National Health Service (Amended Duties and Powers) Bill

Debate between Andy Burnham and Tony Baldry

Friday 21st November 2014 Commons Chamber

[Sir Tony Baldry]

My hon. Friend makes a good point. I think the Labour party will regret signing up to every 38 Degrees campaign, because if 38 Degrees starts drafting the Labour party manifesto rather than the Labour party, the Labour party will never sort out whether it is new Labour, old Labour or any other sort of Labour, which is why it did so incredibly badly yesterday in the Rochester by-election.

[Andy Burnham (Leigh) (Lab)]

The right hon. Gentleman has just made a comment that cannot go unchallenged. He claims that the relationship that this Government have with the private sector is the same as that of the previous Government. That is absolute rubbish. When his Government’s legislation went through, he said that doctors would decide. Doctors throughout the country are now saying that they are mandated to put services out to the open market under section 75 of the Health and Social Care Act 2012—his Government’s legislation. That was not the case under the previous Government. If this Government are just doing the same as the previous Government, why did they need a 300-page Bill to rewrite the legal basis of the national health service?

[Sir Tony Baldry]

May I remind the right hon. Gentleman of a document published on 31 October 2000, under the last Labour Government? The printout that I have is entitled, “A Concordat with the Private and Voluntary Health Care Provider Sector”. It is headed, “Socialist Health Association—Promoting health and well-being through the application of socialist principles”. It was a concordat introduced by the previous Government with the private and voluntary health care sector. It says:

“Introduction. There should be no organisational or ideological barriers to the delivery of high quality healthcare free at the point of delivery to those who need it, when they need it. The Government”—

the last Labour Government—

“has entered into this concordat with the Independent Healthcare Association to set out the parameters for a partnership between the NHS and private and voluntary health care providers. It describes a partnership approach that enables NHS patients in England to be treated free in the private and voluntary health care sector.

The key tests for any relationship between the NHS and private and voluntary health care providers is that it must represent good value for money for the tax payer and assure high standards of care for the patient. The involvement of private and voluntary health care providers in the planning of local health care services at an early stage will enable the NHS to use a wider range of health facilities within their locality. To achieve this Health Authorities in their strategic leadership role will be expected to ensure that local private and voluntary health care providers are involved in the processes designed to develop the local Health Improvement Programme as appropriate.”

And it carries on. The document is headed, by the last Labour Government, “Socialist Health Association…A Concordat with the Private and Voluntary Health Care…Sector”. Indeed, the last Labour Secretary of State for Health signed a concordat with the Independent Healthcare Association on 31 October 2000.

The decision to make greater use of private sector facilities for NHS patients did not require new legislation and it was possible to undertake it within the existing legislation on the NHS, but for the avoidance of doubt let me quote the Labour party manifesto from 2001. In the chapter on NHS reform, Labour promised to

“work with the private sector to use spare capacity, where it makes sense, for NHS patients”

and to

“create a new type of hospital—specially built surgical units, managed by the NHS or the private sector—to guarantee shorter waiting times”.

In my constituency, we have an independent orthopaedic treatment centre run by the private sector and introduced under the Labour Government. We have a Darzi walk-in centre run by private GPs, which was also introduced during the time of the Labour Government.

--- Later in debate ---

[Sir Tony Baldry]

The hon. Gentleman misunderstands my point. The Act did not introduce competition into the NHS because that competition had already been introduced by the previous Labour Government, who introduced greater private sector involvement in the NHS. Labour made binding rules to manage the competition, and the Act continued that approach with an expert health sector regulator working in the best interests of patients. Removing Monitor as the health sector regulator would merely leave commissioners facing actions through the courts under Labour’s own 2006 procurement regulations, which I do not think would be in the best interests of patients.

[Andy Burnham]

I am afraid that the right hon. Gentleman has undermined his entire speech with the ignorance he has displayed in response to my hon. Friend the Member for Eltham (Clive Efford). For the first time in the history of the NHS, the Act gave a role to the competition authorities, under the Enterprise Act 2002, in taking precisely the kind of action that my hon. Friend referred to. I am very surprised the right hon. Gentleman does not know that; may I suggest that he does not know what he is talking about?

