National Health Service

Debate between Henry Smith and Andy Burnham

Wednesday 21st January 2015 Commons Chamber

[Andy Burnham]

As usual, my hon. Friend puts her finger on the issue: the crisis is not as the Secretary of State describes. I will come on to that right now, but the first request I will make of him today is to publish the research that proves that the three top reasons he gave in this House two weeks ago are indeed the reasons for the increased demand in A and E, because I do not believe that they are. Perhaps they have made a small contribution, but they are not the real reason for the crisis. Our analysis of what is behind the extra pressure is very different from his. Let me introduce an important and revealing fact into this debate, which picks up on my hon. Friend’s point.

Over the past four years of the previous Government, annual attendances at A and E increased by 60,000. Over the first four years of this Government, they have increased by 600,000. That is a dramatic increase, which is explained not by those long-term structural issues, but by decisions taken by this Government.

[Henry Smith (Crawley) (Con)]

Under the previous Government, Crawley’s accident and emergency was closed. Will the right hon. Gentleman now commit to increasing funding on the NHS, as this Government have done every single year of this Parliament, and promise to do for the next?

[Andy Burnham]

Changes we made were done in a planned way, with measures to increase capacity at neighbouring accident and emergency departments, and they were done for reasons of patient safety. Have a look at west London, where plans to close A and E departments are being railroaded through, leaving intolerable pressure on the remaining A and E departments. It is not acceptable, and the hon. Gentleman should challenge his own Government on what they are doing.

Regional Pay (NHS)

Debate between Henry Smith and Andy Burnham

Wednesday 7th November 2012 Commons Chamber

[Andy Burnham]

I know that many Members want to speak in the debate, so I shall give way once or twice, to ensure that there is time left for others to contribute.

[Henry Smith (Crawley) (Con)]

The right hon. Gentleman is right that it is a national health service that this country enjoys. Why, therefore, is a Labour Administration reducing funding to the health service in Wales?

[Andy Burnham]

I am here to talk about the NHS in England. I will come on to the Conservative Government’s record on funding the NHS in England, so I would not be so smug if I were the hon. Gentleman.

The drive to turn collaboration into competition depends on breaking national standards—breaking the “N” in NHS. The former Health Secretary’s request to the pay review body to consider the case for “market-facing pay” needs to be seen alongside his Health and Social Care Act 2012. Breaking national pay in the NHS is an essential step towards creating the free market in health that many in the Conservative party have long wanted, and which the Liberals now seem willing to let them have.

Health and Social Care Bill

Debate between Henry Smith and Andy Burnham

Tuesday 20th March 2012 Commons Chamber

[Henry Smith]

I think the biggest risk to the national health service is if we do not reform it and move it forward. It needs reform to stay relevant to the needs of all our constituents. I find the Opposition’s position strange—I would put it down to political opportunism, but I am happy to take another intervention if Opposition Members want to state their case—given what happened with the three requests made when the right hon. Member for Leigh (Andy Burnham) was Secretary of State and under his predecessor.

[Andy Burnham]

Does the hon. Gentleman understand the difference between a strategic risk register and a transition risk register?

[Henry Smith]

I believe I do understand the difference between the different types of risk register, but if we simply stand still and have inertia in our health service, it will become less relevant.

The right hon. Member for Holborn and St Pancras (Frank Dobson) accused members of my party of being chancers. I prefer to consider us as reformers, and only if we embrace reform will we be able to provide a better NHS.

NHS (Private Sector)

Debate between Henry Smith and Andy Burnham

Monday 16th January 2012 Commons Chamber

[Andy Burnham]

Just hang on and listen. Nothing has been done to the Bill to bring together the Prime Minister’s and Deputy Prime Minister’s promises that there would be no privatisation. There has been no substantial change since the pause.

