Housing Benefit (Abolition of Social Sector Size Criteria)

Debate between Andrew George and Baroness Primarolo

Wednesday 17th December 2014 Commons Chamber

[Andrew George]

I think that is slightly outwith the focus of the debate. Nevertheless, I of course acknowledge the merit of what the hon. Gentleman suggests.

The Conservatives have form when it comes to spending public money on the under-occupancy of residential property. After all, the last time they were in government on their own they introduced a council tax discount for second homes. Hundreds of millions of pounds of taxpayers’ money was spent every year subsidising the wealthy to have their second homes, when there were thousands of local families who could not afford their first home. That defines the Conservatives’ approach: they reward the wealthy when they under-occupy their second home and they penalise the poor when they under-occupy their council home.

The Conservatives claim that the purpose of the under- occupancy penalty is to save money by cutting benefit where the recipient occupies a property that is larger than they need, and to ensure the efficient use of a scarce public resource—social housing. Those two objectives, however, contradict each other. If the second objective—the effective use of public resource—were achieved and every last cubic centimetre of every council house was fully occupied, it would fail to meet their first objective of saving money.

I have a problem with the Labour party’s motion, partly because it deals only with the social sector, which is odd. If Labour had applied it to the private rented sector, I might have considered voting for it. Above all, I am concerned to deal with this issue seriously. We can either play party politics and come up with the kind of motion the Labour party has come up with today, or we can use the vehicle that is available, the Affordable Homes Bill. Although my amendment has not been accepted for debate, we should still be working together to seek political consensus to help the victims of this policy, instead of using them to score party political points, and that could be done with the money resolution necessary to advance my Bill. The Minister asked how we would pay for it. We could pay for it by driving down rents, rather than driving people out on to the streets. On the money resolution, I am afraid—

[Madam Deputy Speaker (Dame Dawn Primarolo)]

Order. Will the hon. Gentleman stop talking about the money resolution and get on with it?

[Andrew George]

The money resolution concerns my Affordable Homes Bill, which would address this issue, were we to solve the problem with the money resolution.

In conclusion, we should be seeking consensus, rather than scoring party political points.

Badger Cull

Debate between Andrew George and Baroness Primarolo

Thursday 13th March 2014 Commons Chamber

[Madam Deputy Speaker (Dawn Primarolo)]

Mr George, it is not my patience you will be testing; it is that of your colleagues who are patiently waiting to speak. For the third time, I remind Members that they must speak for eight to nine minutes, including interventions. Mr George, you have been speaking for 11 minutes.

[Andrew George]

Thank you, Madam Deputy Speaker.

I will bring my remarks to a close by reminding people that I believe that vaccination is the way forward. It is the cheaper alternative for the Government, it is likely to be more effective, and it never runs the risk of making the situation worse.

Welfare Benefits Up-rating Bill

Debate between Andrew George and Baroness Primarolo

Tuesday 8th January 2013 Commons Chamber

[Andrew George]

Of course we welcome the Labour party’s last-minute pre-election conversion to increasing tax for wealthy people. The right hon. Gentleman will have heard in my intervention on my right hon. Friend the Secretary of State my sincere misgivings and my wish to encourage him to review this rather arbitrary 1% cap and perhaps to find ways of relating it to average wages. Bearing in mind that the welfare budget is—

[Madam Deputy Speaker (Dawn Primarolo)]

Order. It was only a few moments ago, I remind the hon. Gentleman, when I said interventions on a speech needed to be brief and should not become a speech in their own right.

[Mr Byrne]

I am grateful for the intervention because I think the hon. Gentleman, like us, is concerned that in our country today a food bank is opening every three days, and that 5 million people may resort to payday loans this year in order to balance the books for the end of the month. The Sun on Sunday this weekend, in an article carried next to the one by the Secretary of State, said that a quarter of mums are now turning off heating so that they have enough money to feed the kids. Is that the kind of country that we are becoming, because the Saint of Easterhouse has now become the punch bag of the Treasury? Once he talked about broken Britain; now he is presiding over breadline Britain because he keeps losing his battles with the Treasury.

Food Prices and Food Poverty

Debate between Andrew George and Baroness Primarolo

Monday 23rd January 2012 Commons Chamber

[Andrew George (St Ives) (LD)]

I note that the motion expresses dismay at the Government’s delay, yet it asks for the groceries code adjudicator to be introduced in the next Parliament, rather than in the next parliamentary year, which I assume is a drafting error. Leaving that aside, given the fact that the first Competition Commission report was in 2000, and the Competition Commission report to which the hon. Lady refers was completed in 2008, what word other than “dismay” would she use to describe the Labour Government’s response to that report?