[Sir Tony Baldry]

We heard that argument during the passage of the Act, and it is simply wrong. It is wrong to suggest that somehow the Act opened the door to competition.

Adult Social Care

Debate between Andy Burnham and Tony Baldry

Thursday 8th March 2012 Commons Chamber

[Tony Baldry]

One of the advantages of having been in the House for a little while is that one spends some time on the Government side, some time on the Opposition side and some time on the Government side again—I hope not to be on the other side again but am quite content wherever. One of the things I have learnt is that which side one sits on does not change reality. The reality is that this challenge is so enormous that it will not be solved simply by all of us telling the Treasury, “You’ve given us £2 billion. Please can we have another £4 billion, or another £8 billion.” It will only be changed if we fundamentally rethink how we deliver services for the elderly. If all Members asked how many delayed discharges there were in the general hospitals in each of our constituencies, I suspect that we would find that it is a huge number—I am afraid that Oxfordshire is currently one of the worse offenders. We have to do better. We have to fundamentally rethink the whole way we deliver these services.

[Andy Burnham]

I agree with the hon. Member for Kingswood (Chris Skidmore), who talked about the contributory principle, because there has to be a partnership between the individual and the state. If the hon. Member for Banbury (Tony Baldry) is ruling out general taxation, which I agree with him on because it would not be fair to make the younger population pay yet another cost, does he not accept that one ultimately comes to some difficult options in raising the extra money to build a fairer care system? We all have to start being honest about that and put some difficult options on the table, so that the public can have a debate about them.

[Tony Baldry]

Of course, general taxation will continue to play a part because it will fund the national health service, including the services delivered in acute general hospitals and so forth. However, far too many elderly ladies who go into a general hospital with a stroke or a broken hip stay there for longer than they need to for their treatment and could go home. We all need to engage in a debate in our constituencies that breaks out of the secret garden and involves far more people, including elected representatives, voluntary organisations and others.

Finally, I want to talk about carers, because I do not believe that any debate on care for the elderly should take place without a discussion about carers. I am the co-chair of the all-party parliamentary group on carers, so the House would be surprised if I did not mention them. There are two things that carers want. The first is recognition, which is now becoming slightly better. We need GPs and others to help people to understand that they are carers and to ensure, wherever possible, that they apply for a carers assessment, so that we can give support to carers. That will be particularly important if we are asking people to spend more time living at home when they are suffering from dementia and other conditions.

There are simple things that can be done. One of the worries of people who care for someone with dementia is that they will wander off and get lost. Age UK in Oxfordshire is starting a new initiative that encourages people to text a number if they see Mr Smith wandering down the street. Most of us are a bit embarrassed or shy if we see a neighbour wandering off and do not think that we should apprehend him, even if we think that he might not know where he is going or that it is not in his best interests to wander off. The question is how to deal with that as a community. There are lots of complexities in these matters. The whole community has to get involved if we are going to have more people living at home.

The second thing that carers want—I have said this on occasions too numerous to particularise—is breaks. We must ensure that there is a decent system of respite care. If there is not, carers sooner or later break, and when they break, they break for ever. That means that people whom it had been possible to care for at home go into a nursing or care home, never to emerge. With judicious and supportive carers’ breaks and respite care, many carers can be supported to carry on caring for a long time. Carers need to be valued and deserve to be valued. At every opportunity, the House should say an enormous thank you to the hundreds of thousands of carers in this country.

National Health Service

Debate between Andy Burnham and Tony Baldry

Wednesday 26th October 2011 Commons Chamber

[Andy Burnham]

It is clear that we will get to the bottom of this, because the Secretary of State has committed to publishing the minutes, and if he is suggesting that the RCN has been inaccurate, he needs to produce the evidence.

That takes me to the Prime Minister’s second personal promise on the NHS, which deals with hospital reconfiguration and the mythical moratorium.

[Tony Baldry (Banbury) (Con)]

rose—

[Andy Burnham]

I shall give way in a moment.

