Health and Social Care Bill
Debate between David Anderson and John Healey(13 years, 3 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
John Healey
My hon. Friend is right—and the chief executive of the Patients Association, Katherine Murphy has said just that. Many patient groups are making the same arguments and issuing the same warnings.
My serious concern is that this Government have told only half the story from the start. The Health Secretary and the Prime Minister are happy to talk about GP commissioning and happy to talk about cutting management—the organisational changes—but they downplay or deny the deep ideological changes at the heart of these plans. The Health Secretary mentioned the new economic regulator, Monitor, in just one line in a speech lasting more than 40 minutes. The Prime Minister said last week in his speech on public services that these reforms
“are not about theory or ideology”.
The Prime Minister writes in The Times today, just as the Health Secretary did last week, both of them producing 700 words about their health plans, yet they made not a single mention of competition.
We will explain and expose the truth throughout this debate and the Bill’s passage through Parliament because these changes will break up the NHS; they will open up all areas of the NHS to price-cutting competition from private health companies; and they will take away from all parts of the NHS the requirement for proper openness, scrutiny and accountability to the public and to Parliament. These Government changes are driving free market political ideology into the heart of the NHS, and that is why doctors are now saying:
“As it stands, the UK Government’s new Bill spells the end of the NHS.”
John Healey
My hon. Friend may be right. I have not seen the regulations, but that is certainly in the impact assessment, so he is on to an important point.
Government Members and the Health Secretary have spent a long time talking about Labour’s plans, policies and record, but the debate at the heart of this Bill is not about whether competition, choice or the private sector has a part to play in the NHS—they have and they do. The debate at the heart of this Bill is about whether full-blown competition, based on price and ruled by competition law, is the right basis for our NHS. That is why Labour Members oppose this Bill. We want the NHS run on the basis of what is best for patients, not what is best for the market. We want the NHS to be driven by the ethos of public service, not by the economics of forced competition. We will defend to the end a health service that is there for all, fair for all and free to all who need it when they need it.
If the stated aims for the reform were all the Government wanted—we have heard the Health Secretary say that he wants a greater role for doctors in commissioning, more involvement of patients, less bureaucracy and greater priority put on to improving health outcomes—he should do what the GPs say: turn the primary care trust boards over to doctors and patients, so that they can run this and do the job. But there is no correlation between the aims that the Health Secretary sets out and the actions he is taking. There is no connection between his aims and his actions. He is pursuing his actions because his aims are not sufficient. His actions would not achieve the full-scale switch to forced market competition, which is the true purpose of the changes.
Meanwhile, the biggest challenges and changes for the NHS will be made harder, not easier, by the reorganisation. Such challenges include making £20 billion of efficiency savings and improving patient services; ensuring better integration of social care and health care, of primary care and hospital care, and of public health and community health; and providing more services in closer reach of patients in the community rather than in hospital. But the Government will not listen to the warnings from the NHS experts, the NHS professional bodies, patient groups or even the Select Committee on Health.
Mr Anderson
In a disparaging comment earlier, the Secretary of State said that the voices of concern were the voices of the trade unions. They are led by people who were health professionals and they represent 1.3 million professionals. Surely somebody in this place should listen to what they say and not to Government Members, who have a biased reason for doing this.
John Healey
My hon. Friend is right. The more that NHS staff see of the changes and the consequences of this Government’s handling of the NHS, the more concerned they are about the changes and the more they are starting to see the NHS go backwards. But the Government will not listen to these warnings that are coming from all sides. They are in denial about the risks: the risk that patients will see services get worse, not better; the risk that up to £3 billion will be wasted on internal reorganisation; the risk that innovation and improvements in care that come from greater collaboration will be blocked by the Office of Fair Trading, competition courts and the new market regulator; and the risk that the Bill will create the monster of a full-blown market in health care which GPs will not control and nor will Ministers or Parliament.
If patients have been sold a false prospectus, that is true of GPs too. GPs are being told that they will call the shots on deciding who provides care for their patients, but they are being set up by the Government. They are likely to find their hands tied by Monitor and the Office of Fair Trading and by the courts enforcing competition law. They are likely to find their decisions challenged by private companies if they do not accept “any willing provider”, especially one that offers to undercut on price. The chair of the Royal College of General Practitioners recently issued a warning to her colleagues. She said:
“I understood these reforms were about putting GPs at the centre of planning healthcare for their patients, not about making sweeping cuts, which will include shutting hospitals, making enormous redundancies, closing services”.
Because the reorganisation will force doctors to make rationing decisions as well as referral decisions for their patients, they will make treatment decisions with one eye on their patient and the other on their budget and their consortium’s bottom line.
