National Health Service

Debate between Andrew George and Andy Burnham

Wednesday 21st January 2015 Commons Chamber

[Andy Burnham]

I will give way one more time.

[Andrew George (St Ives) (LD)]

At the start of his speech, the right hon. Gentleman said he was calling for common ground and consensus in this debate, although he seems to have become somewhat deflected from that path. He knows that I very much agree with his criticisms of the Health and Social Care Act 2012 and other things. He has said, on a constructive basis, that he wants to bring health and social care together. There is potential consensus and common ground in that regard. I would like to hear what more he can say constructively on the areas where, I think, we can find, across all parties, common ground and a way forward.

[Andy Burnham]

To find common ground, one has to tell it straight and put on the table the real reasons why there is pressure in A and E. I bet the hon. Gentleman would not disagree with a single reason I have given: NHS 111, closure of walk-in centres, difficulty in getting GP appointments, the collapse of social care—[Interruption.] Yes, he says he does not disagree with any of those things. If we have a shared analysis, then he and I will have a basis on which to devise solutions. I will come to those solutions later.

NHS Services (Access)

Debate between Andrew George and Andy Burnham

Wednesday 15th October 2014 Commons Chamber

[Andy Burnham (Leigh) (Lab)]

We brought in other providers in a supporting role to add capacity to bring down NHS waiting lists to the lowest ever level. That is what the previous Government did. By contrast, this Government are doing something different. It is mandating tendering on GP commissioners, requiring people to compete, wasting money on running tenders and privatising the national health service, which is why they must be stopped.

[Andrew George (St Ives) (LD)]

It is fair to say that the previous Labour Government did introduce the private sector to many areas of the NHS. They also introduced a requirement for the tendering of many NHS services. If we follow the logic of Lord Warner, who is setting out the general direction of Labour party policy, we will find that that is clearly where the heart of Labour party policy has been and probably will go.

[Andy Burnham]

May I remind the hon. Gentleman, for whom I have a lot of respect, that I, as Health Secretary in 2009, introduced to the national health service a policy of NHS preferred provider? That is because I am not neutral about the NHS. I believe in the public NHS and what it represents, which is people before profits. Any policy that I develop will always be based on that principle. I was attacked at the time by the Conservative party for introducing such a policy, but I make no apology for it. We used the private sector in a supporting role, but the Government want to use it in a replacement role, and there is a very big difference between the two things. If they were continuing what we had done, why did they need a 300-page Bill to rewrite the whole legal basis of the national health service?

--- Later in debate ---

[Andrew George (St Ives) (LD)]

It was in fact the Liberals who were the architects of the NHS, but perhaps that might be lost from history. The fact is that we have yet another occasion when the nation will be looking down and counting their shirt buttons as Members on the two Front Benches trade dodgy statistics and rewrite history. I am talking about the nature of the rather tribal debate that we had in the opening exchanges. My fear is that that is the biggest risk to the NHS—too much tribalism and not enough time spent addressing the serious issues of the NHS.

The right hon. Member for Leigh (Andy Burnham) is absolutely right that there are serious issues in the NHS that need to be addressed. What usually happens on these occasions is that the Secretary of State beats the right hon. Gentleman around the head with a report from Mid Staffs. I am pleased that on this occasion he did not, because that is often done in very bad taste and rather inappropriately.

Equally, I have to say to the right hon. Member for Leigh that, as the Secretary of State reasonably pointed out, he failed to acknowledge that Labour cannot ignore the fact that it ushered in and rolled out the red carpet for the private sector. The arrangements for the tendering for Hinchingbrooke hospital happened under a system set up by the then Labour Government. No matter at which stage various companies or NHS trusts fell out of or withdrew from the process, the course had been set by Labour. Unless he is telling us that he was going to preordain the outcome of a proper and open tendering process, which would of course be anti-competitive, he must have known that one of the options—this is what happened—was that a private company would take over the running of the hospital.

[Andy Burnham]

I am grateful to the hon. Gentleman for giving way, as I want him to be absolutely clear about how I operated that process. It followed the NHS preferred provider principle, which I introduced, and I began by asking the officials in the Department to see whether a local NHS trust was prepared to come in and take over. Addenbrooke’s was the trust I had in mind, but for some reason it was not prepared to do so at that point so we had to find a runner. I said that we had to go out more broadly, but my intention was clear: I wanted an NHS provider. That was where things had got to. The former Minister, the right hon. Member for Chelmsford (Mr Burns), mentioned March, but things were going into purdah at that point. That was where the process was when we left government and I want the hon. Gentleman to be clear on that point.

