National Health Service (Amended Duties and Powers) Bill

Grahame Morris Excerpts

Friday 21st November 2014 Commons Chamber

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

I congratulate my hon. Friend on introducing this Bill. Does he agree that the Liberal Democrats have got a brass neck in making criticisms, given that not only did they sit on their hands during that Bill Committee, but the right hon. Member for Sutton and Cheam (Paul Burstow) was the prime advocate who led the Bill during its passage through Parliament?

[Clive Efford]

And then led a campaign to stop his local accident and emergency department closing, having done that for the Government.

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[Sir Tony Baldry]

My hon. and learned Friend makes a very good point. There is confusion about whether we have got new Labour or old Labour. The Labour party has to set out how it would undo the market it created without further top-down reorganisation. It could not do it simply by removing the health rules that manage it. There has been no change on when to tender competitively; the rules on procurement are the same as those used by the previous Government. The Act makes it clear that the Secretary of State remains politically accountable to the NHS. The changes in the Bill would restrict the greater autonomy given to the NHS and inhibit staff from making the innovative changes needed to secure sustainable, high-quality care for patients. In particular, it would tie the hands of clinical leaders on CCGs, which the NHS England five-year forward view says should have more powers, not fewer.

[Grahame M. Morris]

The right hon. Gentleman is engaging in a lengthy filibuster, in my opinion. I served on the Committee for the 2012 Act, and a plethora of organisations pointed out during the passage of that Bill the folly of what the Government were doing. They introduced a lengthy Bill; we spent 40 sittings in Committee; they tabled more than 1,000 amendments to their own Bill; it had 20 different sections; part 3 introduced Monitor. To suggest to the House that that Act introduced no change to the system operated under Labour is—well, it is not disingenuous, but it is not correct. I am not sure what term is best to use.

[Sir Tony Baldry]

During the passage of that Bill, the Labour party and certain organisations, including some trade unions, sought to rewrite history. Interestingly, when Labour introduced things such as the independent treatment centres, the Darzi centres and the 2002 concordat, the trade unions that rallied to support the hon. Gentleman in Committee were totally silent. I do not think it lies in the mouth of those organisations, which did not complain when the Labour party introduced a partnership and a concordat with the independent and voluntary sector when it was in government, now to complain, simply because it is the Conservative party in a coalition Government, that we are somehow “privatising” the NHS. It is simply not true.

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[John Healey]

We on the Labour Benches cannot wait for the debate on the NHS to be put right at the heart of the next five months of policy and political debate, and my right hon. Friend the shadow Secretary of State will make sure that happens.

Let me return to my point about the way that we in this House were misled about the reorganisation and the legislation. I am disappointed to see that the man who led it, the right hon. Member for South Cambridgeshire (Mr Lansley), is not in the Chamber today to explain himself. He argued—it was completely wrong, but he argued it—in the debate on Second Reading in January 2011:

“It is about gearing the entire system towards supporting the relationship between doctor and patient”.—[Official Report, 31 January 2011; Vol. 522, c. 617.]

Of course, it was not and it is not. As I argued, at the time from the Opposition Front Bench:

“The reorganisation and legislation is designed to break up the NHS, to open up all areas of the NHS to private health companies, to remove requirements for proper openness, scrutiny and accountability to the public and to Parliament, and make the NHS subject to both UK and European competition law.”—[Official Report, 16 March 2011; Vol. 525, c. 378.]

The Government were and are driving free market political ideology through the heart of our NHS.

The arguments that those of us on the Opposition Benches made then are those that we make now, and that my right hon. Friend the Member for Leigh (Andy Burnham) makes especially strongly from our Front Bench. That is why the Bill that my hon. Friend the Member for Eltham (Clive Efford) has introduced is so essential and why I am so pleased and proud to be one of his sponsors.

[Grahame M. Morris]

My right hon. Friend made some powerful points when the Health and Social Care Act 2012 was going through Parliament, when Tory Members were denying the purpose of the legislation. He quoted the last Health Secretary, but the current Health Secretary, the right hon. Member for South West Surrey (Mr Hunt), said in a book:

“Our ambition should be to break down the barriers between private and public health provision, in effect denationalising the provision of healthcare in Britain”.

What could be a more succinct and clear expression of their intentions?

