National Health Service (Amended Duties and Powers) Bill

Debate between Andy Slaughter and Baroness Keeley

Friday 21st November 2014 Commons Chamber

[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.

Accountability and Transparency in the NHS

Debate between Andy Slaughter and Baroness Keeley

Thursday 14th March 2013 Commons Chamber

[Mr Slaughter]

I am grateful for that. I did a company profile for Harmoni. It revealed that, although he might have sold his shares for that amount of money, Dr Goodman is still listed as head of clinical spine. A series of press articles deals with the failings of Harmoni—failures that have caused deaths through under-staffing or poor-quality staffing—and why it is under investigation.

Let me return in the time I have available to my attempts to get to the bottom of the matter. The same day as I read the article in The Guardian, I wrote a short letter to the chief executive of the NHS in north-west London. I said:

“I attach the front page article from today’s Guardian, which you may have seen, regarding the sale of out of hours GP service provider Harmoni to Care UK. The article states that a number of GPs will make substantial sums from the sale.

I note that four of the CCG chairs in NW London declare shareholding or directorship in Harmoni, as does your Medical Director. It would be helpful to know if they are beneficiaries of the sale and by what amount.”

I then asked for assurances as to the future.

A month later I received a non-reply reply, the most relevant sentence of which was:

“Any member who declares an interest in a meeting is expected to take no part in discussions and step out of the meeting.”

I wrote back a much longer reply, in which I pointed out that the chair of the Royal College of General Practitioners had said:

“it is not about excluding yourself from the room whenever there is a discussion; it is about how it will drive your decision-making overall”.

I pointed out that, as a consequence of hospital closures in north-west London, there had been a shift in funding from hospital to primary care, a greater involvement of private companies in the primary care sector, and an opportunity for those companies to increase their profits by cutting back on the level of service offered.

I principally raised the fact that the information that should be provided is not provided on declaration of interest forms, especially the scope and value of any interest. I listed doctor by doctor and CCG chair by CCG chair what those interests were and how they were not adequately declared. I dealt with seven out of the nine CCG chairs and the medical director. That was in a letter on 20 December.

I received a reply on 3 February which said:

“The Cluster does not hold this data.”

So three months on from my original inquiry, I am none the wiser in relation to these matters.

I advise any hon. Member to look at their CCG declarations of interest online—not Hillingdon, because it does not publish them online. I use Hammersmith and Fulham as an example here. The husband of one member is a partner of Drivers Jonas Deloitte. The first thing I found on the website of Drivers Jonas Deloitte was that it had been appointed to sell the Kent and Sussex hospital in Royal Tunbridge Wells when it closes in 2011. Another member is the owner of a provider of home care services. Another is the brother of the director of a design company that holds a number of contracts with NHS organisations. It might be that none of them has a direct financial pecuniary interest now or in the future, but it shows touching naivety, complacency or worse.

Before the 28 members of the joint PCT board made the decision to close the four A and Es in north-west London, I said at the public meeting that if any of them had or was likely to have interest of a pecuniary nature they should not take part in that decision. One of them rather touchingly volunteered the information that they had sold their shares. What world are we living in when a third of GPs on the new CCGs can hold financial interests in anything from land sales to an alternative provider?

I raised the question with the Prime Minister yesterday and mentioned Dr Goodman, although not by name, and his estimated minimum return of £2.6 million. Again, I got a non-reply in reply. Sooner or later the Government will have to address these matters.

There is another story in the Daily Mail today that states:

“In 1981 there were eight NHS press officers in Britain. Now there are 82 in London alone”.

It is not that there is a lack of spending on publicity in the NHS. Indeed, almost £1 million has been spent on a private consultancy firm simply to carry out the bogus and botched consultation on the closure of A and Es.

We are seeing the creation of a second-grade health service in north-west London.

[Barbara Keeley]

A number of months ago, I raised the case of a person who rejoices in the title “NHS head of brands”. There seem to be a whole set of units that keep cropping up.

[Mr Slaughter]

I am sure that all Members will have similar examples. It is an obscenity that millions of pounds are being spent on spin and disinformation while basic information is not being provided even to Members of Parliament after three months and persistent requests. Sooner or later, these issues will have to be addressed.

