Winterbourne View

John Healey Excerpts

Monday 10th December 2012 Commons Chamber

[Norman Lamb]

I thank my hon. Friend for his question. I am quite sure that those inspections will involve talking to the people in those settings. The fact that the Care Quality Commission is saying that it will involve people with learning disabilities and their families in those inspections will help to ensure that they have a human face. My hon. Friend also mentioned whistleblowing. It is essential that individuals feel able to blow the whistle when they see examples of abuse or neglect. Indeed, the Government have funded a helpline for any whistleblower in either the health or the care setting to ensure that people can always get access to guidance on how to go through the proper process of blowing the whistle on unacceptable standards of care.

[John Healey (Wentworth and Dearne) (Lab)]

I welcome many of the steps that the Minister has announced today in response to the shameful scandal at Winterbourne View. He says that he wants those who are high up in the organisations to be held to account. Does he therefore accept the argument put forward by my hon. Friend the Member for Leicester West (Liz Kendall) that now is the time to regulate for the best business standards, as well as for the best care standards? He also says that he wants to use regulation to secure higher and tighter standards. Will he ensure that, in putting those standards in place, any regulation of physical restraint deals not only with the excessive use of such restraint but with the appropriate use of the best techniques and with the best training?

[Norman Lamb]

I thank the right hon. Gentleman for his welcome for the broad thrust of my proposals, and for his questions. On standards of business in the sector, it strikes me that the levels of corporate accountability seem to be significantly lower in this sector than in many others. How bizarre is that, in a sector in which the protection of individuals is absolutely vital? In our response to Southern Cross and to this case, we will require owners to adopt a much more transparent approach and to disclose details of their financing arrangements. We are introducing that level of engagement and transparency as well as addressing the need for accountability. The right hon. Gentleman also asked about restraint, and we will certainly look at the appropriate methods of restraint. It should really be used only for the protection and safety of an individual or of others. It should not be used for chastisement or punishment, as appears to have been the case in some locations. That is completely unacceptable.

Oral Answers to Questions

John Healey Excerpts

Tuesday 23rd October 2012 Commons Chamber

[Anna Soubry]

Achieving early diagnosis of symptomatic cancer is key to our ambition to save an additional 5,000 lives a year by 2014-15. As I explained in an earlier answer, we are providing more than £450 million in funding over the spending review period to support early diagnosis. From January to mid March 2013, we will be running a regional pilot of our previously tested local campaign on breast cancer symptoms in women over 70. We are targeting those women because that is an area where, unfortunately, survival rates are particularly poor.

[John Healey (Wentworth and Dearne) (Lab)]

Since his promotion, the Secretary of State has said little and, I assume, read a lot. Did his starter pack include details of the Prime Minister’s promise:

“This year, and the year after, and the year after that, the money going into the NHS will actually increase in real terms.”?

Did it include Treasury figures that show there has been a real terms cut each year since the election? What is he saying to NHS staff and patients who see the cuts and see the Prime Minister’s big NHS promise being broken?

[Mr Jeremy Hunt]

May I just remind the right hon. Gentleman that there has been a real terms increase in NHS spending? That contrasts rather starkly with what was said by the Health Secretary under the previous Government. He said it would be irresponsible to increase health spending in this Parliament. We ignored that advice and NHS patients are benefiting.

Business of the House

John Healey Excerpts

Thursday 6th September 2012 Commons Chamber

[Mr Lansley]

My hon. Friend had an opportunity to raise that with the Prime Minister at Prime Minister’s Question Time, and I hope that he will take the opportunity that the Prime Minister gave him to make his points at a meeting. However, I do not recognise his description of the way in which decisions were made. They were made on the basis of an assessment of how the armed services could be sustainable for the future, and could secure representation and maintain recruitment throughout the United Kingdom.

[John Healey (Wentworth and Dearne) (Lab)]

It is good to see that the Leader of the House is still in the Cabinet, and especially good to know that he will not be steering any legislation through the House in his new position. He will know that the number of university applications from young people in Britain has dropped by nearly 10% for this year, as a direct result of the disastrous decision to raise tuition fees to £9,000. Why will the Government not find time for a debate on the subject—in Government time—rather than leaving it to the Opposition?

[Mr Lansley]

When the Opposition have wished to present an issue for debate and have chosen the issue of tuition fees, I have announced it as a consequence.

I am grateful to the right hon. Gentleman for his reference to legislation. I wonder whether he meant by it the piece of legislation which, shortly after its introduction, he described as “consistent, coherent and comprehensive”.

