National Health Service (Amended Duties and Powers) Bill

David Tredinnick Excerpts

Friday 21st November 2014 Commons Chamber

[David Tredinnick (Bosworth) (Con)]

I am grateful to be called to speak in the debate, Madam Deputy Speaker, and I apologise to my Front-Bench colleagues that I might not be here for the wind-ups because I have to be in Hinckley for the switching on of the Christmas lights, which is something I always look forward to.

I should like to follow a long tradition in the House in which the speaker who follows a Member making their maiden speech—even though I am told that, technically, it was not one—says something nice about them. I congratulate the hon. Member for Rochester and Strood (Mark Reckless) on winning his by-election last night, and I further congratulate him on getting to the House this morning. I imagine that he has been up all night. I simply offer him this warning. I was thinking of Dave Nellist, a former Member for Coventry, who defected to another party and then disappeared. I have to warn the hon. Gentleman—my former hon. Friend—that the history of those who defect in this place shows that they do not remain here for very long after they come back. We expect to regain his seat at the next general election, but well done to him in the meantime.

I should also like to congratulate the hon. Member for Eltham (Clive Efford) on introducing his Bill. I once had the honour to stand for the Greater London council in the constituency adjacent to his. It was then known as Woolwich East, so I know his area and his hospitals a little. He has certainly done well to get his Bill to the House, and I note from the Division this morning that he has 100 additional Members here today, so he is no doubt hoping for a closure motion at some point. If his Bill progresses, I would be happy to serve on its Committee. I have a long-standing interest in health matters and I have been a member of the Health Select Committee since it was set up in this Parliament, as well as of the Science and Technology Committee in this Parliament. I am also the chair of the all-party parliamentary group on integrated health care.

This is a wide-ranging Bill. I hope to address some of the things that are not in it, although I will not talk about all the things that are in it as time is short and I do not want to occupy the stage for too long. I want to look at three areas. The first is the hon. Gentleman’s proposal to change the arrangements that allow trusts to generate half their income from private sources. Secondly, I want to look at whether mergers should be dealt with by Monitor or whether that area should be reclaimed. I want to focus on mergers and integration, because the integration of services in the NHS is of fundamental importance. He might be able to improve his Bill in that respect. Thirdly, if time allows, I want to talk about the proposal to exempt the NHS from the transatlantic trade and investment partnership.

I have been listening to the right hon. Member for Wentworth and Dearne (John Healey), and I believe that Labour’s whole strategy is based on something that is fundamentally untrue. It is based on trying to persuade the electorate that we are setting out to privatise the health service and thereby reduce the health care available. It is regrettable that Labour is taking the Goebbels-esque approach of saying something that is fundamentally untrue and then repeating it and repeating it in the hope that the electorate will buy into it. I put it to Labour Members that that might be a populist approach, but it could be hard for them to defend as we get nearer the election.

[Seema Malhotra (Feltham and Heston) (Lab/Co-op)]

The hon. Gentleman says that he does not believe creeping privatisation is taking place as a result of the changes that the Government have introduced, but does he not see it as an inevitable consequence, even if it is not the Government’s stated intention?

[David Tredinnick]

I thank the hon. Lady for her intervention. The Government have made it possible for trusts to generate half their income from private sources, but it is not true to make out that we are in some way privatising the health service in a way that is detrimental to patients. We have made it possible for trusts to generate more income. In an ideal world, it would be wonderful if we could pay for all health care through general taxation. However, the Health Committee has examined the Nicholson challenge and seen the tremendous demand on resources. We have managed to maintain a flat-line budget in this Parliament, but demand is such that it is difficult to pay for everything through general taxation. One way to do it is by getting the private sector to contribute to the health service. The original arrangements were increased to this figure of nearly half. The thing to remember is that all the money generated from these sources is reinvested in patient care.

