Future of the NHS

Catherine West Excerpts

Monday 31st January 2022 Westminster Hall

[Catherine West (Hornsey and Wood Green) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Gray. I am proud that so many of my constituents in Hornsey and Wood Green signed this important petition about funding for the national health service, and about keeping it in the public sector.

There is no doubt that the national health service is the most popular public service in my constituency, but there is a basic lack of staff, whether we are talking about primary care, GPs and other practice staff—they always seem to be looking for more staff—the 40,000 nurses of whom we are in desperate need nationally, or the thousands more doctors who are needed. Compared to other European countries, we simply do not have the correct ratio of patients to doctors. For example, in psychiatry there are increasing numbers of patients, particularly following the stresses and strains of coronavirus, waiting days and days in a hospital bed to see a consultant. I heard a story this week about a patient who waited 10 days to be seen during doctors’ rounds. That is a very long time to use a bed without getting the correct medical attention.

Many Members have mentioned the insufficient funding for dentistry. Sadly, my constituency of Hornsey and Wood Green, and the London Borough of Haringey, has some of the worst rates of caries in children’s teeth in Europe.

As my hon. Friend the Member for Wansbeck (Ian Lavery) said, 77% of NHS staff believe that they are worse off this year than last year. We know that they are working in excess of their hours, and that since 2010, hourly pay has been frozen or increased by a tiny increment. That does nothing to help staff cope with the challenges of the Tory-driven cost-of-living crisis, be it domestic fuel bills, the cost of food, children’s clothing, basic travel to work, or petrol to drive to work.

The Health and Social Care Levy Act 2021 has recently passed through Parliament. Social care is crucial to fix bottlenecks in the health service. We need a properly funded care system in which the hourly rate is correct in the light of the needs of the people working in it, and we need better overall management to get people into the right sort of care as quickly as possible, so that we can free up the national health service to look after people coming into hospitals through accident and emergency. That is a basic point that every Member in Westminster Hall has made on a number of occasions, but it still seems as if this Government are sitting on their hands and failing to address the crucial question of how we get the flow through the system. The problem also comes down to the terrible cuts to local government. If local government was adequately funded, we would have a much better, more proportionate system. I will stop there, Mr Gray, as other Members wish to contribute.

--- Later in debate ---

[Kim Johnson (Liverpool, Riverside) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Gray. The future of the NHS hangs in the balance, and the petition is entirely correct in calling on the Government to renationalise the NHS, scrap integrated care systems and end private finance contracts.

The Health and Care Bill threatens to open the floodgates to further privatisation by implementing a healthcare model that incentivises cuts and closures and rations funding to health boards while welcoming private profit-driven companies such as Virgin and Serco on to the boards of integrated care systems, giving them a say on where NHS money gets spent. The new legislation will further dilute the voice of patients and the public, with the new boards covering populations of up to 3 million people that will be remote and centralised, with no obligation to be open, transparent or accountable to ordinary people.

[Catherine West]

My hon. Friend is making an excellent speech. Does she agree that if we have that lack of transparency we might see a repetition of the Government’s wasting £4 billion during covid? There is a fear about related-party transactions, where people know exactly where the money is going—into their pockets.

[Kim Johnson]

I fully support what my hon. Friend says. The boards will be remote and centralised and will seriously restrict the power of local authorities to protect local services. With these changes, private healthcare giants will not only have a bigger say over the NHS but will be granted contracts with even less scrutiny than now.

By opening the door to private healthcare providers to take decisions on NHS budgets and services, the Bill makes it easier for public health contracts to be distributed to private providers, with less transparency and accountability. Safeguards in the Public Contracts Regulations 2015 will be excluded, watering down protections for employment and environmental provisions in procurement processes. There is no doubt that the Bill will put on steroids the cronyism we have seen during the pandemic while our NHS heroes have worked day and night, putting their lives on the line. The Government have cut real pay for nurses while handing out billions of pounds of contracts through an illegal VIP system to their mates and donors and to the failed track and trace system.

The NHS is the jewel in the crown of our public services—our proudest achievement. However, 12 years of Tory austerity, and now the pressures of the pandemic, have stripped it to the bone. An unbelievable £100 billion has gone to private healthcare providers in the last decade alone. The last thing the NHS needs right now is a dangerous overhaul that puts the private sector at its heart. We must take this and every opportunity to support amendments to the Bill that establish the NHS as the default option for all NHS contracts, to mitigate the worst parts of it. We must stand up to these new attacks or risk losing the NHS to privatisation by stealth. We must go further in our demands to roll back the damage done, reinstating the NHS as a truly national service and establishing a fully integrated national care service with staff and patients at its heart.

--- Later in debate ---

[Edward Argar]

As the hon. Lady will know, the former chief executive of the NHS, Lord Stephens, was clearing in saying that the

“overwhelming majority of these proposals are changes that the health service has asked for.”

We should do the right thing by them and by patients. It is the right time for the Bill: it is the right prescription at the right time.

The substance of the petition, which has framed many speeches by hon. Members today, calls for the Government to renationalise the NHS. I have to say that it has never been denationalised. The NHS is and always will be free at the point of use. The Government are committed to safeguarding the principles on which the NHS was created. The hon. Member for Denton and Reddish set that out very clearly. We have no plans for privatisation.

[Catherine West]

Will the Minister give way?

[Edward Argar]

I will make a little progress; if I have time, I will give way to the hon. Lady, with whom I sat on a committee of London councils when we were looking at social care reform way back in 2010.

We all recognise the importance of preserving this great national asset for the future and ensuring that the NHS remains comprehensive and free at the point of use, regardless of income, on the basis of need. The Government remain steadfast in their commitment that the NHS is not, and never will be, for sale to the private sector.

We are determined to embrace innovation and potential where we find it, but that is different from many of the accusations in the speeches we have heard today. I know it is tempting to scaremonger and set out accusations about what this Act does, even when people know better, as I know hon. Members do, but that reflects scaremongering rather than reality. There has always been an element of private provision in healthcare services in this country. Labour Members should know that because, as the Nuffield Trust said in 2019,

“the available evidence suggests the increase”—

in private provision—

“originally began under Labour governments before 2010”.

[Catherine West]

Will the Minister give way?

[Edward Argar]

I will just finish this point and then give way to the hon. Lady. The hon. Member for Liverpool, West Derby (Ian Byrne) made the point, which the hon. Member for Middlesbrough touched on as well, that it is important to look at the extent of the involvement of private sector providers, which accelerated when the Labour party was in power. The hon. Member for Liverpool, West Derby talked about the 2012 legislation and “any qualified provider”, but that was not brought in by the 2012 legislation; it was brought in by the Gordon Brown Government in 2009-10, under the term “any willing provider.” The name was changed, but nothing substantive changed from what the Labour Government had introduced in terms of the ability to compete for contracts.

[Edward Argar]

One more sentence and I will give way to the hon. Member for Hornsey and Wood Green (Catherine West); then I will try to bring in the hon. Gentleman.

One of the key changes allowing private sector organisations to compete for and run frontline health services came in 2004, again under a Labour Government, when the tendering for provision of out-of-hours services by private companies was allowed.

[Catherine West]

The Minister is being very gracious. How is the Act going to ensure that there is no conflict of interest between private providers who sit on integrated care boards and who then provide services? Are we going to end up with another Randox scandal?