Let me come directly to whether the Bill represents a privatisation of the kind that we saw in the 1980s. In doing so, I shall refer to a report from the King’s Fund, which I recommend to the hon. Lady. The Government have failed to introduce measures that they promised, months after the pause, so it is still considered appropriate for a body as respected as the King’s Fund to make a fairly shocking comparison that, indeed, the Bill is similar to the privatisations of the Thatcher Government. The report says:

“The Government’s proposals draw heavily on the regulatory framework developed in telecoms and utilities regulators …Interestingly, Secretary of State for Health Andrew Lansley’s own ideas for the reform of the NHS, developed while in opposition, were born out of his experience of the privatisation and regulation of utilities in the mid-1980s when he was Principal Private Secretary to Norman Tebbit.”

There we—[Interruption.] Okay, there we have it. That is the view of the King’s Fund—this is a privatisation along the lines of those we saw in the 1980s.

To back up that point, the King’s Fund quotes from a speech that the Secretary of State gave in 2005 to the NHS Confederation. He said this of the 1980s privatisations:

“The combination of the introduction of competition with a strong independent regulator delivered immense consumer value and economic benefits.”

There are two problems with that statement. First, there are real questions about whether gas, electricity, water and rail customers feel that they have had immense value. Secondly, it is troubling that the Secretary of State for Health, of all people, considers the delivery of health care directly comparable to telecoms and utilities.

[Henry Smith (Crawley) (Con)]

Does the right hon. Gentleman recall saying in 2007 that he celebrated the role of the private sector in the NHS?

[Andy Burnham]

This is getting a little tedious. May I refer the hon. Gentleman to the motion, which indeed does the very same thing? It recognises the fact that there is

“an important role for the private sector”

in the delivery of good NHS care and celebrates the role that it played in helping us to deliver the lowest ever NHS waiting times. Before intervening in future debates, he might like to read the motion that the House is considering.

Let me quote the Secretary of State’s interesting 2005 speech to the NHS Confederation, which set out the essential ingredients that we now see in his Health and Social Care Bill. His plan was to

“maximise competition, transfer risk to the private sector…appoint a strong, pro-competitive regulator…set out clearly the standards which have to be met and how operators will be held accountable for them…be clear about how and by whom universal service obligations are to be met…ensure high quality information for customers”

and have

“more customers rather than fewer.”

That is, do not have a few monopolistic health authority purchasers. The Secretary of State is nodding in assent that that is, essentially, his Health and Social Care Bill. This is, of course, the basic framework that the House of Lords is considering, despite the Deputy Prime Minister’s claim to have rejected

“the free market dogma that can fragment the NHS.”

A phrase leaps out of that 2005 speech that, in the light of recent events, needs to be challenged. It is

“transfer risk to the private sector”.

While acceptable in theory, I wonder whether recent experience with the private cosmetic surgery industry has led the Secretary of State to reconsider whether and how, in the health context, that can be delivered in practice. In an NHS based on commercial contracts, would there not always be arguments about legal liability when things went wrong? Would it not be much harder to control quality and costs in such a way, rather than through the current planned and managed NHS system that we have?

National Health Service

Debate between Henry Smith and Andy Burnham

Wednesday 26th October 2011 Commons Chamber

[Andy Burnham]

Ministers are shaking their heads, but I will read them the Treasury figures published in July this year, and let them tell me then that what I have just said is not true. The public expenditure statistical analyses from this year provide official confirmation of what I have just said. They show that in 2009-10 health spending was £102,751 million. That was in the last year of the Labour Government. In 2010-11, health spending was £101,985 million. There we have it in black and white—the first real-terms cut in health spending for 14 years. In fact, it is the first real-terms cut since the last year of the last Tory Government in 1996-97.

[Henry Smith (Crawley) (Con)]

I am interested to hear how the right hon. Gentleman is trying to manipulate those figures. How does he reconcile what he is saying with what his party’s Administration is doing in Wales, where the health service has been cut and hospital infections and waiting times have risen?

