Health and Social Care Bill

Joan Ruddock Excerpts

Tuesday 13th March 2012 Commons Chamber

[Mr Lansley]

We know that it is necessary for us to reform in order to deliver the improvements that the NHS needs, as well as the sustainability that it needs. We are not even speculating about this; we can demonstrate that it is happening. This is in contrast to what the right hon. Member for Leigh said. He said that he was not scaremongering, then he got up and did just that. He scaremongered all over again. He went to a completely different set of data on the four-hour A and E provision, for example. He went to the faulty monitoring data, which are completely different from the ones that we have always used in the past—namely, the hospital episodes statistics data, which demonstrate that we are continuing to meet the 95% target.

When we look across the range of NHS performance measures, we can see that we have improved performance while maintaining financial control. The monitoring data from the NHS make that absolutely clear, and that is in contrast to what happened when the right hon. Gentleman was a Minister in the Department, when Labour increased the NHS budget and lost financial control. That happened when the hon. Member for Leicester West (Liz Kendall) was a special adviser in the Department. Now, we have financial control across the NHS and we have the NHS in financial surplus.

Let me return to the Labour manifesto—[Interruption.] Labour Members do not like to hear this. It stated:

“Patients requiring elective care will have the right, in law, to choose from any provider who meets NHS standards of quality at NHS costs.”

Yes—choice and any qualified provider are in the Labour manifesto. We are doing what Labour said should be done in its manifesto—and it is now opposing it.

Let us find out what it is that the right hon. Member for Leigh opposes in the Bill. I did not find that out in his speech; I heard generalised distortions, but I genuinely want to know. Let us take some examples. Is it the Secretary of State’s duty in clause 1 to promote a comprehensive health service free of charge, as now? No, he cannot possibly be against that. Is it that the Bill incorporates for the first time a duty on the Secretary of State to act to secure continuous improvement in quality—not just access to an NHS service, but putting quality at the heart of the NHS? Is he against that? No, surely not. Anyway, that approach began with Ara Darzi, and we have strengthened it.

[Dame Joan Ruddock (Lewisham, Deptford) (Lab)]

rose—

[Grahame M. Morris (Easington) (Lab)]

rose—

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[Mr Lansley]

The short answer to that is no. If one wishes to arrive at a place where the clinical commissioning groups have responsibility for budgets and proper accountability—including democratic accountability for what they do—legislation is required to get there. That is why we are putting legislation in place to make it happen.

[Dame Joan Ruddock]

rose—

[Angie Bray (Ealing Central and Acton) (Con)]

rose—

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[Mr Dorrell]

The right hon. Gentleman knows that there is room for more than one view about the extent to which there is a need to rewrite the full statutory basis of the Bill, but that is not the issue now. The question is how, if we went down his route, had a summit and talked for another 12 months about what the institutional structure of the health service should be, that would serve the policy objective that he seeks to espouse, of greater clinical engagement in commissioning. How would it serve the policy objective of which he says he is in favour, of engaging local authorities and the wider political community in decisions that shape the future of the health service?

One issue that the right hon. Gentleman did not mention in his speech is the shift of public health out of the relatively narrow interpretation that is implicit when it is located in the national health service. Instead, public health can properly be understood as being part of the wider range of local government. Those changes do not justify some of the more ambitious rhetoric being used in support of the Bill but they certainly do not come close to justifying the rhetoric being used against it. If half the things being said about the Bill by Opposition Members were true, I and most of my right hon. and hon. Friends, and certainly my right hon. Friend the Secretary of State, would not support it.

[Dame Joan Ruddock]

In answer to a recent parliamentary question I asked about waiting lists, Ministers told me that they had no information on waiting lists for private patients. How does the right hon. Gentleman think it will be possible for NHS patients to believe that their waiting times are consistent with their need for treatment when there are no figures to indicate what happens in the private sector?

[Mr Dorrell]

One of the effects of the Bill will be to integrate the private sector more fully in the delivery of public sector services in order to meet better standards for the national health service patient whose services are commissioned by the NHS commissioner. I should have thought the right hon. Lady would welcome the fact that there was greater opportunity for the national health service patient to enjoy the benefits that have previously been available on too exclusive a basis to the private sector patient. With a proper, open-minded commissioner, those benefits ought to be available, as the Blairite doctrine advocated when the Labour party believed in it, to all patients, including, pre-eminently, the vast majority of patients who rely on the national health service.

It is claimed by the Bill’s opponents that it is in favour of privatisation, but as my right hon. Friend the Secretary of State says, there is not a single provision in it that promotes privatisation. It is said to be a Bill that promotes fragmentation. The service already suffers too much fragmentation. The Bill writes into the law an obligation to deliver integrated, more collaborative, joined-up services. That addresses the problem that has been identified, which is attributed by its opponents to the Bill. It is said to be a Bill that promotes unbridled competition. That is absurd.

It is not only the shadow Secretary of State, the right hon. Member for Leigh, who can be quoted from the past. The hon. Member for Leicester West (Liz Kendall), who is seated alongside him, has said some very useful positive things in the past. I quote from the hon. Lady in 2010:

“I’ve always believed that there needs to be some competition and challenge in the system. . . I am also a strong champion of giving patients more voice and a greater say, not only over which hospital they go to but all aspects of their treatment and care.”

I am sure the hon. Lady was speaking on behalf of those on her Front Bench. The whole Labour party used to believe in that. We believe in that. That is what the Bill provides. It builds on the policy that the right hon. Gentleman used to believe in and used to advocate. He should have the courage of those convictions.