National Health Service (Amended Duties and Powers) Bill

Andy Slaughter Excerpts

Friday 21st November 2014 Commons Chamber

[Clive Efford]

Absolutely essential. The question for the House is whether that policy issue should be decided by Parliament or the courts. Clause 14 is either unnecessary or essential, depending which set of lawyers ends up being proved correct. We say it should be a decision for Parliament, not the courts. Clause 14 puts the matter beyond doubt.

The public must decide whom they trust with the NHS. Do they believe the Tories who say they will protect it? After all, the Tories said there would be no top-down reorganisation, they said there would be no closure of A and E departments, and they said there would be no closure of maternity units except where local people agreed.

[Mr Andy Slaughter (Hammersmith) (Lab)]

I am grateful to my hon. Friend for allowing me to intervene, in addition to my main function today, which is to provide a cordon sanitaire. [Laughter.] I am very pleased that my name appears on the Bill as one of its supporters because nowhere is it more apparent than in west London what the Tories mean for the NHS. Two A and E departments closed, and within weeks up to a third of patients were not seen within four hours at A and E. Does my hon. Friend agree that unless we get rid of all this Tory legislation, the NHS will not survive?

[Clive Efford]

My hon. Friend is right. Before the election the Tories said that they would seek the agreement of local people in decision making, but in south-east London in 2007 my local health managers published a document called “A Picture of Health”. It was drawn up by doctors, nurses and midwives. They held a conference and reviewed all our services. They came to politicians like me and said, “We want you to behave sensibly. This is about improving the quality of care for patients, but at A and E it is also about saving lives.” Just before a general election, it is quite a thing for people to say, “We’re going to close one of your A and Es.” I differed with the health managers over which A and E should close, but when clinicians come and say, “We can save lives and improve quality of care,” we have to listen.

That is what the Government said they would do. What happened? The then shadow Secretary of State for Health, the right hon. Member for South Cambridgeshire (Mr Lansley), came to the A and E proposed for closure in “A Picture of Health”, marched around the area and told local people, “We’re not going to close your A and E.” What happened then? The Tories got into Government and closed the A and E. In London they put nine out of 31 A and E departments under threat, then they attempted to force the closure of Lewisham A and E. When they were beaten off by local people, they took powers to themselves to close it over the heads of local people.

Now, my constituents who get in an ambulance are handed a leaflet that says, “If you come from SE9 or SE3, you can’t go to the local A and E at the Queen Elizabeth.” Where do they have to go? You guessed it: Lewisham. But Lewisham A and E would not have been there if the Government had had their way. On top of that, the Care Quality Commission has condemned A and Es in our area because of lack of resources and lack of capacity. At the same time the CQC commended the staff for their dedication in keeping the service running, yet the Government would have closed Lewisham A and E. So, what of their pre-election commitment not to do anything over the heads of local people or local health managers?

Do we believe the Tories when they say the NHS is safe in their hands? [Hon. Members: “No.”] To defend the NHS, one has to believe in the founding values that led to its creation. Our NHS treats everyone equally—from each according to their means, to each according to their needs. Are these the values of the party that gave us the poll tax or the bedroom tax, or the party that plunges thousands of disabled people into poverty by denying them benefits and forcing them through an unending cycle of appeals to get what they are entitled to?

Throughout history working-class people have had to fight to assert the undeniable truth that all men and women are created equal. From the very first poll tax rebellions, John Ball asked:

“When Adam delved and Eve span, who was then the gentleman?”

He educated common people that they were all created equal. It is a theme that working-class people have been forced to return to throughout the centuries, whether through Christianity or a political fight for social justice from the Levellers to the Diggers, from Thomas Paine and the Chartists to the trade union movement today. These are the people who fought for the values that created the national health service. There is nothing in our society today that embodies those values more than our national health service. It is these values that cannot be defended by a party that talks about fairness while it justifies the bedroom tax and measures people’s worth. That is not what our NHS does.

This Bill will not solve all the problems in our national health service—it will take a Labour Government to rescue it from a crisis—but it is an essential step in rebuilding our national health service.

