Care Bill [Lords]

Joan Ruddock Excerpts

Tuesday 11th March 2014 Commons Chamber

[Andy Burnham]

The hon. Lady is absolutely right. The measure risks damaging, rather than building, public trust in the whole process of changing hospitals. In the end, that is probably the most powerful argument against what the Government are seeking to do.

By any reckoning, the proposal is a major change of policy from the one set out in the coalition agreement; yet there has been no Green Paper, no White Paper, no policy document, no statement to Parliament, no proper explanation of the Government’s intentions and no justification of the extreme measures sought. Instead, on the back of a court defeat, the Secretary of State has rammed a new clause into the Bill, asking the House to give him sweeping powers over the NHS in all our constituencies without even having the courtesy to come to the House to make the argument for the changes himself. How arrogant to expect us just to rubber-stamp the powers, without even coming to explain himself. That really shows the House a major discourtesy.

The fact is that the Secretary of State has not adequately made the case for what he wants to do. Instead, Members are asked to take a leap of faith and to trust him, but that is very hard to do when we see what happened to the people of Lewisham. In standing up to this Government, they won a victory for everyone; without them, we would not be debating clause 119 today. I pay tribute to my right hon. Friend the Member for Lewisham, Deptford (Dame Joan Ruddock) and my hon. Friends the Members for Lewisham West and Penge (Jim Dowd) and for Lewisham East (Heidi Alexander), who provided superb leadership when the people of Lewisham felt incredible outrage at their trusted and valued local hospital being prised out of their hands.

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

I am most grateful to my right hon. Friend. He should also pay tribute to the efforts of all the clinicians, GPs and health workers. It was not just down to the leaders of the community; everybody was united. That was because the decision was not about clinical standards, but was an accountant’s solution to a different problem.

[Andy Burnham]

My right hon. Friend makes a very important point. The community came forward, with clinicians standing beside ordinary people on the streets of Lewisham, to say, “This is not acceptable.” My right hon. Friend and others gave voice to that concern and brought it to this House. That incredible campaign gave heart to campaigners everywhere. She was right to put that point on the record.

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[Andy Burnham]

The difficult thing for me is that when I think back to some of the processes I was involved with—stroke services in London, child care and maternity services in Greater Manchester, changes to A and E across the country, Chase Farm hospital, and other places—those issues were cynically used by those on the Government Benches when they were in opposition, and it was a bare-knuckle fight to save every hospital in the land. That is what they said, whereas we made the case for change because it would improve patient safety. I would not change my tune if I was in opposition; I still believe that hospitals need to carry on changing, but as I said, I will not do that by imposing changes on local people. The right way is to explain why, and take people with us.

[Dame Joan Ruddock]

Let me give my right hon. Friend another example. I and my hon. Friend the Member for Lewisham West and Penge (Jim Dowd) both supported the closure of a local children’s hospital, and its services were moved to Lewisham hospital. When the trust special administrator looked at Lewisham hospital, children’s services were not even considered.

[Andy Burnham]

Government Members would do well to listen to my right hon. Friend because she followed that whole process in detail. If people listen carefully, she is saying that clinical evidence took second place, and the process was driven by management consultants, not by clinicians. Government Members told the House that doctors would be in charge from now on, but that was not the experience of my right hon. Friend or the hon. Member for Stafford. That is why this proposal should not be accepted by any Member of the House.

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One thing that amazed me was the astounding rate at which they were able to get through public money. It was absolutely phenomenal. The consultants—as we were told by my right hon. Friend the Member for Holborn and St Pancras (Frank Dobson), they were mainly from KPMG and PricewaterhouseCoopers—consumed over £2 million of the £5 million cost of the TSA process. The people to whom they were least likely to listen were the local clinicians, whether GPs or hospital doctors, and the local residents and patients. Those people were invited to the consultation groups—although not to the public meetings—but they were then told what they could and could not discuss. If they tried to discuss anything that was not on the facilitators’ list, they were threatened with expulsion. If that is the consultants’ idea of public engagement, it does not commend itself much to the public.

[Dame Joan Ruddock]

I want to ensure that my hon. Friend does not end this part of his speech without reminding the House that one of the things that those involved in the TSA process intended to do was sell off half the land occupied by the buildings of Lewisham hospital—and that was not in the public consultation document.

