A&E Services

John Redwood Excerpts

Wednesday 24th June 2015 Commons Chamber

[Mr Jamie Reed (Copeland) (Lab)]

I beg to move,

That this House notes that hospital A&E departments have now missed the four-hour A&E target for 100 weeks in a row; further notes that trusts are predicting record deficits this year; believes the pressures on hospitals are a consequence of declining access to out-of-hospital services under this Government, including fewer older people receiving social care and more people waiting a week or more for a GP appointment; further believes the increasing bill for agency staff is also adding to the pressure on hospitals; notes that the Government plans to stop the weekly reporting of A&E data; believes this decision will make the NHS less transparent and make it harder for patients to judge the performance of their local hospital; and calls on the Government to reinstate the publication of weekly A&E data and to set out how it will tackle hospital deficits in 2015 in order to protect services.

I want hon. Members from all parts of the House to cast their minds back to the week commencing 14 July 2013: the country was still basking in Andy Murray’s historic win at Wimbledon; England had just embarked on a successful Ashes series against Australia; and hospital A&E departments achieved their target to see 95% of patients within four hours. Since then a number of unlikely things have happened: the then reigning world champions, Spain, have crashed out of the World cup in the first round; a group of scientists remotely have landed a probe on a comet hundreds of millions of kilometres from earth; and Cuba and the United States have begun to repair diplomatic relations. But in the same period some sadly predictable things have occurred: England have crashed out of the World cup in Brazil; they have been whitewashed by Australia in the cricket; and under a Conservative Government hospitals in England have now missed their A&E target for 100 weeks in a row.

I start this debate by paying tribute to the hard-working staff at every level of our national health service. They work tirelessly in trying circumstances, and without them there would be no NHS. Ministers have in this place adopted the practice of attempting to pretend that any criticism of Government policy is a criticism of the health service or its staff, so let us make clear one thing right at the start of this debate: NHS staff are remarkable and we are all in their debt. The achievements of NHS staff are despite Government policy, not because of it.

[John Redwood (Wokingham) (Con)]

What have the Opposition learned from the Mid Staffs disaster and tragedy, where they were hitting the targets but missing the point? What should they learn about how one drives quality forward in the health service?

[Mr Reed]

I thank the right hon. Gentleman for that question. If he paid attention to the Francis report, he would learn that it was not the targets themselves that were to blame for the Mid Staffs tragedy, but the way they were applied in that hospital. That is clearly stated in both the first and second Francis inquiries; indeed, it was a point that the Prime Minister made on the Floor of this House when he reported to Members.

In the past 100 weeks, nearly 2.4 million patients have waited more than four hours in hospital accident and emergency units in England.

--- Later in debate ---

[Ben Gummer]

I apologise, Madam Deputy Speaker.

The motion is about A&E services, and I would like to talk about the progress that the NHS has made in the past five years. Far from the picture painted today by the hon. Member for Copeland (Mr Reed) and Members who intervened during his speech, the NHS is treating more people than ever before, it is treating more people in A&E than ever before and it is treating more people at a higher rate of satisfaction than ever before, and the result of that is that patient outcomes—something we did not hear much about from the shadow Minister—have improved. We are treating more people to a higher standard.

[John Redwood]

Is it not the case that the excellent policy of seven-days-a-week GP services means an expansion in the amount of GP services, which will provide welcome relief from the pressures on A&E, which will add to the good work being done in hospitals?

[Ben Gummer]

That is precisely the sort of policy on which we will seek consensus in the months and years ahead. There is a choice for Opposition Members. I know there are many new Members who wish to make their maiden speech in this debate, and I would just say to them that the choice is this: to come together to try to model better care within the NHS and better outcomes for patients, or to seek division.

GP Services

John Redwood Excerpts

Thursday 5th February 2015 Commons Chamber

[Sarah Newton (Truro and Falmouth) (Con)]

I am very proud to be part of a governing team that has spent more money on the NHS. We faced some incredibly difficult choices when the coalition was formed and protecting the NHS was at the top of our list. I have seen for myself some of the benefits of the reforms. Many more decisions about NHS services are now taken in Cornwall, led by clinicians and local people. That is very welcome.

