NHS Outsourcing and Privatisation

Debate between Jeremy Hunt and Julian Knight

Wednesday 23rd May 2018 Commons Chamber

[The Secretary of State for Health and Social Care (Mr Jeremy Hunt)]

I welcome the opportunity of this debate to dispel some particularly pernicious myths.

May I say how much I enjoyed the shadow Health Secretary’s speech? If they had listened to his denunciation of privatisation and outsourcing, I think my children would have said that Alice in Wonderland has nothing on the Labour party when it comes to taking totally contradictory positions on an identical issue. My favourite thing was the stirring way in which he said, “What concerns me most is contracts handed out that are poor value for taxpayers,” after his Government left £80 billion-worth of PFI contracts for the NHS to pick up the pieces. That costs the NHS £2 billion every year—money that cannot be used for good patient care. He had lots of other gems and we will return to them during the course of this speech.

I want to start with the motion. I am afraid that it is a transparent attempt to set hares running about NHS privatisation that is not happening. He used the phrase “creeping toxic privatisation”, but the truth is that we know it is not happening and the Opposition know it is not happening. With all the pressures facing the NHS today, to scare staff and the public with fake news is breathtakingly irresponsible.

In the motion, the Opposition use the Humble Address mechanism to ask for the release of documents, knowing full well that it will fuel wild conspiracy theories if we refuse to release those documents, as we must for reasons that are nothing to do with the NHS, but to do with good governance. However, there is a flaw in their Machiavellian logic. When I asked officials for advice on what submissions we as Ministers hold on privatisation—this great swathe of secret plans that the Opposition constantly allege—this is the written advice that I got back: “Officials have, since the Humble Address was received, sought to find submissions about the privatisation of clinical or patient services within the period specified, but to this point none have been identified. Her Majesty’s Government has no plans to privatise the NHS.” That was the official advice, but don’t take it from me. The respected King’s Fund said in 2015 that

“claims of widespread privatisation are exaggerated.”

Another way in which the Labour party loves to try to scare the public is to deliberately muddle up privatisation and outsourcing, which of course are quite separate. I think the shadow Health Secretary knows that, going by some of his comments. What are the facts on outsourcing? The Prime Minister did indeed wax lyrical about the possibility of 40% of acute operations in the private sector being done under the NHS banner—not this Prime Minister, but Tony Blair in 2006. Had we followed Tony Blair’s advice, we would be spending nearly £2 billion more on outsourcing than we currently spend. The Secretary of State from that period also said quite openly, “We intend to use the private sector when it can bring expertise or resources to help improve services.” That is not me, but Alan Milburn in 2002.

And boy, did team Labour set about that outsourcing with enthusiasm: not just increasing the PFIs we have talked about and not just giving the first contract for an NHS acute hospital to the private sector in 2009—that was Andy Burnham—but increasing the amount spent on outsourcing by 50% in the last four years of that Government. [Interruption.] Fifty per cent. These are the facts. I know the hon. Member for Dewsbury (Paula Sherriff) wants to do the fake news and the scare stories, but let us just listen to the facts. Let us talk about what has been happening under this Government. In my first year as Health Secretary, the proportion going to the independent sector went up by 0.6%. In the second year it was 1.2%, in the third year it was 0.4% and last year it was 0%.

I need to correct the record. During Prime Minister’s questions, I hurriedly passed the Prime Minister a note about the increase in Wales in the use of the independent sector. She said at the Dispatch Box that in Wales it had gone up last year by 0.8%. I need to correct that, because in fact it went up by 1.2%—50% more than I thought. Wales, where Labour is in government, is racing ahead. In fact, in pounds spent, the use of the independent sector last year in Wales went up by a third. What that shows is not just that these allegations are nonsense, but that Labour knows they are nonsense. If there was any truth to them they would not be increasing outsourcing in Wales by one third at the same time as branding it as verging on the criminal in England. With the huge pressures facing the NHS and immense efforts by frontline staff to cope with flu, winter and an ageing population, can the Labour party really be trusted with the NHS when it spends its time putting out fake news?

