Health and Social Care Bill

John Leech Excerpts

Monday 31st January 2011 Commons Chamber

[Mr John Leech (Manchester, Withington) (LD)]

I am delighted to have an opportunity to speak, given the number of Members who wished to contribute. I will keep my comments brief.

We should all recognise that NHS staff do a great job in looking after our health and well-being, and are constantly striving to improve provision. I refer not just to front-line health workers, but to the office staff managers and professionals who are not always referred to so positively by either politicians or the media. However, we must also recognise that the NHS must continue to improve and do a better job in order to keep pace with rising health care needs. The question we must ask is whether the Bill will allow the health service to continue to improve.

Some positives have come out of the proposals. For too long, unelected officials have made decisions about local health care without listening to local communities, handing contracts for GP practices to private firms or even closing hospitals with local people locked out of decision making. In my constituency, under the previous Government, the PCT closed Burnage walk-in centre without any consultation. It said that this was to save money, despite the centre being more cost-effective than other walk-in centres in Manchester. This was part of the £20 billion efficiency savings demanded by the previous Labour Government. More recently, the PCT has temporarily closed Withington walk-in centre, again without consulting anybody who uses the service. So it is to be welcomed that the Government will not allow a service reconfiguration where the public have not been engaged and where it will reduce people’s health care options locally.

It is also to be welcomed that private sector providers will be expected to appear before local authority health scrutiny committees—that did not happen under Labour’s less democratic system. However, I urge the Secretary of State and Ministers that if private providers remain reluctant to participate, they should be mandated to appear before health scrutiny boards. Getting information on how providers are performing out into the open can only help to improve health outcomes and accountability.

The Lib Dem manifesto promised an end to the rigging of the market in favour of the private sector that we had seen emerge under the Labour Government. The Labour Government pushed for more NHS work to be given to private hospitals, regardless of local decisions on whether it was right for them. Much of the concern about the Bill centres on reforms being seen as being about the break-up of the NHS. Such a view is wide of the mark, because in many ways the proposals will level the playing field for the NHS, which was distorted under the previous Labour Government. They guaranteed that for-profit providers of elective surgical procedures running independent sector treatment centres would be paid a certain amount, regardless of how much work they did, and allowed PCTs to make supplementary payments to new private sector providers to make services more attractive to new entrants. Unfairly stacking the system in favour of the private sector and against public provision was wrong. We cannot allow certain providers to be handed work regardless of what patients want and regardless of the quality of the services provided. I hope that the Minister will confirm that preferential payments and guaranteed payments for new private sector providers will end. Can he also confirm that there will be no target for the proportion of work undertaken by private sector providers, unlike under the Labour Government?

However, there are still areas of concern and many questions remain unanswered. I would be grateful if the Minister explained what will happen to existing PCT-owned provision? Locally, in Manchester, the Labour party has claimed that the PCT-run Withington community hospital will close under these proposals. Of course that is simply not true, but questions do remain over who will own and run the community hospital. When I met the chief executive of Manchester PCT, she made it clear that the new proposals give real scope for widening and expanding provision through the community hospital, but she remained unclear on the model of ownership. I would be grateful if the Minster cleared that up.

Unlike Labour Members, I have no ideological opposition to the idea of allowing hospitals to extend their private provision. Private provision has been extended at the Christie hospital, in my constituency, which is providing millions of pounds extra each year to be reinvested in NHS provision, which surely is a good thing. However, I would be grateful if the Minister assured the House that where private provision is extended, it will not be at the expense of NHS provision. We should allow hospitals to extend private provision—in addition to existing services and certainly not instead of them—so that more money can be reinvested in the NHS.

Questions also remain about the cost of the implementation of change. Manchester used to have three PCTs, but they were merged into one to save money. The new consortia will go back to using the “three model”, and I am not convinced that that will save money. There is also a concern that intense competition for providing services that existing hospitals provide will take away resources and make it more difficult for NHS providers to maintain services or to invest in new technology and equipment. I have run out of time.