[Jim Dowd]

It is with some trepidation that I must disagree with my right hon. Friend. In fact, the figure was closer to two thirds of the estate. The scheme was so well engineered that they left the bit that we were keeping, allegedly, for whatever was going to be there—a glorified first aid post—completely landlocked. There was no access apart from via the River Ravensbourne, which is not the mode of transport favoured by most people using Lewisham hospital. Oh yes, it was all worked out well beforehand.

The public meetings following the publication of the draft report were, of course, rather more difficult to control. People were able to ask questions, although they did not receive many answers. Those who were presenting the case on behalf of the trust special administrator did not seem particularly receptive to what was being said, although on occasion, when they came up against a difficult objection, they would say “South London Healthcare NHS Trust is losing £1 million a week: £1 million that is not being spent on health care for patients.” We know that—it is self-evident—but when they were told “That is not the problem of Lewisham hospital”, and asked “Can you not understand that?” , the answer was no, they could not understand it.

That was followed by a little homily of the kind much beloved of some people: “If your domestic budget was being overspent week after week, you would need to take action, would you not?” Naturally everyone agreed, but a woman who attended the public meeting at Sydenham school said to Mr Kershaw, “If your domestic budget was being overspent, of course you would have to do something about it, but that would not include breaking into the house of the people next door and nicking all their stuff”—which is what was being proposed in south London by the special administrator.

After attending numerous meetings with Mr Kershaw and his associates, and at the other south London hospitals, I eventually concluded that—recognising that those who would be worst affected by their proposals were hardly likely to be very receptive to them—they automatically assumed that there would be opposition and hostility, and automatically factored in and discounted it, saying “Of course they are going to object to the changes, but we have a task and a mission to pursue.” The whole process was condescending, impenetrable and antagonistic. The special administrator and his acolytes and accomplices had a mission, given to them before they ever left Richmond House, which they were determined to deliver. They already knew the answer, and they were not going to bother to do anything other than go through the motions.

We owe thanks to Lewisham council, to the Save Lewisham Hospital campaign and, amazingly enough, to the High Court and the Appeal Court, whose three judges—Lords Justices Dyson, Underhill and Sullivan—within 24 hours unanimously overturned the Secretary of State’s case that he had the powers to do this. As I have said, the Secretary of State had already capitulated by then. The Government knew from the outset that this was legally questionable. They knew they did not have the powers to behave in the way they were behaving, but they basically just said, “Who’s going to stop us?” I will tell you who stopped them: the people of Lewisham and their supporters and the High Court. That is who stopped them.

This clause will make occurrences like that more, not less, likely. More communities across the country are going to be threatened and will come under the tender mercies of the TSA process.

Health Care (London)

Joan Ruddock Excerpts

Wednesday 8th January 2014 Westminster Hall

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

I am most grateful to my hon. Friend for giving way, and I congratulate her on her brilliant speech, which hon. Members understand from our experiences.

If clause 118 of the Care Bill goes through, every hospital and potential patient in the country will be faced with a situation in which no regard is given to clinical standards or clinical needs. The service will be based entirely upon accountancy. That is what the challenge was in Lewisham hospital. That was what was overturned. The people who knew about it—the consultants, the patients and the commissioning groups—all utterly opposed the trust special administrator proposals. We were right and we won the case. With the new powers, however, all that would be set aside and no one would be heard.

[Mrs Anne Main (in the Chair)]

Order. Before I call Ms Buck, I ask that interventions be brief. There will be time to make contributions later. This is a well attended debate and many Members have asked to speak.

Care Bill [Lords]

Joan Ruddock Excerpts

Monday 16th December 2013 Commons Chamber

[Mr Hunt]

I am going to make some progress.

When problems are uncovered, action must be swift. Robert Francis cited confusion over which part of the regulatory system is responsible for dealing with failing hospitals, so this Bill makes it clear where the buck stops. It is the CQC’s job to identify problems and instigate a new failure regime when it does so. Monitor and the Trust Development Authority will then be able to use powers to intervene in those hospitals, suspending foundation trusts’ freedoms where necessary to ensure that appropriate action is taken. If, after a limited period, a trust has failed significantly to improve, the Bill requires a decision to be taken on whether the trust needs to be put into special administration on quality grounds—and, yes, where necessary, a trust special administrator will be able to look beyond the boundaries of the trust and consider the wider health economy. As we know from Lewisham, that is not easy, but we will betray patients if we do not address failure wherever it happens.