[Madam Deputy Speaker (Dawn Primarolo)]

Order. May I remind everyone in the Chamber that the debate ends at 7 pm? There is already a time limit of eight minutes on Back-Bench speeches. Interventions should therefore be short, and I hope opening speeches will not be overly long.

Public Bodies Bill [Lords]

Debate between Andrew George and Baroness Primarolo

Tuesday 25th October 2011 Commons Chamber

[Andrew George (St Ives) (LD)]

I beg to move, That the clause be read a Second time.

[Madam Deputy Speaker (Dawn Primarolo)]

With this it will be convenient to discuss the following:

New clause 8—Office of Rural Affairs—

‘(1) The duties of the Commission for Rural Communities contained in section 19 of the Natural Environment and Rural Communities Act 2006 (Representation, advice and monitoring) are to be transferred to a body to be known as the Office of Rural Affairs, which will report to the Secretary of State.’.

New clause 9—Independent Rural Advocate—

‘(1) The Natural Environment and Rural Communities Act 2006 is amended as follows.

(2) In section 17 (Commission for Rural Communities) for “Commission for Rural Communities” there is substituted “Rural Advocate”.

(3) Subsection 17(2) is omitted.

(4) In section 18 (Commission’s general purpose) and section 19 (Representation, advice and monitoring) for all references to “Commission for Rural Communities” there is substituted “Rural Advocate”.’.

Amendment 32, in schedule 1, page 21, line 11, leave out

‘Agricultural Wages Board for England and Wales’.

Amendment 39, in schedule 1, page 21, line 18, leave out ‘Commission for Rural Communities,’.

[Andrew George]

It is a pleasure to follow the previous debate, which was rather more truncated than I was expecting. I wish to emphasise the importance of retaining, under new clause 7, the protections provided by the Agricultural Wages Board, as well as addressing the importance of maintaining, under new clauses 8 and 9, an overarching mechanism—indeed, an independent body—that can advocate on behalf of rural areas. The Agricultural Wages Board was established under the Agricultural Wages Act 1948, but the heritage of that body goes back to 1924. It is an independent body with a statutory obligation to set minimum wages for agricultural workers in England and Wales and powers to determine other terms and conditions, including holidays and sick pay.

Health and Social Care (Re-committed) Bill

Debate between Andrew George and Baroness Primarolo

Wednesday 7th September 2011 Commons Chamber

[Paul Burstow]

My hon. Friend is making some important points, which give me the chance to underscore the important points that I have made. The Bill retains for the Secretary of State the capacity to intervene and exercise the functions of all the bodies established by it, and—in extremis, as a last resort—to make sure that services are provided. It is clear that that capacity has remained, not least in regard to the Secretary of State’s ability to establish special health authorities.

My hon. Friend is asking for back-stops, and back-stops have to be real and have effect. That is why we put them into the Bill as we have, so that the Secretary of State does have, in extremis—in the circumstances that concern my hon. Friend and others—the ability to take the steps necessary to secure and ensure that services are provided to ensure a comprehensive health service.

[Madam Deputy Speaker (Dawn Primarolo)]

Order. May I gently remind the Minister of two things? First, he has to address the whole House. Secondly, it is not a private conversation between him and his hon. Friend, and his interventions are supposed to be brief. A lot of people are waiting to speak.

[Andrew George]

On that basis, Madam Deputy Speaker, I will end that part of the conversation and move on, acknowledging that my hon. Friend has made a point that is worth considering.

Amendment 1224 would restore the duty to provide or secure provision of health services. Although that is seen as the headline proposal, it is consequential on new clauses 16 and 17, hence my intention to draw attention to the likelihood of my seeking to divide the House on those issues.

Amendments 1222 and 1223 seek to establish why the Bill has never provided for the Secretary of State to provide or secure a comprehensive health service rather than promote a comprehensive health service. This is an either/or situation, but I draw attention to the possibility that instead of pressing new clause 16, I may, in discussion with others, seek to divide the House on amendment 1222.

Amendment 1183 would beef up a duty of the Secretary of State—a theme that runs through a number of amendments. The purpose of amendments 1183 and 1194 is to address the conflict between having regard to reducing inequalities and placing above that duty the other duties that apply—for example, on choice. Amendment 1183 seeks to ensure that it is the duty of the Secretary of State, in reducing inequalities, to

“act with a view to”

rather than merely “have regard to”. Otherwise, the responsibility, and the duty, on the Secretary of State is rather weak. That applies to amendment 1194 in the same manner.