[John Healey]

My hon. Friend has been a strong champion of the NHS and followed this issue from day one of this Parliament. To answer directly his question of what could be more succinct and clear, I suspect that when we hear from the new Member for UKIP, the hon. Member for Rochester and Strood (Mark Reckless) or his colleague, the hon. Member for Clacton (Douglas Carswell)—given some of the things that they have argued should be the basis of the NHS in future—they will make the vision of the right hon. Member for South West Surrey look positively UKIP-lite.

This Bill is essential because it starts to correct the three fundamental flaws, brought about by the reorganisation legislation, that are now driving the NHS. We could call them the three Cs—cost, complexity and competition.

On cost, the scale of the reorganisation was simply huge. As the chief executive of the NHS said at the time, it was

“beyond anything that anybody from the public or private sector has witnessed”.

The cost of the waste has been huge. We reckoned beforehand that it was about £2 billion; we now reckon £3 billion. What is clear is that getting on for £1 billion has been paid out in redundancies, much of which was to staff who were paid off and then re-hired by our NHS.

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[Mark Reckless]

Indeed, I am proud, and many people in my constituency have moved down from Eltham and the surrounding areas, and I am delighted that they returned me to the House in the early hours of this morning.

I found the hon. Gentleman’s speech compelling. At half-past 4 this morning or thereabouts, I was extolling the virtues of the Levellers and the Chartists. I can only think that I had a premonition of the speech that the hon. Gentleman was to make in the House this morning.

The other reason for my presence here is that, in the by-election I have just fought, we had in Naushabah Khan a Labour candidate who made—quite eloquently, I thought —the case against fragmentation and privatisation of the NHS, and she and others in Medway Labour commended the Bill to me.

[Grahame M. Morris]

I was not in Rochester last night. I joined a vigil outside Parliament by groups who are campaigning to save our NHS, and I had a conversation with a consultant oncologist on that very issue of fragmentation. He said that the only competition we should have in the NHS is the competition to defeat disease. Does the hon. Gentleman agree with that?

[Mark Reckless]

That sounds a good statement. I myself feel a certain degree of scepticism, as the hon. Member for Southport (John Pugh) said, about internal markets in the NHS and other public services. Much depends on the circumstances of the service provided, and an ideological predisposition either against or in favour of internal markets is probably not wise.

The Labour candidate in the by-election opposed fragmentation and privatisation of the NHS, and the Bill appears to do so as well. I have discovered that this is now the Labour party’s position. I had assumed that the Labour party was in favour of fragmentation and privatisation in the NHS, because that was my understanding of what the record had been.

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[Dr Poulter]

I will come on later to the costs that the hon. Gentleman’s Bill would directly create. The point is that we should be proud—the Labour party should be supporting the Government—that we are reducing administration and bureaucratic costs, because that money is now being spent on patients. Why cannot Labour for once accept that a good thing has happened and that more money is now going into front-line patient care?

The second effect of the 2012 Act is that it empowered local doctors and nurses, as those closest to and most able to determine the needs of their patients, to design and lead the delivery of services around the needs of those patients. Thirdly, the Act placed great importance on and sought to drive increased integration across our NHS, a point clearly articulated by my hon. Friend the Member for Bosworth (David Tredinnick). Commissioners had duties placed on them by the Act to consider how services could be provided in a more integrated way, and we have since built on the Act by supporting a number of integration pioneer sites, which will trail-blaze new ideas to bring care closer together, particularly for frail elderly people and people with complex care needs. They will be leaders of change—a change we have to see in the health system, if we want to offer the very best quality of care to patients.

We are also supporting the health and care system through the £5.3 billion better care fund, with commissioners working in partnership with local authorities to deliver more integrated person-centred care. Offering seven-day services and delivering care that is centred on patients’ needs will encourage organisations to act earlier to prevent people from reaching crisis point. That is the sort of clinical leadership that the Act has fostered. It will refocus the point of care towards more proactive community-based care, for the benefit of so many patients.

[Grahame M. Morris]

The Minister is defending fragmentation, but may I, as a former member of the Health Committee, remind him that Sir David Nicholson, the former chief exec of the NHS, summed up the situation last year by saying:

“You’ve got competition lawyers all over the place, causing enormous difficulty. We are getting, in my view, bogged down in a morass of competition law which is causing significant cost in the system”.

Is the Minister saying that the chief exec is wrong in his assessment?