NHS Outsourcing and Privatisation

Helen Whately Excerpts

Wednesday 23rd May 2018 Commons Chamber

[Jonathan Ashworth]

My hon. Friend, who is extremely experienced, shows with great eloquence the dangers of this relentless outsourcing of services. It damages patient care and is not in the interests of the taxpayer.

[Helen Whately (Faversham and Mid Kent) (Con)]

I thank the hon. Gentleman for giving way. I remember well when I worked in the NHS under a Labour Government, before I was a Member of Parliament. All around me was talk of independent sector treatment centres, offering more choice through bringing in more private sector provision to the NHS, and PFI contracts. That was under the previous Labour Government, who I believe were trying to make the NHS give better patient care, but Labour has changed its tune. I am concerned that this seems to be all about ideology. I care—

[Mr Deputy Speaker (Sir Lindsay Hoyle)]

Order. Members cannot make speeches in interventions.

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[Rosie Duffield]

Absolutely. I was just about to speak about Unison, which is my union.

Leading unions have called the move in my local NHS trust—the East Kent Hospitals University NHS Foundation Trust—a “wolf in sheep’s clothing” and fear, with good reason, that workers’ conditions, including pay, will be eroded. I know many of those workers personally and they include some of my friends. The unions are right: workers’ conditions will be eroded, and it is already happening in other public services across Kent.

The Conservative-run Kent County Council, for instance, has introduced another ALMO called the Education People. Educational psychologists currently working directly for the council are being transferred to be employed by the Education People. The terms and conditions being offered by the ALMO to new educational psychologists are significantly worse than existing terms and conditions for those employed by the county, so no new educational psychologists have been recruited for Kent. We already have a serious shortage.

Of course, Kent County Council is doing that because central Government have starved it of funds and, perhaps because it is the same shade of blue, it is too timid to make that big a noise about things, so I will do it instead: Conservative central Government cuts are reducing our ability to care for people properly. In my constituency, the local NHS is potentially doing the same by setting up an ALMO to make yet more cuts by stealth. More money, less responsibility.

My union, Unison, represents nearly half a million healthcare staff employed in the NHS. That is one in every 60 or so working adults in one sector in the UK represented by one union standing up with one voice against injustice.

In Canterbury, rooms at the once thriving city hospital can now be found stacked with old equipment, and staff tell me that whole wings of old, neglected hospitals, such as the Buckland in Dover, lie abandoned, underused and under-occupied while waiting rooms in our not-so-local accident and emergency departments remain rammed. In Canterbury, services that were removed “temporarily” in 2017 look likely never to return to those old buildings. Proposals are afoot for a new hospital, but it simply will not be built if the central Government funding is not there to fill it. I am the only Labour MP in Kent and, as such, I am proud to make a loud noise about and stand up against the Conservative cuts that have caused vital hospital services to disappear in my county in recent years.

Things need to change drastically, and the new university medical school in Canterbury will be part of that much-needed change. If someone in my constituency is sick, they currently have to travel a long way to Ashford or Margate to get the emergency care they need.

Combine an underfunded NHS with a South East Coast Ambulance Service in special measures, and we have the ingredients for chaos. Chaos and a lot of sadness are apparent in all the letters I receive from constituents about the NHS week in, week out. Members will get the idea. The funding is not there, so the services have gone.

[Helen Whately]

I have a question about what the hon. Lady said regarding the loss of services at Canterbury Hospital. She and I both oppose that. Does she acknowledge that services were lost under a Labour Government?

[Rosie Duffield]

I agree that services started to be cut under a Labour Government, but they have got so much worse that our hospital is now underused, unusable and unrecognisable.

Madam Deputy Speaker, you will hear the same thing repeatedly from my concerned Labour colleagues this afternoon. The impact of austerity on our health service has been truly dreadful. Trusts are beginning to look to PFIs to keep walls from crumbling, and the desire for a short-term fix has meant that private companies, such as Virgin, Serco and Spire, have stepped in, especially near me in Kent, to profit from sickness, which is fundamentally abhorrent.

So much must change. The privatisation of the NHS and supporting services must be stopped and funding must be fully restored to the levels it was at under the last Labour Government. If Conservative Members continue to erode our health service and encourage private companies to step in to fill in the gaps, there will be little left when they finally realise what they have done. With so many pieces given away, the NHS jigsaw will certainly never look the same again.

Labour Members are constantly accused of running down, criticising and putting down our health service. The fact is that we are telling the truth about the urgent state of our broken NHS, which is staffed by amazing, dedicated and selfless people who deserve so much better from this Government.

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[Alex Chalk (Cheltenham) (Con)]

The allegation of privatisation of the NHS is wholly misconceived. It is a reheated and debunked myth that irresponsible elements have been trotting out for decades, and repeating it does not make it any more true. NHS outsourcing to private providers is being weaponised in a way that involves dressing it up as a threat to the NHS’s guiding principle that treatment should be provided free at the point of use and regardless of ability to pay. That is what people understand when the expression “privatisation” is used, but the reality is that nothing could be further from the truth.

That principle is fundamental, inviolable and enduring. It is all those things because it reflects so much about the kind of country we are and want to continue to be. It is the principle that says that when a member of the public is rushed into hospital needing emergency care, we take pride in the fact that the ability to pay is irrelevant. NHS staff are interested in vital signs, not pound signs. There is no appetite in this country for the Americanisation of British healthcare. Even if there were, I could never support it, my colleagues could never support it and the Government could never support it. That is why it is so important that we make that position crystal clear.

