Oral Answers to Questions

Clive Efford Excerpts

Tuesday 22nd October 2013 Commons Chamber

[Mr Hunt]

I will tell the hon. Lady why the public can have confidence in their health service: compared with three years ago, on broadly the same budget, the NHS is doing 800,000 more operations year in, year out; MRSA rates have halved; and the number of people who wait for a year or longer for operations has gone down from 18,000 to fewer than 400.

[Clive Efford (Eltham) (Lab)]

Will the Secretary of State explain why we have had a summer crisis in A and E? We are all used to the emergency services being overwhelmed in winter. Given the crisis that we have had, what will he do to assist the NHS in averting a winter crisis this year, rather than just blaming everybody else?

Oral Answers to Questions

Clive Efford Excerpts

Tuesday 11th June 2013 Commons Chamber

[Mr Hunt]

As ever, the Labour party is being selective in its use of information. As I have said, I visited seven A and E departments, including over the Easter period when we had some severe A and E pressures that I wanted to investigate for myself. Let me tell the hon. Gentleman about another thing that this Government have done that his Government never did: it is not just Ministers who are going out on to the front line; we have asked all our civil servants to go on to the front line for up to four weeks. I am extremely proud that my Department will be the first to connect with the front line in that way, and am even prouder of the response from my own civil servants, who embraced the scheme with great enthusiasm.

[Clive Efford (Eltham) (Lab)]

Could we have some accountability for the strategic planning of A and E services across London? Nine of them face closure and 28 ambulances were redirected to Lewisham, which the Secretary of State intends to downgrade. Without a strategic approach, how can patients be confident that their best interests are being served?

[Mr Hunt]

We do have a strategic approach, but we also have some very important safeguards that any big change in approach has to go through before it is implemented. That is why I asked for a report from the Independent Reconfiguration Panel on the plans for north-west London, and I will consider that report very carefully before I make any decision.

South London Healthcare NHS Trust

Clive Efford Excerpts

Thursday 31st January 2013 Commons Chamber

[Mr Hunt]

I recognise how hard my hon. Friend has campaigned on behalf of his constituents and how deeply they feel about these issues. He knows that the decision has been made. We want to get the safe implementation of that decision absolutely right and I would be more than happy to meet him to discuss how we can best ensure that that happens.

[Clive Efford (Eltham) (Lab)]

The Secretary of State inherited a mess that was created by his Conservative predecessor, who abandoned the “A picture of health” process. That led to the betrayal of my constituents in respect of what they expected to come out of that process, particularly at Queen Mary’s hospital Sidcup. When he opposed “A picture of health”, the former Secretary of State said that he would decide on that closure based on what local clinicians said. In this process, it is clear that local clinicians are opposed to the closure of the A and E. Will the Secretary of State therefore say what value he places on the views of the local commissioners, who are completely opposed to what he proposes?

[Mr Hunt]

Of the six local clinical commissioning groups, five support these proposals. One group is against the proposals, but it accepts the principles behind them, including the idea that to deliver higher quality care, we must perform complex surgery at fewer sites. That will mean that more of the hon. Gentleman’s constituents have better care outcomes. I remind him that if his Government had resolved this problem when they were in office before 2010, none of us would be having this discussion today.

Hospital Services (South London)

Clive Efford Excerpts

Tuesday 22nd January 2013 Westminster Hall

[Clive Efford (Eltham) (Lab)]

It is a pleasure, Dr McCrea, to speak under your chairmanship. I congratulate my hon. Friend the Member for Lewisham East (Heidi Alexander) on securing this important debate. I want to start by defending South London Healthcare NHS Trust. Its financial difficulties are enormous and there is no disguising that, so people have tended to roll up its performance into something that is failing on all fronts, but that is clearly not the case.

