The National Health Service

Barry Gardiner Excerpts

Wednesday 23rd October 2019 Commons Chamber

[Sir Mike Penning (Hemel Hempstead) (Con)]

It is a pleasure to follow the hon. Member for Huddersfield (Mr Sheerman). I fully agree with many of the points that he made, and I think that everyone in the House would agree with them.

I am not usually confrontational politically, so I will do only a tiny bit of that. This fear thing that is being thrown around about a privatisation of the NHS is very damaging. It is not particularly damaging to my party, but it is damaging across politics. I was at the Opposition Dispatch Box as a shadow health Minister for four and a half years, and during that time all those PFIs went through. Under the private finance initiative, private companies were being paid for surgery that was not even carried out. They were contracted for 1,000 knee operations or 1,000 hip replacements which did not take place, and they were still paid. That is what happened under the previous Labour Administration.

We need to admit that we make mistakes when we are in government. We have made mistakes before. I made mistakes as a Minister when I was in seven different Departments—it will probably not be eight now. Governments sometimes make mistakes for the best of reasons. One of the great mistakes was that era of privatisation, with PFI deals that were off the balance sheets, and Darzi clinics. Lord Darzi was a great surgeon, a great medical man; I just happened to disagree completely with many of his proposals which were implemented by the Government, and which, frankly, have not worked. There are still many clinics out there to which trusts have to pay huge amounts of money, not to get out of their contracts but just so that they can carry on. That is something that we need to admit. So, in this House, let us admit that Governments make mistakes and that the PFI privatisation carried out by the Labour party was wrong, although it was probably done for the best of reasons. A PFI hospital was promised to my constituents; it never came even though the Labour party closed the A&E at Hemel Hempstead hospital, in the largest town in Hertfordshire. We were promised that that would be looked after, because St Albans had had its hospital closed. However, it was closed and the whole thing moved to a Victorian hospital in the middle of Watford, which cannot cope today and has not been able to cope since then.

Adding little bits to hospitals, as the hon. Member for Huddersfield (Mr Sheerman) said, and putting a new A&E on the front can sometimes work, but when there is serious funding around, which is what we are talking about now, a modern, new, environmentally proper hospital that can actually have sufficient footfall to enable the medics to work in their specialties is what we need.

I am one of the few Conservative MPs to have been offered the £400 million for a new hospital. I have said to the Secretary of State and to my trust that it is not a new hospital; it is a refurbishment of a Victorian hospital in the middle of Watford next to a football ground, and my community does not want that. The people of Watford might, but if they thought outside the box—I am not being rude to them—I am sure they would agree that it would be better to have a brand spanking new hospital that looks after the communities of Watford and the surrounding areas of Hemel Hempstead and St Albans in that massive growing area just north of the M25.

So I do not want my old hospital reopened. It is still sitting there boarded up; it is just sitting there like a running sore in my constituency. It was a wonderful new hospital when the new town was built, but there she sits now with two wards, out-patient facilities and a minor injuries unit that does not even open for 24 hours even though we were promised it would.

What we want is a tiny bit more money—the Secretary of State knows this; I am not saying anything to the Minister that he does not know. We should not keep frightening people by saying it will cost £750 million or £1 billion to build a new acute hospital on a greenfield site, because we know it will not. We have the experts working for the new hospital action group and I am going to meet the experts in the Department in the next couple of days. So I am saying to the Department, “Hold back for a second on this new hospital for us, because if you hold back a second, we might get a completely different result.”

[Barry Gardiner (Brent North) (Lab)]

The right hon. Gentleman is speaking very candidly and with great integrity. My mother died in the Hemel Hempstead hospital that he speaks of many years ago. He talked about PFI and some of his remarks are absolutely spot on, but does he now recognise that the money owed on the PFI liabilities is actually £9 billion, as opposed to the £11 billion, which is the backlog of what hospitals are paying to the Department itself because of the borrowings they have had to take out as a result of the financial problems they are facing?

[Sir Mike Penning]

As was said in debate with the Scottish National party spokesman earlier, the Government can borrow money much cheaper than any private organisation.

I am thrilled that there is some honesty in the Chamber, because we have argued about PFI for donkey’s years; it was a way of getting things off balance sheet, and let us move on from that. There is no more PFI—we can all agree on that—but actually we are not privatising the NHS, as everybody with an ounce of common sense knows. The NHS is perfectly safe; it has been safe under this party for the majority of its time since inception, and it will stay perfectly safe. There are massive demands on it, however, and I cannot allow all this money—taxpayers’ money—to be put into a Victorian hospital next to a football stadium in the middle of Watford. Anybody who knows our part of the world knows that Watford football club is in the premiership. It might be struggling a little bit at the moment, although it did very well against Spurs the other evening. Let us pause, get the experts around the table and stop scaring people with costs that are completely unrealistic—new hospitals were built in Birmingham for £425 million and a new one can almost certainly be built in Harlow for similar amount. Let us have a 21st-century hospital. Let us be honest with each other and move that forward.

--- Later in debate ---

[Barry Gardiner (Brent North) (Lab)]

At the opening of the London Olympics, Danny Boyle wanted to show the world what it meant to be British, and he chose the NHS because it illustrates all that is best in our country. Watching on TV, millions marvelled at our nurses, our doctors and our carers, and in the stadium, thousands cheered. That is how proud we are of our NHS. All the people who work in it—cleaners, consultants, nurses, night porters, radiographers and receptionists—play a vital role in caring for our society. They are our national symbol of community and our model of selfless service.