Of course, our main preoccupation is to maintain our first-rate health service—our blue light A and Es, our stroke centres and our major hospitals—rather than having it replaced by urgent care centres and minor primary care facilities. That is what we face in north-west London and, I am sure, around the rest of the country. It adds insult to injury if the individuals who are making the decisions to sell the land and to transfer services into the private sector are also the shareholders and owners or if they benefit in any other way. This is a corrupt act and it must be addressed by the Government. They cannot continue to turn a blind eye to it.

Localism Bill

Debate between Andy Slaughter and Baroness Keeley

Monday 17th January 2011 Commons Chamber

[Mr Slaughter]

I agree entirely with my hon. Friend. I hope that Government Members have read the comments of Shelter, which has said:

“The proposed changes sever the link between homelessness and recognising the need for a settled home by allowing councils to discharge homeless households into the insecure PRS”

—the private rented sector—

“rather than find them a settled home.”

It is a shameful day for the country when a tradition that all parties have supported for many decades is abandoned: the tradition of ensuring that poorer families have stable and affordable homes. Given all that they have said over the past five years about the need to provide more good-quality affordable housing, the Liberal Democrats above all should not vote for provisions that will destroy security of tenure and the opportunity for people to live in stable homes.

Let me end by making two points that I shall have no time to amplify. The Bill’s provisions for Gypsies and Travellers are also shameful, because they constitute a cynical way of not providing Gypsy and Traveller sites. That is dog-whistle politics.

[Barbara Keeley]

I believe that the Bill contains the first indication of cuts in Sure Start, which we expected despite what the Prime Minister said about protecting it.

[Mr Slaughter]

I am grateful for that intervention, because it has given me a little more time to amplify the point that I was making.

In view of what has been said today about provision for Gypsy and Traveller sites, I think that Members should sometimes examine their rhetoric. The single most important issue is that the Secretary of State for Environment, Food and Rural Affairs wishes to cut all provision for Gypsies and Travellers: both the capital funding and the requirement for local authorities to provide sites for them. If there were enough sites, there would not be unlawful encampments. It is shocking that the Government should wilfully close their eyes to that fact and simply introduce civil and criminal penalties for Gypsies and Travellers, and they should examine their conscience.

Finally, let me echo the words of Sir Christopher Kelly, who said that the end of the standards regime allowed councils, such as Hammersmith and Fulham, to get away with what they were doing. That provision should also be rejected.

--- Later in debate ---

[Barbara Keeley (Worsley and Eccles South) (Lab)]

We have had a lively debate, with some 40 speakers. There is a clear division between the Government and the Opposition on the Bill, and some Government Members have expressed concerns. There have been some excellent speeches.

My hon. Friend the Member for Sheffield South East (Mr Betts) put it well when he said that the Bill was a missed opportunity. He said that the general power of competence should sit within a constitutional framework —of course it should—and that there would be a void in the standards of conduct for councillors. He questioned the powers that the Secretary of State wants to take for himself, in particular the power to impose shadow mayors, which many hon. Members have spoken about. He said that the Bill signalled the end of the provision of social housing.

Similar concerns were raised by my hon. Friend the Member for Birmingham, Ladywood (Shabana Mahmood) and my right hon. Friend the Member for Tottenham (Mr Lammy), who said that the Bill was atrocious. My hon. Friend the Member for Mitcham and Morden (Siobhain McDonagh) reminded us of the era of “Cathy Come Home”. She said that her test was whether it was a hand-up or a handout, and that the Bill failed the test. Similarly, the housing section of the Bill was the main concern of my hon. Friend the Member for Islington North (Jeremy Corbyn). Opposition Members think that the Bill has the potential to raise levels of homelessness, which is a serious concern. My hon. Friend the Member for Stretford and Urmston (Kate Green) feared that the disadvantaged had no voice and said the Bill was bad on many levels for the poorest in our communities.