When the hospitals—Bromley hospital, Princess Royal University hospital, Queen Elizabeth hospital in Woolwich and Queen Mary’s hospital at Sidcup—were merged approximately four years ago into one healthcare trust, there were serious difficulties with clinical performance, but very quickly the trust improved its performance significantly, and so much so that it was one of the best performing on many indicators. That is why it was so sad that when the trust was put into administration, unattributable sources in the Department of Health put out rumours that that was about not just financial mismanagement, but the fact that standards of care were failing. That was completely and utterly untrue.

I go back several years, and I am on my fifth chief executive at my local hospital. All have gone through the same scenario as Mr Kershaw, and all have given me assurances about the areas—I will not go into them because I do not have enough time—where financial performance needed to improve and efficiencies needed to be made. Always, they made the point about the need to treat people close to where they live in the community and reduce pressure on acute services.

All have made that point, and all have needed to improve clinical performance. Just over a year ago, the South London Healthcare NHS Trust had only one case of blood-borne MRSA, which was the best performance in the country. The improvement in the quality of care under the new trust was significant indeed. Waiting times in A and E improved, and Dr Foster reported on a significant and consistent improvement in the standardised mortality ratios over a couple of years. On those performance indicators, it outperformed Lewisham hospital.

When the decision was made to put the trust into administration, its performance on quality of care for local patients was improving. Anyone who was concerned about care for local patients would have worked through the financial difficulties with the trust. It was a big ask in that short period to improve clinical performance as it did, to merge the hospitals as it did, and to improve financial performance as it was required to do. It was always a big ask, and I think it was impossible. That should have been recognised, and the Government should have worked with that hospital trust to work through those difficulties.

We all know that PFI has not caused this problem, but it has added to it. PFI accounts for roughly a third of the deficit, which is not to be ignored, but one issue that has come to light recently, in relation to PFI in general—not just in relation to South London Healthcare NHS Trust—is the effect that the manipulation of LIBOR has had on the rates that hospital trusts have had to pay, in terms of interest, as a consequence. I do not expect the Minister to have an answer to this question, but will she go away and consider what the cost implications of LIBOR manipulation have been for every PFI in the NHS? Are the Government considering taking legal action to retrieve any of that money, as is being considered in the USA?

I am conscious of time and I want to let the hon. Member for Beckenham (Bob Stewart) speak, so I shall move on. As has been said, the recommendations fail several tests, and they clearly fail the test of satisfying local GPs and receiving local GP support. The chair of the local GP commissioning body, Helen Tattersfield, wrote an article in The Guardian under the headline: “GPs are already wise to the scam of new commissioning groups”. She absolutely lampooned what is being proposed by the Government.

[Jim Dowd]

Does my hon. Friend realise that the Government have shifted ground on that? In the response that the Prime Minister gave to my hon. Friend the Member for Lewisham East, he said that the first test was

“the support of local GPs.”—[Official Report, 31 October 2012; Vol. 552, c. 230.]

However, the Secretary of State’s written statement, following the publication of the final report said that the first test was “support from GP commissioners”. The word “local” has disappeared, and what the TSA is trying to do is claim the support of commissioners from outside Lewisham to meet that test.

[Clive Efford]

The point made by my hon. Friend is self-evident, but if I may, I will not be drawn down the road, because I want to get the next point on record.

Lamenting the fact that local commissioners have not been listened to, Helen Tattersfield says in her article:

“No argument has any weight, however, against the needs of a failing trust, foundation trusts and potential private companies eager to expand their areas of influence, and NHS managers convinced of the merits of their model of fewer larger hospitals. Those of us who have spent hours acquiring the skills supposedly to lead commissioning have been shown that, in fact, decision-making and influence remains where it always was: with central managers, computer-derived models and reasoning that takes no account whatsoever of human behaviour in real life. We are little more than window-dressing for central planning geared to the needs of large foundation trusts, and open to the interests of the private sector.”

That comment alone just about sums up where we are.

