National Health Service (Amended Duties and Powers) Bill

Debate between John Healey and Andy McDonald

Friday 21st November 2014 Commons Chamber

[John Healey]

I did not want to open up all the old arguments that we fought in 2010-11, though it was extraordinary to see the extreme lengths to which the Government went—seen before only on matters of military information—to stop the disclosure of the risk register about the potential impact and likely consequences of their policy. My hon. Friend was a great supporter of mine in trying to use the Freedom of Information Act to allow the public and this House to see the terms of what the Government knew could happen to the NHS if they passed the legislation.

My second C is complexity. NHS services are now so much harder to plan and so much harder to hold to account because of the changes the Government have made. We saw new national quangos responsible for tens of billions of pounds of spending of public money in each and every one of our local areas in England. The commissioning role, which was previously undertaken by one body, the primary care trust, is now fragmented with at least five different bodies trying to do the same job.

On the third C, competition, the Secretary of State has his foot lightly on the accelerator of privatisation for now, but let us make no mistake, if the Tories win the next election, he will press it hard down to the floor immediately afterwards. Even though they are soft-pedalling on the privatisation that their Act put in place, we have seen in the 18 months since it came into force 131 contracts won by companies such as Care UK, Virgin Care and BUPA. According to the NHS Support Federation, that is already valued at £2.6 billion. At that win rate, the contracts already currently advertised will mean another £6.6 billion in the private sector—getting on for 10% of our NHS run by private companies in private hands.

[Andy McDonald (Middlesbrough) (Lab)]

Has it come as any surprise and is it just a coincidence that the very companies securing these major contracts are six-figure donors to the Tory party?

[John Healey]

It comes as no surprise, and I am grateful to my hon. Friend for underlining that point. I was not planning to make that point, but I am glad that it has been made so clearly.

My argument is with the Prime Minister. So much for what he said, and so much for his word when he said back in 2011 that

“we will not be selling off the NHS”.

Perhaps the most serious consequence of this fragmentation, this privatisation and this contractualisation is the fact that the most important and fundamental value at the heart of the NHS—an imperative at its heart—is the ability properly to plan, co-ordinate and deliver services. That is being made much harder, as the Health Select Committee has said, and sometimes impossible by the operation of the Health and Social Care Act and competition law. If anybody doubts it, they should look at the case of the two NHS trusts—the Royal Bournemouth and the Poole NHS Trusts—whose merger made great sense to patients, but was prevented by this Government’s legislation.

Let me say a few words about the transatlantic trade and investment partnership. I have chaired the all-party group that has followed these negotiations for the last 18 months in order to try to encourage a better and more balanced public and parliamentary understanding and debate, as well as to put the Government on the spot and hold them to account for what they are doing. We are trying to ensure that if we get a deal, it will bring real benefits not just to British business, but to British workers and British consumers.

Two things have become clear. First, the NHS can be fully protected in TTIP. I am convinced of this, not just because other EU trade agreements have protected public services, but because if the Government want them, there are specific member state reservations to cover public services and because we have heard the confirmation, directly from the chief negotiator whom I have met twice about this, that even with ISDS—investor-state dispute settlement—provisions, which I do not support, nothing could prevent a future Labour Government from bringing parts of the NHS now in private hands back into public hands.

The second thing that has become clear is that these commitments have been secured despite, not because of, Government Ministers. It is clear that Ministers have done next to nothing to try to influence the negotiations and secure the full exclusion and protection we require for our NHS and wider public services. Indeed, rather as the right hon. Member for Banbury (Sir Tony Baldry) observed, the Minister for Trade and Investment, Lord Livingston, who is responsible in government for leading the British position, has said that he would welcome the inclusion of health services in any deal. When the Minister gets up to speak, perhaps he will—formally, in this House—make the Government’s position clear. What is clear is that if we are properly to protect our NHS in any future TTIP, we must have a strong British voice in Brussels, which we do not have at the moment.

Offender Rehabilitation Bill [Lords]

Debate between John Healey and Andy McDonald

Monday 11th November 2013 Commons Chamber

[John Healey]

There are some useful provisions in the Bill. My right hon. Friend the Member for Tooting (Sadiq Khan) has said that the Opposition do not object to some of the Bill. Additional requirements as part of supervision orders are sensible. Extending the supervision requirement to those who are released from custody after short-term sentences is sensible. My argument is that the legislation is part of a wider programme, the policy purpose of which lacks evidence and justification, but not the ideology that drives the Justice Secretary. That purpose—that end—is the privatisation of our probation services. It is not about the means to a better probation service or better protection for the public.

Let me develop my argument. I have mentioned the first and second coalition consultation reports. To be fair, the third report—“Punishment and Reform: Effective Probation Services”—which was published in March 2012, restated the intent to open up the market for the supervision of low-risk offenders. However, it also proposed a stronger role for probation trusts and a stronger emphasis on partnership working. The report states:

“We intend that there will be a stronger role for public sector Probation Trusts as commissioners of competed probation services…We will devolve to Probation Trusts the budget for community offender services”.

At that time, the Government said:

“Trusts are best placed to work with courts and with local partners to design and commission services jointly…We will support the joint commissioning of services for offenders between probation and key partners such as local authorities, health and the police.”

[Andy McDonald]

Does my right hon. Friend agree that the current proposals run the risk of dispensing with excellent services in the not-for-profit sector, which Government Members say they want to preserve? Will the proposals not leave that door open, because such charitable organisations do not have the critical mass to enable them to bid for the contracts or withstand a payment-by-results mechanism?

[John Healey]

My hon. Friend is right. One of the real worries about this so-called reform programme is that it borrows from the Work programme, which the Justice Secretary introduced when he was Minister of State for Employment. Frankly, many of the failures, flaws and potential fraud in the Work programme could be replicated in our probation service.

Returning to probation trusts, I quoted from the March 2012 consultation report. What has changed since then? The Justice Secretary has changed. He has stopped the pilots; he has added medium-risk offenders who have served a custodial sentence, and those on community sentences and suspended sentences, to the list of offenders who will be handed over to the private sector; and he has issued the invitation to contract for £450 million of services before the Bill has even had its Second reading in this House. There has been no testing, no costing, no evidence to support such sweeping changes and no backing from any serious professional probation voices.

Clause 1 was inserted by the Lords as a vote of no confidence in the case that the Justice Secretary has been making. That was not a party political move, as it was led by Cross Benchers and a former chief inspector of prisons. Clause 1 was introduced and approved because there are still too many doubts about the Bill and the programme of privatisation—doubts about the viability, accountability, affordability and safety of services under a new, largely privatised system. How much will it cost? How much will it save? How will it be more effective? How will it reduce reoffending? How great will the risk be in putting serious offenders in the hands of private companies? How much money will be offered up front? How much will be held back and paid via payment by results? How will the repeated failures of the Work programme be avoided? How will the fiasco and fraud we have seen before be avoided in the Ministry of Justice’s management of contracts?

To justify the proposed legislation, the Justice Secretary has to address those concerns, and he has not. He has to be able to demonstrate that his plans are better than building on what is already in place. He cannot do that because all 35 probation trusts in England and Wales have been independently judged either good or excellent. All 35 probation trusts are hitting all the targets they have been set. Reoffending rates for those under their supervision have been falling every year for more than a decade. Imagine the credit the Secretary of State for Communities and Local Government would take if all local authority children’s services were judged good or excellent. Imagine the purring pleasure of the Secretary of State for Education if all schools were judged good or excellent. Imagine the huge relief of the Secretary of State for Health if all hospitals were judged good or excellent. No other part of the public sector performs so consistently, and to such a high professional standard, as the probation service.