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

Why, when the Secretary of State and the Prime Minister have clearly set out the four tests that have to be met for any downgrading of hospital services, is he now introducing this clause? Those greater powers will totally undermine the clinical commissioning groups that his Government set up to meet local clinical and health needs, and not to balance the books for people outside their area.

[Mr Hunt]

I recognise that the right hon. Lady campaigns hard for her constituents. The four tests set out by the Prime Minister were never designed to require unanimous support from local CCGs for necessary changes. If we had to secure that, it would be virtually impossible to make any major reconfigurations. Where there is a failing hospital, it is important to resolve and address situations. There are exceptional occasions when that cannot be done in an individual trust’s area. The change in the law will not apply retrospectively to Lewisham, but it is right to ensure that, if we are to learn one lesson from what has happened in recent years, we deal much more quickly with failing hospitals, and that applies to South London Healthcare NHS Trust as well. Governments and the NHS must never again sit on coasting or failing hospitals for year after year without doing what it takes to sort them out. That is why this year, for the first time, we have put 13 hospitals into special measures. How utterly inexplicable but sadly predictable it is that the Labour party, which failed to sort out those problems, is today refusing to back the changes that mean those mistakes can never be repeated.

Another lesson from the Francis inquiry is that we need to create a culture of openness in health and social care so that, rather than being bullied and intimidated, doctors and nurses feel they can speak out about problems. The Care Bill will introduce a duty of candour as a requirement for registering with a CQC. That means that honesty and openness must come as standard for every organisation. We are also introducing a new criminal offence that will apply to care providers that supply or publish false or misleading information. Directors and other senior staff involved in committing the offence will be held to account. In addition to the Bill, the professional regulators have agreed to place a new strengthened professional duty of candour on all doctors and nurses. The Government are on the side of openness and transparency in our health care system.

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[Andy Burnham]

I will make some progress and turn to part 2 of the Bill and measures related to the NHS. It would help to get a few facts clear. The Secretary of State seeks to denigrate Labour’s record at every opportunity, but let me remind him that the Labour party left an NHS rebuilt with the lowest ever waiting lists and highest ever public satisfaction. The previous Labour Government introduced independent regulation of NHS hospitals for the first time, prompted by previous scandals at Bristol, Alder Hey and the Shipman murders. The Secretary of State should cast his mind back a little further before coming to the House and making unfounded allegations.

As Robert Francis rightly acknowledged in his report, there was no system of independent regulation before 1997. It was the independent regulator that first uncovered the failings at Mid Staffs and, later, at Basildon. As the party that introduced independent regulation in the NHS, Labour has no problem with strengthening it and providing legislative backing for the appointment of chief inspectors for hospitals, general practice and social care, but let us be clear: those were not recommendations of the Francis report.

The Secretary of State accused us of not supporting the Francis report. We do support the report; it is the Government who are not implementing its recommendations. Just as part 1 of the Bill fails to implement the Dilnot report, part 2 fails to implement the Francis report. One of the report’s central recommendations was for a statutory duty of candour for individuals, but the Government are proposing that it should apply only to organisations. How will an organisational duty help individuals to challenge an organisation where there is a dysfunctional culture? It will not, and we urge Ministers to think again. They also need to clarify whether the duty will cover the most serious incidents, and whether it will apply to all organisations that provide NHS services, including outsourced services.

My main objection to part 2, however, is that it embodies the huge contradiction that now sits at the heart of Government health policy. The Secretary of State talks of independence for the Care Quality Commission in the same way as the Health and Social Care Act supposedly legislated for the independence of the NHS, but this is the Secretary of State who has taken to ringing up hospital chief executives who are not meeting their A and E targets. The Secretary of State nods, but that is not “independence of the NHS”. This is the Secretary of State who holds weekly meetings with the supposedly independent CQC, Monitor and NHS England. What precisely is the Government’s policy on independence? People are becoming confused. Clause 118 makes it clear that the Secretary of State wants more control: he wants sweeping powers to close hospitals without proper consultation and clinical support.