I will finish soon to allow the hon. Member for Beckenham to speak, but I just want to ask the Minister whether she will consider a review of proposed A and E closures across London. We are seeing a piecemeal, salami-slicing of A and E services, which is putting the safety of Londoners at risk. As we know, we have seen a 50% increase in people waiting in ambulances for 30 minutes or more outside A and Es to gain access, and we have seen a 26% increase in those waiting for 45 minutes. We know that they are under pressure, so before we see any closures, that review must take place.

We can pray in aid what the Lord Chancellor and Secretary of State for Justice said. The headline on the relevant article read: “Hunt faces Cabinet split over A and E closure after Justice Secretary blasts plans as ‘sticking two fingers up’ to patients”. We also have the right hon. Member for Sutton and Cheam (Paul Burstow)—the former Minister of State, Department of Health—who lamented, when he was still a Minister, the proposed closure of St Helier:

“This is a flawed conclusion from a flawed process. There is still a lot of water to flow under the bridge before final decisions are made. The panel have ignored the pressure on all the A and Es and maternity units in south west London.”

We can pray those people in aid to defend our A and Es, and the Government should go back and look again.

To make one last point, we have seen the closure of an A and E, despite the promises of local Conservatives. The Leader of the House of Commons, when he was shadow Secretary of State, was going to save the A and E at Queen Mary’s, Sidcup, but it never came about. Under “A Picture of Health”, there was a proposal to have overnight stay, elective surgery at that hospital. It was promised to my constituents, who welcomed it and wanted to see it. I ask the Minister to reconsider removing that planned service from that hospital, because it was beginning to work and people welcomed it. It will be a serious cut to the quality of health care.

[Steve Baker (Wycombe) (Con)]

Will the hon. Gentleman give way?

[Clive Efford]

No, I will not, because I want to allow the hon. Member for Beckenham to speak. It will be a serious cut to local services, and we should not allow that cut to go ahead.

South London Healthcare NHS Trust

Clive Efford Excerpts

Tuesday 8th January 2013 Commons Chamber

[Mr Hunt]

I heed absolutely the right hon. Gentleman’s warning that reorganisations are not always the panacea that they are made out to be. We need to be absolutely clear that, if we accept the proposals, they will deliver a sustainable, robust and clinically sound outcome for the right hon. Gentleman’s and neighbouring constituents, as the trust special administrator believes they will. I shall be delighted if the right hon. Gentleman attends the meeting with other MPs affected by the proposal. I shall hear what he has to say further at that meeting.

[Clive Efford (Eltham) (Lab)]

The Secretary of State has to recognise the serious contradictions between the proposals in the trust special administrator’s report and the Conservative manifesto before the last general election. If he were to accept the proposals, particularly in relation to A and E, that would be a serious betrayal of promises made to the electorate. There are also the changes expected from the “A Picture of Health” proposals for Queen Mary’s hospital in Sidcup in relation to overnight elective surgery. How much is the Secretary of State bound by the specific promises made in the Conservative manifesto before the election when it comes to making a decision on the report?

[Mr Hunt]

We were concerned in the run-up to the last election at the pace and scale of many of the reconfigurations pursued by the last Government. That is why when we came into office we paused the reconfigurations and introduced the four tests—an additional safeguard to make sure that reconfigurations were not done without local clinical support.

We wanted to avoid what had happened so often, including in my own constituency—an alliance of Health Ministers and NHS managers riding roughshod over what local people wanted. We wanted to stop that, so we put in place new systems. I hope that the hon. Gentleman will be comforted by the robustness and thoroughness of the processes that we are now going through.

NHS Funding

Clive Efford Excerpts

Wednesday 12th December 2012 Commons Chamber

[Andy Burnham]

I have not seen the quote, but I did the deal with the former Chancellor of the Exchequer just months before the general election, protecting the NHS in real terms. A deal was done for schools and for the Home Office too. Those were the plans. At the election I was arguing for real-terms protection. The Secretary of State was on the hustings calling for real-terms increases. I said it would be irresponsible, yes, to give real-terms increases over and above real-terms protection because the only way he could pay for that would be taking it off councils, hollowing out the social care budget. That is what I said at the election, but the right hon. Gentleman has not even given real-terms protection. He has cut the NHS in real terms, so it beggars belief that he has the nerve to heckle and shout out from the Front Bench, when he has cut the NHS lower than the plans that I had left in place.