NHS Annual Report and Care Objectives

John Healey Excerpts

Wednesday 4th July 2012 Commons Chamber

[Mr Lansley]

My hon. Friend makes an excellent point—in fact, an excellent series of points. On his behalf I am glad to send to the Minister for Health and Social Services in the Labour Government in Wales a copy of the annual report for England, perhaps inviting her to publish a similar report in Wales. As the NAO said, and, indeed, as the Wales Audit Office said, only 60% or, on the latest data, only 68% of patients in Wales waiting for treatment accessed it within 18 weeks—the right under the NHS constitution—whereas in the NHS in England, the figure is 92%.

[John Healey (Wentworth and Dearne) (Lab)]

NHS staff and patients simply do not have the same rosy view of the NHS as the Secretary of State. When a Government-commissioned survey asked people last summer what they thought of the NHS, why had satisfaction with the NHS plummeted from 70% to 55% in just a year under the Secretary of State?

[Mr Lansley]

The right hon. Gentleman makes an interesting point, because MORI conducted an independent survey last December after the survey conducted on behalf of the King’s Fund. The survey said that 70% of people were satisfied with the running of the NHS; 77% agreed that their local NHS provided a good service; and 73% agreed that England had one of the best national health services in the world—the highest level ever recorded in that survey.

Health Transition Risk Register

John Healey Excerpts

Thursday 10th May 2012 Commons Chamber

[Mr Lansley]

I am grateful to my right hon. Friend. This case is seen and was judged by me and my colleagues on its particular circumstances; as I made clear, it is an exceptional case. One of the arguments that underlay our decision was necessarily the one about the principle that we were assessing. That principle is very clear: the Freedom of Information Act envisages that there should be an exemption for the formulation and development of policy, and that under those circumstances the public interest in the proper development of policy could outweigh the public interest in disclosure.

In this case, we are very clear—and my colleagues have been very clear—that the risk register, when it was produced, was at that time instrumental to the formulation and development of policy and that therefore the public interest did not require its disclosure.

[John Healey (Wentworth and Dearne) (Lab)]

On Tuesday, the Health Secretary said that the veto was justified because the NHS risk register case is exceptional. On Wednesday, Earl Howe, the Health Minister, said:

“This isn’t just about the NHS. The Cabinet collectively took a decision that this was a matter that extended across Government.”

On Tuesday, the Health Secretary said that he was blocking publication, but on Wednesday, the same Health Minister said:

“We have every intention of publishing the risk register”.

This is a conspiracy and a cock-up. Is it not typical of this Government—too incompetent even to organise a decent cover-up?

Oral Answers to Questions

John Healey Excerpts

Tuesday 27th March 2012 Commons Chamber

[Mr Lansley]

I will of course accept representations from my hon. Friend and, indeed, from anyone else. Pilot schemes are under way in County Durham and Darlington and in Nottingham, Lincolnshire and Luton. The system is also live in Derbyshire, the Isle of Wight, Cumbria, parts of Lancashire and parts of London. An evaluation will be published shortly by the university of Sheffield, but an interim evaluation suggested that 93% of patients were pleased with the service that they had received, and, most important, 84% felt that it had delivered them to the right place first time.

[John Healey (Wentworth and Dearne) (Lab)]

Will the Secretary of State confirm the provision in regulation, reinforced by his new guidance, that no GPs should use 0844 numbers for their surgeries? Some patients are having to pay over the odds to contact their GPs.

[Mr Lansley]

We have made it very clear that GPs should not be using 0844 numbers for that purpose and charging patients for them. One of the benefits of NHS 111 is that it will be a free service for patients, and will give them an opportunity to gain access to integrated urgent care wherever they are in the country. That is why we want to roll it out as soon as we can.

Health and Social Care Bill

John Healey Excerpts

Tuesday 20th March 2012 Commons Chamber

[John Healey (Wentworth and Dearne) (Lab)]

This Standing Order No. 24 debate is an important statement from Parliament to the Government. We expect better from the Executive, and the public demand better, as they have shown in e-mails, surveys and petitions.

This afternoon, the House is being asked to agree to the longest ever NHS legislation and to back the biggest ever reorganisation of the NHS. We are being asked to accept that from Ministers who have lost twice in law and still keep secret the risks that they are running with our NHS. This is a legal and constitutional argument; it is not a political argument. This is not about being in favour of or against the Health and Social Care Bill; it is about the public’s right to know the nature and scale of the risks that the Government are running with their NHS, and it is about their elected Parliament’s right to know about those risks when it is asked to legislate—as we are being asked to do—on their behalf. We are elected to the House to legislate by the people, for the people.