New clause 18 would impose a new duty on the CQC, the NHS Commissioning Board and clinical commissioning groups not to undermine existing NHS services in an unplanned way through the operation of competition. Rather than extending my description of this issue, it might be worth referring to the debate that we had yesterday about the regulations surrounding the functions and duties of Monitor, as the same question arises. We have to look at the impact that competition is likely to have on the provision of essential services such as major trauma and accident and emergency, where its existence may destabilise emergency services through the loss of, for example, important underpinning elective services provided by the hospital.

New clause 20 would ban the wholesale outsourcing of commissioning work with regard to clinical commissioning groups. That was demanded in a Liberal Democrat conference motion but has still not been delivered. The commissioning process is a public function, not a private function. The amendment therefore seeks to change schedule 2 in different ways to prevent private entities on clinical commissioning group committees and sub-committees from commissioning and making other decisions. This also applies to amendments 1224, 1245, 1244 and 1249.

The Minister said that the work of the Neurological Alliance is important to preserve. I hope he will recognise that new clause 20 talks only about commissioning work being

“predominantly retained as a function by staff directly employed by the clinical commissioning group.”

There is nothing in the Bill that prevents the bulk of the commissioning work—not the decision, but the work—of a clinical commissioning group from being done by a private company and thus, potentially, in secret. I hope he will accept that under the current wording of schedule 2, private entities will be able to sit on clinical commissioning committees and sub-committees and make commissioning decisions.

Amendments 1184 to 1188 and 1195 would demote choice to a subsidiary duty of commissioners to tackle fair access and inequality of outcomes. They relate to page 17 of the Bill. The priority of choice over inequity and inequality was introduced by the Government after the pause and the NHS Future Forum report as a way of promoting competition in ways other than through the role of Monitor. The amendments would reverse that priority for the NHS commissioning board.

Amendment 1211 provides that clinical commissioning groups should be more coterminous with local authorities than is the case under the Bill. The Minister said that there is no intention that clinical commissioning group boundaries will cross local authority boundaries. However, we all know that district councils do not cross local authority boundaries. In Cornwall, for example, we are likely to move from one PCT to three clinical commissioning groups, which will make the streamlining of the pathways between health and social care a lot more difficult. The purpose of amendment 1211 is to enforce that point.

I am aware of time and I hope that the House will appreciate that I will not explain every aspect of the many other amendments I have tabled. I am aware that there are significant issues that other people wish to raise. I simply emphasise that what the Minister said about health and wellbeing boards being able to refer matters to the Secretary of State is once again something that we have always argued for. Local authorities should of course be given a far greater say in commissioning decisions and in setting the strategy for health services in their area. As a back-stop, it is important that matters can be referred to the Secretary of State. My hon. Friend the Member for Cheltenham (Martin Horwood) has tabled some important amendments in respect of public health, some of which I have supported, and I hope that the Minister will consider them. I apologise for the amount of time I have taken, but I hope that the Minister will address the important issues advanced by the amendments.

Health and Social Care (Re-committed) Bill

Debate between Andrew George and Baroness Primarolo

Tuesday 6th September 2011 Commons Chamber

[Andrew George]

rose—

[Madam Deputy Speaker (Dawn Primarolo)]

Order. If the hon. Gentleman will resume his seat, let me say that the knife comes down at 8.30 pm and I would like the opportunity to give the Secretary of State five minutes at the end of this debate. I would therefore be grateful if the hon. Gentleman would watch the clock and bear that in mind.

--- Later in debate ---

[Andrew George]

No pressure, then. I will be as brief as I can. I tabled nine of the amendments in this group, and I had hoped to spend a little more time on them than I have been given this evening. I accept new clause 2, which I shall be supporting; the purpose of that proposal is primarily to rearrange the deckchairs on the Titanic, so that they do not get in the way of the lifeboats. I am happy to support new clause 2, although I have already made clear my views on the Bill and the general direction of the Government’s policy. I am not persuaded by many aspects of the Bill; indeed, I am very unhappy about them. I was very persuaded by the coalition agreement and felt that the balance of policy proposals in it was pretty much right. There were a number of debating points about the role and dynamics of “any willing provider”, but apart from that the themes were absolutely right. However, they were not reflected in the White Paper.

That said, the purpose of my amendments—the right hon. Member for Holborn and St Pancras (Frank Dobson) articulated this point far better, I am sure, than I am about to—is primarily to ensure that Monitor’s role to ensure that anti-competitive behaviour is kept in its box is balanced by looking at the impact of competitive behaviour that might undermine the ability of NHS services to collaborate.