[Clive Efford (Eltham) (Lab)]

It is not just on the budget that the Government have let people down. They promised that they would not close accident and emergency departments. Before the general election the former Secretary of State went to Bexley and said he would not close the accident and emergency department at Queen Mary’s, Sidcup, and it closed after the general election. Now they are planning to close the A and E at Lewisham—another broken promise about the NHS. It just goes to show: you can never trust the Tories with the NHS.

[Andy Burnham]

The two guilty men here have a list of broken promises as long as their arm. The previous Secretary of State toured marginal seats before the election, promising the earth—“Burnley A and E? Oh, we’ll re-open that. Whatever you want. Chase Farm? That won’t close.” It was unbelievably cynical politics. It was all self-serving politics for their own ends and it had nothing to do with the reality in the NHS, but the problem for the present Secretary of State is that he has presented this false version of events to the House. On 13 November he said that

“there has been a real-terms growth in spending—actual money spent in the NHS, compared with Labour’s plans.”—[Official Report, 13 November 2012; Vol. 553, c. 188.]

[Interruption.] He says there has been. I ask for your help, Mr Deputy Speaker. How can Ministers deny the facts—deny what the watchdog is telling them? What do we do in such circumstances, when they have the sheer nerve and brass neck to carry on making these false statements?

Based on what we know, there is no way the Secretary of State can back up that claim, and I ask him to withdraw it today. It is an inaccurate claim. He made it at the Dispatch Box; the onus is on him to withdraw it. We know that he is taking time to come to terms with his brief, but he is in danger of developing a credibility problem with his utterances in the House. Take this from last month’s Health questions:

“Cancer networks are here to stay and their budget has been protected.”—[Official Report, 27 November 2012; Vol. 554, c. 127.]

But again the truth emerges, and it is somewhat different from the version of events presented to us by the Secretary of State. On Monday, responding to excellent research by my hon. Friend the Member for Leicester West (Liz Kendall), the national cancer director conceded that in future cancer networks would have to live with a smaller budget. What are we to do? Who are we to believe? We have a Secretary of State who is making statements that contradict his national cancer director. It is shameless.

--- Later in debate ---

[Mr Hunt]

It is because we have protected the NHS budget that the number of clinical staff in the NHS has gone up and not down. [Interruption.] Okay, let me explain this, because there is a very important point here. Unlike Labour Front Benchers, I do not want to micro-manage every hospital in the country and tell them exactly how many doctors and how many nurses they should have. I want them to put money on the front line, and the result is that the number of clinical staff—doctors, nurses, midwives and health visitors—has gone up and not down.

[Clive Efford]

rose—

[Mr Hunt]

I am going to make some progress.

Let me move on to the accusation that the right hon. Member for Leigh made. He says that, using 2009-10 as a base year, NHS spending went down in 2010-11.

Oral Answers to Questions

Clive Efford Excerpts

Tuesday 27th November 2012 Commons Chamber

[Mr Hunt]

I remind the right hon. Lady that the Government have not cut the NHS budget; we have protected the NHS budget. There is an ongoing consultation on the proposal that she mentions. It will finish on 13 December and I hope she will contribute to it. I will receive the recommendations of the trust special administrator at the beginning of January, and I will then make my decision.

[Clive Efford (Eltham) (Lab)]

The 2010 Conservative manifesto stated:

“We will stop the forced closure of A and E and maternity wards, so that people have better access to local services,”.

They then closed the accident and emergency department at Sidcup, having promised to save it, and they now plan to close the A and E at Lewisham hospital. Is that not a betrayal of people in south-east London and the NHS?