[Andrew George]

I am grateful to the right hon. Gentleman and, of course, he has now had the opportunity to put that point on the record. However, he must recognise that as others have said—indeed, I made this point when I intervened on him—the Labour Government rolled out the red carpet with the policy of independent treatment centres, walk-in centres and other services, where the taxpayer paid dearly for services that were not delivered.

The right hon. Gentleman knows that I did not support the Health and Social Care Act 2012. I saw it as a missed opportunity to address a large number of issues and it engaged in a top-down reorganisation that was not necessary. I fear that both the Conservative party and the Labour party appear to have been beguiled by a set of PowerPoint-wielding management consultants who have persuaded them that changing how the system works is an easy solution when, as a number of Members have mentioned, more than anything else the NHS needs much more integration of services—certainly not fragmentation—and for standards within it to be addressed.

The House knows that I always look to make a constructive contribution to such debates, so, as the Minister knows, I have been championing the case for safe staffing levels. The campaign of the Safe Staffing Alliance has argued for no more than eight acutely ill patients for every registered nurse, excluding the nurse in charge, on acute hospital wards. We need to establish a floor below which standards cannot fall, because services are often engaged in a race to the bottom because of financial pressures. That is very important. It is encouraging that that issue is now being taken seriously and I hope that the Government will consider the recommendations from other bodies to advance the cause.

With regard to the integration of health and social care in the wider community, there has always been the mantra that we need fewer hospital beds, and that certainly happened under Labour. That has resulted in many of our acute hospitals being on red alert and unable to manage the situation, with patients on inappropriate wards or stuck in ambulances queuing outside. That was clearly predicted by many people, not least me, when the policy was being pursued.

What we need to do is front-load the system to ensure that we can discharge patients from hospitals safely. We do not have the facilities for that, either in the community or in primary care. Of course, having that system of discharge and avoiding unnecessary admissions depends on having adequate services at home. Ultimately, that falls on the shoulders of home care workers, who themselves face a race to the bottom, as they are often paid the minimum wage and their travel times and costs are not properly covered. We therefore need a new benchmark that puts a floor in the system by paying those workers a living wage, covering their travel times and expenses, and protecting them so that we do not end up with the race to the bottom that I fear we are seeing in the system.

We need to ensure that we have safe services. Ultimately, we need to address care standards in our hospital wards and press for, rather than simply talk about, the integration of health and social care in order to address the fundamental challenges that the NHS faces.

Care Bill [Lords]

Debate between Andrew George and Andy Burnham

Tuesday 11th March 2014 Commons Chamber

[Andy Burnham]

Before the hon. Gentleman makes that argument, I suggest that he speaks to the people of Lewisham to see whether they think that the process was fair. I suggest that he goes and speaks to the people of Stafford to see whether they think that the process has been fair. I do not know how he can argue that the new process is better than the original process, whereby there was always local engagement and through which elected Members had a chance to refer matters to the Independent Reconfiguration Panel.

[Andrew George (St Ives) (LD)]

We often debate this matter in the House and we all agree in principle with the concept of reconfiguration, until it is the local hospital in our constituency that is affected. That is the conundrum. What facility does the right hon. Gentleman think the Secretary of State and the Department of Health need to overcome the fact that every MP will defend their local hospital, even though reconfigurations are clearly required?

[Andy Burnham]

The hon. Gentleman makes that argument as if there were no changes to hospitals under the previous Government. There was plenty of change, but there is a right way and a wrong way of doing things. I would argue, as I just have, that the previous way of doing things was a better way.

Francis Report

Debate between Andrew George and Andy Burnham

Wednesday 5th March 2014 Commons Chamber

[Andy Burnham]

My hon. Friend is right: it is the poor relation that has always been on the fringes of the system, and is always the first service to be targeted for cuts. That has happened again in these difficult times. The Government are cutting mental health services more deeply than the rest of the NHS, and that has led to all the problems that I have been describing.

I went to Stafford recently to meet campaigners who are working to support the hospital. One of them told me that because of the lack of available mental health beds, beds had had to be found in the hospital for people who were experiencing serious mental health crises. That is what begins to happen when we do not have adequate capacity on the ground. Government Members say that this is not relevant, but it is directly relevant to all the matters that we are discussing today.