Hon. Members raised concerns about other aspects of the Bill. My right hon. Friend the Member for Greenwich and Woolwich (Mr Raynsford) made it clear that although we understand the aspirations of the Bill, we have suspicions about the outcomes. There are problems with the drafting of the Bill. A big issue is that it is silent on how to settle competing claims. How will claims be settled among the views of a neighbourhood forum, a local authority and a mayor? My hon. Friend the Member for Stoke-on-Trent North (Joan Walley) warned that mayors could undermine local communities and councillors. The hon. Members for Cleethorpes (Martin Vickers) and for Keighley (Kris Hopkins) and a number of other hon. Members disagreed with the imposition of shadow mayors. We heard a bid for the independence of Keighley. Unfortunately, that will not come about through a local referendum, as such referendums will only be advisory. Another matter of concern to hon. Members from all parts of the House was EU fines.

For many Opposition Members, the key issues that underlie the Bill are the unfairness of the local government settlement and the absence of the resources necessary to build capacity in communities. My hon. Friends the Members for Birmingham, Ladywood, for Chesterfield (Toby Perkins), for Hammersmith (Mr Slaughter) and for North West Durham (Pat Glass), my right hon. Friend the Member for Tottenham, and my neighbour, my right hon. Friend the Member for Salford and Eccles (Hazel Blears), spoke eloquently about the problems caused by cuts.

[Mr Slaughter]

Will my hon. Friend give way?

[Barbara Keeley]

There is not time, I am afraid.

The Secretary of State told council leaders that they were in charge of about £38 billion each year, no strings attached. Since then, the Conservative-led Government have subjected council leaders to savage front-loaded cuts and to a stream of exhortations on what they should and should not do with their budgets. Ministers have told councils that they have a duty to preserve library services, that they should treat voluntary organisations fairly, that they have no justification to tighten eligibility for social care and that they should not issue redundancy notices immediately. Department for Communities and Local Government Ministers are telling councils to cut senior management posts, merge services with other councils and cut posts that Ministers see as non-jobs.

My hon. Friend the Member for Hammersmith told us that senior executive pay cuts and shared service cuts each contribute only 1% of the cuts that are needed, whereas 50% of the savings will be made by cuts to adult services and children’s services, including a disturbing 60% cut in funding for Sure Start—a service that the Prime Minister said the Tories would protect. My hon. Friend told us about an individual who was paid £700,000 in consultancy fees over four years, while drawing a £50,000 pension from the same council. On hearing such facts, we have to question why Hammersmith and Fulham is the apple of the Secretary of State’s eye. Indeed, the Secretary of State has called any council leader who could not predict cuts of £40 million to £100 million negligent

“to the point of stupidity”.

DCLG Ministers also want to direct councils on small details. They want to tell them how often they should empty their bins, ban them from putting out newsletters and tell them to reduce street signs and bollards. That is the background to the 126 new secondary powers that the Secretary of State wants to take in the Bill.

The general power of competence should give councils the freedom to act ambitiously on behalf of local residents, but the Secretary of State wants to take major powers to restrict how councils may use it and attach conditions to its use. He also wants the power to

“amend, repeal, revoke or disapply”

any statutory provision affecting or overlapping with the general power. That is a very broad power for a Secretary of State to ask for, and it undermines the concept of localism. It raises serious concerns, particularly because, as we have heard, he wants to direct councils on every aspect of their work, from how they manage their budgets through to what they should do about street signs.

The Secretary of State wants to order 12 of our cities to change their governance model to the mayoral model, and to appoint their current leaders as shadow mayors. Furthermore, he wants the power to order any local authority to start operating a mayoral governance model, subject only to a later referendum. Where is the belief in localism in all that?

The Under-Secretary of State for Communities and Local Government, the hon. Member for Hazel Grove (Andrew Stunell), said in September:

“This Government will let councils and communities decide how to organise themselves. We don’t presume to know more than local people about how their area should be run.”

However, the Government do presume to know more than local people, because the Secretary of State wants the power to dictate to councils exactly which model of governance they must adopt. Also, there is no level playing field for councils that opt to retain cabinet or committee systems, as they will not be able to bid for new powers in the same way as elected mayors using the new provisions in the Bill.