[Mr Hunt]

The hon. Gentleman should talk to the shadow Minister on the Opposition Front Bench, the hon. Member for Leicester West (Liz Kendall), who said yesterday that she would not automatically oppose all reconfigurations. The coalition Government have introduced four tests, which were not used by the previous Government. Those tests state that we will not impose closures of A and E and maternity units unless there is local clinical support, and evidence that it will benefit local people and improve patient choice. The tests exist to provide precisely the safeguards about which the hon. Gentleman is concerned.

Oral Answers to Questions

Clive Efford Excerpts

Tuesday 17th July 2012 Commons Chamber

[Mr Lansley]

My hon. Friend will, I am sure, know that an application for foundation trust status from the Royal Cornwall Hospitals NHS Trust is currently being considered by my Department. The trust is being assessed on whether it meets the quality, service, performance, business strategy, finance and governance standards required if a trust is to be an FT. Once the trust has demonstrated that it has met those standards in all other regards, the Department will ensure that any outstanding liquidity issues are resolved in time for the trust to be authorised as an FT. The process of assessing FT applications will ensure that any remaining debt carried by the trust when it becomes a foundation trust is affordable within the trust’s forward plans.

[Clive Efford (Eltham) (Lab)]

The chair of the South London Healthcare NHS Trust has written to the Secretary of State to correct inaccurate information given out by the Department of Health regarding the trust’s performance. [Interruption.] Instead of barracking me, would the Secretary of State—[Interruption.] Instead of shouting at me now, it is a shame that the Secretary of State did not meet the local MPs when he had the opportunity. Will he distance himself from the false information put out by unattributable sources in his Department, which will undermine the performance of the hospital and shows little respect for the health service workers who are working to improve services?

[Mr Burns]

If I can calm the situation down. [Interruption.] If the hon. Gentleman will just hush I will give him the answer.

National Health Service

Clive Efford Excerpts

Monday 16th July 2012 Commons Chamber

[Mr Simon Burns]

rose—

[Clive Efford (Eltham) (Lab)]

rose—

[Andy Burnham]

I will give way to the Minister one more time, and then to my hon. Friend the Member for Eltham (Clive Efford), but after that I must make some progress.

[Andy Burnham]

The Minister seems to equate removal of the Act with bringing back PCTs and SHAs. I do not have a problem with clinical commissioning, and I said as much during the Bill’s passage. I introduced it myself. I do not have a problem with clinical commissioning groups; my problem is with the job that they are asked to do, and the legal context in which they are asked to operate. We reject the Secretary of State’s market, and that is why we will repeal his Act.

[Clive Efford]

Clinicians in south-east London presented proposals for the reorganisation of our health care provision in “A picture of health”. It was all agreed by local commissioners, but when the Tories took office, they imposed a two-year delay that cost our health care trust £16 million a year—and that is the same trust that the Secretary of State has just put into administration.

[Andy Burnham]

This is what happened: when they came into government, they had a cynical policy of a moratorium, and they went up to Chase Farm hospital to announce it, saying, “There will be no cuts and no closures at this hospital.” They traded and touted for votes in that constituency for years on the back of that issue, and now that hospital is going to close. They delayed the reconfiguration and then they delayed the savings that came to the NHS. It was disgraceful, and people will have seen through it.

--- Later in debate ---

[Andy Burnham]

I was prepared to make difficult decisions and be honest about them. I am not proposing the reversal of that decision and I note that clinicians in his area recently said how it had improved outcomes for his constituents. What I will not do—what I will never do—is go to marginal constituencies, as the Secretary of State did, and make false promises that I will reopen such units. The Secretary of State did that before the last election; no wonder he is looking shifty in his seat right now. He went to the hon. Gentleman’s constituency and said that he would reopen that unit. Has he done that? I do not believe that he has.

[Clive Efford]

On that very point about turning up in constituencies just before general elections promising to save A and E services, the Tories pledged to save 999 services at my local hospital, Queen Mary’s, Sidcup. They pledged to keep that A and E open—the Secretary of State did so himself. Where is the A and E?