[Andrew George]

As the right hon. Gentleman knows, I was critical of the last Labour Government for rather bizarrely rolling out the red carpet for the private sector and, indeed, allowing financial targets to distort clinical priorities to an extent which, I think, created the circumstances that led to the Mid Staffs difficulties. He has mentioned integration of care. Does the Labour party propose full integration in terms of the pooling of budgets, and does he support the campaign for a fundamental safety standard in respect of the ratio of registered nurses to patients on acute hospital wards?

[Andy Burnham]

I do support that campaign, because I think that we need transparency so that local people can see whether their hospitals have enough staff. I also support the full integration of health and social care into a single service—an even deeper integration than a pooled budget—because I believe that that is the only way in which we will build a service based on the individual. We need a system in which all the needs of one person are clear and the service can start in the home, rather than this fragmented world in which care in the home is being cut and older people are being left at ever greater risk of hospitalisation.

I find it worrying that Government Members seem to be in denial about what I have been saying, and that brings me to the central point that I want to make. I believe that the Government have mishandled their response to the Francis report, and I shall cite three examples in support of my claim. First and most obviously, the Government have failed fully to implement 88 of the report’s recommendations, as they have themselves acknowledged. Secondly, Stafford hospital has, in my view, been hung out to dry. Thirdly, by overtly politicising the whole issue of care failure, the Government have created a climate of fear throughout the NHS—the worst possible response to what Francis said.

It seems to me that the Government have missed the entire point of the Francis report. If we distil the report into a few words, it called for a culture change. A range of measures were proposed with the aim of achieving that change, including a duty of candour for individuals and organisations, regulation of health care assistants, and, crucially, moves to strengthen the patient voice at local level by giving Healthwatch more protection and prominence. Francis recommended that local authorities be required to pass centrally provided funds to local Healthwatch groups, but that recommendation was not accepted. Of the £43 million allocated by the Department last year, HealthWatch groups have received only £33 million, which leaves £10 million unaccounted for. The Patients Association has said that

“vital recommendations have not been accepted and…patient care could suffer as a result.”

We support measures that the Government are introducing in the Care Bill on the appointment of chief inspectors, but let us be clear: they were not recommendations of the Francis report, and, if we are not careful, they will risk reinforcing a much more top-down approach to regulation. The position is not helped, I might add, by the Secretary of State’s new habit of calling hospital chief executives directly himself. Indeed, one of the great ironies of the Government’s reorganisation is that it has left the NHS a more top-down organisation than it was before, with clinical commissioning groups yet to find their voice and NHS England calling all the shots.

Let me quote from the Nuffield Trust’s report, entitled “The Francis Report: one year on”. In his foreword to the report, Francis himself says:

“Perhaps of most concern are the reports suggesting a persistence of somewhat oppressive reactions to reports of problems in meeting financial and other corporate requirements. It is vital that national bodies exemplify in their own practice the change of cultural values which all seem to agree is needed in the health service.”

Robert Francis himself says that national bodies are still behaving in a top-down fashion—one year on.

NHS

Debate between Andrew George and Andy Burnham

Wednesday 5th February 2014 Commons Chamber

[Andy Burnham]

I am afraid that under the coalition, NHS treatment for “Gove-itis” is being rationed, like everything else, unfortunately. As my hon. Friend said, the Government claim they are keeping A and Es and call them “local” A and Es, but they are actually downgrading A and E units all over the country. How can it make sense to close and downgrade A and Es in the midst of an A and E crisis? In west London, as my hon. Friend knows, incredible changes are being introduced without proper regard for the evidence I am presenting to the House today of a change in A and E and of sustained pressure on A and E units. The Government must go back and consider their plans for my hon. Friend’s constituency and the rest of London.

[Andrew George (St Ives) (LD)]

I totally agree with the right hon. Gentleman that the last thing the health service requires is complacency, but synthetic rage does not help either. He must remember that when he was Health Secretary, and indeed a Health Minister, up to seven ambulances were queuing outside Treliske hospital in Cornwall. That problem happens from time to time and it would be better for parties to co-operate and to come together to try to find a solution, rather than simply trying to score political points and ignoring the past.

[Andy Burnham]

I will put forward a solution that the hon. Gentleman might support. I think he supported the campaign to oppose the Government’s Health and Social Care Bill, and I pay credit to him for that as we worked across party lines on that issue. It is my job to hold the Government to account where there are problems in the national health service, and if the Minister is saying to me that there are no problems in the health service right now, I am afraid I do not agree with him. Emergency services are under intense pressure. If he looks back to our time in government, as he invited me to do, he will see that the winter crisis was a regular feature at the turn of the millennium and the early years of the last decade, although it got progressively better and better and we did not see the annual winter crisis. Now it is back with a vengeance, although it is different. The winter/spring crisis has become a summer/autumn crisis too. The pressure is relentless and it needs a proper, lasting solution.