To Labour Members, the scrutiny powers of local government are a key aspect of democratic accountability. In the context of the Government’s massive and unnecessary reorganisation of the NHS, about which much has been said today, powers for local councils to scrutinise new health commissioning arrangements are more important than ever, and councillors should be given adequate powers to do that. It was interesting to hear hon. Members of all parties refer to that matter. Councils opting for the committee governance system will not even be required to have a scrutiny committee. We believe that to ensure accountability, those councils should have at least one scrutiny committee, in line with councils that have a mayor or council leader.

The Bill proposes local referendums, a community right to challenge, a community right to buy and a duty on councils to maintain lists of assets of community value. As we have heard, Labour would welcome some of those proposals if the legislation introducing them were better thought through. As it stands, the Bill provokes more questions than it answers. It will lead to extra burdens on local councils, which are already struggling to maintain local services in the face of the Government’s swingeing, front-loaded budget cuts. My hon. Friend the Member for Edinburgh East (Sheila Gilmore) highlighted how the community right to buy, which has been tried in Scotland, is an empty gesture if it is without funding.

On local referendums, we support greater public engagement in the political process, but much more should be decided locally. For instance, we do not understand how it can be up to the Secretary of State to decide what is a local matter. The proposals on the new community right to challenge and the duty on local authorities to maintain a list of assets of community value are ill thought through. Despite there being no definition of the term “assets of community value”, 10 powers are proposed for the Secretary of State to make regulations on those lists.

The DCLG note on the extra powers proposed in the Bill, is a fascinating document and it states that the debates during the passage of the Bill will constitute the principal initial scrutiny of the scheme, and I have to ask Ministers why that is the case. There could have been pre-legislative scrutiny, and my right hon. Friend the Member for Greenwich and Woolwich said that it cried out for it. That would have been preferable to giving the Secretary of State powers to regulate, order and specify matters that would be better decided locally.

The Bill aims to allow communities a say on developments in their area through the planning system, but those measures are particularly poorly thought through. Indeed, the Royal Town Planning Institute says that work is needed on the Bill

“to remove those barriers in its drafting that deaden its effectiveness and hinder the ability of Government to achieve its own objectives”

and that

“the lack of a coherent strategic planning system combined with the complexity of the neighbourhood planning system”

that the Bill proposes will

“hinder…economic recovery…addressing climate change and enhancing the environment”.

On that last point, 17 organisations in the Wildlife and Countryside Link say that the Bill must:

“Introduce…strategic planning across local authority boundaries”.

They feel that the Bill risks creating a two-tier system in which

“only well-resourced neighbourhoods can take part”,

which echoes the comments that we have heard from many hon. Members.

The Government have made the wrong choices in their proposals on social housing and the rights of people who depend on it. On that and other proposals in the Bill, there has been scarce opportunity for scrutiny—indeed, a rushed consultation closed only today. Housing and homelessness charities have rightly criticised the desire of Lord Freud, the Under-Secretary of State for Work and Pensions, to weaken the rights of homeless families. The Bill proposes to strip them of the right to any say over the accommodation that they are offered.

Many of my right hon. and hon. Friends spoke about the fact that the Bill will mean that social tenants lose their right to social housing if their circumstances change. Families who play by the rules and improve their lot could be at risk of losing their homes. The Conservative party said in April that it had no policy to change the current or future security of tenure of tenants in social housing, but the Bill contains provisions to do that. The Government have a record of breaking their word—on VAT, on the education maintenance allowance and on tuition fees—and now council and housing association tenants will see whether the Government keep their word.

If the Secretary of State were a true champion of localism, he would have proposed real freedoms for councils, rather than give himself wide-ranging new powers to direct them. He would have produced a Bill that engaged local people in planning their neighbourhoods at the same time as promoting sustainable development and protecting the environment, and he would have fought for a fair and manageable financial settlement for local councils. Had he done so, councils could work on giving their residents a real say in how their local areas are run, rather than focus all their energy on making cuts.

My hon. Friends said that the Bill is the worst of all worlds, that it will set community empowerment back years, that true localism will not emerge without a fair settlement for local government, that the Bill gives rights but no resources to back them up, that it is a shambolic cover-up, that it is not fair and not progressive, and that it fools no one. I urge hon. Members with concerns about the Bill to join us in supporting the amendment tonight.