Nothing is more precious to people than our NHS. We all need the NHS. We depend on it utterly when we are at our most vulnerable and fearful. The NHS in England employs more than 1.4 million people, treats 3 million patients each week and provides each of us, throughout our lives, with some of the best health care in the world, free at the point of need. That is why it matters so much, and that is why people mind so much about the plans for the NHS.

The NHS, as an institution, is exceptional, and the public interest in anything that puts it at risk is exceptional, too. The current reform plans are exceptional in their nature, scale, timing and speed, and concern about the risks to the NHS is exceptional. That was expressed by all NHS experts, professional groups and patients in the consultation on the White Paper, and it was expressed by the Health Committee in its reports in December 2010 and January 2011. Risk was, is and will continue to be at the heart of the concerns about the biggest ever internal NHS reorganisation. That is why I made my original FOI request for the transition risk register in November 2010. That is why I refused to accept the Department’s refusal to release it. That is why I went to court this month to help to argue the case against the Government’s appeal.

Good government demands that Ministers get the best and fullest policy advice from officials, and it requires some safe space in which to make major policy decisions, but I am not asking for the release of policy advice. Risk registers are management, not ministerial, documents. They do not contain policy advice or accounts of policy discussions. They derive from major policy decisions, and the White Paper of July 2010 set out the main policy decisions three and a half months before the first transition risk register was compiled.

Nor am I asking for the release of information that will bring to a halt the Government system of risk management. It did not do so in 2008 when we were forced to release the risk register for the runway at Heathrow. Nor am I asking for the routine disclosure of risk registers. I am asking for the non-routine disclosure of this risk register because of the exceptional case and the balance of public interest that is in favour of disclosure and not in favour of withholding, just as the Information Commissioner and now the Information Tribunal—both of whom have had the benefit of having seen this risk register—have decided.

We are at the very end of the eleventh hour of this Bill’s 14-month forced passage through this House. Beyond today, the Government must decide whether they will respect the law and release the risk register. This is part of the reason why the Government have lost the support of NHS staff and lost the confidence of NHS patients, and have now lost the trust of the British public.

--- Later in debate ---

[Mr Dorrell]

I will give way to my hon. Friend in a moment.

The important principle—it is always an important principle in the law—is certainty: the certainty that people can be clear whether the advice or the register that is being given to a Minister will remain confidential or whether it will be published. My concern is that this motion is seeking to move that line retrospectively, in a way that two distinguished former heads of the home civil service clearly believe would prejudice the space that the right hon. Member for Wentworth and Dearne said was important.

[John Healey]

rose—

[Mr Dorrell]

As I have quoted the right hon. Gentleman, I shall give way to him.

[John Healey]

The right hon. Gentleman is making an argument for blanket secrecy. However, this is less about his view or even mine; rather, the point is that the Information Commissioner and the judge, along with his two wing members on the tribunal, all of whom have seen and studied the risk register, have determined that, in their legal judgment, the balance of interest lies in publishing and not withholding it. Those are the facts of this case.

[Mr Dorrell]

The right hon. Gentleman is correct, but he does not go to the end of the process, because the reasons for that decision have not yet been published. The House is therefore being asked to make a decision on the basis of a judgment that has not yet been published, which cannot be right.

--- Later in debate ---

[Grahame M. Morris]

Absolutely; good point, well made. If the Government had nothing to hide and were not concerned, they would have published the contents of the risk register. We have had a flavour of the contents of the other risk registers that have been compiled at strategic and other levels, and I believe that the Government are concerned about them.

We know that the Bill will increase the risks to the national health service. Indeed, the chief executive of the NHS, Sir David Nicholson, told the Health Select Committee, of which I am a member:

“I’ll not sit here and tell you that the risks have not gone up. They have. The risks of delivering the totality of the productivity savings,”—

that is, the Nicholson challenge; the £20 billion—

“the efficiency savings that we need over the next four years have gone up because of the big changes that are going on in the NHS as whole.”

It is clear that local and national risk registers, as well as the strategic risk registers to which we have had access, have highlighted serious concerns with patient safety, increased costs, the break-up of care pathways—which we have seen on Health Select Committee visits—as well as competition harming integration, about which the Committee was very concerned, and the specific risks during the transition stage.