Care Bill [Lords]

Debate between Andrew George and Andy Burnham

Monday 16th December 2013 Commons Chamber

[Andy Burnham]

I would have thought that the hon. Gentleman had been here long enough to know the difference by now. We will not oppose the Bill, in the sense that we will not vote against it on Second Reading, but it contains measures to which we simply cannot give a clear endorsement, as I will go on to explain. That is the purpose of our reasoned amendment. We will not oppose the Bill’s passage on Second Reading, which is why I objected to the Secretary of State misrepresenting my position.

[Andrew George]

I was going to make a similar point. Is it wise to bring forward an amendment of the type the right hon. Gentleman has tabled, bearing in mind the rather partisan nature of the debate we have had so far? What we really wanted was a debate on the Bill’s contents. Does he not now regret having brought forward such an amendment, because it has precipitated our going down into the gutter of partisan politics?

[Andy Burnham]

I agree with the hon. Gentleman, which is why I am not opportunistically opposing the Bill. I have tabled a reasoned amendment to put on the record the very serious concerns people have about funding for local authority care in England, the way the new cap will work and, in particular, the proposed clause on hospital reconfiguration—the Lewisham clause. I cannot let those concerns pass without making clear our position on them from the Dispatch Box. That is why we have taken that stand. That is why I am seeking to introduce my remarks in a non-partisan way.

Managing Risk in the NHS

Debate between Andrew George and Andy Burnham

Wednesday 17th July 2013 Commons Chamber

[Andy Burnham]

The Keogh report exposes alarming ratios at my hon. Friend’s hospital and others. We have been warning the Government for months—years, in fact—about cuts to nursing numbers. It is neither right nor fair to criticise nurses for being uncaring when too many of them are unsupported and are working in conditions in which they have to make compromises that they would rather avoid.

Staffing emerged as the main concern arising from the Keogh report, but the problems go way beyond 14 trusts. The CQC says that one in 10 trusts in England does not have adequate staffing levels. Can we agree today that the staffing in all hospitals must urgently be brought back up to adequate levels, as defined by the commission, with clear benchmarks set for the future? [Interruption.] I am pleased if the Secretary of State is agreeing, because that represents progress, so I look forward to finding out how his plan will be delivered.

[Andrew George (St Ives) (LD)]

The right hon. Gentleman will remember that yesterday I drew attention to the fact that all but one of the 14 hospitals Keogh reviewed had staffing and skill mix issues that needed to be dealt with, but it would be quite wrong to suggest that that has happened only in recent years. Graham Pink drew attention to the problem in the early ’90s, and it also happened during Labour’s years in government. I think that it would be good for this debate if the right hon. Gentleman at least acknowledged that it has been going on for more than three years.

[Andy Burnham]

I will acknowledge that. A moment ago, I mentioned the Francis report, which I commissioned, which revealed the dangerous cuts to front-line staffing that the hospital pursued as the primary cause. I accept what the hon. Gentleman has just said. Rather than always pursuing central regulation as the solution, if local communities had identifiable benchmarks that they could use to check up on their local hospitals, surely that would be progress we could all get behind.

On the duty of candour, the Government are legislating for a duty on organisations, but not on individuals. I think that we all agree that changing the culture of NHS organisations is essential if we are to move forward. The Francis recommendation is a necessary part of bringing about that culture change. Rather than being a threat to staff, as some have argued, it would protect them when they make known any concerns. Will the Government look at that again and legislate for the full Francis recommendation in the Care Bill? That is incredibly important in the light of yesterday’s report by Sir Bruce Keogh. He revealed—this will shock anyone who has not spotted it yet—that some trusts were telling members of staff what they could and could not say to his review. Surely we can all agree that is fundamentally unacceptable.

Accident and Emergency Waiting Times

Debate between Andrew George and Andy Burnham

Wednesday 5th June 2013 Commons Chamber

[Andrew George (St Ives) (LD)]

With the Serco contract for out-of-hours GP services in Cornwall having been referred to the Care Quality Commission, the manipulation of the data, falsely representing the outcomes of the service, has been identified. It is worth reminding the right hon. Gentleman that this was set up under a contract that resulted from decisions made when he was in government.

