Health and Social Care Bill

Joan Walley Excerpts

Monday 31st January 2011 Commons Chamber

[Joan Walley (Stoke-on-Trent North) (Lab)]

I am pleased to speak briefly about this Bill; I know that many Members on both sides of the House still want to contribute to the debate. It seemed to me that not to speak in this debate would somehow mean not being true to the important issues surrounding the NHS. I have listened to the debate and heard some good constructive comments, but I do not think we have gained a sense of what the NHS was like when I was first elected almost 25 years ago. At that time, people simply could not get treatment because of the underinvestment during the years of the Conservative Government. As for the point about organic change and building on what has been done, it seems to me that this Bill, lengthy as it is, is doing away with the step-by-step improvements that have been made.

[Robert Flello]

I look forward to hearing more of my hon. Friend’s speech, which I know will be to her usual high standard. Does she agree that, since 1997, Stoke-on-Trent has seen the building of the first new hospital for 140 years, a brand-new oncology unit, a brand-new maternity unit and health centres developing everywhere? Is that not real investment under a Labour Government, which never happened during the previous 18 years of the Conservative Government?

[Joan Walley]

What we have seen is the university college of North Staffordshire linked to the medical college at Keele. We have never before seen that kind of medical training going on outside London in areas like Stoke-on-Trent. Hayward hospital has been rebuilt and there has been investment in clinics and a huge increase in the number of staff. That does not mean just bureaucrats—like everyone else, I do not want to see unnecessary bureaucrats. I am talking about the number of health personnel trained to do their jobs and to treat people, which has been second to none—despite what the Minister says.

[Mel Stride (Central Devon) (Con)]

In looking at NHS performance, should we not seek to compare ourselves with international equivalents today rather than with the past? If we look at coronary heart disease, for example, we find that we have twice the death rate of France, and we are also lagging behind the rest of Europe on cancer outcomes.

[Joan Walley]

I am coming on to public health, as it is the main issue on which I wish to concentrate.

[Mrs Jenny Chapman (Darlington) (Lab)]

In response to the intervention on the recorded death rates from coronary heart disease in France, I want to observe that France makes much more frequent use of the “unknown” category in the recording of deaths. I have been led to understand that this goes some way towards explaining the apparent difference in death rates between the two countries.

--- Later in debate ---

[Joan Walley]

Statistics can be used in all kinds of ways. I remember the case of a young girl of six who could not get the heart surgery that she needed, even when we had invested in those facilities. The important role of public health is relevant to heart disease, and we need to focus on what can be done to prevent ill health. This Bill is very short on detail in that area, which is why I want to concentrate on it.

I want to stress that what we are seeing in this Bill is dogma. We are replacing the primary care trust layer with the GP layer, but the GPs will not be able of themselves to provide the clinical leadership of which we have heard. They will have to engage with equally bureaucratic agencies or companies to do that work for them. My fear is that the clinical leadership element will get lost when the new provisions come into force.

The provisions will not allow us to build on the work of the previous Government, which did so much to improve aspects of the NHS. I accept that the new Government have come into power and that they have a remit, but that means that they should get what they do right. I fear that what will happen as a result of the Bill will be destructive. I am afraid that it is also risky. We have already heard about the need for pilot projects. Why can we not wait for a proper evaluation of those projects before rushing ahead with a move that might cause us to throw out the baby with the bathwater? What safeguard will we have against that?

I fear that when the public realise that the Bill is not fit for purpose and will not achieve what is claimed for it, they will be not saddened but angered by the knowledge that they will no longer be able to raise issues for which the Secretary of State has previously had responsibility. The Bill will merely transfer responsibility, and it is easy to see who will have that overall leadership and where direct accountability will lie. The hon. Member for Stafford (Jeremy Lefroy) will probably wish to raise issues relating to Stafford hospital. It is important that when things go wrong in hospitals, there is full transparency. When everything is done on a commercial basis, that transparency will not exist in the new health service that the Bill will introduce.

The Government say that the Bill will end inequalities. I am old enough to remember the resource allocation working party, and the “distance from target” money that was to help areas such as Stoke-on-Trent which had received the least investment in health and experienced the most illness. I am not convinced that the Bill will continue that work. Stoke-on-Trent primary care trust is currently £30 million short of its target, and it is difficult to see how the Bill will make amends for that.

Realising as I do that the devil is often in the detail, I want to raise two more points. The first relates to public health. Speaking as an honorary vice-president of the Chartered Institute of Environmental Health, I am well aware that the public health consultation that has invited responses later this year will not be co-ordinated with the legislative changes in the Bill. Will the Government take account of the need for the institute to look in detail at the way in which public health will be integrated with local authorities across the board? That is critical if we are to improve public health services at all levels.

My second point relates to a private Member’s Bill of mine. I have heard that, through the Government’s Bill, the Prime Minister will require hospitals to improve nutritional standards. We all know that poor food leads to ill health. I hope that Ministers will consider the proposals in my Bill, and think about ways in which hospitals could serve high-standard food rather than food that is often linked to ill health. That in itself could make a major difference to people’s health.

I have many other concerns which I have no time to mention, but let me say finally that it is not clear how the Bill will secure the investment in dentistry that is currently needed.