Health and Social Care Bill (Programme) (No. 2)

John Pugh Excerpts

Tuesday 21st June 2011 Commons Chamber

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

Last week, we had a political fix on the Government’s health Bill. This week, we have a procedural fix. The way the Government are dealing with the national health service and with the House of Commons is a disgrace. Last week, the Prime Minister was forced to backtrack in some areas to buy off the many critics of his health plans. This week, to head off proper parliamentary scrutiny of his plans, he refuses to put the whole Bill back into Committee.

The changes announced last week to the Prime Minister’s NHS changes are not a proper plan for improving patient care, or for a better or more efficient NHS. Those aims could largely be met without legislation, and certainly without the huge risk and cost of the biggest reorganisation in NHS history. The big quality and efficiency challenges the NHS must meet for the future will be made harder, not easier, by the reorganisation and the announcements last week.

The NHS has seen a wasted year of chaos, confusion and incompetence from the Government. Today, it is clear from the motion that that will continue. The motion signals the onset of sclerosis in the health service. The Bill will mean that the NHS is deeply mired in more centralisation, more complex bureaucracy and more wasted cost in the years to come. There will be five new national quangos and five new local bodies doing the job that one—the primary care trust—does at present.

Today, the motion signals that the essential elements of the Tories’ long-term plan to see the NHS broken up as a national service and set up as a full-scale market are still intact.

[John Pugh (Southport) (LD)]

Regardless of the merits of the Bill, does the right hon. Gentleman accept that what the NHS and the public want is to find out whether the House supports it? They do not want to prolong the agony.

[John Healey]

What the public and patients want is to get to the bottom of the changes the Government said they were bringing in. They want us to do our proper job of scrutinising the detail, and for that we need the time to do so, with the full Bill recommitted to the Public Bill Committee. Even some of the hon. Gentleman’s Lib Dem colleagues are beginning to see through this. Yesterday, the hon. Member for St Ives (Andrew George) wrote that the Government

“leaves many of the previous concerns—about the risk of a marketised NHS, a missed opportunity to better streamline health and social care and a lack of accountability—still unresolved.”

[John Pugh]

But does the right hon. Gentleman accept that those concerns will all be covered in the areas of the Bill to be discussed? Nothing will be left out.

[John Healey]

I do not normally quote the hon. Gentleman’s party leader, but a few weeks ago, the Deputy Prime Minister said:

“It is very important that MPs, who represent millions of patients up and down the country, have the opportunity to really look at the details that we are proposing…I have always said that it is best to take our time to get it right rather than move too fast and risk getting the details wrong.”

The Prime Minister has stopped listening to the Deputy Prime Minister, and that is exactly the mistake the Government are making with the motion.

--- Later in debate ---

[John Pugh (Southport) (LD)]

I will briefly specify three linked reasons, good and bad, why we support the Government’s programme motion. We oppose the Opposition’s amendment to the motion because it would simply lead to unnecessary delay. The Government have identified through the listening exercise, perhaps belatedly, the controversial, difficult and unworkable aspects of the legislation and want to change them. In deference to the people they have consulted, they want to change those aspects promptly and subject them to proper scrutiny, not only in Committee, but in an evidence session that we will also have.

Surprisingly, many areas of the Bill are relatively uncontentious and ought not to detain the House a great deal longer, such as the aspects relating to social work, the health and care professions or the National Institute for Health and Clinical Excellence. Those areas are relatively uncontentious and need not be massively reconsidered. In addition, there is the summer recess, as the right hon. Member for Wentworth and Dearne (John Healey) said, which means that after the Committee has concluded its considerations there will be ample time for him and anyone in the NHS, including all the consultees, to make adequate representations. The Bill will then go to the Lords and return for our further consideration.

[Bill Esterson (Sefton Central) (Lab)]

The hon. Gentleman will have been lobbied by constituents in the same way that I and other Members have been. Does he agree that the public’s real concern is the potential for cherry-picking by private companies, even with the amendments that are being made, and that this approach will be unable to stop such a process?

[John Pugh]

The public are perfectly entitled to an answer on whether the Bill contains cherry-picking or not, but it is better that they have that answer sooner rather than later. There is a second reason—[Interruption.] May I just set my stall out? The second reason why this must be done properly is that the Bill has so far led to uncertainty and the implosion of primary care trusts. Whoever’s fault it is—[Interruption.] People will know that I did not support the original Bill. It has led de facto to the implosion of PCTs and to some irregular adjustments and appointments being made on the hoof—Members can ask their constituents about that—and to some premature arrangements being made.

[Karl Turner (Kingston upon Hull East) (Lab)]

I am obliged to the hon. Gentleman for giving way. How many times did he support my colleagues and I in the Bill Committee?

[Several hon. Members]

None.

[John Pugh]

None is not the correct answer. The issue that Labour Members need to understand is that the NHS, as a result of the Budget that most of them voted for in 2010, needs to find £20 billion, and we cannot do that unless—[Interruption.] If it is a disgrace, it is a disgrace that the Labour party inflicted on us. We cannot do that against a background of complete and utter uncertainty, not knowing who will be running the NHS and having to find those savings. Members can check for themselves, but that is the view of the local people running their hospitals. Regardless of the merits of the legislation, they now want a decision.

[Angela Smith]

Given that the hon. Gentleman voted for the Bill on Second Reading and got that wrong, how can we be confident that he has got it right today?

[John Pugh]

If the hon. Lady checks Hansard, she will find that I did not vote for the Bill on Second Reading––okay?

A third and more consensual reason—I might now withdraw it—is that I can assure the House that, having served on the Bill Committee, it could not find a better or more informed set of individuals who are on the ball. The Opposition drilled down on every clause with laser-like precision. There are some very talented individuals sitting on the Opposition Benches, and there is still that galaxy of informed talent. They might feel, as I do, that it is a little like being sent back to the trenches, but the fact is that if that team cannot win the arguments for either accepting or rejecting these changes in the time allotted, frankly there is no hope for this House. They must approach the matter in the right spirit, although that seems somewhat in doubt. I urge Opposition Members to have confidence in their team, the timetable and the ability of the British public to judge if it all goes horribly wrong, but it will not go horribly wrong simply because of the programme motion.