I very much welcome the “Five Year Forward View” that NHS England has put together to cope with the considerable increase in demand on the NHS that is anticipated. Whoever is in government will face the challenge of how we can deliver the first-class services that everyone in this House wants for every constituent in every part of the country.

In the short time that I have, I will share with the House four observations that I have made from talking to staff in the NHS in Cornwall and to patient groups in my constituency, and we could usefully take them forward to help us to tackle some of the challenges we will face in the future.

The first is the role that women can play in addressing some of the work force challenges faced by the NHS as a whole and, in particular, by general practice. The second is how we can expand the services provided by GPs’ surgeries. The third is the role that GPs can play in A and E departments, and fourthly I wish to share some of the learning we have had from our great fortune in Cornwall in being part of the integration pioneer.

[Mr John Redwood (Wokingham) (Con)]

Does my hon. Friend agree that our party’s excellent policy of extending GP opening times and days is crucial, but it will require more GPs to work more flexible hours on an agreed basis?

[Sarah Newton]

My right hon. Friend makes a good point. The plan that NHS England has put forward is about shifting resources from the acute emergency care sector into primary care sectors, especially GP practices. The point that he makes about flexible working fits well with my point about enabling more women to stay in the NHS or to return to it. Many walks of life are addressing the issue of enabling women to combine their caring responsibilities with their desire to play a full part in society, whether that is in public service as a GP, as a Member of Parliament or in business. Much more work needs to be done by the NHS to look at ways to enable women to combine caring for children or elderly parents with being a GP or fulfilling other roles in the NHS.

Women often take a break to look after their families—it is something that I did myself—and it can be difficult for women in their late 30s or 40s to find the ladder back into their previous careers and occupations. I note that many former GPs could make excellent GPs again if they were given the opportunities to retrain and reskill. They could contribute enormously, through working flexibly, to enable GP practices to open more hours.

National Health Service

John Redwood Excerpts

Wednesday 21st January 2015 Commons Chamber

[Andy Burnham]

I give way to the right hon. Member for Wokingham (Mr Redwood).

[Mr John Redwood (Wokingham) (Con)]

I am grateful to the shadow Secretary of State. Can he explain why Labour only ever now has any interest in England’s health service? We would like to hear about Labour’s conduct of the Welsh health service and its message for Scotland. Does Labour not know that this is an English devolved matter?

[Andy Burnham]

It is my responsibility to hold the Government to account on behalf of patients in England for what is happening in England now. That is my job, and I will make no apologies to the right hon. Gentleman or anybody else for doing it.

The response times in the ambulance service are not good enough, nor is the plan to introduce an experiment in the middle of winter, but the problems are not confined to the ambulance service. We need, too, to relieve the pressure on hospitals. Last week just seven out of 140 hospital A and E departments in England met the Secretary of State’s lowered A and E target. Hospital staff are trying their best, but it is as if the Government have simply given up on it. If that is so, it means that they are giving up on the thousands of people waiting hours to be seen. What is his plan to stop the decline and bring A and E back up to acceptable standards? It is time he told us.

--- Later in debate ---

[Mr Hunt]

I am going to make progress, but I will give way later.

I want to look at the pressures that the NHS is facing, because the right hon. Member for Leigh asked about the direct causes. There are more than 1 million more over-65s than there were four years ago. Many older people become particularly vulnerable when it is cold, which is why winters are always difficult for the NHS. The truth is that over successive decades, we have made older people more dependent on emergency care by under-investing in primary and community care, reducing the responsibility of GPs for out-of-hours care, removing the personal responsibility for patients from GPs, and failing to integrate health and social care.

The right hon. Gentleman spoke as if that was nothing to do with Labour. However, he knows what damage was caused by the GP contract changes in 2004, he knows that his Government failed to integrate health and social care for 13 years, and he knows that where Labour runs the NHS today—in Wales—the performance is even worse. Instead of debating constructively, he chose to start this year by putting up a scaremongering poster that implied that the NHS would cease to exist if this Government were re-elected. That is not good enough. The whole country can see that, for him, it is not about the ward, but the weapon; it is not about the patients, but the politics. For this Government, it is about the patients.