[Dame Joan Ruddock]

Does my right hon. Friend recall that in the case of the failing South London Healthcare NHS Trust, the trust special administrator got his financial projections wrong? He massively overspent his own budget, and failed to point out the consequences for the solvent Lewisham hospital, which was in a different trust and which, as a result, did not consult on them. Does my right hon. Friend imagine that there is any way in which such a consultation could take place and produce good outcomes in just 100 days?

[Andy Burnham]

I pay tribute to my right hon. Friend. She and the people of her community stood up to an arrogant Government, and won a victory for every community that was worried about the future of its hospital. One would have thought that, following humiliation in the courts, the Government would have backed off gracefully, but no: here comes the Secretary of State again today, like someone who, having been caught breaking in through the back door, has the brass neck to return and try to force his way in through the front. Well, we will not let him get away with it. We give him notice that clause 118 is wrong, that it is an affront to democracy, and that we will oppose it every step of the way.

Hospital reconfiguration should always be driven by a clinical case first and foremost, but clause 118 paves the way for a new round of financially driven closures. It rips up established rules of consultation and the clinical case for change. It allows the Secretary of State to reconfigure services across an entire region for financial reasons alone, which means that no hospital, however successful, is safe. The House needs to stand up to this audacious power grab by the Executive.

Mid Staffordshire NHS Foundation Trust

Joan Ruddock Excerpts

Tuesday 19th November 2013 Commons Chamber

[Mr Hunt]

It is really important that we value the work of some of the lowest-paid people in hospitals who are carrying out some of the most important personal care for patients. They need to be managed properly, fairly and decently, given how important that work is. We need to ensure that nurses have the right attitude to the health care assistants who are working for them—as, most of the time, they absolutely do. That is why earlier in the year we proposed changes that we are piloting, so that before getting funding for a nursing degree, people had to spend time, potentially up to a year, on the front line as health care assistants. That will allow them to experience just how important that work is and then perhaps appreciate it a bit more.

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

The Secretary of State has spoken about staffing levels, which will be of the greatest interest to patients and their families. He said that the situation will vary across wards and that there would be local discretion, with failings being exposed. When those failings are exposed, how will corrective treatment occur? Who will be responsible for ensuring that the corrections and changes are actually made?

[Mr Hunt]

We have set up a new inspection regime with a new chief inspector of hospitals under the Care Quality Commission. The CQC will look at the figures that are published every month on a trust-by-trust basis, alongside other safety data such as MRSA rates, bedsore rates, numbers of complaints, and other information that is crucial to its decisions. It is then its absolute duty and responsibility to swoop quickly if it thinks there is any cause for concern.

Changes to Health Services in London

Joan Ruddock Excerpts

Wednesday 30th October 2013 Commons Chamber

[Mr Hunt]

I thank my right hon. Friend for that comment. He is right that this is about facing up to difficult decisions. One aspect of the proposals that is so exciting for people who want a transformation in services is that they involve employing 800 additional people for out-of-hospital care. The real way we will reduce pressure on A and E units is by ensuring that people, particularly the frail and elderly, are looked after better at home. That is what we must do. We must recognise that, fundamentally, the problems will not be solved by trying to pour in money in the way that it has always been poured in. We must rethink the model. This is a positive and ambitious programme. If the shadow Secretary of State were in my shoes, he would speak differently of the proposals, because they represent the way forward for the kind of integrated care he normally champions.

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

Let me remind the Secretary of State that the High Court ruled that his actions in trying to remove services from Lewisham hospital to save a separate failing trust were illegal. He then lost the appeal. Will he now stop throwing good public money after bad, leave Lewisham hospital alone, and learn to respect the views of the people who work in our hospital and those who use its services?

[Mr Hunt]

I respect those views and the right hon. Lady for her campaigning. I understand why the people of Lewisham were unhappy about those changes but, as Health Secretary, I had to take a decision in the interests of all patients in south London. That was the first time the powers—the trust special administrator powers—were used. My interpretation was different from the courts, but I respect them as the final arbiter of what the law means. However, when we have to make difficult decisions about turning round failing hospitals—south London has some of the most serious problems in the country—it is important that the local NHS can take a wider health economy view of what changes are necessary. As I have said, I will respect what the Court has decided, but it is important that I continue to battle for the right thing for patients.