The underlying purpose of amendments 1207 and 1208 is to neutralise or balance the new duty on Monitor to prevent anti-competitive practices that are against the interests of the people who use the services—in other words, patients—by also applying a duty to prevent anti-collaborative practices that would have the same effect. The Government say that that would result in Monitor preventing all practices that were against the interests of patients, but I disagree. Some unsafe practices would be neither competitive nor anti-competitive. The amendments would result in there no longer being a focus mainly on dealing with anti-competitive practices. I believe that that would strengthen the role of the regulator. This is a question of putting competition in its box, and it is important to ensure that it is put properly in its box, properly defined, and that the lid is put on. The purpose of the amendments is to achieve that outcome.

The Secretary of State told me, in response to an intervention relating to amendments seeking to secure a far better ability for Monitor to regulate the integration of services, that it should not be Monitor’s role simply to sustain services that are presumably otherwise unsustainable. The problem with that, in relation to my amendments 1205, 1209, 1229 and others, is that we need to ensure that we sustain the essential services. The important point here, which others have articulated, is that certain services clearly need to integrate. An example is acute emergency trauma centres. If the orthopaedic, paediatric or ophthalmology services were removed from such essential centres, their ability to deal with a wide range of emergencies would be fundamentally undermined. They serve populations of between 250,000 and 500,000 people—sometimes more—and they are absolutely essential. We must ensure that we do not end up with a regulator that allows them to be undermined by imposing a duty on them not to act in an anti-competitive manner.

The purpose of the amendments is to probe these issues, but the Government have made it clear that the NHS will no longer be the preferred provider, which leaves a question mark over the future of those essential and acute services. I will sit down now in order to give the Secretary of State more time than you requested for him, Madam Deputy Speaker, but I want to emphasise that I shall support the Government’s new clause. My amendments are probing amendments, but I wish that we had more time to debate these issues. This is very frustrating.

[Madam Deputy Speaker]

Order. I just remind the hon. Gentleman that the timetable for the debate was not set by me. I am merely assisting the House to meet its deadlines.

--- Later in debate ---

[Andrew George]

I beg to move, That the clause be read a Second time.

[Madam Deputy Speaker (Dawn Primarolo)]

With this it will be convenient to discuss the following:

New clause 22—Private health care: rules—

‘(1) Section 44 of the National Health Service Act 2006 (Private healthcare) is amended as follows.

(2) Insert new subsection (A1) as follows—

“(A1) NHS Foundation Trusts must act in accordance with the following rules when carrying out their functions under this section—

(a) NHS Foundation Trusts are not permitted to operate NHS functions or contracts in a manner which promotes their private healthcare operation;

(b) any private healthcare service offered should only be within the provision of the services and procedures which are not also duplicated by the Trust’s NHS functions or contracts; and

(c) the Trust should at all times operate any private healthcare interest in a manner which in no way conflicts with its responsibility to provide unfettered access of its NHS patients to its NHS services.”’.

Amendment 1165, page 159, line 24, leave out clause 168.

[Andrew George]

The new clauses deal with a totemic issue that has bedevilled the debate throughout and raised concerns. The question whether to raise the cap or leave it where it is is a ham-fisted reaction to our current situation in the Report stage of a re-committed Bill. There should be an opportunity for further consideration, and I hope the issue will be examined in another place.

There has been much hyperbole about the privatisation of the NHS and other themes that have run through the debate. The general concern is that, as a result of various genies being let out of bottles and caps being lifted, we will end up with an NHS driven more by concern with private profit than by concern with matters of patient care. There is a slippery slope, of which that issue is symptomatic, throughout the Bill.

The purpose of the new clauses is to address that issue and retain the cap to ensure that the matter is kept under appropriate control. The rough and tumble of political debate means that we will end up scoring points off each other and asking who introduced foundation trusts and so on. We have been through that playground before and I do not intend to go in that direction, but I want to make sure that we have an opportunity to explore the matter. We do not have much time so I will not detain the House unnecessarily.

The removal of the cap will give more scope for NHS trusts to compete in the market, which will make them more likely to be considered undertakings for competition law purposes, even in respect of NHS services which the hospitals claim their private work subsidises, thus allowing competition law to reach further and more firmly into the NHS. The Government briefing does not even dispute that fact, as far as I can see. Also, if NHS foundation trusts can muscle in on the private market, rather like the BBC, private providers will feel more justified in arguing for the right to compete for far more NHS services, and the courts may well agree.