This debate has reflected that, with 34 speeches and 49 interventions. There have been some wonderful speeches, including personal testimonies from the right hon. Member for Old Bexley and Sidcup (James Brokenshire), the hon. Member for Dudley South (Mike Wood) and my hon. Friend the Member for North Tyneside (Mary Glindon)—my dear friend—who if she did not quite move herself to tears, certainly moved the rest of us.

However, millions now worry that the NHS could be up for grabs in a future free trade agreement. At the heart of those fears is the Health and Social Care Act 2012, passed by the Conservative and Liberal Democrat coalition. It puts costs before quality and commercial competition at the heart of health commissioning. Just after the Act was passed, our local 111 service in Brent North was outsourced to a private company, the majority of the directors of which sat on the local clinical commissioning group—the very group that had awarded them the contract.

The Health and Social Care Act has allowed perverse commissioning decisions like that up and down the country. Today, our local CCG in north-west London faces not the £51 million deficit at year-end set out in its operational plan, but £112 million—an additional £61 million overspend as a result of an increase in acute activity of 18% against a population increase of 5%. When Conservative Members and their Liberal Democrat partners told us that the NHS was not for sale, those assurances were worthless. People may not be able to buy it, but privatisation is tearing it apart. My CCG has announced the closure of the 24-hour service at the urgent care centre in Middlesex Hospital.

[Craig Whittaker (Calder Valley) (Con)]

Will the hon. Gentleman give way?

[Barry Gardiner]

I cannot give way because of time.

It is this legislation that now exposes our NHS to foreign competition and undermines our public healthcare system. It is Donald’s door into our NHS. Some 170,000 people already know this, and they have signed a parliamentary e-petition calling on this Government to introduce safeguards that will protect it from new trade deals. Trade agreements lock in privatisation, and open up access to foreign investors and speculators. That is why we need safeguards.

[Matt Western (Warwick and Leamington) (Lab)]

Does my hon. Friend agree with me that one of the great threats to our NHS is a trade deal with the US that, as happened in Australia 10 years ago, will drive up the price of medicines significantly?

[Barry Gardiner]

I agree with my hon. Friend.

In 2007, Slovakia wanted to move from a private health system, modelled on the USA’s, to a system more like ours. Slovakia was sued for millions of euros by a Dutch company that thought the move might affect its future profits. Trade deals often contain clauses that give foreign investors the right to sue Governments for decisions that might affect their profits. These investor-state dispute settlement—ISDS—clauses are common in modern free trade agreements.

Policy decisions such as legislating for the plain packaging of cigarettes have been subject to ISDS claims. Labour believes the UK should be free to make public health policy based on the health needs of the British people. We should not have to bend to some company that is profiting from keeping our people ill, whether from tobacco, polluted air or too much sugar.

More than 750 cases are known to have been brought under ISDS clauses in other countries, and more than half resulted in compensation for foreign investors or in financial settlements out of court. Labour will not sign up to any free trade agreement that uses these ISDS-style rules, which are wrong in principle and, even where they are not used, can lead to regulatory chill.

Incredibly, the right to sue the Government under these ISDS clauses does not extend to our own UK companies, only to foreign companies in separate private courts. Labour has confidence in our courts and thinks foreign companies should have no greater rights of redress than British companies.



Free trade agreements also typically include market access clauses and national treatment provisions. These would set out the extent to which overseas businesses can operate in our markets, and they would insist that we afford at least the same treatment to foreign businesses as we do to our own businesses. In the past that was done by listing all those services that had been agreed. If an NHS service was not on the list, it could not be the subject of foreign competition. Agreements used to set out only those services that we were prepared to open up to competition, but modern trade agreements do not work that way.

Instead, modern trade agreements adopt a negative list system that says every service is opened up to competition unless it is placed on the negative list. Anything missed off the list is automatically open to competition. Once missed, a service can never be put back on the list. Any new service that comes as a result of technological or scientific breakthrough, if it is not on the list, is automatically open to foreign competition.

Imagine if we had agreed a negative list before the age of the internet and before digital technology had changed how patients can be screened and tested. If we lose our capacity and skill to provide these services directly, we will become a captive market and vulnerable to the abuse of private monopoly and spiralling costs.

Governments cannot intervene where there has been a clear failure in the sector or where patient health has been compromised. We need legal guarantees that no such negative list trade agreement will be concluded. That is why Opposition Members sought to introduce measures into the Trade Bill to achieve this protection. Conservative Members voted down every single one.

When their lordships secured essential provisions for proper scrutiny of trade agreements and a defined parliamentary procedure for ratification, what did the Government do? They abandoned the Bill entirely. Now they want to bring back the same legislation, but without those safeguards.

A potential deal with the US is of major concern to those who care about our health service. The American model is renowned for its pursuit of profit and its indifference to the poor. The US ambassador told national TV that the NHS would be on the table and that the US had already looked at all the components of the deal. President Trump confirmed it, and the Office of the US Trade Representative has published its list of negotiating objectives for any such deal. One objective is to stop the NHS using its bulk purchasing power to negotiate lower drug prices. The US Secretary of Health and Human Services actually said that the US would “pressure” other countries in trade negotiations so that Americans pay less and we pay more.

The USA wants to stop the UK regulating the pharmaceutical industry unless the US industry has agreed. So much for taking back control. In one of their first acts after establishing the Department for International Trade, this Government opened three new offices in the US, in Raleigh, in Minneapolis and in San Diego—biopharma hubs where major healthcare providers, biotech, pharmaceutical manufacturers and health insurers are headquartered. What made those cities so attractive if it was not an attempt to attract players from those sectors into our NHS? The Labour party created the NHS. We will not allow this Government’s trade agreements to damage it. Under Labour, the NHS will remain a universal service, free at the point of use, and based on medical need, not ability to pay.