The Government say they are devolving power to front-line services, putting clinicians in control, making the NHS more accountable and improving the integration and quality of services, but in the Bill they are making the forces of competition and centralisation far stronger than those of devolution, democratic accountability or the development of quality in patient services. We will explain and expose the gap between what Ministers are saying and what they are doing in every debate at every stage of this legislation.
Patients and staff are already seeing signs of strain in the NHS. They are starting to ask, “What on earth are the Government doing with the NHS? Why don’t they listen to the warnings? Why is the Prime Minister breaking the very personal promise he made to protect the NHS?” The Bill puts competition first and patients second. That is why we will oppose the Bill tonight and expose this truth in the months ahead. These are the wrong reforms for the wrong reasons at the wrong time.
Coalfields Regeneration Trust (Wentworth and Dearne)
Debate between David Anderson and John Healey
John Healey (Wentworth and Dearne) (Lab)
I welcome the opportunity to debate the work of the Coalfield Regeneration Trust in my constituency in South Yorkshire. I am proud to say that it has its headquarters in the Wentworth and Dearne constituency, which I am privileged to represent, and it works throughout England, Wales and Scotland. I welcome the Under-Secretary of State for Communities and Local Government, the hon. Member for Hazel Grove (Andrew Stunell) to the Front Bench; he is certainly the hardest working in the ministerial team, picking up the widest possible range of debates and other business on behalf of colleagues in the Department. In his constituency on the south-east fringes of Manchester, the last of the pits, in and around Poynton, was closed some 70 years ago.
It is therefore a useful opportunity for me to underline for the Under-Secretary and his ministerial colleagues the impact of the wholesale closure of the coal industry in a very short time in the 1980s and 1990s and the importance of the review that the Department is currently conducting about the work of the Coalfield Regeneration Trust and the coalfield regeneration programme, led, of course, by Michael Clapham. Parliament is much the poorer for not having Michael Clapham in the House. He was a very strong voice, not only for Barnsley, but for the coalfields, health and safety and workers in all industries in this country.
The timing of my debate is deliberate. I would like the Minister and his ministerial colleagues to understand that there has been good progress, not least through the trust, in the regeneration of our coalfields, but that there is still a lot of work to do. I would also like him to understand that there is strong support in the House, in local government and in the communities in the former coalfields for the work of the trust and of the regeneration programme. The decisions that he and his colleagues make on the review that Michael Clapham produces will be a test of the Government and of whether they can claim to be a Government for the whole country.
I am proud that a Labour Government set up the Coalfield Regeneration Trust in 1999, following the report of the Coalfields Task Force, which noted the coalfield areas of Wales, Scotland and England as having
“a unique combination of concentrated joblessness, physical isolation, poor infrastructure and severe health problems”
in 1998, at the start of the regeneration programme. After more than 15 years in many cases, many of our coalfield communities were still reeling from the unprecedented devastation and deliberate destruction of the coal industry at that time.
Of the 130 pits that were operating in 1981, 124 closed. More than 190,000 of the 200,000 jobs in the coal industry in 1981 went. In the Yorkshire coalfields, some 67,000 jobs were lost—more than one in four of all the male jobs in the coalfield region. In my constituency, there are four wards, in which in 1981, between two fifths and two thirds, in one case, of men aged over 16 were employed in coal mining. That was the extent of the importance of the industry to our areas at the time. There was unparalleled and unique reliance on a single industry, not only for jobs, but for housing, social and welfare support, often for sports and recreation facilities and sometimes for the financial and retail services for the community.
I am proud that the Labour Government set up the Coalfield Regeneration Trust and that its headquarters has been in my constituency for the past eight years, on the site of the old Manvers colliery, which had the first shaft sunk in 1870 and was closed by the previous Tory Government in 1988. When that was closed, its 285-acre site became part of one of the largest derelict areas in western Europe, and one of the biggest regeneration challenges this country has faced. Now, I am happy to say, it has been overtaken by new jobs, businesses and housing.
The trust has played an important part in that regeneration since it was set up, supporting groups and activities in the constituency with more than £3 million. It supported the widest possible range of work, from the Dearne Valley college to the Rawmarsh St Joseph’s football club and the Montgomery hall needlework group in Wath. Across the country, the trust has distributed grants of around £190 million. I pay tribute to the work of the chief executive, Janet Bibby, and her small team of staff, and in particular to the trustees—dedicated men and women—who are chaired by Peter McNestry. They have committed their work to backing the trust and have served the coalfields so well.