Unlike Labour, we do not believe that the NHS should close its ears to innovation in other sectors or other countries. We want the NHS to be the best in the world and there are things to learn from others that will help patients and help the NHS. Sometimes those innovations will even come—dare I say it?—from America. But to copy global best practice from one small part of what is happening in America does not mean that we want to copy its system itself, which I think, and I think most people in this House think, is an affront to that great country, with poor outcomes, lack of coverage and high cost.

To stop ideology trumping the needs of patients, the Conservative-led Government in 2012 legislated to stop politicians choosing whether to boost the private or the public sector, formally and legally giving that decision to clinicians who run clinical commissioning groups. I will tell the House why we did that. What would happen if we followed what the shadow Chancellor advocated last year, when he said

“we will reverse Tory privatisation by renationalising the NHS”

is that 120,000 people would have to wait longer for operations on their hips, knees and for other elective surgery. The price of Labour ideology, putting ideology before patients, would be nearly 200 people waiting longer in every constituency in this House.

[Julian Knight (Solihull) (Con)]

The Secretary of State touches on a point that is very pertinent in my constituency. I met a former police officer who had an NHS operation on his hip. The operation went wrong, so the local NHS trust paid privately for the officer to have the operation done correctly. Does that not show that at times it can be a very good thing to involve the private sector? The key is that the NHS is free at the point of need.

[Mr Hunt]

That is exactly the point. Sometimes the quality is high in the private sector and sometimes it is low. When it is low, we will clamp down hard just as we do with the NHS.

NHS Staff Pay

Debate between Jeremy Hunt and Julian Knight

Wednesday 21st March 2018 Commons Chamber

[Mr Hunt]

What is a matter of fact is that the NHS in Wales would have £1 billion more if the Welsh Government had matched the increases that have taken place in England and that Welsh patients waiting for both elective and emergency care are 40% more likely to wait too long.

[Julian Knight (Solihull) (Con)]

I have the great good fortune to be married to a former renal nurse, and she tells me regularly that much of retention is about work-life balance, training and interactions with management. Will the Secretary of State tell us what progress he is making in those areas?

[Mr Hunt]

I am happy to do so. Work-life balance is something that we need to handle a lot better. I think we have been slow to recognise that today’s NHS staff are likely to live in households in which both partners are working and that juggling life and work has therefore become much more complex than it was 30 or 40 years ago. The reform of the increments system means that there will be more focus on training and skills, which will be much more motivating for NHS staff, so I hope that my hon. Friend’s wife is pleased.

NHS Pay

Debate between Jeremy Hunt and Julian Knight

Wednesday 13th September 2017 Commons Chamber

[Mr Hunt]

I want to make some progress on the recruitment issues, which a number of hon. Members have raised. The argument we seem to be hearing from the shadow Health Secretary is that Labour’s policies would mean more nurses for the NHS and better care for patients, but nothing is further from the truth. Let us look at Labour’s policies at the last election. What did the independent Institute for Fiscal Studies say then about Labour’s spending plans? It said there was a black hole of up to £29 billion, which made even Gordon Brown look like the paragon of prudence that he never was. How can a black hole like that be filled? There are only two ways of doing it. The first is by raising taxes on ordinary people—this is what the IFS said would be one of the biggest tax increases in the past 30 years, equivalent to a 7% increase in income tax. For a nurse on average earnings, this would be a £1,400 tax hike every year. Alternatively, the hole could be filled by increasing borrowing, but that simply passes on debts to future generations in a con as explicit as the con of telling students before an election that their debt will be waived only to cancel the promise after the election.

[Julian Knight (Solihull) (Con)]

My right hon. Friend does not even need to cite the IFS to see what things would be like with Labour in charge of the UK NHS—he just needs to look to Wales, where the NHS has been cut by 10% and one in seven people are on the NHS waiting list. That is Labour in action.

[Mr Hunt]

My hon. Friend is absolutely right about that. The whole problem with the tone of the argument made by the shadow Health Secretary is that he is saying that the difference between the Government and Labour is about our support for public sector workers, but we all agree, in all parts of the House, that they do a fantastic job. I see that in the NHS every week. The difference between us and Labour is about knowing what harms public sector workers the most; it is between ignoring and repeating the mistakes of the 2008 crash, as Labour Members are, and what we think, which is that we need to learn from those mistakes and not repeat them.