Health and Social Care Bill

Grahame Morris Excerpts

Tuesday 13th March 2012 Commons Chamber

[Dame Joan Ruddock (Lewisham, Deptford) (Lab)]

rose—

[Grahame M. Morris (Easington) (Lab)]

rose—

[Mr Lansley]

Let us try this one. For the first time the Bill introduces in clause 3 a duty that embeds the need to act to reduce inequalities firmly within the health system. After 13 years of widening health inequalities under Labour, surely he cannot be against that—or is he? No. Well, what about clinically led commissioning, with doctors and nurses who are responsible for our care given the leadership role in designing services? We heard earlier about one CCG, but 75 leaders of clinical commissioning groups wrote to The Times a fortnight ago. Let me quote them, because it is instructive of what is happening. They said:

“Since the…Bill was announced, we have personally seen more collaboration, enthusiasm and accepted responsibility from our GP colleagues, engaged patients and other NHS leaders than through previous ‘NHS re-organisations’”.

They continued:

“Putting clinicians in control of commissioning has allowed us to concentrate on outcomes through improving quality, innovation and prevention”—

precisely the things that the NHS needs for the future.

Now the right hon. Gentleman says, “Oh, yes, we can do GP commissioning”, but let us recall that in 2005, practice-based commissioning was in the Labour manifesto, and that in 2006, he said he was in favour of it. He said that he was

“introducing practice-based commissioning. That change will put power in the hands of local GPs to drive improvements in their area”—[Official Report, 16 May 2006; Vol. 446, c. 861.]

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[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Member say that she welcomes the new measures on health inequalities, so it is a shame that the legislation could be repealed in its entirety.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.

[Grahame M. Morris]

On the hon. Gentleman’s point about efficiency, costs and so on, I draw his attention to an article in The Guardian today which says that the cost of replacing with a locum GPs who are away on clinical commissioning duties is £123,000 a year, while one clinical commissioning group has reported that 15 local doctors are each spending two days a week away from their surgeries. How is that an efficient use of resources?

[Chris Skidmore]

We are reinvesting the billions of pounds saved on managers into front-line care, and that is why we have already seen over 5,000 new doctors working on front-line services this year. I understand where the hon. Gentleman is coming from in terms of the political spectrum, but I believe that he is referring to a TUC press release that The Guardian published in full.

In a previous debate, the right hon. Member for Leigh said that he would put a cap on private practice in “single figures”. That would take the NHS backwards from its current position, and it is an arbitrary cap based on ideology, not on what is in the best interests of NHS patients. Nor is it in the interests of some of our best-loved hospitals. Dr Jane Collins, the chief executive of Great Ormond Street hospital, has said:

“The lifting of the private patient cap would allow us as a Foundation Trust to treat more patients, but also, through re-investment, to help more NHS patients.”

So Labour has set its face against Great Ormond Street hospital: well done!

We need a constructive debate about what needs to be done for patients in the 21st century. The right hon. Member for Leigh should stop using the shroud-waving language that he used today in stating:

“Time is running out for the NHS.”

In December last year, he said that there were 72 hours to save the NHS. What happened? He should beware, above all, of becoming the boy who cried wolf. I believe that this Bill will improve the NHS. I sincerely urge him to base his argument not on intuition but on facts, and, for the sake of patients, not to turn his back on reform that he once believed in and should go back to believing in.

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[Nicky Morgan]

Thank you, Madam Deputy Speaker. After many, many weeks on the Health and Social Care Bill Committee, there is no danger of the hon. Gentleman agreeing with any of the points that I make, but that will not stop me making them.

My hon. Friend the Member for South West Bedfordshire (Andrew Selous) talked about mental health. Those who spent time on the Public Bill Committee will know that I am particularly involved and interested in mental health, and I hope that we will have a debate on mental health in the Chamber soon, but what has struck me in discussions of the Bill is that mental health service users want to be involved in decisions about the commissioning of their services. They have that opportunity in the Bill through the health and wellbeing board, HealthWatch, the clinical commissioning groups, the involvement of the voluntary sector, and, as hon. Members have said, the integration of health and social care services. The Secretary of State talked about shared decision making. It is incredibly important that that is allowed to flourish under the Bill.

My next point—a damning and depressing one for a Member of Parliament to make—is the misinformation that has been perpetuated about the Bill. Tonight, we heard the shadow Secretary of State say that time is running out for the NHS. An hon. Member said that the shadow Secretary of State spoke in December of our having 72 hours to save the NHS, and another said that their constituents are worried about the services that will be on offer. All that is scaremongering, and it is unfair on those who do not have the time, capacity or inclination to read the Bill. We need to talk about the reality.

