Health and Social Care Bill

Diane Abbott Excerpts

Tuesday 13th March 2012 Commons Chamber

[Ms Diane Abbott (Hackney North and Stoke Newington) (Lab)]

The British public, as I think everyone here acknowledges, have a great care and concern for the national health service. That is not an idle superstition, as Conservative Members sometimes imply, but probably arises because we all interact with the health service when we are at our most vulnerable and at pivotal moments of our lives. Perhaps it happens when we are having our children or when a parent is dying or when we are ill and frightened. It is therefore unfortunate, to put it mildly, that no Government Members have been prepared seriously to engage with the depth of public concern about this Bill.

Let me quote a joint editorial, written by the editors of the British Medical Journal, the Health Service Journal and Nursing Times—publications that originally supported this Bill, to which fact I draw the Secretary of State’s attention. They describe the Bill as

“poorly conceived, badly communicated, and a dangerous distraction at a time when the NHS is required to make unprecedented savings.”

That is the consensus within the NHS. Ministers talk about the GPs involved in clinical commissioning groups. Of course GPs are moving forward and trying to engage with the changes—because they want what is best for their patients, not because most of them support the Bill in principle.

I have spoken about opinion within the NHS. As some Members know, my mother was a woman who gave her life to the NHS. She came to this country in the 1950s as a pupil nurse, and she ended her career working in a mental hospital just outside Huddersfield in West Yorkshire. She was part of that generation of men and women who built our NHS in the years after the second world war. In preparing for this debate and thinking about how to cut through the bluster, allegations, counter-allegations and politicking, I thought to myself, “Perhaps I should say what my mother would want me to say”. She was not a politician; she was not the head of a royal college; she was not a manager; she did not work for a glitzy Westminster think-tank: she was just an ordinary woman who was very proud indeed to say that she worked for the British NHS. My mother would have wanted me to say that the NHS is special and that from its earliest years it has been about change and adaptability. She would have wanted me to say, too, that politicians should handle it with thoughtfulness, not engage in party political games, but give the debate the care and thought that she always gave her patients.

I have to reinforce the point about the specialness of the NHS because part of the Secretary of State’s narrative, as this year has worn on, is that the NHS is somehow broken, and only his Bill can fix it. Well, we have heard that the Commonwealth Fund says that the NHS is one of the world’s leading health care systems for quality and value for money, and we know that it had the highest satisfaction ratings ever at 72%. Even the Secretary of State said on Second Reading that on a number of indicators,

“including mortality rates from accidents and self-harm, equity and access to health care—the NHS leads the world”.—[Official Report, 31 January 2011; Vol. 522, c. 606.]

This is far from a health care system that is broken.

My Labour Front-Bench colleagues and I need no reminding of how special the health service is and how we should respect the people who work in it at every level. We have spent the past year going up and down the country, shadowing workers in the NHS. We have met radiotherapists in Wirral, physiotherapists in Northumbria, ambulance crew in Cambridge, mental health nurses in Rochdale, cancer nurses in Birmingham, hospital porters in Leeds, paediatricians in Bristol and midwives in London. These were different people working at different places at different levels, but from every visit, we heard the same abiding message—“Our NHS is not for sale.”.

The second point that I am sure my mother would have wanted me to make is that from its earliest years the NHS has always been open to change and improvement, as I said. Workers are not opposed to change. Why would workers in the NHS be opposed to change? It is a service where people and science interact. Of course people are different first thing in the morning from how they are when they go to bed. Of course NHS workers are able to deal with change. No one needs to tell a nurse’s daughter that there have always been things in the NHS that could have been improved.

The Labour party is not opposed to change. It was our willingness to change and reform that drove down waiting times to unprecedentedly low levels. Some of the things we tried were so radical that some of us could not vote for them, but it is no discredit to my right hon. and hon. Friends that they were willing to try every lever they could to bring down waiting times and provide a service for the people who voted us here.

[Nicky Morgan]

Will the hon. Lady give way?

[Ms Abbott]

Time is against me, I am afraid.

The final thing that ordinary health service workers would wish me to say is that if anything has exemplified the unfortunate practice of politicians of saying one thing and doing another, it is the frequency and vehemence with which the Government decried top-down reorganisations when they were in opposition. In 2006, the right hon. Member for Witney (Mr Cameron), then Leader of the Opposition said:

“So I make this commitment to the NHS and all who work in it. No more pointless reorganisations.”

In 2007, the then shadow Health Secretary said:

“The NHS needs no more pointless organisational upheaval”.

In 2009, still as Leader of the Opposition, the right hon. Member for Witney said:

“But first I want to tell you what we’re not going to do. There will be no more of those pointless re-organisations”.

Then, the coalition agreement of 2010—I do not want to touch on private grief here for Liberal Democrat Members—said:

“We will stop the top-down reorganisations of the NHS that have got in the way of patient care.”

We are thus presented with a Bill that is based on a bizarre sort of life support—the arrogance of the coalition leadership.

Now we know that the doctors, the nurses, the midwives, the health visitors, the paramedics, the cleaners, the porters, and the scientific and technical workers will do their very best with this Bill if it becomes law. That is what Clare Gerada was saying this morning: if it becomes law, they will do their very best, but why should they have to see an already discredited Bill on the statute book? Why should they have to see more bureaucracy, which is what the Bill will mean, and why should they have to see billions of pounds wasted at a time when the health service is under unprecedented financial pressure? Government Members have sought to denigrate those who oppose the Bill by saying that their opposition is merely party-political. Of course it is not: we are proud to be part of a coalition of concern about the Bill.

My right hon. Friend the Member for South Shields (David Miliband), my hon. Friend the Member for Stalybridge and Hyde (Jonathan Reynolds), my right hon. Friend the Member for Manchester, Gorton (Sir Gerald Kaufman), my hon. Friends the Members for Stoke-on-Trent North (Joan Walley) and for Worsley and Eccles South (Barbara Keeley), my right hon. Friend the Member for Wentworth and Dearne (John Healey) and my hon. Friend the Member for Bethnal Green and Bow (Rushanara Ali) spelt out our concern about the Bill. It is extraordinary that we can proceed while the Government are still refusing to reveal the risk register. There is concern throughout the NHS about the fragmentation that will result from the Bill. Government Members say that we are scaremongering—[Hon. Members: “You are.”]—but private sector companies such as Humana and Capita are already advertising their willingness to take over GPs’ commissioning powers on their websites.

The NHS does not belong to the Secretary of State, and it does not belong to the Deputy Prime Minister. It belongs to the people of Britain who built it after the war. The NHS is not for sale, and I urge the House to support the motion.