[Andy Burnham]

I do not know how the Secretary of State justifies what has been done. Even in my own patch, Greater Manchester was going through a children’s and maternity services review and some constituencies were benefiting from the changes—Bolton, for example, was getting a bigger maternity unit—but some were not and this Secretary of State went both to Bury, where he said that he would defend the maternity unit, and to Bolton, for a photo call celebrating the new investment. If anything illustrates the sheer opportunism of the Secretary of State in opposition, surely that is the example that does.

--- Later in debate ---

[Mr Burns]

No, I will not.

The motion speaks of the

“increasing number of cost-driven reconfigurations of hospital services”.

The reconfiguration of NHS services must always be led by a desire to improve patient care and patient outcomes. As lifestyles change, as needs and expectations grow and as technology develops, the NHS must respond. This Government are very clear that the reconfiguration of services is a matter for the local NHS, and that the best decisions are those taken closest to the front line and tailored to the needs of the local population. But, when making those decisions, it is imperative that the NHS carries the support of local people, patients, carers and clinicians.

The principle is enshrined in the four tests that my right hon. Friend the Secretary of State set out in 2010: all local reconfiguration plans must demonstrate support from clinical commissioners, strengthened public and patient engagement, clear clinical evidence and support for patient choice.

[Clive Efford]

rose—

[John Woodcock (Barrow and Furness) (Lab/Co-op)]

rose—

--- Later in debate ---

[Mr Burns]

The right hon. Member for Leigh equates the coalition agreement’s promise of a temporary moratorium on changes to hospital services, with a commitment to hold the NHS in a permanent state of suspended animation. The moratorium was needed to put a stop to the arbitrary reconfigurations that his Government instigated—reconfigurations that lacked the support of local clinicians, lacked a clinical evidence base and lacked basic democratic legitimacy. This Government and the Secretary of State have put that right.

Now I turn to another issue that the right hon. Gentleman raised and which is of considerable importance, given what has—

[Clive Efford]

rose—

[John Woodcock]

rose—

NHS Risk Register

Clive Efford Excerpts

Wednesday 22nd February 2012 Commons Chamber

[Mr Lansley]

It is because we are clear that the reason he said that was that there was no mechanism available to Monitor in legislation for the maintenance of services and interventions. The Bill will mean that there is.

I sometimes think that the shadow Secretary of State has not actually read the Health and Social Care Bill. He keeps saying that this or that is in it, or that it does or does not do this or that, but for the first time since 2003, when his predecessor’s legislation stated that there should be a mechanism for dealing with hospitals that are failing, we are setting out a proper structure for the continuity of services. He says that it is just about de-authorisation, but it is not.

[Clive Efford (Eltham) (Lab)]

rose—

[Grahame M. Morris (Easington) (Lab)]

rose—

--- Later in debate ---

[Mike Freer]

I will tell the hon. Gentleman what I did say. When I met GPs, I said that I would support putting patients first. Moreover, reform of the NHS was clearly specified in the Conservative manifesto on which I stood.

The previous Government sought to involve the private sector. Where was the risk register then? Was it published when the private sector was involved in the NHS? No, it was not. Will we get to see that risk register now? I doubt it.

Risk registers are, by definition, meant to explore everything that could possibly go wrong. They never make happy reading. The Secretary of State has already published more information than has ever been published before. He has already published relevant risks connected with the Health and Social Care Bill in the combined impact assessments, which consist of 400 pages of detailed analysis. The Opposition see the release of the risk register as simply an opportunity to cherry-pick the doomsday scenarios that it may contain. It is no more than a charter for shroud-waving. Every risk register contains such scenarios, and opponents would present them as fact.

I oppose the publication of risk registers because it would be impossible to pick and choose which were to be published and which were not. Once the Pandora’s box has been opened, it is open. The Opposition may argue that the publication of this risk register is in the public or the national interest. No doubt Department of Health risk registers examine what could go wrong, as in the case of other threats. What about threats relating to terrorism or outbreaks of infectious diseases?

[Clive Efford]

Will the hon. Gentleman give way?