If we thought that the Conservative party’s promises on funding were bad enough, the sheer audacity of its claims on hospital closures is breathtaking. Before the last election, the right hon. Gentleman toured the country promising the earth to every Conservative candidate he met. I recall seeing his commitments—I have them here—pile up in the Ashcroft-funded glossy leaflets that landed on my desk in the Department of Health. He said that he would reopen the accident and emergency department in Burnley; he said that he would save and A and E in Hartlepool, but, scandalously, only if the town elected a Conservative MP; and I well remember the day he visited his hon. Friend—although, after this week, I doubt that the Government Front Bench team still consider him a friend—the hon. Member for Bury North (Mr Nuttall) and promised the people of Bury in the leaflets I have here:

“Vote Conservative and if there is a Conservative government the maternity department will be kept open.”

It could not be clearer. However, the maternity department at Fairfield hospital is scheduled to close next March. It is disgraceful. However, the Prime Minister’s most shameful politicking came in north London. I lost count of the number of times he promised to save the A and E department at Chase Farm hospital.

--- Later in debate ---

[Andy Burnham]

After that rude interruption from the hon. Member for Kingswood (Chris Skidmore), I shall get back to my script.

Just days after the election, the Prime Minister went to Chase Farm hospital, with the Secretary of State, to announce the coalition’s new policy of the moratorium and the following commitment in the coalition agreement:

“We will stop the centrally dictated closure of A&E and maternity wards.”

I have with me the photograph from that very visit of the Secretary of State holding up a placard stating his opposition to any changes to the A and E at Chase Farm hospital. However, he has recently failed to prevent those changes to the A and E department and maternity unit at Chase Farm hospital, leaving the new hon. Member for Enfield North writing a desperate letter to the Prime Minister stating that his constituents had been utterly let down by them both. I do not know whether the Prime Minister or the Secretary of State have the decency to feel embarrassed today, hearing these cynical promises repeated in the House. The proposed moratorium and opposition to closures were purely political and designed to help the Conservatives win votes in marginal seats. That is a fact.

[Tony Baldry]

I apologise for not having intervened quickly enough earlier, but the right hon. Gentleman says that he accepts the Nicholson challenge. Given that efficiency savings will have to be made in the NHS, where does he envisage those savings being made? It seems to me that every hospital trust will have to make efficiency savings somewhere, as a result of the Nicholson challenge.

[Andy Burnham]

The hon. Gentleman asks a very fair question. It is precisely such issues—about how to produce the savings—that are the important issues. Care has to be taken out of the hospital setting and we have to prevent too many elderly people, in particular, from going into hospital in the first place if we are to create an NHS that is able to face the future and that is financially and structurally sound. That is why I take such exception to the naked opportunism that we saw before the election, when I, as Health Secretary, was taking on some of those difficult challenges and grasping the nettle, including in my own backyard in Greater Manchester, where there was a difficult review of maternity and children services, involving the closure of four maternity units and shrinking their number to eight. We did that, we took on that debate, and yet the now Health Secretary was touring those marginal constituencies in Greater Manchester, saying that he would overturn our decision in office, but he has not done it. That is precisely the point that I am making to the House. We need a Health Secretary prepared to take those difficult decisions, if the NHS is to be able to make the savings that will sustain it in the long term.

--- Later in debate ---

[Mr Lansley]

No. I think that the moratorium has led to a better way forward even in Enfield. It is in the hands of the commissioners and the local authority in Enfield collectively, to make decisions for Enfield. Within two months I shall receive a report from NHS London advising whether it would be better organisationally for Chase Farm to be combined with North Middlesex rather than Barnet, and I should be interested to know the hon. Gentleman’s view on that. We continue to seek not top-down forced reconfigurations, but reconfigurations that consistently meet the four tests, and do so in the best interests of the NHS.

[Tony Baldry]

The right hon. Member for Leigh (Andy Burnham) implied that my right hon. Friend should have completely ignored the advice of the independent reconfiguration panel. Can my right hon. Friend tell us whether, when the right hon. Gentleman was Secretary of State for Health, there were any occasions on which he sought to ignore the panel’s advice?

[Andy Burnham]

No.

[Tony Baldry]

What is the point of having such a panel if it is to be ignored?