Health and Social Care Bill

Debbie Abrahams Excerpts

Monday 31st January 2011 Commons Chamber

[Debbie Abrahams (Oldham East and Saddleworth) (Lab)]

Thank you for calling me to make my maiden speech in this debate today, Mr Speaker. I am deeply honoured to have been elected as the Member of Parliament for Oldham East and Saddleworth in the recent by-election—the first woman MP for Oldham. The circumstances for the by-election were indeed unusual, and it is only right to mention that many constituents and colleagues from across the House have remarked on my predecessor Phil Woolas’s intellect, his incredible attention to detail and the kindness he showed to them. [Hon. Members: “Hear, hear.”]

My constituency is a beautiful place with a remarkable history. For example, it was not only where the Independent Labour party was born and where Winston Churchill started his political career, but where the suffragette Annie Kenney originated from. Oldham’s first parliamentary representatives were of course the radicals William Cobbett and John Fielden, and I intend to be equally radical in my own way.

As beautiful and as varied as my constituency is, what I care most about are the remarkable people. During the by-election, I met thousands of constituents from all walks of life, some of whom supported me and some of whom did not. Regardless of their political affiliation, however, they were invariably polite. Of course, there were one or two who chased me down their garden paths, but, fair dos, it was Christmas day! [Laughter.] Their tolerance and decency reflect something very special about our society: a social conscience that values fairness, treating people as they would like to be treated, while recognising that different people have different needs and merits. As we know, both intuitively and from research, fairer societies do better, and are better for everyone. Of course, all political parties have claimed that they are the party of fairness, but I think most people will agree that action speaks louder than words.

I promised the people of Oldham East and Saddleworth that I would stand up for them and fight against unfairness. I believe—there is increasing evidence to support this—that the Government’s policies are deeply unfair and, contrary to their assertions, unwarranted. As history has shown, Governments set the tone for the culture of a society. The tone being set by this Government threatens the country’s sense of fair play and social justice.

I asked to deliver my maiden speech on Second Reading of the Health and Social Care Bill because, as some people will know, my professional background is in health. I am passionate about the NHS. For me, it not only plans and provides our health services, but reflects the very values of our society.

In ’97, the NHS was on its knees. Staff were leaving in droves, and the level of spending on health was one of the lowest in Europe. Labour more than trebled investment in the NHS, enabling us to recruit more doctors and nurses and to improve access to care. Gone are the days when people waited two years or more for a hip replacement or to have their cataracts removed.

The shift to improving health, preventing illness and providing care closer to home has made real, positive differences to the nation’s health. The Bill threatens not just those developments, but the very future of the NHS. I have expressed my concerns in the past about the marketisation of our NHS, but the Bill is in another league—it is about the total privatisation of our NHS. Some fear that all that will be left will be the name.

Where is the mandate for that from the British people? We can all sign up to the Bill’s objectives, but there is no evidence to support the idea that the proposals will deliver better health outcomes. The reforms are based on the notion that increasing competition drives down costs and improves quality. However, the overwhelming evidence from the UK, the US and elsewhere, is that that is not how competition works in health care.

I have heard some Government Members ask, “What does it matter who provides our health care as long as it is free at the point of need?” I say to them that that does matter. I have seen how the decisions about which patients those providers treat are based on whether they are profitable or not; they are not based on clinical need.

The reforms will affect the choice of medicines prescribed, and what type of treatments are provided and what kind of patients are prioritised. Certainly, that will not mean those with complex conditions. Unprofitable patients can expect short shrift from this evolved NHS. At my surgery last week, one of my constituents, who is in remission from leukaemia, came to see me because she fears that the drugs that she has been prescribed will be unavailable under the new reforms. What am I going to tell her?

Abolishing primary care trusts as part of the costly NHS reorganisation is yet another broken promise from this Government. Putting £80 billion of the NHS budget into the hands of a few GPs who enjoy managing a business might sound liberating, but in my experience, the vast majority of GPs want only to care as well as they can for their patients. In reality, the commissioning of health services will also be done by private health care companies, and there are significant conflicts of interests when those companies are both commissioners and providers of care.

The impact on equitable access to health care is another real issue. The Bill does not require GP consortia to work together, which leaves the possibility of neighbouring consortia taking different decisions about services, giving rise to a new postcode lottery. By forcing those GP consortia to put all services out to competitive tender, the Bill encourages any willing provider to cherry-pick profitable slices of NHS services. The introduction of price competition for the first time is a disastrous step, with the potential to undermine the quality of patient care.

In public health, which is my field, I have little confidence that the move of the public health service to local authorities will lead to health gain. That depends on an independent and well-resourced public health work force. The Bill also fails to define what will be covered by the ring-fenced budget that is given to local authorities. Thank you again, Mr Speaker, for calling me.