[Andy Burnham]

I remember debating that with the hon. Gentleman when I was the Secretary of State. Those problems rightly needed to be addressed, and the particular issue he raises today should be investigated. I hope, however, that he will also understand the problem that I am describing to the House. If we go down the path of fragmenting services—if we take a successful national service such as NHS Direct, for example, which was trusted by the public, and then break it up into a patchwork of fragmented, some privatised, services—this sort of chaos will be the result.

A report has emerged this afternoon, showing that the viability of NHS Direct is in serious question. The headline states, “Leaked report casts doubt over NHS Direct’s ‘overall viability’ in the wake of NHS 111 failings”. This is a warning that NHS Direct may well go down altogether. What an indictment that would be of this Government’s mismanagement.

Regional Pay (NHS)

Debate between Andrew George and Andy Burnham

Wednesday 7th November 2012 Commons Chamber

[Andy Burnham]

No, I will make some progress.

Breaking national pay is what the Government want to do, and that springs from an entirely different philosophy from the one that forged the NHS in the first place. The Government are rejecting the “one NHS” approach, whereby hospitals collaborate and the unpredictable pressures of any health service are balanced across the system. Instead, they have a vision of hospitals as stand-alone small businesses, on their own in the marketplace, with no bail-outs and free to earn up to 49% of their income from the treatment of private patients, but—as we are seeing in south-east London—finding little mercy in a private-sector-style administration process if the sums do not add up. That is a very different vision of the NHS, and it is not one to which the British people have ever given their consent in a general election.

[Andrew George (St Ives) (LD)]

I will join the right hon. Gentleman in the Lobbies on one reasonable condition: he acknowledges that the last Labour Government did not just introduce regional pay in the Courts Service, but introduced flexibilities for foundation trusts which, through employment law, could result in detriment to NHS employees. If he acknowledges that and apologises for his introductory remarks, I will certainly join him in the Lobbies.

[Andy Burnham]

I partly welcome what the hon. Gentleman has said. I have already acknowledged the flexibilities, and mentioned that only one trust in England ever sought to make use of them, because it wanted to add to the national floor that we had introduced. The flexibilities were there and I support them, but we left office with a national pay system in place. I look forward to his support later this afternoon.

We have a new Secretary of State, but those who expect a change of direction look set to be disappointed. In his first major interview, he described his mission thus:

“I would like to be the person who safeguards Andrew Lansley’s legacy”.

That must qualify as the shortest suicide note in political history. We have Lansley-lite—more of the same—but, in fact, it may be worse.

Looking at the Secretary of State’s past speeches, I could find nothing that conveyed any passion, belief or commitment to the NHS. On the contrary, I was worried when I read that he tried to remove Danny Boyle’s NHS tribute from the opening ceremony of the Olympic games. He is also one of the co-authors of a right-wing pamphlet entitled “Direct Democracy”. He may remember that pamphlet. It said:

“Our ambition should be to break down the barriers between private and public provision, in effect denationalising the provision of health care in Britain.”

Is that still the Secretary of State’s view? He has gone quiet now, has he not?

You will understand, Mr. Speaker, why NHS supporters get nervous about the intentions of this Secretary of State, but today he has a chance to calm those nerves. He can come to the Dispatch Box and send the clearest of messages to NHS trusts seeking to break from national pay. What he will learn about his job is that, if he says something with sufficient force, the NHS will respond.

The developing pay crisis in the NHS is the Secretary of State’s first real test, but so far he is failing it. As we reveal today, on his watch, the 20 NHS trusts that were threatening to break away in the south-west have become 32 NHS trusts across England. That is creating real worry for thousands of NHS staff and uncertainty for businesses, which have raised their concerns with the Chancellor. But what do we get from the Government today? A “do nothing” amendment expressing no view on the south-west issue, and inviting Government Members to sit on the fence and wait for the conclusions of the pay review body’s review. That will not do.

As the Government do nothing, national pay is being unpicked and the NHS is fragmenting before our eyes, but perhaps that is all part of the plan—it is nothing to do with them; it is all due to a local decision. The idea is to hide behind a review while national pay slowly and conveniently unravels, region by region, trust by trust. Staff facing the threat of a pay cut deserve some straight answers, but rather than getting a straight answer to the question “Does the Secretary of State support regional pay in the NHS or not?”, they are hearing contradictory statements from this shambolic Government. Not for the first time, the coalition is not speaking with one voice. I understand that the Liberal Democrat conference passed a motion opposing regional pay and that the Deputy Prime Minister was captured on film voting for it—although, as we know, being photographed making pledges does not make him more likely to keep them.

