonuses, stop conflicts of interest and do not allow commissioning jobs to be done by the private sector; and keep a cap on the number of private beds. Let us do that, which would be a fundamental change to the Bill. Most importantly, let us delete part 3.
Instead of wasting time, energy and money on unnecessary top-down reorganisation, the Conservative party should have been building on Labour’s achievements. When we handed over the NHS to the Conservatives, we did so in trust. They should have built on our achievements. I am not saying that the NHS was perfect, but it was much better than it was when it was handed to us. These reckless, costly and ideologically driven reforms are not doing well for the health service. As the hon. Member for Totnes has said, while competition has a role, it is not an end in itself. If we allow competition to run rife within the NHS, it will fundamentally undermine its essence, which is that it is built on a culture of collaboration and co-operation. It is an expression of our fundamental commitment to equality.
Oral Answers to Questions
Andrew Bridgen Excerpts(13 years, 2 months ago)
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Mr Burns
I am sorry, but the hon. Lady is a little bit confused. She says, rather dismissively, that the calls are being answered by telephonists. These are non-medically trained people who have nurses and GPs available to give them help and advice as and when the callers demand it, because of the complaint or problem that they are raising. The beauty of the 111 service is that people do not have to wait to be called back, as they do with NHS Direct. Instead, the people trained to help callers will point them towards the appropriate care—which in some cases will be the emergency services—and they are right to do so when this has been clinically determined.
Andrew Bridgen (North West Leicestershire) (Con)
Can my right hon. Friend assure the House that 111 telephone operators will be trained to the same level as 999 telephone operators?
NHS Reorganisation
Andrew Bridgen Excerpts(13 years, 4 months ago)
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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.
Andrew Bridgen (North West Leicestershire) (Con)
Does my right hon. Friend agree that the words of the shadow Secretary of State in this debate seem to contrast somewhat with his words back in January, when he said that
“the general aims of reform are sound—greater role for clinicians in commissioning care, more involvement of patients, less bureaucracy and greater priority on improving health outcomes”?
Why does my right hon. Friend think he has changed his mind?
Health and Social Care Bill
Andrew Bridgen Excerpts(13 years, 5 months ago)
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John Healey
My hon. Friend won his seat at the last election because he helped to expose the truth about the Conservative plans for housing—a truth that it denied but which has now come true. He is absolutely right. The truth about what is happening in the health service now is that patients are starting to see the signs of strain and services being cut, and that is not what they expected when they heard the Prime Minister, before the election and afterwards, promising to protect the NHS.
Andrew Bridgen (North West Leicestershire) (Con)
I thank the right hon. Gentleman for giving way. In my first two weeks as an MP, I paid a visit to the local PCT in Leicester, and in a meeting with the chief executive I asked how the PCT would cope with the immediate 35% cuts in management imposed by the coalition Government. The answer truly shocked me: I was told, “It will be no problem at all, because we have already increased our management by 50% in the past year.” Will the right hon. Gentleman accept that under the previous Government’s watch, the PCTs became the bloated bureaucracies that now need reforming?
John Healey
The problem for PCTs, and the managers and staff who work in them, is that they are being asked to do several things at the same time: to make unprecedented efficiencies at a time when the NHS is being put through its tightest financial squeeze in history; to axe its own jobs; and to guide the reorganisation and ensure that it can take place. That is a tough challenge for anyone. I am sure that the hon. Gentleman will keep on his local PCT’s case.