[John Healey]

Will my hon. Friend also confirm that, in that session on 23 November 2010, Sir David Nicholson stated that the scale of the proposed change was enormous, and that it was beyond anything that anyone in the public or private sector had witnessed? That is why the risks involved in the reorganisation are so great, as is the imperative for the House and the public to know about them.

[Grahame M. Morris]

Absolutely; I completely agree with my right hon. Friend. These are huge structural changes to a beloved organisation, and it is in the public interest that we know precisely what is in the transition risk register.

A little while ago, I tabled early-day motion 2659, which called on the Health Secretary

“to respect the ruling by the Information Commissioner and to publish the risk register associated with the Health and Social Care Bill reforms in advance of Report Stage in the House of Lords”,

so that we could have proper scrutiny in the Lords and in the House of Commons. We have not seen what is in the transition risk register, but we are aware of the existence of other risk registers. While the Health Secretary has been fighting tooth and nail to prevent the publication of the transition risk register and, in the process, hiding the risks to the NHS in England, other NHS bodies and clinical groups have been compiling their own risk registers into the impact of the Health and Social Care Bill.

One such body is the Faculty of Public Health, the body for specialists in public health, which is a joint faculty of the three Royal Colleges of Physicians of the United Kingdom. I am grateful to Professor Clare Bambra, from the north-east, and Professor John Ashton, from the north-west, for providing this information. In a letter to The Independent, Professor Lindsey Davies, the president of the Faculty of Public Health, outlined his concerns about the pressure that clinicians were now under from their employers for criticising the Government’s plans to reform the NHS. He wrote:

“Public health professionals have the right and duty to speak out on issues which they perceive as threatening the health of the population they serve”.

The bunker mentality of the Health Secretary, and his determination to silence clinical and public opposition, have astounded the country as a whole.

In response to the Department of Health’s refusal to publish its own strategic risk assessment of the impact of the Bill, the Faculty of Public Health has undertaken its own study, in which it has highlighted a number of significant risks, not least the potential for a postcode lottery. It states:

“Clinical Commissioning Group flexibility to determine services will lead to an increase in geographical variation in service provision.”

It identifies the possibility of costs being pushed up, and states that the

“development of more overt market mechanisms, and the greater role for the independent sector in the provision of healthcare is likely to increase the overall cost of providing healthcare.”

It also raises concerns about issues of quality as a consequence of the reforms. If the transition risk register indicates that, we should know about it.

The delaying tactics employed by the Secretary of State are, to my mind, holding Parliament in contempt. He should publish and employ no further delaying tactics. Reports that Tory-Lib Dem Cabinet members banged their Cabinet table in delight and glee at the prospect of the health Bill finally being rammed through and becoming law at the end of today leave a very sour taste in the mouth. I urge all Members to support this motion and get the risk register published.

--- Later in debate ---

[John Healey]

The right hon. Gentleman argues that one of the principal reasons why the Government have not accepted the decision to disclose the risk register is that information about risks has been disclosed to the public already. The Information Commissioner considered that. Will the right hon. Gentleman recognise that, in his legal decision, the Information Commissioner said that he did not accept the argument that the Government advanced, and that he considers that

“disclosure would go somewhat further in helping the public to better understand the risks associated with the modernisation of the NHS than any information that has previously been published”?

[Mr Lansley]

The right hon. Gentleman knows perfectly well that in the debate on 22 February we made it clear that we felt that our appeal to the tribunal was justified, and indeed it was, because we won at appeal on the question of the publication of the strategic risk register. The Government’s objection and my objection to the publication of the risk register is precisely that risk registers are not written for publication. They are written in that safe space within which officials give advice to Ministers.

Health and Social Care Bill

John Healey Excerpts

Tuesday 20th March 2012 Commons Chamber

[John Healey (Wentworth and Dearne) (Lab)]

Before my hon. Friend moves on, will she pay tribute to our Labour colleagues in the Lords, who have worked across the House, but who, by dint of the way the House of Lords works, cannot always claim credit for the results they have achieved by working in that way?

--- Later in debate ---

[Simon Hughes]

Let me deal with both those points. I acknowledge that absolutely. On past occasions, the right hon. Gentleman has been to our party conference, although I do not think he came to the Gateshead conference. [Interruption.] It appears that one of his colleagues did. There were and are concerns in my party about this. My party wrote the plan for the NHS, which the good Labour post-war Government implemented, so of course we think we are as much the proprietors of the NHS as his party and of course there are concerns. There are many concerns—many colleagues are not happy with the Bill—and I am owning up to that.