On the issue of outsourcing, we must not rewrite history. As moderate members of the Opposition concede, certain services have been provided independently since the NHS’s inception 70 years ago. Most GP practices are private partnerships; the GPs are not NHS employees. The same goes for dentists and pharmacists. Equally, the NHS has long-established partnerships for the delivery of clinical services such as radiology and pathology, and for non-clinical services such as car parking and the management of buildings and the estate. To give an everyday example, the NHS sources some of its bandages from Elastoplast. That is common sense; it would be daft if public money was diverted from frontline patient care in order to research and reinvent something that was already widely available.

That is why certain members of the Labour party have slammed this kind of argument as scaremongering. Lord Darzi, a former Health Minister, has been highly critical. In 2017, the shadow Secretary of State said on the “Today” programme that there may well be examples

“where in order to increase capacity you need to use the private sector”,

so this argument is completely misconceived. In 2009, Andy Burnham admitted that the private sector could benefit the NHS. As Labour’s Health Secretary, he said:

“the private sector puts its capacity into the NHS for the benefit of NHS patients, which I think most people in this country would celebrate.”—[Official Report, 15 May 2007; Vol. 460, c. 250WH.]

[Helen Whately]

My hon. Friend is making the point extremely well that there is complete inconsistency in Labour’s argument on this point. Which of the various parts of NHS services that are provided by independent sector providers is Labour against?

[Alex Chalk]

My hon. Friend is absolutely right. I shall give three brief examples from my own constituency. First, Cobalt is a Cheltenham-based medical charity that is leading the way in diagnostic imaging. It provides funding for research, assists with training for healthcare professionals and provided the UK’s first high-field open MRI scanner. Is the Labour party now suggesting that that should be ditched—that we should axe that fantastic facility in my constituency?

Secondly, the Sue Ryder hospice at Leckhampton Court is part-funded by the NHS and part-funded by charitable donations; again, is that for the axe under Labour? Thirdly, what about Macmillan and its nurses? It is a fantastic organisation, yet we have the extraordinary situation in which the Labour party says, “Macmillan is all right, but another provider is not.” What is the logic of the Labour position? What about Mencap? The list goes on and on.

Let me deal briefly with the second part of Labour’s motion, whereby it wants to ensure that all communications between Ministers and their officials are revealed. The reason why that is so bogus was explained clearly by the former senior Labour Secretary of State Jack Straw in a statement that was quoted with approval in the Chilcot committee’s report. He said that meetings in Cabinet

“must be fearless. Ministers must have the confidence to challenge each other in private. They must ensure that decisions have been properly thought through, sounding out all possibilities before committing themselves to a course of action…They must not be deflected from expressing dissent”.

What about advice given by officials in the form of memorandums and so on? What would Labour Members say to those officials about a motion that might result in the making public of the advice of professional civil servants—people who, of course, can never answer back themselves—that they thought was given to Ministers in confidence? As I have already indicated, it would also be completely inconsistent with the Freedom of Information Act 2000, which was introduced by a Labour Government. On both bases, the motion is misconceived, and I shall have no hesitation in voting against it.

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[Helen Whately (Faversham and Mid Kent) (Con)]

A constituent wrote to me last year to say that, against the backdrop of negativity around healthcare in this country, he personally had had a really good experience of treatment on the NHS at his nearest hospital. It happened to be KIMS Hospital, an independent sector provider, but it had given him what he really wanted: timely, high-quality and caring treatment free at the point he needed it.

The shadow Secretary of State recognised earlier that there was a place for private providers in the NHS. As in the example I have just given, that place might be enabling somebody to get timely treatment at a time of huge pressure on NHS resources, but, from what we have seen, it seems Labour considers the place for private treatment to be whenever Labour is in power. As we heard, in the years running up to 2010, when Labour was in power, there was an increase in the use of private sector providers in the NHS, as I saw when I worked with the NHS, and there was an increase in their use last year in Wales, where Labour is in power.

I do not want to make an ideological argument—I do not particularly want to talk about who provides the care, because what matters to me and my constituents is that they get good care when they need it—but, as Labour is picking this fight, it is only fair to put some truths on the table, and as far as I can see, the place for private providers, from Labour’s point of view, is whenever it is in government.

What matters to me is great care, and I have observed some ways of getting it. In some parts of healthcare, one way is by offering choice. Giving mothers-to-be the choice of where to have their baby makes maternity teams say, “Hold on. We want to be the best place in the area to have a baby.” Choice works, so long as it is accompanied by transparency, and the Government have done much to improve transparency in healthcare, meaning that people can know where to get good treatment and where there are problems, which has driven up quality.

Innovation and new technology can also transform healthcare. Whether the introduction of keyhole surgery, which has hugely shortened stays in hospital, or the exciting things happening with genomics and personalised medicine, innovation is making a huge difference, and it should not matter where that innovation comes from. If it comes from the private sector, we should welcome it. The workforce also matter. We have skilled, capable and committed people providing great care day after day, but I would argue the Government need to place an even greater emphasis on the workforce to make sure that those who work in the NHS or train to be doctors, nurses or other healthcare professionals are valued and nurtured and have rewarding careers that make the most of their talents.

I will conclude with some facts, given the many myths peddled this afternoon: it is clear the NHS is not being privatised—there has been a zero increase in the last year in the use of the independent sector; the NHS is getting more money—£8 billion more this Parliament; and the NHS is treating thousands more people. Times are difficult, but the NHS is rising to the challenge. We should get away from these ideological arguments and put our energies into making sure we have the best possible NHS.