[Andy Burnham]

The hon. Gentleman uses the word “manipulate”. May I say that I take great exception to that? I have read out the Treasury statistical analysis from this July. If he is telling me that I have misrepresented it, let him stand up again now and say so. If not, he should hold his peace. I remind him that his party’s Government delivered a much deeper cut to Wales than to Scotland or Northern Ireland. The Labour Administration are now dealing with the consequences of that.

--- Later in debate ---

[Andy Burnham]

For the avoidance of doubt, let me address directly what my hon. Friend has said. A moment ago I mentioned a photograph of the Secretary of State on a visit to Chase Farm hospital just days after the election, when he announced his so-called moratorium—although no one has yet seen any evidence of it. He is holding up a placard in that photograph that says, “HANDS OFF! Chase Farm A & E”, underneath which are the words: “I oppose any cutbacks to our A & E,” and on the bottom we can see his signature. How on earth he can square that with the letter that he recently exchanged with his hon. Friend the Member for Enfield North, I do not know. I do not know how the Secretary of State can reconcile those two things in his mind or how he could look anyone in Enfield North in the eye, having promised them that he would save their accident and emergency department. It is quite scandalous. People across the country are discovering that the Prime Minister’s moratorium is utterly meaningless, as A and Es restrict opening hours and maternity wards close.

We now come to the third of the Prime Minister’s broken promises, on NHS reorganisation. Again, the coalition agreement could not have been clearer:

“We will stop the top-down reorganisations of the NHS”.

I have never understood how those in the coalition could possibly sign up to those words, when only weeks later they would bring forward a White Paper heralding the mother of all reorganisations, the biggest since 1948. I can see the cynical politics behind the Prime Minister’s first two pledges, but on this pledge at least he was right. A reorganisation is precisely the last thing that the NHS needs right now. I am clear: the abandonment of that pledge is the Prime Minister’s biggest mistake in office. If he ploughs on, he will ultimately pay a heavy price for it, because it is a catastrophic error of judgment to combine the biggest ever financial challenge in the NHS with the biggest ever reorganisation.

As Health Secretary, I was told by officials that rising to the financial challenge would require every ounce of our energy and focus. The NHS would need stability. Instead, this Government have picked up the pieces of the jigsaw and thrown them up in the air, distracting the service at the very moment it needed maximum focus. Grip has been lost; the NHS is drifting.

[Henry Smith]

Does the right hon. Gentleman not agree, however, that our NHS needs greater efficiency and localism, and that this requires reorganisation?

[Andy Burnham]

I said just a moment ago that I was the one who put my name to the Nicholson challenge, because that money was going to help the NHS respond to the new demands placed on it at this difficult time, so the hon. Gentleman need not lecture me about efficiency. He needs to tell me how placing a moratorium on change in the NHS helps it to respond and deliver those efficiencies. That is the contradiction of his position, and he stood for election on that policy, as did others.

Sure Start Children’s Centres

Debate between Henry Smith and Andy Burnham

Wednesday 27th April 2011 Commons Chamber

[Andy Burnham]

That absolutely does let the cat out of the bag, and I am about to go through some examples of Conservative spokespeople in local government who do not seem to have read the Prime Minister’s words before the election last year.

I congratulate Tameside council, however, because it has dealt with a disproportionately larger cut to its early intervention grant than other authorities in Greater Manchester—Trafford, to name but one, which Government Front Benchers routinely mention. In Tameside, for every young person aged under 20 years old there has been a £70 per child cut in the early intervention grant.

The council is working in those circumstances to keep the network of Sure Start centres open, and that is why I congratulate Tameside, and I hope my hon. Friend will take my congratulations back to his friends. Owing to all the benefits that I have described, it is not surprising that the Field review concludes:

“Local Authorities should aim to make Children’s Centres a hub of the local community”.

My right hon. Friend describes them as a “targeted universal service”.