[Grahame M. Morris]

On the charges of scaremongering, is the hon. Lady aware that the George Eliot hospital in Nuneaton is engaged in conversations with two private sector providers—Serco and Circle—on taking over that provision? In my 30-odd years involved in the NHS, I have never known that to happen.

[Nicky Morgan]

I thank the hon. Gentleman for his point and the measured way in which he made it. That is welcome in the debate on the Bill. As a midlands MPs, I am aware of what is happening in Nuneaton, but it is not my constituency so I will refrain from saying too much. I will say only that the hospital management have asked in other providers because they are concerned and want to ensure the best possible care. Is that not what we want?

[Grahame M. Morris]

They are private providers.

[Nicky Morgan]

That could be the voluntary sector or the community sector. They are all private. If someone has a physio appointment, it could be with a private provider. At the end of the day, we want the best care for patients and constituents. That is what we all want.

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[Grahame M. Morris (Easington) (Lab)]

I want to pay tribute to all the hard-working individuals who work in the national health service, and to Dr Éoin Clarke and Dr Clive Peedell, who have been supportive of the coalition, for highlighting the dangers of the Health and Social Care Bill. I suspect that this will be my final opportunity to speak up on the Bill. I understand that there are only about seven days before its Third Reading debate in the House of Lords. It terrifies me that the Bill, which I have studied intently during its 40 Committee sittings, is going to become law. The Secretary of State is introducing a new health system. It is a system that no one voted for, and it will be unrecognisable in comparison with the NHS that cared for an entire population from the cradle to the grave.

[Jim Shannon]

Does the hon. Gentleman share the concerns of many Members on the Opposition Benches—and, I suspect, many people outside the House—that the Government will create a two-tier health system consisting of those who can afford to pay and those who cannot? Does not that fly in the face of what the NHS was originally set up to do?

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[Grahame M. Morris]

That is precisely our fear, and I hope to develop that argument in a moment.

The national health service was established in 1948, against the background of the devastation following a world war. Men and women with a vision for a better, fairer society set in law the guiding principles and values of our NHS. Let us not forget that, during the post-war period, this country faced a bigger deficit as a proportion of our national wealth than we are facing today.

[Bill Esterson]

Will my hon. Friend give way?

[Grahame M. Morris]

I am afraid not, as I have very little time.

Those people knew that the value of money would be worthless if it did nothing for ordinary people. Nye Bevan stated:

“No longer will wealth be an advantage, nor poverty a disadvantage. Healthcare will be provided free of charge, based upon clinical need and not on ability to pay”.

In contrast, this Government seem to see any money spent by public sector providers as somehow wasteful unless it is trickled through their friends in the private sector who can turn a profit. I am concerned that their whole philosophy is antagonistic towards the public sector. I was outside the Lib Dem conference on Saturday, lobbying the delegates. I hope that Lib Dem MPs will support the motion tonight.

[Andrew Selous]

Will the hon. Gentleman give way?

[Grahame M. Morris]

No, I will not.

The Health Secretary’s problem is that no one voted for these reforms. He has no mandate, and 24 organisations are ranged against them. He has cited Clare Gerada of the Royal College of General Practitioners as his new ally, but nothing could be further from the truth. She has said that, just because the GPs are being forced to man the lifeboats, it does not mean that they agree with sinking the ship. They really have no alternative.

It has been suggested that Labour left the NHS in a dreadful state. Let us not forget that when the Labour Government were elected in 1997 only 34% of those surveyed in the British social attitudes survey said that they were satisfied with the NHS. That was the lowest level since the survey was started under the Tories in 1983. By 2009, however, public satisfaction in the NHS had more than doubled, to 64%. So, from that starting-point of cutting bureaucracy, decentralising powers and increasing clinical commissioning, we now seem to have an end-point, which is becoming clearer. It seems to be the NHS ripped asunder by competition and private provision.

This Bill is about establishing competition and entry-points for the private sector at every level of the NHS. In essence, it is a Trojan horse for privatisation. [Interruption.] People are saying that this is not true, so let us look at clause 163, as amended by the Lords, whereby for NHS hospitals and foundation trusts, up to 49% of their treatments can be set aside for private fee-paying patients. That must surely put NHS patients at the back of the queue.

In conclusion, Labour Members are keen to form a coalition with progressive Members who recognise the damage that these so-called reforms are likely to do to our health service. We fervently oppose the reforms as set out in the Bill. What we should be doing is talking about how to create a national care service, which would be the next and logical step for the NHS. On behalf of everyone in this country, my party, the Labour party, created the NHS and is now fighting to save it. We are building a coalition so to do. We will fight for the values, principles and future of the NHS well beyond the passage of this Bill.