Health and Social Care Bill

David Burrowes Excerpts

Tuesday 13th March 2012 Commons Chamber

[Valerie Vaz]

My hon. Friend makes an important point. He should read the front page of the left-leaning newspapers, and he will see how much money is being spent on locums.

The GP in Walsall said that the pace of change is too fast. GPs are being forced into larger organisations. They have no experience of managing a business model. The Secretary of State says he wants to cut the numbers of managers. If the number of managers has been cut, why are the management consultants crawling all over the NHS? A group of consultants including McKinsey, KPMG and PricewaterhouseCoopers sealed a £7.1 million contract with 31 groups of GPs. Pulse found that four in 10 clinical commissioning groups across England have begun to enlist commissioning support from the private sector. That was the work that the PCTs did.

The Secretary of State says that change is happening anyway. So why have the Bill? The Secretary of State says that Monitor did not have a duty to promote competition. So why did the Government not approve the amendment tabled by Lord Clement-Jones that sought to designate the health service as

“a service of general economic interest”,

taking it out of EU competition law? That was not accepted.

The Government said that the role of Monitor is like that of Ofgem, Ofwat and Ofcom. David Bennett said:

“We did it in gas, we did it in power”.

Who are the shareholders? Look at Centrica. Its shareholders include Bank of New York Mellon, the Government of Singapore, the Government of Norway, the state of California, the Government of Saudi Arabia, and Goldman Sachs. The shareholders of the NHS are the people of Britain—but for how long?

The Secretary of State says he wants integration, but the Bill will effectively repeal the integration that started with the Health and Social Care Act 2001. Torbay is a classic example of that. What about the cost, which is £1.2 billion and counting?

[Mr David Burrowes (Enfield, Southgate) (Con)]

Will the hon. Lady give way?

[Valerie Vaz]

I am sorry, but I have nearly finished my speech and must press on.

There was a chorus of disapproval from professionals when the White Paper was published, as they wanted more information. As Rogers and Walters say in the sixth edition of “How Parliament Works”, if there is pre-legislative scrutiny, Ministers have less political capital at stake and changes are not seen as defeats; the scrutiny of a Bill in draft gives higher quality legislation. That is not a description of the Health and Social Care Bill. The pre-legislative scrutiny was in the Secretary of State’s head, not in a draft Bill.

What about my constituent Stephen Wood, who went to his local GP’s surgery only to be told that doctors would only refer him to a consultant privately, not on the NHS, as he had apparently used up his budget?

--- Later in debate ---

[Joan Walley (Stoke-on-Trent North) (Lab)]

I am grateful for the opportunity to follow the hon. Member for St Ives (Andrew George), and the House would do well to listen to what he says. The Secretary of State may feel that he can bluster his way through the debate, but people out there—our constituents—are listening. When I became a Member almost 25 years ago to the day, I made the point that the health of the people is the highest law, so even if we cannot deal with the Bill in this debate, we have three hours in which we can send a message. Although I came into the Chamber to support the motion in the name of my right hon. Friend the Member for Leigh (Andy Burnham), I have listened to what he has said and to what the hon. Member for St Ives has said, and I am quite content to back the amendment and to ask for an urgent summit—and for the trade unions to be involved as well.

[Mr Burrowes]

Will the hon. Lady give way?

[Joan Walley]

No, I will not.

I agree with the right hon. Member for Charnwood (Mr Dorrell), who chairs the Health Committee, that some aspects of the Bill are very worthy, particularly those on public health, and we do not want to lose them, but four issues need urgent clarification, and I hope the Minister will address them when he replies.

First, why are my constituents not entitled to know what is on the risk register? What is there to hide? Why can we not have it laid before us when we are making important decisions about the future of the NHS? I am quite content for there to be service changes, but not structural, top-down reform, which the Prime Minister himself, in one of his commitments before the general election, said he was not going to introduce.

The key issue for the House is whether the NHS will be subject to the full force of domestic and EU competition law, and that has not yet been clarified. The Government maintain that it will not, but the changes brought about by the Bill make certain that it will. In any event, it is not in the Government’s gift to decide, because the issue will be decided in the courts, so I genuinely believe that we are entitled to clarification on that issue—[Interruption.] I will not give way on that point. It is absolutely essential that the Government, not the law courts of this country, determine NHS policy.

Secondly, what safeguards are there against private companies using loss leaders to replace NHS services and then, once the NHS service has been eliminated, maximising profits by reducing quality? We have heard from the Secretary of State on that, but once the service is eliminated, the private companies that come in will surely have a free hand. The Government say that there will be no competition on price, but private companies will still be able to use loss-leader tactics by overloading a bid with quality for the specified price, so we must have regard to the real concerns about that.

Thirdly, how will the Government stop cherry-picking in practice? If they attempt to exclude private companies from bidding for a particular contract, will they not face court action, and in those circumstances will not services be put on hold while the courts deal with how NHS care is to be provided?

Finally, again when the Minister replies—

--- Later in debate ---

[Chris Skidmore]

I am talking about the right hon. Member for South Shields, not the hon. Member for St Ives (Andrew George).

Professor Julian Le Grand stated on 28 February:

“With respect to the NHS bill, it is important that even those who generally prefer to rely upon their intuitions should avoid muddying the waters by accusing the bill of doing things that it does not, like privatising the NHS; and that all those involved should acknowledge the peer-reviewed evidence demonstrating that its provisions with respect to public competition…are likely to improve patient care.”

More hours have been given to debating this Bill than any other during this Session. Despite Labour’s message, which seems to be opposition for opposition’s sake, we are gradually learning what its policy will be for the next general election. It is interesting that at a rally in Manchester last week, the right hon. Member for Leigh stated, in front of his union faithful,

“And I will make you a promise today—if I am the health secretary after the next general election I will repeal this bill.”

According to the Opposition, this is the greatest reorganisation in history. Yet the Bill will save £4.5 billion straight away and then £1.5 billion recurrently, year on year, thereafter.

[Mr Burrowes]

All our constituents will be listening intently to the debate and will hear that following the health inequalities that have grown under the previous Government, the Opposition will oppose and repeal legislation that imposes a duty to tackle those inequalities. What will they think of that?

[Chris Skidmore]

We have already heard one Labour Member say that she welcomes the new measures on health inequalities, so it is a shame that the legislation could be repealed in its entirety.

Last week, Labour Members committed themselves to re-establishing primary care trusts and strategic health authorities—to reconstituting the NHS as if time had stood still, with middle-level management holding the reins. It is remarkable that Labour is not the party of the NHS patient but has become the party of the PCT, the SHA and, above all, the NHS manager.