(10 years, 1 month ago)
Commons ChamberWe 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.
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?
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.
(10 years, 1 month ago)
Commons ChamberI think that the best protection is offered by new clause 2, with the market rent only option. Time is short, but I shall try to explain why. We have heard from the respected Chair and former Chairs of the Select Committee on Business, Innovation and Skills. We have had debates, and the all-party save the pub group is certainly aware of the four reports produced by the Committee that concluded that there had been abuse of the tied system, and that recommended time and again the market rent only option.
During her opening remarks, the Minister was harangued by Government Members with prophecies of doom about the consequences for local economies and regional brewers, but in truth the Federation of Small Businesses suggests that there will be a considerable benefit to the economy of offering this option. CAMRA estimates that large pub companies force their tenants to buy beer at prices that are inflated by as much as 50% or 70%; that is on top of rent that is already excessive. Anyone who believes in fairness would support new clause 2, which would correct that.
My hon. Friend makes a powerful case. Does he agree that tied tenants, such as those of the Monkwood tavern in Rawmarsh, The Crusty Pipe in Goldthorpe and The Bull’s Head in Cortonwood, simply want a fair basis on which to run their pubs as a business for them and their families?
Absolutely. All we are arguing for is fairness—[Interruption.] The hon. Member for Burton asks from a sedentary position why this has not been done before. We have an opportunity to do something now, and I cannot be answerable for things that happened before I was a Member of this House.
As a result of excessive behaviour by the pub companies, an estimated 57% of tied landlords earn less than £10,000 a year. That is a disgrace. Anybody who, like me, frequents pubs regularly will realise what an incredible effort goes into running a public house—the hours put in bottling up after customers have gone home, the huge commitment it takes, and the toll it takes on the owners’ personal life. For them not to have the opportunity to earn a decent living is a disgrace.
(12 years, 9 months ago)
Commons ChamberAbsolutely; 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.
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.
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.
(13 years, 6 months ago)
Commons ChamberI do not normally quote the hon. Gentleman’s party leader, but a few weeks ago, the Deputy Prime Minister said:
“It is very important that MPs, who represent millions of patients up and down the country, have the opportunity to really look at the details that we are proposing…I have always said that it is best to take our time to get it right rather than move too fast and risk getting the details wrong.”
The Prime Minister has stopped listening to the Deputy Prime Minister, and that is exactly the mistake the Government are making with the motion.
Does my right hon. Friend agree that despite the Conservatives saying that they are against cherry-picking, that is exactly what they are doing? They are cherry-picking the elements to be referred to the Bill Committee. Clause 60, for example, which deals with Monitor and the regulation of the NHS, is not included. There are so many inconsistencies in the Bill.
(13 years, 7 months ago)
Commons ChamberMy hon. Friend has been pressing that point with his local hospital, because it is quite clear that the hospital’s managers were forced to look at privatising it and having its management run by a private company. I fear that under the provisions of the Health and Social Care Bill, more hospitals will be driven to the brink and will have to face the prospect of insolvency or a takeover by the private sector companies that are lining up to make the most of the Government’s plans for the NHS.
On the transfer of responsibility for public health, can my right hon. Friend explain how withdrawing the funding for the public health observatories, which have informed health policy, will help improve public health?
My hon. Friend gives good service on the Health Committee and follows the details of the matter more closely than most in the House. He has an important point, because the quality of health services for patients is inevitably affected by the deep and fast cuts in other areas. People in local authorities are experiencing difficulty in continuing to provide good social care, which is causing problems for the people who depend on that care and for the NHS.
(13 years, 9 months ago)
Commons ChamberI am just responding to the hon. Gentleman’s colleague, so I ask him to be patient. We set out exactly how we could reduce the costs and some of the bureaucracy. Perhaps the hon. Member for Crawley (Henry Smith) could ask his Front-Bench colleagues how bureaucracy will be cut when the function currently carried out by 150 primary care trusts in England will be carried out instead by more than double that number of general practitioner consortia.
Perhaps the Secretary of State, too, would share his thoughts about how money will be saved on bureaucracy when expenditure on Monitor, which will take on a new economic regulator role under clause 52 of the Health and Social Care Bill, will increase from £21 million a year under Labour to as much as £140 million a year—£500 million over the course of a Parliament. How is that saving money on bureaucracy?
My hon. Friend does a great job in ensuring that this Government are held to account on the NHS through the Health Committee. He rightly says that Monitor’s budget is currently about £20 million and the impact assessment calculates that that could increase to as much as nearly £140 million—although Monitor’s core operating costs are not that entire total, the figure will be at least three times as high as it is now. That is not a decrease in bureaucracy and operating costs, it is an increase. Hon. Members would do well to read some of the documents, rather than the briefings they have been given by their Front Benchers.