I had some freedom of information requests made, and wish to refer to the effect of these arrangements on four NHS foundation trusts in the midlands. They are not from Leicestershire, because those figures did not come through, but I do represent a midlands constituency. The Dudley Group NHS Foundation Trust received £68,000 in 2010-11, £50,000 in 2011-12 and another £80,000 in 2012-13 in funds that can go directly into patient care. The figures for the Heart of England NHS Foundation Trust are £559,000 in 2009-10, another half a million in 2010-11, a bit more in 2011-12 and nearly £532,000 in 2012-13, and there has been an increase to £628,000 in 2013-14.

My FOI request to the Shrewsbury and Telford Hospital NHS Trust elicited the following response—it is a short paragraph, so if I may, I will read it out:

“The Shrewsbury and Telford Hospital NHS Trust gains substantial income from Apley Ward and Clinic. Where private patient work is carried out in an NHS hospital, it is carried out in addition to and not in place of regular NHS treatment. Profits from this private facility make a considerable contribution to the running costs of the hospital for the benefit of all patients and staff.”

The hon. Member for Eltham made a passionate speech, but this point goes to the heart of the issue: privatisation is not about reducing resources, but increasing them. I gave notice to the hon. Member for Walsall South (Valerie Vaz) that I was going to mention the other figures I received, which are from the Walsall Healthcare NHS Trust and which show that over the past four years it has gained between £14,000 and £50,000 a year. The figures illustrate clearly that this approach is helping, and that is very welcome.

[Mr Nuttall]

The point my hon. Friend has just made is key in showing the dangers of this Bill. People have been writing to say that they are concerned about the risk of privatisation, but what is actually happening as a result of the 2012 Act process is that there is more money in our NHS, rather than less.

[David Tredinnick]

The Act is complicated. It is a big Act and it landed with a thump when the right hon. Member for Wentworth and Dearne (John Healey) dropped it on the Opposition Benches. I think he did so intentionally; and it was very theatrical and effective. It is true that there is more money there, and it is clear that the Government pledged at the last election to maintain the funding of the health service and have done so. We also have in place the Nicholson challenge, a phrase coined by my right hon. Friend the Member for Charnwood (Mr Dorrell)—formerly the Member for Loughborough—when he was Chair of the Health Committee, and we now face even greater challenges.

Let me set out to the hon. Member for Eltham what he could include in his Bill if it goes forward. He could examine the next stage of bringing together health and social care. On Tuesday, the Health Committee heard from Dame Kate Barker, the chair of the Commission on the Future of Health and Social Care in England. We were examining the transitional costs of bringing health and social care together, and looking ahead at the savings that can be made. The hon. Gentleman might apply his mind to the complications arising from the different streams of funding represented in health and social care, whereby health is funded by general taxation and some private support, which I have already discussed, whereas social care is the subject of means tests and other constraints. We are therefore talking about completely different funding stream. I do not know how the Health Committee will report this, but I was struck by Dame Kate Barker’s determination that there should be one person running health and social care. That is essential if we are going to bring those two things together.

The other point the hon. Gentleman should take on board as we look at the Bill is the high profile that the Secretary of State and his predecessor, my right hon. Friend the Member for South Cambridgeshire (Mr Lansley), have given to patient choice. The Government have said time and again that patient choice is at the heart of the health service, and we have already seen the benefits. The personal budgets now available for people who are seriously ill have had three benefits. First, they enable the patient to choose whatever treatment they want, be it tai chi, yoga or piano therapy—I believe that there have even been cases where tickets to a football match have been given. This is not something regulated by double-blind placebo controlled trials, as some of the other access arrangements for health care are. Secondly, the personal budgets enable the carers to go out into the world and get jobs, so freeing them up. Thirdly, when the personal budget money is given, it is spent responsibly by the patients. We have a whole new paradigm of health through personal budgets, and that should be examined through this Bill.

I have always felt that the 2012 Act and the reforms that were made produced something that put in place two legs on the stool, not three. The third leg comprises the vast and diverse multiplicity of support services that are not used in great depth in the health service now. Using them would considerably reduce costs and increase choice. The choice of these other support services will inevitably come to the fore as patients demand what they want, and we really have to bring this into the health service.