I am absolutely clear about that, but do not let the right hon. Gentleman misrepresent what happened at Gateshead. My party is a democratic party. It is more democratic than his, thank God, and much more democratic than the Tory party. Our party voted to commend the Lords for the work they had done, but to suspend judgment on the Bill. My party neither voted to say that the Bill should not go ahead, nor to decide that the Bill should go ahead. That was what the debate, in the end, was about. There was not quite a majority saying, “Stop the Bill”; that was not the view of the conference, although there are many people in our party, as there are in his—this view is also shared by some in the Tory party and elsewhere—who would want the Bill to be stopped.

The Bill is not going to be stopped; it will become law. The Bill contains many good things. My concern now is to reflect what constituents, both health professionals and those who are not health professionals, come to talk to me about. They feel that there is a need to get back to concentrating on the things that really matter, such as making sure the wards are clean; making sure that the staff are of the highest quality; making sure that the waiting times go down; making sure that we can get decent care for the mentally ill; and making sure that our NHS is able to do better on all that it does. That is what the concerns are.

I want to make sure that Ministers understand that once the Bill is on the statute book there should be no cause for rejoicing, because this is not a matter for rejoicing. It is a matter of a challenge for Government to go back in humility to the health professionals and say, “We may not have got it all right—we may have got some of it wrong—but we are willing to listen, to learn and to work with you.” In the end it is collaboration between local authorities, local councillors, local people, Ministers, parliamentarians and those millions of fantastic people who work in the national health service who will make sure that the health service survives. It will survive and prosper in this country as a public health service—thank God—and we must all work together to respond to concerns, alleviate fears and not fan the flames. We must make sure that from now on we work on the basis of facts, not fiction, and that we work with those who have the concern, like we do, that the NHS should survive and prosper.

[John Healey]

I had not intended to speak in this part of the debate but I was so underwhelmed and unimpressed by the Minister that I felt moved to do so. It is interesting to follow the right hon. Member for Bermondsey and Old Southwark (Simon Hughes). I think he was offering his support to the Front-Bench team, but often it was not entirely possible to be certain. One thing he talked about was quite telling—the flaws in the systems we as a Government tried to put in place after we did away with community health councils. The Secretary of State and his colleagues were very critical about those arrangements when they sat on the Opposition Benches. One might have hoped that they would make their criticisms and learn the lessons and not repeat some of the mistakes that we certainly made in the arrangements for a strong patient voice and strong patient representation after the community health councils, but this evening’s debate and what we have been presented with in this final stage of the Bill make it quite clear that that is not the case.

At the heart of the proposal in the White Paper, which was co-signed by the Prime Minister and the Deputy Prime Minister in July 2010, was the proposition to put patients at the very heart of the NHS. That was common ground and was supported by many. It was a promise that really went to the heart of the proposition about the NHS changes. Despite that promise, it is clear that patients are not at the heart of the NHS but at the margins. The slogan for patients that there will be no decision about me without me is simply that—a slogan. I remember that early in the autumn of 2010 patient groups who were trying to come to terms with the plans were saying—quietly at first but more loudly later—that the arrangements in the White Paper and then in the Bill when it was first introduced in the House would lead to less involvement of patients in future, not more. Since that point, the Bill has had more than 1,000 amendments—some 374 amendments were made in the other place and we have four hours to consider those amendments tonight—but looking at the Bill now I can see very little difference from the position as it was first expressed almost 18 months ago, when it first caused concern to those patient groups.

In this area of all areas in which party politics should not be part of provision for a strong patient voice, representation and safeguarding, I want to take the Government at their word. They said that they wanted to set up at the heart of the NHS a strong independent voice for patients. The House needs to consider what that means, and to do that we need to go back to first principles.

It seems to me that there are four principles or characteristics which must serve as yardsticks by which to measure whether an organisation can be a strong, effective voice for patients. The first is independence. In order to function as a strong, fearless voice for patients, any organisation that acts on their behalf must be independent of commissioners, independent of providers and independent of regulators because part of its job on behalf of patients may well be to stand up to and criticise the providers, the commissioners or the regulators at some point in fulfilling its duties. The arrangements that the House is asked to approve tonight fail that first basic test of an effective organisation for patients.

The second principle or yardstick is representation. If the organisation is to be an effective representative voice for patients, clearly it must have some representation system and accountability to the people on whose behalf it acts and speaks. Again, on that test, the arrangements that we are asked to approve tonight fail. The third principle or test of an effective patient organisation is whether it is rooted or grounded in good local information and monitoring. Again, nothing in the arrangements and nothing I heard from the Minister, who has now left the Chamber in the middle of the debate that he opened, gave me any reassurance that that third principle or test is met in the arrangements.