The Deputy Prime Minister has also made the following unambiguous statement:

“There is going to be no regional pay system. That is not going to happen.”

The trouble is that it is happening, under the Deputy Prime Minister’s nose and by the back door. Twenty NHS trusts in the south-west are openly defying the authority of the Deputy Prime Minister. Some 88,000 NHS staff are being affected by a unilateral drive to set a new going rate of NHS pay in the regions, which would be up to 15% lower than national “Agenda for Change” rates. The trusts are proposing to end overtime payments for night, weekend and bank holiday working, and to reduce holiday leave. They are also proposing to force staff to work longer shifts, and to cut sick pay rates drastically. That is no idle threat. The silence from Ministers is clearly emboldening them. Despite concerns raised here and elsewhere, they have built a fighting fund, set up a website, and appointed lawyers to make all this happen.

--- Later in debate ---

[Andrew George (St Ives) (LD)]

It is a pleasure to follow the hon. Member for Worsley and Eccles South (Barbara Keeley), a fellow member of the Health Committee. I endorse her comments. She, like many others, has emphasised the reason it is so important that the House rejects the concept of regional pay and urges unions and employers to accelerate the process in order to reach a speedy conclusion on national pay bargaining. This is a serious issue, and it deserves a serious response from all parties in the House. It should not become a subject to be kicked around the playground of an Opposition Day debate in an opportunistic manner, as has so often happened—before the election as well as after it, to be fair. A matter as serious as this should not be debated in that way.

I intervened on the right hon. Member for Leigh (Andy Burnham) to ask whether he would acknowledge that we are where we are today because of the freedoms the previous Government created for the cartel in the south-west, or in any other part of the country. We are aware that other trusts are looking closely at what is happening with that cartel. The previous Government should be applauded for introducing the “Agenda for Change” and attempting to introduce a rigorous and effective method for agreeing pay and conditions at national level, but they also legislated to introduce foundation trusts and the new freedoms that went with them. The Liberal Democrats opposed that legislation at the time.

[Andy Burnham]

rose—

[Andrew George]

I was going to go on to talk about employment law, but I am happy to give way to the right hon. Gentleman.

--- Later in debate ---

[Andy Burnham]

This subject has featured a lot in today’s debate. I would encourage the hon. Gentleman to go back to the speeches made by Ministers when that legislation was being introduced. They were clearly saying that there could be occasions when flexibility would be needed at the margins to deal with a particular short-term pressure or problem. Such an arrangement was used once, in respect of Southend, to put pay up. It is important to understand that there was no suggestion that pay could be reduced across the board in a co-ordinated, orchestrated move to undercut the national pay system that was being brought in at the same time. That argument has been put today, but it simply does not hold water.

[Andrew George]

That might have been the stated intention, but the effect is being seen through the cartel’s actions. What is happening is not the result of any coalition Government legislation; it is the result of an opportunity having been made available under employment law. This is not within the parameters of “Agenda for Change”. It is a result of the freedom given to foundation trusts to step outside those agreements and to use employment law to seize the opportunity of certain flexibilities, to the detriment of the employees in their pay. That might not have been the intention behind the legislation, but it has been the effect of it, whether the previous Government appreciated that or not.

If the right hon. Gentleman is really so concerned about this, and given the fact that he can now see the effects of his legislation being played out by the cartel in the south-west, perhaps the shadow Minister, the hon. Member for Copeland (Mr Reed), will acknowledge, in summing up the debate, that that was not the intention behind the legislation. Will he, having noted what is now going on as a result of that legislation, commit to rescinding that element of it if Labour were to come to power, to put right the weaknesses of it? If so, we would know that Labour Members were genuine and sincere in their intent, and that they acknowledged that weakness, which they had not anticipated at the time but which is now being exploited.

I strongly support my hon. Friend the Member for Southport (John Pugh) and congratulate him on his characteristic breathtakingly brilliant contribution to the debate. He was most entertaining, and there was disappointment across the whole House when he resumed his seat without having used all the time available to him. He made many insightful comments about the situation we are in today, and the weaknesses of it.