Accident and Emergency Departments

Joan Ruddock Excerpts

Tuesday 10th September 2013 Commons Chamber

[Mr Hunt]

The changes that my hon. Friend alludes to are locally driven and have not crossed my desk. I want to reassure him that if they do cross my desk, I would not approve them unless there was convincing evidence that that was in the interests of patients and there had been proper consultation.

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

Having been defeated in the High Court by the Save Lewisham Hospital campaign, the Secretary of State has decided to appeal that decision. Given the crisis in A and E in London, has he any new ideas as to how A and E services should be provided in Lewisham, and if so, will he share them with the local MPs?

[Mr Hunt]

We are determined to do what is right for the people of Lewisham and of south London. Let me be clear: the problems of South London Healthcare NHS Trust were not addressed by the right hon. Lady’s Government when they were in office. We are addressing them, and sometimes those decisions are difficult, and sometimes they are not popular with local people. I took the decision that I did because it will save about 100 lives a year. I think it was the right decision, and I want to ensure that I do the right thing by her constituents.

Managing Risk in the NHS

Joan Ruddock Excerpts

Wednesday 17th July 2013 Commons Chamber

[Mr Hunt]

I will make some progress and then give way, because I want to come on to one of the main things that the right hon. Member for Leigh said, which was to criticise an NHS reorganisation that has put 8,000 more people on the frontline of the NHS.

The right hon. Gentleman said that that reorganisation cost £3 billion, when he knows full well that the National Audit Office shows that it will be half that amount. It will save £5.5 billion in this Parliament alone. For the avoidance doubt, it is that £5.5 billion saving that means we are now employing 1,000 more health visitors, 1,400 more midwives and 5,600 more doctors than at the previous election.

The right hon. Gentleman talked about the risk register. Let us look at what he said about publishing the risk register when he was Health Minister in 2007. These are his own words:

“Putting the risk register in the public domain would be likely to reduce the detail and utility of its contents. This would inhibit the free and frank exchange of views about significant risks and their management, and inhibit the provision of advice to Ministers.”—[Official Report, 23 March 2007; Vol. 458, c. 1192W.]

I agree with him.

The right hon. Gentleman is right that pressures on A and E are building, so why does he oppose changing the GP contract to make primary care more accessible? Why does he criticise the extra £2 billion being put into joint commissioning by health and social care systems to reduce the number of delayed discharges? Why does he tell the NHS Confederation he supports the reconfiguration of services and then refuse to support every difficult reconfiguration, such as at Trafford or Lewisham?

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

Is the Secretary of State aware that in the league table of the busiest A and Es in London, St Thomas’s, Queen Elizabeth and King’s occupy the second, fourth and sixth places? Does he really think there is no risk in moving tens of thousands of patients from Lewisham A and E to those three utterly overburdened and full-to-capacity hospitals?

[Mr Hunt]

I take the risks the right hon. Lady talks about very seriously, and we need to be very careful in managing any change, but there are also big risks in not making change. South London Health Care Trust is one of the worst-performing in the country, and it was used by her constituents. I have a duty to sort out these problems in the NHS, which have been left unsorted for many years.

The right hon. Member for Leigh said we should look at our record since 2010. Let us look at that record: the numbers of people waiting longer than 18 weeks, 26 weeks and 52 weeks to start treatment are lower than at any time under the last Government; as I said, we have 5,600 more doctors; and we have a £650 million cancer drugs fund, giving more than 30,000 people access to cancer drugs—his Government refused to set up such a fund; the number of mixed-sex wards is down by 98%; and hospital infection rates have halved. These are real achievements for a service under great pressure, and we should recognise the hard work and dedication of the NHS staff who have delivered them.

Hospital Mortality Rates

Joan Ruddock Excerpts

Tuesday 16th July 2013 Commons Chamber

[Mr Hunt]

Tackling failure in our NHS is not an easy path to take, but it is the right thing to do for patients. If my hon. Friend believes that all the care problems in the NHS started in 2010, I think he is the only Member who does. [Interruption.] Opposition Members must bear their share of the responsibility for the failures that they did not sort out. Staffing is indeed a problem that needs to be sorted out in many trusts, which is why we commissioned the review and why we are sending in turnaround teams to do just that.