The fourth test or principle for an effective, independent organisation surely must be adequate resources. There are serious questions over the nature, the level and the system for the resources that will allow such an organisation to do the job that we in the House are legislating for it to do on behalf of patients.

At a national level first, I say to the Secretary of State as his junior Minister is not present that setting up HealthWatch England as a sub-committee of the Care Quality Commission just does not cut it. It is implausible that a body can act impartially and fearlessly on behalf of patients if it is a sub-committee of the care regulator. How can it be, and equally important, how can it appear to be independent and authoritative, if it is set up within the administrative, organisational and financial embrace of the CQC? The CQC itself is clearly one of those organisations that HealthWatch England and local healthwatch bodies may need to stand up to and criticise.

There was an amendment in the other place to give the Government an opportunity to change their mind and set up HealthWatch England as an independent statutory body. That Labour-led, Labour-moved amendment was defeated in the other place, I am sad to say, by a combination of Conservative and Liberal Democrat peers.

Secondly, on the local healthwatch organisations, I think I understood what the Minister said earlier—that the Bill introduces a statutory duty on local authorities to set up a local healthwatch organisation. Placing a statutory duty on a local authority to carry out a particular activity is very different from creating a statutory basis for that organisation to operate in its own right. How will that arrangement at local level ensure independence, representativeness, good local links and resources—the four things that I would argue are the essential elements of an effective organisation on behalf of patients? On the fourth point, which is about resources, I may have missed something in today’s debate or in the debate at the other end of the building, but we still have not had clear answers to the following questions. I would be grateful if the Minister answered these questions when he deigns to return to the Chamber to respond to the debate, unless the Secretary of State will be doing that himself.

First, will local healthwatch organisations be funded directly by the Department of Health? Secondly, if funding will go via local authorities, what will the mechanism be for that funding? Thirdly, will funding for local healthwatch organisations be consistent across local areas so that patients, wherever they live, can be confident that they have a strong local representative organisation working on their behalf? Otherwise, this is legislation for a local lottery in patient representation and the strength of local patient voices.

[Chi Onwurah (Newcastle upon Tyne Central) (Lab)]

I congratulate my right hon. Friend on the many excellent points he is making. Is it his understanding, as it is mine, that all the local healthwatch activities could be carried out by private sector—and therefore, for-profit—bodies? Does he feel that providing the strong, independent, representative voice for local people should be a profitable activity for private sector organisations?

[John Healey]

My answer to my hon. Friend’s second question is no, and I do not know the answer to her first question, which should really be directed to the Minister. We need an explanation of how the system for setting up, or in effect franchising, local patient organisations will be carried out, what sort of framework that will take place in, and what standards, if any, will be required for the way they are set up and run.

[Fiona O’Donnell (East Lothian) (Lab)]

Does my right hon. Friend not find it incredible that after a pause, two Bill Committees and all the debates in this place and the other place, we still do not have answers on a matter that is so important to patients?

[John Healey]

I find it dismaying, because there are so many people who are committed to the health service, work in the health service or are dependent on the health service, as we all are, and they want answers to that question, but the Government are simply not giving them. To be honest, I think that this stems from the genesis of the legislation, something that was ruled out explicitly in the Conservative party manifesto and the coalition agreement but then sprung in a White Paper less than two months after the general election. That meant that the civil service, the health profession and the NHS were unprepared for this huge reorganisation and this huge Bill, so in many respects, beyond the main decisions set out in the White Paper in July 2010, all the evidence indicates that the Government are making it up as they go along. The fact that we have seen more than 1,000 amendments to the Bill since it was first introduced is a further indication of that.

Is the Minister coming back?

[Nic Dakin (Scunthorpe) (Lab)]

My right hon. Friend is making a very decisive set of points. I would like briefly to draw his attention to the local patient healthwatch group in north Lincolnshire, Who Cares, which has produced some hard-hitting reports on matters such as mental health and discharge from hospital. Does he feel that arrangements are being put in place that will allow that sort of independence of view and those hard-hitting reports that help to improve the quality of care in future?

[John Healey]

My hon. Friend hits right at the heart of the flaws in the arrangements proposed tonight, which I was going to move on to. I am sure that Who Cares has its ear to the ground, good local connections and strong representation, and I want to see that continue, as I am sure he does. The real question is whether those organisations can go beyond hard-hitting reports, and who then will be accountable for the action that might need to be taken to follow them up. Where are the enforcement powers that could ensure that any problems they identify on behalf of patients are properly dealt with? I will move on to that point in a moment.