I also thank my hon. Friend the Member for North Cornwall (Dan Rogerson) for pointing out the significant weaknesses in the legislation and the impact they are likely to have on NHS staff. I am pleased to see my hon. Friend the Member for St Austell and Newquay (Stephen Gilbert) in the Chamber today. We are all aware that the Royal Cornwall Hospitals Trust’s involvement in the cartel is creating deep concern across Cornwall. The hon. Member for Truro and Falmouth (Sarah Newton) made a telling intervention earlier when she said that Cornwall has some of the highest costs of living in the country, while perpetually being at the bottom of the earnings league table, pretty much since records began.

One of the drivers behind the problem is the cherry-picking in the NHS. The private sector is already offering the easiest procedures. A private provider in Cornwall carries out the easiest procedures for the fittest patients with low anaesthetic risk and those who are the least likely to suffer complications following orthopaedic procedures. It is now extending its services into areas such as cardiology, hernias, haemorrhoids and endoscopy. If any complications occur, it will simply pass the patient across to the Royal Cornwall Hospitals Trust to deal with any difficulties or emergencies. It therefore has no need to invest in all the facilities necessary to provide the kind of wrap-around service that we want the NHS to provide. The fact that such private sector companies are able to vary wages, terms and conditions for their staff is undermining the NHS. The foundation trusts are having to compete with those companies, and that is one of the pressures that is driving their agenda. All parties need to recognise that fact, and Ministers need to acknowledge that this continued cherry-picking by the private sector is fundamentally undermining the capacity and ability of the NHS to respond adequately.

We must also ask why we are in this situation in the south-west. In regard to resource allocation, only two years ago Cornwall was getting £56 million a year less than the Government said that it needed to provide the necessary services. If there is a significant gap between the funding actually provided for the local health community and the amount that the Government say is the target funding, it is no wonder that local trusts find themselves having to make extremely challenging decisions.

I urge the Under-Secretary of State for Health, my hon. Friend the Member for Central Suffolk and North Ipswich (Dr Poulter), when he winds up the debate, to acknowledge that resource allocation still needs to be addressed. Members of Parliament from across the south-west and I have arranged to hold a meeting with him on this matter, and I hope that it will take place soon so that we can have an opportunity properly to address the issues.

National Health Service

Debate between Andrew George and Andy Burnham

Monday 16th July 2012 Commons Chamber

[Andy Burnham]

At the heart of the defective legislation that the Government rammed through the House of Commons is an unresolved conflict of interest, in which commissioners can also be providers who can remove services from hospitals and then provide them themselves. Under pressure in the other place, the Government came up with a requirement for a statement of such interests, but without introducing any mechanism for enforcement to ensure that decisions in the NHS are being made for the right reasons. I fear that that conflict of interest will return to haunt the Government.

[Andrew George (St Ives) (LD)]

The right hon. Gentleman knows that I share his critique of the Health and Social Care Act 2012. He mentioned the fact that civil servants had given him warnings and cautioned him about the consequences of his decisions during his time in office. Was he warned about the changes in regulations that have resulted in the decision of the south-west consortium to suggest changes to the terms and conditions and pay of staff in that area? That was a direct result of regulations brought in by his Government.

[Andy Burnham]

No, it was not. Agenda for Change was one of the proudest achievements of our Government, and we always staunchly defended national pay arrangements. The hon. Gentleman talks about warnings, but I have just read out the explicit warning that was given to the current Secretary of State that this was the wrong time to reorganise the NHS. It was unforgivable to proceed in those circumstances. This was the single most reckless gamble ever taken with the NHS, and patients and staff are already proving to be the biggest losers.

Health and Social Care Bill

Debate between Andrew George and Andy Burnham

Tuesday 13th March 2012 Commons Chamber

[Andrew George (St Ives) (LD)]

I beg to move an amendment, to leave out from “Bill;” to end and add:

“declines to support the Bill in its current form; and calls for an urgent summit of the Royal Colleges, professional bodies, patients’ organisations and the Government to plan health reforms based on the Coalition Agreement.”

It is a pleasure to follow the hon. Member for Walsall South (Valerie Vaz), a fellow member of the Health Committee, who talks with great knowledge and, from the manner in which she handles herself in the Committee, is clearly very committed. The primary concern of us all in this debate is the future of the NHS; I do not question anyone’s motives as far as that is concerned. That is why I was particularly pleased when the right hon. Member for Leigh (Andy Burnham) opened the debate by reassuring us that we would have a non-tribal, non-partisan debate, and that is also why I feel rather saddened that the debate so quickly degenerated once again into tribalism, which I am sorry to say will seriously undermine our chances of coming forward with a rational solution to the intractable problem of what to do with the Bill.