[Mike Freer]

I have already given way twice.

There are clearly good reasons why the details of such threats should not be open to public scrutiny. Some might argue that their publication too is in the public or national interest, but we are not hearing that argument today; we are hearing only about this register, and not about the others. The Opposition’s stance is strong on opportunism and weak on intellectual coherence.

Let us look at their record in government. In 2009, when the shadow Health Secretary was Health Secretary, he refused a freedom of information request for publication of the Department’s strategic risk register. According to the Department,

“'a public authority is exempt from releasing information, which is or would be likely to inhibit the free and frank provision of advice or the free and frank exchanges of views for the purpose of deliberation'”.

There was also reference to the neutering of the free exchange of opinions between Ministers and advisers. That held then, and it holds now.

There is another issue, which was touched on by my right hon. Friend the Secretary of State. If the Department of Health is forced to issue all risk registers, what about other Departments? Will the Treasury have to release all risk registers involving the economy? Would that not cause financial havoc in the international markets? That explains why past Administrations have also refused to publish such documents. From a governance perspective, the Government’s stance is entirely right.

One of the problems of risk registers is that they are meant to be frank about what could go wrong. Any Member who has served on a project board will know how valuable such registers can be and how invaluable completely blank ones can be, and will also know that if the authors of risk registers are afraid to be open because of what might be misinterpreted, routine publication will cause them to become bland and anodyne and will render them useless.

The motion is simply posturing at its worst, and I will be voting “No” this evening.

--- Later in debate ---

[Andrew George]

I am grateful for that intervention, because it plays into my next point, which is on my general concern about the nature of Opposition day debates. It is not that I think that Opposition parties should not have the opportunity to debate issues, but such debates tend to over-dramatise the political tribalism of this House. It is in the nature of government that when in government people tend to have to face up to and take unpopular decisions, whereas in opposition they tend to avoid them. Equally, on this issue, those in opposition tend to say that they would be more open, because they look at the matter from a different perspective and take the view that they would have more open government. When people come into government, they tend to err on the side of seeing good technical reasons for why they cannot engage in the process of open government.

[Clive Efford]

rose—

[Andrew George]

I will give way, although I am going to lose time.

[Clive Efford]

I shall be brief. This transition risk register refers specifically to the Bill, about which there is widespread concern. The register is unprecedented in that regard so, with due respect to the hon. Gentleman, his argument really does not hold.

[Andrew George]

I am cantering around the issues. I have signed the early-day motion, so I judge that disclosure is better than non-disclosure. However, I wish to make a further point about the kid psychology of this whole thing. We all tend to want what we cannot have and if we obsess about this issue, we might take our eyes off the ball of what the debate ought to be about. That brings us back to the point made by the former Secretary of State.

I ask the Minister who is winding up: when has the disclosure of such documents actually harmed Government public services? If we were given examples of where disclosure of information has actually harmed the delivery of effective government, we could begin to mount a case for trying to define the lines of where and when such documents should be published. On the basis of the debate so far, I am not sure that we have demonstrated that if we were given the new toy in this political playground—the publication of the risk register—it would necessarily improve the quality of the debate.

Of course, the main show, rather than the sideshow, is the Bill itself. I am concerned that if the risk register were to be published soon, and we were to have information that would perhaps help to change people’s minds and enable a more informed debate, it would not be possible to come to a considered conclusion that it would be best to withdraw the Bill because of the nature of the prism of the Westminster village. Given the virility contest in which such decisions are taken, the climbdown needed for a Secretary of State to withdraw a Bill such as this would be catastrophic both for himself and for the Government. So we end up continuing on with something that I believe could be catastrophic for the NHS—I have put my views in the public domain on many occasions on this issue.

The right hon. Member for Leigh (Andy Burnham) may want to win over Liberal Democrats, but describing us as “spineless” will not necessarily get many of us into the Lobby with him. If he does not want to contaminate his party with people he believes are so infected with such a disabling condition, I am not sure that it will help.