Health and Care Bill

Dan Poulter Excerpts

Report stage
Monday 22nd November 2021 Commons Chamber

[Edward Argar]

I take my hon. Friend’s amendments in the spirit in which they are of course intended. I recognise the importance and value that those on both sides of this House put on parity of esteem of mental and physical health. I suspect that we may debate the amendments in subsequent groupings and I look forward to responding then.

We have, in the process of drafting this amendment, heard suggestions that we should simply ban private company employees completely from the boards of ICBs. I am afraid that doing so is not so simple, nor would it achieve the desired result in all cases. In fact, our amendment goes further to underline the importance of NHS independence than would an amendment that focused purely on banning employees of private providers. There are clearly some candidates who would be suitable but may have minor interests in private healthcare. GPs, for example, do provide, and have provided, their excellent knowledge and experience of their patients in guiding commissioning decisions, and some may have private practices as well. Excluding them would be to lose their experience from the NHS, and therefore such an involvement with the private sector would clearly not risk undermining the independence of the NHS.

[Dr Dan Poulter (Central Suffolk and North Ipswich) (Con)]

I draw the House’s attention to my declaration in the Register of Members’ Financial Interests as a practising NHS doctor. A number of GPs have, in recent times, sought to group together into confederations of practices, which could create a bloc interest within a local board area. How will that potential conflict of interest in the commissioning and provision of services be addressed by the Government through legislation?

[Edward Argar]

I am grateful to my hon. Friend, who knows of what he speaks in terms of the operation of healthcare services. We would not wish to exclude GPs or groups of GPs from being able to participate in decision making. That expertise, as we have seen with clinical commissioning groups, can be hugely valuable. What we have sought to do, in an amendment that is technically worded, for want of a better way of putting it, is to strike the right balance while also ensuring that the additional measures on the constitutions of the ICBs and ICPs have to be approved by NHS England to avoid any obvious conflict of interest. But we are not seeking to avoid GPs being able to operate in that space and sitting on ICBs.

--- Later in debate ---

[Richard Burgon (Leeds East) (Lab)]

The Health and Care Bill is deeply problematic. I want to focus on two issues that, when combined, mean that it is a complete disaster. It not only makes it easier for private health giants to profit from the national health service; it also makes a charter for corruption because it opens the door to even greater private sector involvement in our NHS. That is why this Bill should really be called the NHS corporate takeover Bill. For example, it allows private corporations to sit on health boards, which make critical decisions about NHS budgets and services, and the Government’s amendment 25 does not go nearly far enough.

Even before this Bill, an unbelievable £100 billion has gone to non-NHS providers of healthcare over the past decade alone, and earlier this year half a million patients have had their GP services quietly passed into the hands of a US health insurance giant. This Bill would lock in yet more privatisation in future, with even less scrutiny, because it means less transparency. It means private health giants getting an even bigger slice of the action with less scrutiny.

[Dr Poulter]

I draw the House’s attention to my declaration in the Register of Members’ Financial Interests as a practising NHS doctor. On the issue of private healthcare provision, the hon. Gentleman will recognise that GPs are in fact small businesses in their own right, and some of them quite large businesses. How does he equate the role of the GP as a small business in the context of his concerns about private healthcare?

[Richard Burgon]

We are not seeking to wage war on GPs; we want to support GPs and properly resource them. We see so many GPs retiring and not being replaced. It is this Government who are waging war on our NHS with this further Americanisation of our NHS. It is a dangerous cocktail where the dodgy contracts we have seen throughout covid risk becoming the norm. The billions squandered on test and trace should serve as a warning of what the Government could do to the whole of our NHS.

There is a sleight of hand going on with this Bill. It is true that under the Bill NHS bodies will no longer have to put services out to competitive tender to the private sector. Such tendering to the private sector was made a requirement under section 75 of the coalition Government’s Health and Social Care Act 2012. It was a shameful Act and its scrapping has long been demanded by those opposed to privatisation of our national health service. However, the change in this Bill does not reverse privatisation, because without making the NHS the default provider, that simply means that contracts can not only still go to private healthcare corporations but can do so without other bids having to have been considered.

To prevent all this, I tabled amendment 9, which I want to put to a vote—unless of course the Government accept it—because it establishes the NHS as the default option. [Interruption.] Conservative Members groan, but the only reason for people not to support my amendment is if they do not believe in the NHS not moving to a privatised insurance model. Why else would people object to the NHS being the default provider of healthcare? The British Medical Association supports it, so the Tory groans are groans against the position of the British Medical Association. Unison supports it, so the Tory groans are groans against the voices of those who work in the NHS—for most of whom, if they need to have more than one job, it is because they do not get paid enough, not because they are trying to get their own snouts in the trough. I will be voting against the whole Bill, but if the Government refuse to accept amendment 9 to make the NHS the default provider, that shows what the Government of the party that objected to the foundation of the NHS in the first place are really up to, despite all the warm words.