Although the positions have become further entrenched by the debate, I am concerned about its outcome, because ultimately we will not defeat the Bill. This is not Second Reading, when Members could independently make up their mind on the issue outside the tribal mix. We should debate the matter in a manner that might assist the Government to reflect on where we are. I hope that ultimately they will withdraw the Bill, which is what many of us want them to do. As far as I can see, the Bill cannot be defeated by either House, so the power, and the fate of the Bill with it, lies pretty much entirely in the hands of the Government.

Although I understand that the Secretary of State is obliged to advance the arguments in the way he did today, I am concerned. Therefore, if we are to advance as I propose by withdrawing the Bill and, as set out in the amendment, calling a summit of those who want to take forward a lot of what I think is good in the Bill and in the coalition agreement, I am not sure how that could be achieved on the basis of what we have heard so far. Clare Gerada, the chair of the Royal College of General Practitioners, this morning talked about withdrawing the Bill in order to stabilise the NHS and ensure that we go forward without basing the future of the NHS on ideology, but we of course need to do that while ensuring that everyone is working together.

I agree with the Secretary of State’s approach to the issue, which is that no change is not an option and that change and reform are of course required in the NHS, but I think that it is better that we take this forward on a more consensual basis than the Government have achieved so far.

I already have only a little time left, so let me say something about the Secretary of State himself, because his commitment to the NHS has been questioned in today’s debate. Let me make it clear to my right hon. Friend—in this regard—that, as I said on Second Reading, I believe that he approaches the issue with the very best of intentions, and I would never question the sincerity of his commitment to the NHS over many years, which I highly respect, along with his knowledge of the subject; our disagreement is on the judgment of the legislation. I do not know whether that metaphorical embrace will damage his reputation among his Conservative colleagues, but I hope that it will not.

There are many failings in the current legislation.

[Andy Burnham]

I am listening very carefully to the hon. Gentleman, but may I push him a little? He says that the Bill cannot be defeated, because of parliamentary arithmetic, but what is his take on the points that his right hon. Friend the Member for Bermondsey and Old Southwark (Simon Hughes) made? Is it not the hon. Gentleman’s understanding that the Lib Dem conference withdrew its permission for his peers to vote for the Bill? Does that not therefore take permission away from Liberal Democrat MPs to support it?

[Andrew George]

The right hon. Gentleman is aware that the conference was advisory on the issue. The motion before it actually congratulated our noble Friends in the House of Lords on having achieved significant amendments to the Bill. They have made the Bill less bad but not good enough to make it acceptable to myself—or indeed to many of my colleagues.

The right hon. Gentleman knows very well that Liberal Democrat Ministers and others cannot vote against the Government, so it is not very helpful of him to try to tease out such a situation. The pressure on those who are not so constrained has, however, been lifted.

National Health Service

Debate between Andrew George and Andy Burnham

Wednesday 26th October 2011 Commons Chamber

[Andrew George (St Ives) (LD)]

rose—

[Andy Burnham]

I will give way to the hon. Gentleman and then to my hon. Friend.

--- Later in debate ---

[Andrew George]

I accept that the Health and Social Care Bill is the longest and most incoherent suicide note in NHS history. Indeed, I am robust on this issue: I have voted against the Bill and will continue to take that view. However, considering that the right hon. Gentleman was involved when preferential arrangements were provided for private sector providers coming into the NHS, is this debate not an opportunity for him to acknowledge that at the Dispatch Box and apologise to the House for what was a rather ridiculous and one-sided policy?

[Andy Burnham]

Let me first acknowledge the hon. Gentleman’s courage in standing up and voting against the Health and Social Care Bill. I just wish that more of his Liberal Democrat colleagues had similar conviction and principle, and could stand up to the Government on a Bill that he knows—and which, in their heart of hearts, many of them know—will seriously damage the NHS.

The hon. Gentleman also asked me about the introduction of private sector capacity. I will not apologise for that, because that additional capacity was brought in to bring down NHS waiting lists, something that benefited his constituents. By bringing in that extra capacity we brought down NHS waiting lists to an all-time low and delivered the 18-week target. I am not going to apologise for that. The reason the NHS commands such strong support in the country today is that people’s experience of it improved in those years. I mentioned the preferred provider policy a moment ago. I believe that the private sector has a role to play in delivering world-class care to patients, and I am happy to put that on record.