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

The Secretary of State has made an appalling attempt to smear my right hon. Friend the Member for Leigh (Andy Burnham). Will he now acknowledge that in 2009, my right hon. Friend sought a review of all the hospitals with high mortality rates, that 21 were registered with conditions, and that five had warnings placed on them, which he and he his predecessor inherited? Will he tell the House what he and his predecessor did in respect of those hospitals in 2010, 2011 and 2012?

[Mr Hunt]

As I said in my statement, in nine of these 14 trusts, the chief executive or chair has been either replaced or moved on. However, the most important thing that we are doing is setting up a transparent failure regime, so that when problems arise they will be made public, so the system will never know something that the public do not, and so that Ministers will be required to take action to sort out failing hospitals. That is what is happening under this Government, but I am afraid that it did not happen when the right hon. Lady’s party was in power.

Oral Answers to Questions

Joan Ruddock Excerpts

Tuesday 11th June 2013 Commons Chamber

[Mr Hunt]

As is so often the case, my right hon. Friend speaks extremely wisely on this issue. Integrated services will be the big thing that transforms the service we offer vulnerable older people, which the right hon. Member for Leigh (Andy Burnham) mentioned earlier. Health and wellbeing boards will have an extremely important role to play in bringing together local authorities and clinical commissioning groups so that we have joint commissioning of services for those very vulnerable people.

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

On accountability, whenever I have asked the Secretary of State how lives might be saved by downgrading Lewisham’s A and E he has cited the medical advice of Sir Bruce Keogh. My colleagues and I have repeatedly sought meetings with Sir Bruce and it is unprecedented in my experience to not receive a response to such a request. Is the Secretary of State satisfied with that? Is Sir Bruce free to meet Lewisham MPs, or has the Secretary of State told him not to?

[Mr Hunt]

Sir Bruce is free to meet anyone he likes. Actually, he had a meeting with MPs last month, which the right hon. Lady could have attended if she had wanted to do so, and there was extensive engagement with local south-east London MPs before the decision on Lewisham hospital was made.

Accident and Emergency Waiting Times

Joan Ruddock Excerpts

Wednesday 5th June 2013 Commons Chamber

[Andy Burnham]

It has been left to us to call this debate, and now Government Members sit there and groan. Well, it is not good enough. They are going to hear what I have to say because they need to do something about what is happening.

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

Before my right hon. Friend gets on to his plan, may I ask him a question? Given the chaos that he has described throughout the whole country—in London, ambulance queues have doubled in the past couple of years—why does he think that the Secretary of State believes it is sensible to downgrade the A and E service at Lewisham and divert tens of thousands of people to other hospitals where the ambulances are queuing all down the road?

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[Heidi Alexander (Lewisham East) (Lab)]

It is a pleasure to follow the Chairman of the Select Committee, the right hon. Member for Charnwood (Mr Dorrell).

The speech that we heard from the Health Secretary was pathetic. He spent 25 minutes making up excuses for not taking action but not telling us anything about what this Government plan to do.

When I stood for election three years ago, A and E services were not an issue on the doorsteps of Lewisham East but now, as a result of this Government’s determination to decimate services at Lewisham hospital, it is the most frequently cited concern. My constituents are at a loss to understand why, when there is such pressure upon A and E, this Government want to get rid of the full A and E service at their local hospital. This situation is not limited to Lewisham. It is happening all over the country.

[Dame Joan Ruddock]

My hon. Friend will know that on every occasion when she and I have had exchanges with the Secretary of State—it is a great pity that he has left the Chamber—he has justified the downgrade of Lewisham hospital on the basis that 100 lives across the south-east of London could be saved. We can find no evidence for that. Both my hon. Friend and I have written to Sir Bruce Keogh—I did so on 14 May—who the Secretary of State always says is the man who made this recommendation. The Secretary of State takes no responsibility.

[Madam Deputy Speaker (Dawn Primarolo)]

Briefly. Interventions are supposed to be brief, not a speech in their own right. The right hon. Lady will have to resume her seat.

[Dame Joan Ruddock]

rose—

[Madam Deputy Speaker]

Now.