The trust is an independent charity and limited company. It supports our communities through grants, but it also supports them by linking up in a more long-term and strategic way with other agencies. It operates in England, Wales and Scotland. Simply put, the trust reaches people and parts of our communities that public agencies simply cannot reach. It helps to rebuild the community and strengthen the spirit of the old pit villages, as well as providing the physical regeneration of the other programmes.
The trust is special because it understands the unique culture and character of the coalfields, because it is trusted by the communities, and because it reaches back with families and through generations, sharing their history, but also helping them to shape their future. In my constituency, the trust gave an important grant to Cortonwood Miners Welfare club. Cortonwood, of course, was the pit where the miners strike started in March 1984. The grant enabled what was still a well-used building to become a one-stop shop for services and, more importantly, the future hub of the community. It supported the Cortonwood Comeback Centre, a group of women who originally formed as part of Women Against Pit Closures during the strike. They kept going, took over the Methodist church with the help of the trust, and ran a support group for the community and attracted other volunteers.
The trust has helped the South Yorkshire credit union, which is based in Goldthorpe in my constituency, and run a programme of debt support as part of a programme across the coalfields. That now helps more than 5,000 people in the light of the recession, and managed nearly £38 million of debt. Otherwise, those people would have been sunk.
Of course, one of the latest grants—small but nevertheless important—was used to set up a boat house on the lake that occupies part of the old Manvers pit site, in conjunction with the British Canoe Union. A new form of activity and use for the coalfield area has therefore been created.
In fact, since the trust began, it has created 119 new community facilities, and refurbished and improved more than 2,000. It has helped more than 17,000 people in our communities to find work and more than 115,000 to get skills and training for the future. It has worked on child care places, social enterprises, community transport, and debt and financial advice, and it has helped nearly 10,000 people to become new volunteers in projects within their communities. It is special and it works in special ways, because it recognises the special challenges in the coalfields.
Mr David Anderson (Blaydon) (Lab)
I am speaking as a former miner and as the chair of the all-party coalfield communities group. We recognise and welcome the trust’s work. However, the Audit Commission, in its 2008 report, praised the physical and economic regeneration, but made the point that in former mining areas throughout the country, there were still high levels of worklessness, low skills and poor health.
John Healey
Indeed, and my hon. Friend chairs the all-party coalfields group very ably and plays an important role. He is right, and the National Audit Office recognised that progress had been made. Some of the gap with the rest of the country in jobs and skills has been closed, but a big challenge remains ahead. That is why the work of the trust and the wider programme is necessary for the future.
The trust works in unusual ways that are especially suited to our coalfield communities. It helps groups to develop ideas in order to bid for support. It ensures that the support that it can give goes beyond the grant of money and assistance. Most importantly, the trust backs projects that increase opportunities for local people to get involved. That is why more than 250,000 young people, in the projects that the trust has supported over the years, have become involved and part of the activities that the trust has supported. That is why nearly 10,000 people have volunteered as part of the projects.
The trust is backed by local authorities in the coalfield communities, a network that is ably led by Ian Watts, the leader of Bolsover council. It is backed by public agencies that often use the trust to deliver programmes better than they can themselves, as the £3 million jobs, skills and training programme run by the trust in the east midlands demonstrates.
Most importantly, the trust is backed by independent evaluators. In 2007, the Department for Communities and Local Government commissioned a review of the trust’s work, which said that it
“has made an important contribution to the transformation of the coalfields. Initially the Trust was…a responsive, opportunistic regeneration grant donor…over time the Trust has taken on more of a strategic role, supporting larger schemes…including the targeted multi-agency work…developing stronger links”—
with the wider coalfield regeneration programme—
“and other delivery partners such as at Shirebrook or through its work on the impressive Breathing Space Centre in Rotherham.”
The NAO has said something similar and that the trust’s family employment initiatives produce work and jobs at a better rate and for more people—and at less cost to the Treasury.
As my hon. Friend said, there has been progress but there are still problems. The 2009 report by the NAO said:
“The gap with the rest of the country has narrowed, but many coalfields remain among the most deprived areas in England.”
A range of problems remain, related to those communities’ former dependence on coal mining and described in one of the reports as
“unique challenges in the coalfields with inner city type deprivation coupled with rural isolation.”
That is why the CRT is needed now as much as it was in 1999. It is needed in the coalfield areas that are still struggling and those that were hit harder in recession and will find it harder to grow again in recovery.
There is one other reason why the work of the trust should recommend itself to the Minister’s Tory ministerial colleagues. The Prime Minister today spoke of the big society. It is not new, but it is important. It is important that it complements, not substitutes for, public services and investment. The Prime Minister criticised Government as top-down and top-heavy. The trust has always worked from the bottom up—in, with and for the coalfield communities. It supports the big society actions, but it supports the men, women and young people in the small pit villages in our country.