In a sense, that links to the point I wish to put to Ministers now. In the arrangements before us it seems that if a local healthwatch organisation is not up to standard, is not doing the job and is somehow failing patients in an area or falling short of what is expected, we will be offered a new provision, a new power introduced by the Government through an amendment in the other place, for HealthWatch England to write a letter to the local authority, telling it that it must do better. Thinking of the two local authority leaders in the area that I am privileged to represent—Steve Houghton, the leader of Barnsley metropolitan borough council, and Roger Stone, the leader of Rotherham metropolitan borough council—I could not use language in this House that is likely to reflect their reaction. If I think of them, as elected local government leaders, receiving a letter from a sub-committee of a national quango responsible for regulating things that their local authorities have little or no responsibility for, telling them that they are not doing their job properly, I can just imagine their reaction. Quite frankly, “You’re having a laugh.” That is simply not a serious power of, or provision for, redress on behalf of patients when a local patients’ representative organisation is failing to do the job properly. So, no enforcement powers and no intervention powers, only the power to write a letter to the local authority.

In the end, that brings us to the point. At this stage, in the final hour, at the end of this extraordinary Bill’s passage through Parliament, we can see very clearly the truths at the heart of it. There is provision for an independent national commissioning board, an independent market regulator and independent hospital foundation trusts, but there is no provision for an independent patients’ organisation.

In this Bill there are powers to ensure strong action to guarantee competition, strong action to guarantee financial efficiency and strong action to guarantee professional concerns, but there are no powers to guarantee any sort of action, let alone strong action, on behalf of patients.

I listened very carefully to my hon. Friend the Member for Leicester West (Liz Kendall), who made a very good speech from our Front Bench. When she notes that the representative body, National Voices, says on behalf of patients and interests groups, “You’re setting us up to fail,” and reads the letter from Malcolm Alexander, the chair of the National Association of LINks Members, who says, “You’re creating weak bodies that will not be independent,” I think that we in this House should be worried. Such action is, to borrow a phrase, pennywise, pound foolish. The Government are cutting what to Ministers and civil servants might seem to be small corners, but there could be big consequences for patients.

I see a link—a common characteristic—between this debate and our earlier debate on the risk register. The Government will live to regret at length poor judgments and decisions made in haste and under pressure now. The Secretary of State will face the question of whether to release the transition risk register. If he insists on remaining resolute in refusing to disclose, and if he insists on keeping it secret, patients will ask, “What are they hiding from us?” In the future, in the months ahead, long after the Bill has received Royal Assent and is on the statute book, patients will rightly ask when things go wrong, “Did they know these risks were there, and why didn’t they tell us?”

The same applies to HealthWatch. When things go wrong, patients will find that they do not have the recourse and the representation that they may need to act and intervene on their behalf, and they may well find that the arrangements that we are invited to pass tonight are too weak to help them. I say to the Health Secretary, who is now on his own on the Front Bench, that this is likely to reinforce that lack of confidence and lack of trust in the notion that the Government’s huge upheaval in our NHS, and this huge piece of legislation before the House, really is in the best interests of the NHS and NHS patients.

[Liz Kendall]

On a point of order, Mr Deputy Speaker. Is it in order for the Minister who moved these particularly important amendments, which will abolish a statutory organisation, HealthWatch, to be absent from the debate? If it is in order, is it not a huge discourtesy to Members on both sides of the House?

Health and Social Care Bill

John Healey Excerpts

Tuesday 13th March 2012 Commons Chamber

[John Healey (Wentworth and Dearne) (Lab)]

It is good to follow the hon. Member for Loughborough (Nicky Morgan). Hers was an heroically loyal attempt to fill time on the Government Benches. But she is wrong. The Government have lost the confidence of the NHS to make further changes, and they have lost the trust of the British people to oversee those changes. Why no apology from Ministers? Why no apology to the 1.4 million NHS staff for the last wasted year of chaos, confusion and incompetence? Why no apology to the millions of patients who are starting to see services cut and waiting times get longer? And why no apology to the British people for breaking the promise in the coalition agreement to stop the top-down reorganisations of the NHS that have got in the way of patient care?