I have had many conversations about these things with the Under-Secretary of State for Health, my hon. Friend the Member for Central Suffolk and North Ipswich (Dr Poulter)—the Minister on the Front-Bench today. He has entrusted me with being vice-chair of the herbal working group, which is trying to sort out herbal medicine regulation. When we examine the support services that are not now part of mainstream health care, we see that we have a fundamental problem relating to the insistence that we rely on evidence-based medicine. I do not know where that phrase came from—it has not been around for a long time. Various bodies protect the public, and all new drugs are carefully scrutinised, by the pharmacists and the Herbal Medicines Advisory Committee, which has put together a list of what are, in effect, poisons and bans the use of some herbs. The public are protected in that way, but it is very difficult to use normal measurements to assess the effectiveness of, for example, acupuncture, which the National Institute for Health and Care Excellence has approved for treating lower back pain. A lot of evidence shows that acupuncture can reduce the effects of lower back pain and save the NHS a lot of cost. With homeopathic medicine, which I have long supported and advocated, it is impossible to run trials on every dilution: some are so dilute that they do not show up.

[Dr Huppert]

Will the hon. Gentleman give way?

[David Tredinnick]

I am always glad to give way to the hon. Gentleman—I am sure he will agree with my every word.

[Dr Huppert]

My hon. Friend will be well aware that there have been many trials of homeopathic medicines, and the fact is that none of them has shown that they work better than a placebo. He is right that they are very dilute; that is why they do not work.

[David Tredinnick]

The hon. Gentleman makes my point. I remember when some of his friends went to Boots in Kensington high street and consumed the entire stock of homeopathic medicine. They saw that as a huge triumph, as they felt it illustrated the fact that homeopathic medicine was not effective. Of course it did nothing of the sort; it proved that it was absolutely safe to take these preparations under any circumstances, and that the only time they work is if they are in the right preparation and are taken in the right amount, as prescribed by a professional.

I say to the Minister—I hope he will tune in to what I am saying—that we must move away from this insistence on evidence-based medicine and look at evidence-based practitioners. This is an area that has been overlooked for a very long time. There is much evidence that practitioners are well regulated, and we do not need to insist on checking every single preparation that people consume. Five areas of regulation already exist. The hon. Member for Eltham might want to think about that, as it is a matter that could be put into the Bill if it goes to Committee.

[Madam Deputy Speaker (Mrs Eleanor Laing)]

Order. The hon. Gentleman is aware that I am watching very carefully the matters that he is addressing in the House right now. He must speak to the Bill. We are discussing whether the Bill should have a Second Reading and go into Committee.

[David Tredinnick]

Madam Deputy Speaker, you are kind to draw that to my attention. I simply say this: there are different regulatory bodies—not just Monitor—that we should consider. We should be taking on board the fact that osteopaths, chiropractors and homeopathic doctors are regulated by separate Acts of Parliament, yet the Health and Care Professions Council regulates clinical scientists, paramedics, physiotherapists. The Professional Standards Authority, which is another regulatory body, provides oversight of nine statutory bodies. Then there is the umbrella body, the Complementary and Natural Healthcare Council. I will leave it at that, as I do not wish to stray. On the safety aspects of those bodies, I understand from Balens, which has been insuring support services for 10 years, that there has not been a claim against a herbalist for more than 10 years.

The Bill partly addresses the issue of the transatlantic trade and investment partnership. Across the world, there is a whole mass of new thinking that could be incorporated in our health service. I am nervous that if we take out TTIP—if an exemption for the NHS is proposed—it will not be in our interests. In America there are a lot of integrated practices, in which a range of different health disciplines are brought together to reduce costs.

[Angie Bray (Ealing Central and Acton) (Con)]

Does my hon. Friend agree that the Government and the European Commission have made it clear that decisions on the provision of public services will continue to be made by the Government here in Westminster?

[David Tredinnick]

We are agreed on that. It is a case of the extent to which we derogate the powers of the Secretary of State. We have a whole lot of new bodies, including clinical commissioning groups, which have been a great success.

I congratulate the hon. Member for Eltham on securing this slot today. I wonder whether he still has 100 troops in the Tea Room waiting to come in for a closure motion, if Madam Deputy Speaker is gracious enough to grant it. I am happy to serve with him in the future on his Bill.