Mr Speaker, I do not beg to move that this Bill be read; I demand it be read, on behalf of NHS patients, on behalf of the staff—the nurses, the doctors, the support staff, the carers, the volunteers. On behalf of everyone who holds our national health service dear, I move that this Bill be read a Second time.

--- Later in debate ---

[Andy Burnham]

Those examples will alarm people. In Greater Manchester, a bus company has been running ambulance services. We had news this week that an arms manufacturer is bidding for a GP contract. These are the things that are beginning to happen to the NHS. Nobody’s constituents have ever given their permission for any of this to happen.

We heard speeches from the hon. Member for Bosworth (David Tredinnick) and the right hon. Member for Banbury (Sir Tony Baldry), who said that nothing had changed and what was happening in the NHS now was just a continuation of what the previous Government were doing. No, it is not. The right hon. Member for South Cambridgeshire said in a speech on 9 July 2005:

“The time has come for pro-competitive reforms in…health”

and he help up the example of utilities and rail. That was the specific inspiration for his reorganisation. He sold his Bill on the basis that doctors would decide, but doctors tell us that they have no choice but to put services out to the market. Section 75 says that commissioners may not run a tender if there is only one available provider. That is never the case, which is why CCG lawyers conclude that they have no choice but to put services out to tender.

That is why we see, according to figures from the NHS Support Federation, that 865 contracts for NHS services, worth £18.3 billion, have been offered to the market. Some 67% of the contracts awarded so far have gone outside the NHS. It is this decision to mandate the tendering of services which places the NHS in the full glare of EU procurement and competition law. Because Ministers have refused to exempt the NHS from the TTIP treaty, we could soon have private US health care providers ringing up CCGs to challenge them on their commissioning decisions.

This Bill legislates to remove that threat. It repeals section 75 and it really does let doctors and local commissioners decide. It restores the role of the Secretary of State and brings much needed ministerial accountability back to this House. No longer will Ministers be told to write to NHS England when they have concerns. Instead, there will be answers from the Government Dispatch Box about the service that matters most to their constituents. It removes the role of the competition authorities that the Government’s Act introduced. It stops the ludicrous situation where hospitals such as Bournemouth and Poole are not allowed to collaborate. Importantly, it stops hospitals devoting half their beds and half their facilities to the treatment of private patients.

[Mr Slaughter]

Since Hammersmith and Central Middlesex A and E departments closed two months ago, we have had people waiting in ambulances and waiting rooms with every seat taken. We have even had people waiting on floors. The Government’s answer to that is to close two more A and E departments, those at Charing Cross and Ealing in west London. Is that not just preparing the NHS for failure and for privatisation?

[Andy Burnham]

What is happening in west London should send a shiver down the spine of every community in the country. The NHS is being torn apart, which is damaging patient care and leading to the consequences that my hon. Friend outlines.

This is how the character of the NHS is changing under this Government and before our eyes. With every year that the Health and Social Care Act stays on the statute book, the private sector will be more embedded in the NHS and the public NHS weakened as a result. The Government have undermined the “N” in NHS. They are letting our hospitals become part-privatised and they must be stopped. If the Government continue on their current course, in the next Parliament the NHS will be overwhelmed by a toxic mix of cuts and privatisation.

If the Government stop this Bill receiving Royal Assent, it will form the basis of the repeal Bill that the next Labour Government will lay before the House in May next year. But it will do more than that: it will remove the competition role to allow the full integration of health and care to build and lay the foundations for a 21st-century NHS.

One final thing needs to be said. Before we vote, there is a simple truth that all Members in all parts of the House must confront: nobody here has permission from their constituents to put the NHS up for sale. Today is their last chance to put that right before they face their constituents in six months’ time. The people of this country value and trust a public NHS that puts people before profits. This Bill restores that. The party that created the NHS is proud to support it, and I urge all Members to vote for it.

--- Later in debate ---

[Dr Poulter]

I am happy to confirm and to put on the record the points that my hon. Friend has made. It is important that the NHS is not used as a political football, and that services are always designed and delivered in the right way for patients. There is often too much scaremongering in these debates. I reiterate that what she said about the local A and Es is absolutely correct.