[Mr Redwood]

Does my right hon. Friend understand Labour’s attack on privatisation? Under Labour, the NHS always had private-sector contractors as GPs— and nothing has changed; and it always bought all its pharmaceuticals from competitive, profit-making pharmaceutical companies—and nothing has changed. What is the shadow Secretary of State’s grievance?

[Mr Hunt]

Privatisation is one of the most pernicious fears that Labour is seeking to stoke up—not least because, as Secretary of State, the right hon. Member for Leigh allowed the decision to go through that Hinchingbrooke hospital should be run by the private sector. He has been running away from that decision faster than anything that anyone has seen before, because he is still trying to curry favour with the unions.

The companies on the shortlist for Hinchingbrooke hospital were Circle, Serco and Ramsay Health Care. He could have stopped that as Secretary of State, but he did not. He knows—[Interruption.] Those were the three bidders—the private sector-led bids. He could have stopped that process when he was Secretary of State, but he chose not to. That makes my point very well.

Care Bill [Lords]

John Redwood Excerpts

Monday 10th March 2014 Commons Chamber

[Paul Burstow]

The hon. Lady is right, and with her own experience in social work practice, she will know why this matters so much. She is right to say that in the Bill, for the first time, many aspects of adult safeguarding are put on a statutory basis, which is welcome. None the less, there is still a gap, which the Government with this Bill should seek to fill. We have had a lot of back and forth between the Minister of State and his officials, and I am grateful to him for the patience that he has shown. I just hope that the patience translates into something else. However, he has told Members that there is a balance of risks, and his judgment is that the powers are not needed. I say to him and to officials that if that is the case, why, in the scenario that I have described, can he not produce the evidence?

I welcome the fact that the Social Care Institute for Excellence has been commissioned to do work on this issue, but if there is a gap in the law, that will not fix it. It has been suggested that the problem is that practitioners are ignorant of the law. Again, I have to ask where the evidence is for that. Thanks to Action on Elder Abuse, which instituted a freedom of information request, we know that the evidence does not support that line either. So far, 84 out of 152 local authorities have responded. Twenty-nine councils have reported at least one instance in the past 12 months in which they have been unable to gain entry because a third party had denied them access. In 21 of those cases, they never gained access. Therefore, all the arts of negotiation and relationship building that are essential to good social work practice did not gain those people access, and who knows what happened to those individuals. Let us hope that they do not find their way on to the front page as a tragic story.

Not a single one of the 84 authorities that responded to that request have suggested that a failure to gain access was the result of a lack of knowledge. It is really about a lack not of knowledge but of that backstop power, which the new clause provides. In a survey of front-line practitioners, 365 of whom have responded, 82% believe that the power is necessary.

New clause 1 provides a proportionate power for a circuit judge, approved by the Court of Protection, to determine whether an entry warrant should be granted where a person is believed to be under duress and a victim of abuse. Let me be clear that the measure should be rarely used, but it is required for those circumstances in which a person is in the situation that I have described. I agree with the Minister about good social work, but just talking about good social work is not an adequate answer.

[Mr John Redwood (Wokingham) (Con)]

Who drafted new clause 1 and which main outside organisations support it?

[Paul Burstow]

Organisations that have supported the new clause, which I have drafted, include people with a legal background, social workers, Age UK and Mencap—those who often provide a voice for the voiceless. One of my concerns is that the people whom the Bill seeks to benefit are very likely to be those who are under duress and therefore unlikely or unable to express an opinion. That is why the new clause has been crafted to try to ensure that the necessary safeguards are built in.

New clause 3 addresses the issue of carers, particularly the identification of carers. Carers are the backbone of our care and support systems. Without them, those systems could not function in delivering the quality of care that we would expect. Those carers make huge sacrifices to care for their loved ones. Their health, their wealth and their lives are often sacrificed as a result of what they do. We know from the census that a carer is twice as likely to be in bad health as a non-carer.