New clause 19 recognises that pay beds in the NHS represent a challenge, both ethically—it is about how beds can be reserved for paying patients in the same hospitals where poorer patients with higher needs must wait—and with regard to competition law. It would phase out the reserving of beds for paying patients in NHS hospitals by 2015.

New clause 22 would put a bar on foundation trusts offering private services where that would compete with their NHS provision. I certainly know, having undertaken surveys of the NHS 12 years ago, that the specialties with the longest waiting times—I will not say which, but Members might guess—happened to be those in which the most private practice was going on. One might argue that the private practice resulted from the long waiting times, but the long waiting times could have been part of a system that enabled the private sector to flourish. I fully accept—to save the Minister a lot of time in his response—that the new clause is technically very deficient, so I will not press it to a vote, but I want to express my concern and probe the issue in debate.

I know that there are ethical considerations here and that the General Medical Council and others would not only frown on the kind of practices I am implying might go on, but would rule against them. The concern is that the trusts, or those working for them, might be seduced into behaving in ways that drive their NHS patients into the arms of their private wings. Once we go down that road, many conundrums will arise and will need to be sorted out. I do not believe that the Government entirely have a handle on the issue, which is why I believe that simply lifting the cap, despite all the justifications they have given, needs a serious rethink.

Future of the NHS

Debate between Andrew George and Baroness Primarolo

Monday 9th May 2011 Commons Chamber

[Andrew George (St Ives) (LD)]

It is a pleasure to follow the right hon. Member for Holborn and St Pancras (Frank Dobson) and I was glad that his speech contained an element of recognition of the excellent contribution made by my hon. Friend the Member for Southport (John Pugh), who set out far more articulately than I could many of the concerns about the Bill that underpin this evening’s debate. These concerns have been raised by Liberal Democrat Members and I know for a fact that a number of Conservative colleagues feel the same way about aspects of the reform, although that has not been articulated this evening.

I wish to get one piece of rough and tumble out of the way before I commence with the substantive comments I wish to make in the short time available to me. I will not be supporting Labour’s motion this evening because to do so would be to endorse Labour’s history of having introduced the following: independent treatment centres, which wasted hundreds of millions of pounds of taxpayers’ money; alternative providers of medical services enforced through primary care trusts; and many other top-down reorganisations, which Labour Members now pretend they are against. It would also mean endorsing their approach to the whole concept of top-down reorganisations, the billions that Labour wasted on NHS IT systems and Labour’s failure to address the unfair funding formula, which set back my part of the country significantly and left it in significant debt, from which it is still trying to escape.

I set out my position in the Second Reading debate on the Health and Social Care Bill, on 31 January, when I refused to support the Government because of the criticisms and concerns that I raised then. I do not need to repeat them now, but I also made it clear then, as I do now, that I would vote against the Government on Third Reading if the Bill were to look in any way like the measure that we saw come out of the Committee and that will come through to the Report stage. I therefore look forward to the outcome of the listening exercise, and hope that it is a genuine listening exercise and that substantial changes will be made to the Bill. The changes that I wish to see are so substantial that they would take the guts out of the Bill.

To the concept of commissioning proposed in the Bill and the idea of handing all that power to one narrow group of clinicians—GPs—there is, despite what the hon. Member for Banbury (Tony Baldry) said about GPs in his area, at best a resigned reluctance and at worst outright hostility about what GPs are being asked to do. I do not go along with the hon. Gentleman’s view that they are keen to get on with it. They are responsible people and responsible professionals; they recognise when they are being asked to do something and they will get on with it, but I must say that they will not do so with any enthusiasm.

Secondly, the substantial elephant in the room is not the risk of privatisation of the NHS, as the hon. Member for Easington (Grahame M. Morris), who is no longer in his place, described it, but the marketisation of the NHS. My hon. Friend the Member for Southport (John Pugh) put it well: the cherries will be picked by the private sector. Any decisions on commissioning could easily be unscrambled by a process whereby decisions that were intended to try to integrate services could be challenged because they were structured uncompetitively. Those are two fundamental failings in the Bill.

This comes to the heart of what coalitions are about. No one gets their own way, as Labour knows from being in coalition in other places, and it is silly to be childish about that. In a coalition, the parties work together when they agree and seek a compromise where they fail to agree. I would argue that when they cannot come to any kind of agreement or compromise, they should allow Parliament to decide. What I do not like about what is happening is the fact that the Secretary of State is largely implementing this—

[Madam Deputy Speaker (Dawn Primarolo)]

Order.