Health and Social Care Bill

Grahame Morris Excerpts

Tuesday 20th March 2012 Commons Chamber

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

I have got out of my sick bed to be here today, because this is a vital debate, and I am grateful for the opportunity to participate in it. I often feel that these debates are a bit like the siege of Stalingrad: we are rolling back the forces of oppression. I content myself, with my cough and sore throat, that at least the red army was victorious on that occasion.

In response to the point that the hon. Member for Banbury (Tony Baldry) and the right hon. Member for Charnwood (Mr Dorrell), who chairs the Health Committee, made about the ruling by the Information Commissioner, I think we should reflect on the fact that it was indeed a ruling. It was not advice that he was giving. Mr Christopher Graham has some expertise in this field, and although the detailed reasons have not been published, the arguments that were made by my right hon. Friend the Member for Wentworth and Dearne (John Healey) and the co-applicants from the Evening Standard—that it was in the public interest to publish the risk register—were obviously accepted.

If I may, I would like to remind the House of what the Information Commissioner said, which was upheld on appeal. Mr Graham said:

“Disclosure would significantly aid public understanding of risks related to the proposed reforms and it would also inform participation in the debate about the reforms”.

Earlier on, Government Members were shouting “Frit!” at Labour Members. I really did not understand what that meant—I am just a simple working-class lad from Easington—but I now understand that it means “You’re afraid”. However, if the Government have complete confidence in the direction of their reforms, surely it is they who are afraid, because they should have the confidence to publish the document.

[Jim Dowd (Lewisham West and Penge) (Lab)]

It is beyond doubt that the Information Commissioner considered all these matters before reaching his decision. Does my hon. Friend agree that, if the risk assessment had supported the Government’s case, the Government would have got it out like a shot? That they have not done so exposes the fact that they are playing fast and loose with one of the nation’s most treasured institutions, and that they are trying to hide that.

[Grahame M. Morris]

Absolutely; good point, well made. If the Government had nothing to hide and were not concerned, they would have published the contents of the risk register. We have had a flavour of the contents of the other risk registers that have been compiled at strategic and other levels, and I believe that the Government are concerned about them.

We know that the Bill will increase the risks to the national health service. Indeed, the chief executive of the NHS, Sir David Nicholson, told the Health Select Committee, of which I am a member:

“I’ll not sit here and tell you that the risks have not gone up. They have. The risks of delivering the totality of the productivity savings,”—

that is, the Nicholson challenge; the £20 billion—

“the efficiency savings that we need over the next four years have gone up because of the big changes that are going on in the NHS as whole.”

It is clear that local and national risk registers, as well as the strategic risk registers to which we have had access, have highlighted serious concerns with patient safety, increased costs, the break-up of care pathways—which we have seen on Health Select Committee visits—as well as competition harming integration, about which the Committee was very concerned, and the specific risks during the transition stage.

[John Healey]

Will my hon. Friend also confirm that, in that session on 23 November 2010, Sir David Nicholson stated that the scale of the proposed change was enormous, and that it was beyond anything that anyone in the public or private sector had witnessed? That is why the risks involved in the reorganisation are so great, as is the imperative for the House and the public to know about them.

[Grahame M. Morris]

Absolutely; I completely agree with my right hon. Friend. These are huge structural changes to a beloved organisation, and it is in the public interest that we know precisely what is in the transition risk register.

A little while ago, I tabled early-day motion 2659, which called on the Health Secretary

“to respect the ruling by the Information Commissioner and to publish the risk register associated with the Health and Social Care Bill reforms in advance of Report Stage in the House of Lords”,

so that we could have proper scrutiny in the Lords and in the House of Commons. We have not seen what is in the transition risk register, but we are aware of the existence of other risk registers. While the Health Secretary has been fighting tooth and nail to prevent the publication of the transition risk register and, in the process, hiding the risks to the NHS in England, other NHS bodies and clinical groups have been compiling their own risk registers into the impact of the Health and Social Care Bill.

One such body is the Faculty of Public Health, the body for specialists in public health, which is a joint faculty of the three Royal Colleges of Physicians of the United Kingdom. I am grateful to Professor Clare Bambra, from the north-east, and Professor John Ashton, from the north-west, for providing this information. In a letter to The Independent, Professor Lindsey Davies, the president of the Faculty of Public Health, outlined his concerns about the pressure that clinicians were now under from their employers for criticising the Government’s plans to reform the NHS. He wrote:

“Public health professionals have the right and duty to speak out on issues which they perceive as threatening the health of the population they serve”.

The bunker mentality of the Health Secretary, and his determination to silence clinical and public opposition, have astounded the country as a whole.

In response to the Department of Health’s refusal to publish its own strategic risk assessment of the impact of the Bill, the Faculty of Public Health has undertaken its own study, in which it has highlighted a number of significant risks, not least the potential for a postcode lottery. It states:

“Clinical Commissioning Group flexibility to determine services will lead to an increase in geographical variation in service provision.”

It identifies the possibility of costs being pushed up, and states that the

“development of more overt market mechanisms, and the greater role for the independent sector in the provision of healthcare is likely to increase the overall cost of providing healthcare.”

It also raises concerns about issues of quality as a consequence of the reforms. If the transition risk register indicates that, we should know about it.

The delaying tactics employed by the Secretary of State are, to my mind, holding Parliament in contempt. He should publish and employ no further delaying tactics. Reports that Tory-Lib Dem Cabinet members banged their Cabinet table in delight and glee at the prospect of the health Bill finally being rammed through and becoming law at the end of today leave a very sour taste in the mouth. I urge all Members to support this motion and get the risk register published.

[Mr Speaker]

I inform the House that there is a slight discrepancy between the clock time shown on the annunciator screen and that shown on the digital display panels on either side of the Chamber. For the avoidance of doubt, this debate began at 3.44 pm and has to end at or before 5.14 pm. For the purposes of deciding when we reach the end time, the Chair will use the time on the Chamber digital display panels. I hope that that is helpful. Given the level of interest in the debate, the time limit for Back Benchers will be reduced to three minutes with immediate effect.

--- Later in debate ---

[Dr Wollaston]

There we go—a deliberate misrepresentation. After I made those comments, I wrote to senior colleagues and told them that what I had said was completely different. I was deliberately misquoted on that statement and have been consistently misquoted by Labour Members. They should go back and look at the original.

I feel that it would be reasonable to present all the risks, but it would be crucial for Members of all parties to recognise that we are talking about a lasting change. We would also need to see a change in how risks are extrapolated out of all proportion to what they represent and an end to the deliberate frightening of patients into believing that they will have to pay for health care, which has been a consistent feature of how this Bill has been misrepresented by Labour Members.

[Grahame M. Morris]

In the context of her medicinal anecdote, does the hon. Lady not accept that members of the public at least have the right to read the little inserts in books of pills before they take them? Should we not have the same right to read the risk register?