Two authoritative reports delivered to the Government advocate the importance of children’s centres, but now we get to the heart of the matter. We will soon discover whether the Government really wanted to hear the views of my esteemed friends on that crucial subject, or whether they were brought in for presentational reasons—as a piece of theatre to send a desirable political message.

To be fair to the Prime Minister, I remember well how about a year ago, during the election campaign, some Labour Members doubted the sincerity of his commitments to Sure Start. I looked back to what he said, however, because I remembered it from the television debates, and on 5 May 2010, on the very eve of the general election, readers of The Independent sent in questions to the then Leader of the Opposition. A questioner asked:

“As a parent who relies heavily on Sure Start centres for the educational and social needs of my child, I would like to know whether these centres will continue to receive funding.”

The Prime Minister replied:

“Yes, we back Sure Start. It’s a disgrace that Gordon Brown has been trying to frighten people about this. He’s the Prime Minister of this country but he’s been scaring people about something that really matters.”

That is what the Prime Minister said last May. In some ways, his anger was reassuring because it looked as if the Government-to-be were genuinely committed. I wonder how the Prime Minister feels today, given that it has turned out that those things that, as he said, “really matter” are under serious threat.

Evidence is emerging of widespread disinvestment by local authorities in Sure Start children’s centres. That seriously challenges the deliverability of the vision set out by my right hon. Friend the Member for Birkenhead.

[Henry Smith (Crawley) (Con)]

I am happy to join the cavalcade of other Conservative authorities that have already been mentioned; in West Sussex, no Sure Start centres are closing. Indeed, there is a greater desire to improve the services for early years. Surely that is at odds with what the right hon. Gentleman is saying.

[Andy Burnham]

It is a mixed picture. We will get to the bottom of the true picture on the ground as we get into the debate today. If Conservative local authorities are not just keeping the centres open, but protecting the services within them, I will of course recognise that that is what we want and what the Government said they would do. If that is the case, then good. But other Conservative-controlled authorities are not doing that. My question back to the hon. Gentleman is: what are he and his Front-Bench colleagues saying to Conservative authorities that are disinvesting from Sure Start and siphoning the money out? I look forward to an equally fulsome answer on that question.

If the Government accept the vision in the review that they commissioned my right hon. Friend to produce, I put it to the House that it must urgently consider what is happening on the ground and ask the Government to change course to preserve the network of children’s centres and services. As I will show today, children’s centres are closing right here, right now. Highly trained staff are being made redundant. Some children’s centres are keeping the lights on, but no more. That is the reality on the ground that the Prime Minister must urgently confront.

School Sports Funding

Debate between Henry Smith and Andy Burnham

Tuesday 30th November 2010 Commons Chamber

[Andy Burnham]

May I politely refer the hon. Gentleman to the letter that head teachers sent to The Observer at the weekend? I know that the Secretary of State has been inundated with letters from head teachers who say that the whole infrastructure saves them money and time, because they do not have to organise expert coaching and competition themselves. I think that the hon. Gentleman will find that head teachers strongly support the present system.

[Henry Smith (Crawley) (Con)]

rose—

[Andy Burnham]

I want to make some progress.

I have mentioned the names of those who are lining up against the Government. They are not people who want to score points; they are fighting for something in which they passionately believe. Until now, the Government have dug in and patronised people with bogus statistics, but this is now turning into a real test for them. Are they prepared to listen and to change course?

Today, I am setting four clear objectives for the debate. The first is to probe the background to this decision. The second is to test the figures that the Government have used and to find out whether they stand by them. The third is to obtain clarity on what has happened to school sport funding. Fourthly, and most importantly, I want to make the Secretary of State a genuine offer that will help us to re-establish the consensus on school sports as we head towards a home Olympics.

Let me start with the decision-making process. We admire the erudition that the Secretary of State brings to our proceedings. Mr Lansley never quoted Dryden to me, and I really admired that about the Secretary of State for Education, but let me extend his cultural references today. How about Defoe? I know that he is thinking “Daniel”, but I want to know what he thinks about—