NHS Reorganisation

Baroness Keeley Excerpts

Wednesday 17th November 2010 Commons Chamber

[John Healey]

Yes, of course; we had been doing that for some years before the election and we had plans to do it after the election, but the fact is that we did not win the election, and the Secretary of State is in power now. He is making the decisions and he is the one who is entrusted with the future of our NHS. He is the one who needs to answer to the House for his plans.

The problem with broken promises is worse than I have already suggested. The coalition agreement promised:

“The local PCT will act as a champion for patients and commission those residual services that are best undertaken at a wider level, rather than directly by GPs.”

The Secretary of State’s plans will do precisely the opposite. He is abolishing the PCTs, not building on the best of what they do.

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

There is a great deal of talk about reducing bureaucracy and administration, but PCT staff work on issues such as NHS treatment for people with learning disabilities. Ministers have talked about that role continuing, but will those staff not be really worried about their futures now? They will be looking around, and if they see another job, they are not going to wait two years; they are going to jump now, and the PCTs will lose that expertise. It will drain away and the PCTs will be unable to carry out all those important residual functions.

[John Healey]

This is precisely why those who understand the health service, including those who run it, say that it is going to be so hard, at a time when the NHS has never faced such a tough financial challenge, to see through the biggest reorganisation in its history at breakneck speed.

Whether on funding, reorganisation or the role of the PCTs, the Secretary of State is doing precisely the opposite of what was set out in the coalition agreement. He is running a rogue Department with a freelance policy franchise, in isolation from his Government colleagues. He claimed on the “Today” programme yesterday that he had been saying all this for four years before the election. So when did he tell people, and when did he tell the Prime Minister, that GPs will be given £80 billion of taxpayers’ money—twice the budget of the Ministry of Defence—to spend? When did he tell people that, in place of 150 primary care trusts, there could be up to three times as many GP consortiums doing the same job? When did he tell people that GP consortiums will make decisions in secret and file accounts to the Government only at the end of the year?

When did the Secretary of State tell people, and the Prime Minister, that nurses, hospital consultants, midwives, physiotherapists and other NHS professionals will all be cut out of care commissioning decisions completely? And when did he tell the Prime Minister that hospitals will be allowed to go bust before being broken up, if a buyer can be found for them? When did he tell people that NHS patients will wait longer, while hospitals profit from no limit on their use of NHS beds and NHS staff for private patients? When did he tell people that lowest price will beat best care, because GPs will be forced to use any willing provider? When did he tell people that essential NHS services will be protected only by a competition regulator, similar to those for gas, water and electricity? And when did he say that he was creating a national health service that opens the door for big private health care companies to move in?

--- Later in debate ---

[Mr Lansley]

I will give way to the hon. Member for Worsley and Eccles South (Barbara Keeley) first, and then to my hon. Friend the Member for Bexleyheath and Crayford (Mr Evennett).

[Barbara Keeley]

The Secretary of State talks about protecting social care, but he must be aware that at the same time cuts of 28% are being made to local council budgets, of which social services and social care account for the largest component. Even before the comprehensive spending review, six or seven councils were already saying their situation was moving from moderate to substantial, and for one council that has now risen from substantial to critical—and that is before the Government implement their cuts of 28%. There is no such protection in place, therefore. Instead, this radical NHS reorganisation is happening at the same time as those huge council budget cuts, and next year will be terrible. My right hon. Friend the Member for Leigh (Andy Burnham) was right to protect social care, as well as in the other things that he did with the NHS.

[Mr Lansley]

The hon. Lady is simply completely wrong. Local government budgets are not being cut by the figure she cites. The formula grant from central Government is having to be cut because of the debt we inherited from Labour, although she, like the rest of her party, is in denial about that, but that does not mean a cut—

[Barbara Keeley]

Will the Secretary of State give way?

[Mr Lansley]

No; I am addressing the point that the hon. Lady made. That cut in formula grant does not mean a corresponding cut in council tax, so that revenue is available to local authorities. In addition, the NHS is going to support social care activity in the ways I have described, such as through telehealth, re-ablement and equipment adaptations. We are transferring the learning disability transfer grant and other adult social care grants collectively representing £2.7 billion a year from the NHS to local authority funding, without reductions in those grants. I am afraid the hon. Lady is just simply wrong, therefore.