Future of the NHS

Barry Gardiner Excerpts

Monday 31st January 2022 Westminster Hall

[Barry Gardiner (Brent North) (Lab)]

I begin by praising all the staff in the NHS, who, often at enormous personal risk, have provided dedicated care to so many of us over the past two years. The Minister must know—and the Government should acknowledge—that they are exhausted. As a country, we must show that we care for all of them as they address the backlog of over 5 million people waiting for treatment.

That care must be more than warm words and clapping. It must be tangible and financial, and it must be realistic. That means expanding workforce capacity, both as regards beds and staffing, in order to reduce the pressures our NHS heroes are facing. It means meeting the capital maintenance backlog of more than £9 billion. It was dereliction by the Chancellor to entirely omit any funding for infrastructure and building repairs when announcing the NHS settlement. There are two futures for the NHS: the disastrous one contained in the Health and Care Bill, or one that integrates health and social care in an efficient, comprehensive service that is free to everyone, from cradle to grave, whatever their medical need. It would be delivered entirely by, and be accountable to, our public sector—staff who are fairly treated and properly rewarded. I want to pay tribute to all the unions, particularly my own, Unite the union, for the work they have done to ensure that that is the case for staff.

By “comprehensive”, I mean that the service should include mental health and public health. If the pandemic has taught us anything, it should be the importance of public health, yet the integrated care boards have no delegated places for directors of public health, mental health or adult social services. There is not even a place for the voice of the patient, around whom everything should be centred.

By “efficient”, I mean that the service must deal with the backlog of 5.3 million patients waiting for treatment. By “whatever their medical need”, I mean that it should definitely include dentistry, as we have heard from my hon. Friends. By “accountable public service”, I mean that there should be no conflict of interest that allows a private company to sit on the ICB and commission contracts from which it will then be able to benefit. In 2012, I railed against the imposition of section 75 because it put competition, rather than co-operation, at the heart of our health system. I thought—correctly, as it turned out—that this would give rise to increasing privatisation, the rationing of care and the lessening of patients’ access to the care they need. Putting competitive tendering at the heart of the service destroyed trust and introduced a profit motive, rather than allowing a focus on successful medical care outputs.

It may be wondered why the reversing of the Health and Social Care Act 2012, introduced by Andrew Lansley, would be of concern to me. In 2012, none of us could have conceived of the fact that doing away with competitive tendering might mean not less, but more privatisation, unregulated by the tendering process. In 2012, we would not have believed that we would see VIP commissioning routes, through which contracts for medical equipment worth billions—not millions—of pounds would be given out to friends of Ministers, but that is what we face in the Bill. It puts that ability into legislation, which is why the Bill should be stopped.