Oral Answers to Questions

Debate between Diane Abbott and Jamie Reed

Monday 12th May 2014 Commons Chamber

[Mr Jamie Reed (Copeland) (Lab)]

Our amendments to Lords amendments 40B and 40C are designed to protect patients, improve transparency and decision making, and ensure that health service reconfigurations do not result in a restriction of access to services for patients. I give notice that I wish to press amendments (a) and (b) to Lords amendment 40B to a vote.

This is probably the final piece of health legislation that will come before this Parliament. To date, this Bill marks four years of chaos and confusion in the NHS—chaos inflicted on the service by the Prime Minister and his two Secretaries of State for Health. What a four years it has been! The Prime Minister promised no top-down reorganisation of the national health service, then introduced the biggest and most chaotic, expensive and wasteful reorganisation that the service has seen in its entire history. He promised a bare-knuckle fight against hospital closures—a fight that not only never appeared, but was knowingly untrue from the outset. We have seen Ministers admit that the 111 service was not ready to be rolled out, but who went ahead, scrapped NHS Direct and rolled it out anyway. We have seen one of the most important schemes for the future of the country and the NHS in the shape of the care.data scheme being bungled, botched and brought to the brink of collapse by ministerial incompetence. We have seen military hospital field tents outside accident and emergency units and police cars being used as makeshift ambulances, queuing outside hospitals for hours on end.

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

My hon. Friend mentions the supposed attack on bureaucracy by the Conservatives. Is he aware that since their reorganisation there is actually more bureaucracy? Many of the people who have been sacked, and who received redundancy payments, are now working in the commissioning support organisations.

[Mr Reed]

My hon. Friend is entirely right, and the Lords amendments will only make that situation worse.

Now, as this zombie Parliament limps towards the finishing line, we are asked to consider a Frankenstein Bill—a badly stitched together Bill—which began with good intentions, but which, for the most part, will not end well. The Care Bill should have remained just that. On the face of it, part 1, building on the work of the last Labour Government, makes some modest improvements which we welcome, but let us be under no illusions. For all the Government’s bold claims, this Bill is a modest Bill. We support the rights for carers and many of the provisions and principles contained in part 1. Even though we believe that these could have gone much further towards the creation of a properly integrated model of whole person care, the real issue is that the Government have hijacked the Bill to push through a back-door reconfiguration tool that undermines the principle of local commissioning by centralising hospital closure and service removal decisions. It exposes as a sham the Government’s rhetoric about local clinical commissioning over the last four years.

Before I address the trust special administrator clause in more detail, let me touch on Lords amendment 11B, relating to human rights. Hon. Members may remember this issue from our debates on Report. The amendment will ensure that all users of publicly funded or arranged care have direct protection under the Human Rights Act 1998. Under the law as it stands, the fundamental protection and access to individual redress offered by the Act are not applied equally in all care settings.

This measure has a long history. In the other place, Lord Low tabled and passed a new clause which sought to close the loophole. But the Government removed it in Committee in this House, and then voted down an Opposition amendment on Report that would have restored it. The Minister did, however, say that he would go away and look at the issue again. The result is the amendment that we have before us today. For our part, we welcome the Government’s U-turn on this. It is good that Ministers have seen the light, having voted against this kind of protection at every previous stage of the Bill’s passage.

The amendment is clear that any care that is paid for out of public money

“directly or indirectly, in whole or in part”,

or which is arranged by a public authority, will now be covered by the Human Rights Act. However, I have a couple of questions for the Minister. First, he knows that personal budgets are absolutely critical in giving people greater choice and control over their lives, and enabling people to make their own decisions about how their care is delivered. It is important that personal budgets are covered by the amendment. Will the Minister confirm that that is the case, and that social care provided by a regulated provider and paid for by direct payments is included?

Secondly, it would be good if the Minister could clarify for the House whether so-called non-personal care is covered by the amendment. The definition of care used in the Lords amendment is that used in the Health and Social Care Act 2008. This is quite a narrow definition, and it is possible that it could exclude some very important types of care for people with learning disabilities or mental health problems, such as assisting them to participate in activities or to get to appointments. The Opposition amendment tabled on Report, which was drafted by the Joint Committee on Human Rights, would have covered this non-personal care, but as the Government’s amendment contains a narrower definition, we are concerned that they may be excluding quite broad categories of publicly provided social care services that may not be defined as personal care. We would be grateful if the Minister could allay our fears on that point, and confirm that those extremely important types of care for some very vulnerable people will be covered by this amendment. I look forward to his reply.