The Government should be applauded for the fact that in this Bill and in the Children and Families Bill they have taken great strides to improve the rights of adult carers, parent carers, and young carers. They have listened, engaged and responded to the concerns that Members in all parts of this House and in the other place, and many carers’ organisations, have raised with them. However, all this hinges on whether carers are aware of these new rights and whether their council is successful in its new duty of identifying them, as required under the Bill. The problem is that the NHS is still left untouched. Millions of people caring for someone with a health problem may never come into contact with their council or be aware that that would be the next step in coping with their situation.

--- Later in debate ---

[Liz Kendall]

I am really sorry, but I want to make a bit more progress. I have a lot of new clauses to get through, and Back Benchers have also tabled new clauses and amendments.

We also know that many care workers do not even get the minimum wage at the end of the week, because they are not paid for their travel time, among other things. Her Majesty’s Revenue and Customs recently undertook an evaluation of minimum wage enforcement in the social care sector. It found that a staggering half of all care providers had failed to pay the minimum wage to at least one of their employees, yet despite Ministers’ insistence that such people will be named and shamed, not a single provider in the care sector has so far been identified.

We need to look at all those employment issues, which I think have a fundamental impact on the quality of care. If the Bill is to promote well-being, shift services towards prevention and improve standards, we must get to grips with those issues; otherwise, it will not work. New clause 17 would require the Secretary of State to conduct an overall review of the economic and financial factors affecting employment, publish the results and consult on the findings.

[Mr Redwood]

I quite agree that we need a high quality work force who are well trained and supported, but if the review concludes that they are not, is the hon. Lady saying that controls should be imposed on local authorities from the national level?

[Liz Kendall]

If the right hon. Gentleman reads our new clause 18, he will see what our approach is. Local councils commissioning social care and having to fulfil their obligations under the Bill will need to look at employment terms and conditions. We have tabled the new clause because unfortunately the Government are removing the Care Quality Commission’s role in assessing how well councils are commissioning services, which I think is a mistake.

Francis Report

John Redwood Excerpts

Wednesday 5th March 2014 Commons Chamber

[The Secretary of State for Health (Mr Jeremy Hunt)]

I beg to move,

That this House has considered the matter of the Francis Report: One year on.

A year on from the Francis report, let us remember that we stand here today thanks to the courage of a few lonely voices who fought against the odds to be heard as they campaigned against appalling neglect and abuse at the heart of our national health service. They had a truth to be told, they refused to be ignored, they stood up to a mighty system, and when they were turned away by regulators, NHS leaders and Ministers, they just came back speaking even louder—people such as Julie Bailey and Helene Donnelly, both of whom received honours this year, and thousands more who wrote and campaigned for loved ones, not because they wanted a penny of compensation but because they wanted to prevent this tragedy from ever happening again.

The last Government repeatedly refused to set up a public inquiry into what happened at Mid Staffordshire NHS Foundation Trust, but to his enormous credit, my predecessor overturned that decision, with the honourable support of a number of Staffordshire Members. As a result, the voices of their constituents were finally heard, and hard truths were told.

Today, the whole House will want to thank Robert Francis QC and his inquiry team for the thorough and thoughtful job that they carried out. Their remarkable report demanded a monumental response, and I sincerely hope that that is what the coalition Government have delivered. The Care Quality Commission, once ridiculed, is now trusted, with a record number of calls to its whistleblowing helpline. Failing hospitals are being turned around, with stronger leadership and improved staffing levels: there are 3,500 more nurses on our hospital wards since the Francis report, more than 80% of hospitals have taken new action in response to the report, and confidence among NHS staff that their organisation has the right priorities has risen. Of course, there are many more things to do, but it is clear that something profound has changed in the culture of the NHS.

[Mr John Redwood (Wokingham) (Con)]

I admire what my right hon. Friend is doing to get a new culture of honesty in the NHS. Does he think that all the major hospitals in the country now automatically report problems and mistakes, so that they can be investigated and remedied?

[Mr Hunt]

The truth is that the process takes time, and there are still examples of where candour is lacking. Allegations have recently surfaced in the press, the substance of which makes it appear that that reporting has not happened. There is much work to do, but the signal has gone out loud and clear that if people are open, transparent and honest from the start when something goes wrong, that should not be punished but should be recognised as a way of improving how we look after patients, in the same way as profound changes in the airline industry have made our aeroplanes much safer. We need that change in the NHS.