[Pat Glass (North West Durham) (Lab)]

I was contacted last week by a constituent of mine, Ruth Murphy, who told me that she had waited more than 40 weeks for an operation that had then been cancelled four times. She asked me if that was what we had to expect from a Tory NHS. That is the kind of thing that my right hon. Friend is referring to.

[John Healey]

Sadly, Ruth Murphy’s experience is more and more common. By the end of last year, the number of people having to wait more than 18 weeks to get into hospital for the operation they needed was up 13% since the previous year.

[Jim Shannon (Strangford) (DUP)]

Like many in the House, the right hon. Gentleman will have received a lot of correspondence from professional bodies, such as the British Medical Association, the Royal College of Midwives, the Royal College of Nursing, the Chartered Society of Physiotherapy and many, many others, and they all say that these changes will lead to an unsafe foundation for the NHS. Does he feel that they all want change, but the right change, and the right change is not what will be delivered by the Government here?

[John Healey]

The hon. Gentleman is right. One of the great tragedies here is that the Government have squandered the good will and confidence of NHS staff that is necessary to make the changes to the NHS that it must make. This health Bill will make making those changes more difficult, not easier.

The Government could have built on the golden legacy and the great improvements that patients saw under 13 years of Labour investment and reform: hundreds of new hospitals and health centres; thousands more doctors, nurses and specialist staff; and millions of patients with the shortest ever waits for tests and treatments. Instead, we have a Tory-led Government, backed by its Lib Dem coalition partners, who have brought in the chaos of the biggest reorganisation in NHS history; wasted billions of pounds on new bureaucracy; and betrayed our NHS with a health Bill that will, in the long run, break up the NHS as a national health service and set it up as a full-blown market ruled, in time—for the first time—by the full force of competition law.

Everything about this NHS reorganisation has been rushed and reckless. This has been a master class in misjudged and mishandled reform—implementing before legislating, and legislating before being forced to call a pause to listen and consult on the plans already in hand. This health Bill was introduced last January. What was a very bad Bill is still a bad Bill. Make no mistake: this legislation will leave the NHS facing more complex bureaucracy and more confusion about who decides what and who accounts for what, and mired in more cuts and wasted costs for years to come.

Risk has been at the heart of the concern about these changes from the outset. There has been a lack of confidence and a lack of evidence, yet the Government are ready to manage the risks of introducing the biggest ever reorganisation in NHS history at the same time as the biggest financial squeeze since the 1950s. These risks were the reason for the growing alarm among the public, professionals and Parliament in the autumn of 2010, when I made my freedom of information request for the release of the transition risk register.

Last Friday the courts dismissed the Government’s efforts to keep secret the risks of their NHS reforms. Apocalyptic arguments were made in court, in defence of the Government, about how releasing the register would lead to the collapse of the Government’s system for managing risk. That did not happen when the Labour Government were forced to release the risk register for the third runway at Heathrow. Nor will it lead to the routine disclosure of Government risk registers, because the tribunal’s decision, like the Information Commissioner’s decision before it—both saw the transition risk register—was based on my argument that the scale and speed of these changes was unprecedented, and therefore that the public interest in their being disclosed was exceptional.

The Government have dragged out their refusal to release this information for 15 months. That is wrong. They have now lost in law twice. This is not a political argument but a legal and constitutional argument. It is about the public’s right to know the risk that the Government are running with our NHS, and about Parliament’s right to know, as we are asked to legislate for these changes.

[Yasmin Qureshi (Bolton South East) (Lab)]

Will my right hon. Friend give way?

[John Healey]

I will not, as I have less than a minute left.

Release of the transition risk register is now urgent, in the last week before the Bill passes through Parliament. It will also be important in the two or three years ahead, as this reorganisation is forced through the NHS. I say to Ministers this evening: do the right thing. Respect the law, accept the court’s judgment and release the register immediately and in full, so that people and Parliament can judge for themselves.

Health and Social Care Bill

John Healey Excerpts

Tuesday 28th February 2012 Commons Chamber

[Mr Lansley]

My hon. Friend is absolutely right, and I am sure that in that context he shares with me the appreciation of the benefit that will come from campaigns to promote the early awareness of cancer, such as, following piloting, the roll-out of the national campaign for the awareness of bowel cancer symptoms.

[John Healey (Wentworth and Dearne) (Lab)]

Is not this another attempted PR and political fix for a mismanaged health Bill that is again in chaos? Which of the changes set out in the Deputy Prime Minister’s letter was not agreed in government first?

[Mr Lansley]

Would that be the same Bill that the right hon. Gentleman described as “consistent, coherent and comprehensive”?