Health and Social Care Bill

Ian C. Lucas Excerpts

Monday 31st January 2011 Commons Chamber

[Mr Lansley]

With his knowledge of European matters, the right hon. Gentleman knows that we are in the later stages of the collective approval through the European Union of the European cross-border health directive, which allows precisely that and makes it clear that the same criteria are applied to patients seeking health care in other countries as would apply were they to seek it through the NHS in this country.

[Ian Lucas (Wrexham) (Lab)]

Will the Secretary of State give way?

[Margaret Hodge (Barking) (Lab)]

Will the Secretary of State give way?

--- Later in debate ---

[Mr Lansley]

Thank you, Mr Speaker. I can give my hon. Friend the Member for Ealing Central and Acton (Angie Bray) precisely that reassurance. I was with NHS London at the beginning of last week, and it is clear that GP commissioning groups are coming together with providers to develop those kinds of commissioning plans, going beyond trauma and stroke care, which has already happened in London, to look, for example, at the integration of diabetes care between primary care and hospital services.

Under the Bill, patients will come first and will be involved in every decision about when, where, by whom, and even how, they are treated—“there must be no decision about me, without me.” The 2002 Wanless report called for patient engagement, but that did not happen. Now it will. Because patients cannot be empowered without transparent information, an information revolution will give them more detailed information than ever before, showing them and their doctors the consultants who deliver the best care, giving them control over their own care records and enabling everyone to access the care they need at the right place and at the right time. Patients and their doctors and nurses will be able to see clearly which health care provider offers the best outcomes and to make their decisions accordingly.

[Ian Lucas]

The right hon. Gentleman is being generous in giving way. If those proposals are so important and necessary, why were they not included in the Conservative party manifesto at the general election?

[Mr Lansley]

They were, as I will explain in a minute.

--- Later in debate ---

[Mr Lansley]

I agree with my hon. Friend. In effect, that gives the lie to what the hon. Member for Wrexham (Ian Lucas) suggested. The coalition agreement states:

“We will strengthen the power of GPs as patients’ expert guides through the health system by enabling them to commission care on their behalf.”

Our manifesto stated that we would strengthen the power of GPs,

“putting them in charge of commissioning local health services.”

[Ian Lucas]

Will the right hon. Gentleman give way?

[Mr Lansley]

I am sorry, but 57 Members wish to speak, as you have rightly told us, Mr Speaker. I will give way as often as I can, but more than one intervention from each Member is excessive. [Interruption.] I have just quoted from the coalition agreement and our manifesto, so hon. Members have heard both.

Through the outcomes framework, which we published in December, we will stop the top-down, politically motivated targets that have led to real quality being sidelined. We will ensure that we focus on the outcomes that really matter and back them up for the first time with quality standards that are designed to drive up outcomes in all areas of care. Those standards have not been dreamt up in Whitehall, but are being developed by health professionals themselves. Similarly, doctors and other health professionals will not be told by us how to deliver those standards. The standards will indicate clearly what is expected, but it will be up to clinicians to decide how to achieve them. At every step, clinical leadership—that of doctors, nurses and other health professionals—will be right at the forefront. It will be an NHS organised from the bottom up, not from the top down.

The shift in power away from politicians and bureaucrats will be dramatic. The legislation none the less builds on what has gone before. It is not a revolution, but as the shadow Secretary of State said just a fortnight ago:

“The general aims of reform are sound—greater role for clinicians in commissioning care, more involvement of patients, less bureaucracy and greater priority on improving health outcomes—and are common ground between patients, health professions and political parties.”