[Mr Slaughter]

Will the Minister give way on that point?

[Dr Poulter]

I have just dealt with it, and I am going to make a little progress.

I want to deal with the contribution made by the hon. Member for Rochester and Strood (Mark Reckless). He failed to address the issues that I had raised earlier about the support that the hon. Member for Clacton (Douglas Carswell), his party colleague, gave to the Health and Social Bill—now the Health and Social Care Act. In fact, as the right hon. Member for Leigh (Andy Burnham) said, the hon. Member for Clacton thought that the reforms did not go far enough. Indeed, the leader of his party is on record as talking about the need, in effect, to privatise our NHS. I would like to reaffirm the commitment that that will absolutely never happen under this Government or any Conservative Government.

Another important point needs to be made. Earlier this week, the hon. Member for Rochester and Strood expressed frankly unacceptable and distasteful views on repatriation. We must of course bear in mind that 40% of staff in our NHS come from very diverse, multicultural backgrounds. We very much value the contribution that doctors, nurses and health care staff from all over the world make to our NHS. I do not want to see those people repatriated; I want to see them continuing to deliver high-quality care for patients in our NHS—something that UKIP clearly opposes.

--- Later in debate ---

[Barbara Keeley]

My hon. Friend absolutely should be concerned and I know that he is.

One of the elements of cancer and end-of-life care given to us as an example of where improvement is needed in Staffordshire and Stoke was patient transport. However, we know in the north-west that going to new private providers does not tend to help. We have already had a negative experience since patient transport was contracted out to the bus company Arriva.

A number of my constituents have had problems with Arriva’s patient transport. One contacted me following a wait of more than three hours for ambulance transport to be arranged for her husband. He has terminal cancer and needed to be transported back to Salford Royal after oncology treatment at the Christie hospital. That was the second time in three weeks that this terminally ill patient had to wait two or three hours for transport. Staff at the Christie hospital told my constituent that such long waits were common, despite the fact that many oncology patients are very sick.

[Mr Slaughter]

I am very grateful to my hon. Friend for giving way, particularly because the Minister did not in the course of his very long speech. Of course, that might have been because the main emergency hospital in my constituency, Charing Cross, is being demolished, losing all but 24 of its 360 beds, losing the best stroke unit in the country and losing its A and E, which, according to board papers, is moving from the site. There will be no emergency consultancy services at all. Is not what is happening on the ground very different from the jargon-filled rubbish we heard from the Minister today?

[Barbara Keeley]

Absolutely, and I am saying what is happening on the ground to a terminally ill cancer patient.

In her letter to Arriva, my constituent told the company:

“Your company should not have this contract if it displays such a lack of concern for very ill patients causing distress to both them and their relatives”.

Not only was the delay unacceptable to a terminally ill patient, but the reply to my constituent’s complaint was one of the worst I have ever seen, as we are talking about gobbledegook. For instance, the explanation for the long wait included the following sentence:

“When an outpatient booking is made, the expected outbound blocking is automatically populated, using the throughput assumption.”

The jargon that starts at the top permeates down even to the complaint handling. It took a lot more letters to get an apology for such appalling service and such a poor reply.

Another constituent has told me of unsuitable transport and untrained staff—we have heard about this happening across the country—sent to the home of a patient who needed to use a wheelchair. That meant that the patient missed their appointment and an important investigation of their health was delayed by a number of weeks. I trust that the commissioners driving the privatisation of cancer services in Staffordshire and Stoke are aware of just how wrong transport services can go with a private transport provider.

This Government’s measures have put competition and privatisation above the needs of NHS patients. The Health and Social Care Act has put pressure on regulators to make clinical commissioning groups and NHS trusts adopt tendering processes that are not in the best interest of patients. That means wasted money, resources and time. This Bill would remove these damaging reforms, and patient care would be prioritised instead of unnecessary competition. The Bill would not prevent competition within the NHS, but it would prevent competition at the expense of patient care.

Our national health service is different from other sectors and needs a different approach. Integration to improve patient care needs collaboration rather than competition. It is a great pleasure to be in the Chamber today to speak and vote in support of the Bill.