We also now recognise that however important ministerial objectives and national targets may be, NHS organisations should never prioritise them at the expense of dignity and respect for patients. We now know that the best way to deal with poor care is for people to speak out about it, whether they are a health care assistant, doctor, nurse or even Secretary of State, and that that should never be confused with “running down the NHS”. We also know that failing to speak out about poor care, or to support those who do, is a betrayal not just of patients but of the kindness and humanity of more than 1 million dedicated NHS staff, thousands of whom pledged themselves to compassionate care just two days ago on NHS change day.

What has happened in the past year? Robert Francis asked why the system effectively failed to detect or deal with the problems at Mid Staffs for a shocking total of four years. We have re-established the CQC as a rigorous and independent inspectorate, with three powerful new chief inspectors appointed to speak truth to power. The Keogh review inspected 14 hospitals last summer, and the new chief inspector of hospitals, Professor Sir Mike Richards, has already completed inspections of a further 18 trusts, with 19 more inspections taking place now. As a direct result, 14 trusts are now in special measures—a record in NHS history—and, thankfully, long-standing problems are finally being tackled.

On staffing, the inquiry found

“an unacceptable delay in addressing the issue of shortage of skilled nursing staff.”

The latest figures show that not only are there 3,500 more nurses on our hospital wards since the Francis report, in just a year, but we now have more nurses, midwives and health visitors in the NHS than ever in its history. From this summer, all hospitals will publish their staffing levels monthly, on a ward by ward basis, so that shortfalls are speedily identified.

Robert Francis identified a closed, defensive and secretive culture at Mid Staffs. In response, we have ended gagging clauses and we are making it a criminal offence for trusts to publish or provide specified information that is false or misleading. We are also placing a statutory duty of candour on organisations so that they are required to be honest with patients about poor care, and professional regulators are consulting on a new professional duty of candour that provides protection for staff against being struck off if they are open about the problems they see. I believe that will create one of the most transparent and open health care systems in the world.

Social Care Funding

John Redwood Excerpts

Monday 11th February 2013 Commons Chamber

[Mr John Redwood (Wokingham) (Con)]

Does the Secretary of State see any difficulty in this coalition Government pre-empting a future Chancellor of the Exchequer over tax policy, when I thought everybody in the House wanted a different kind of Government after 2015, who might have their own ideas?

[Mr Hunt]

We have funded these proposals until 2020 on plans that have been agreed by the Liberal Democrats and the Conservatives. We hope very much that we will have the support of the Opposition for these plans as well. Then we can have a national consensus around them, which is what we need because in the end, if we are to create that certainty in the markets, people need to know that whichever Government are elected, they support the basic approach that we are endorsing.

Oral Answers to Questions

John Redwood Excerpts

Tuesday 23rd October 2012 Commons Chamber

[The Parliamentary Under-Secretary of State for Health (Dr Daniel Poulter)]

There was an option to discuss this issue at the board meeting on 29 August—not of the hon. Lady’s hospital trust but of the Halton hospital trust—because the Halton trust is looking to achieve foundation status. So I can reassure her that the services at Warrington hospital are safe.

[Mr John Redwood (Wokingham) (Con)]

T3. What is the administration overhead cost to the NHS and the Department this year and how does it compare with 2009-10?

[Mr Jeremy Hunt]

I will get back to my right hon. Friend with the exact details, but the impact of the reforms that the Government have introduced will cut administration costs by a third across the whole NHS, leading to net savings of £4 billion during this Parliament.

Health and Social Care Bill

John Redwood Excerpts

Tuesday 20th March 2012 Commons Chamber

[Andy Burnham (Leigh) (Lab)]

I beg to move,

That this House has considered the matter of whether the House should defer consideration of Lords Amendments to the Health and Social Care Bill until after disclosure of the NHS transitional risk register.

My right hon. Friends and I are grateful for your agreement to give the House this opportunity, Mr Speaker. On this of all days we should be celebrating what a much-valued social institution has done to bind our nation together throughout the 60 years of Her Majesty’s reign. Instead, we gather to dismantle it. A health service that is judged by international experts to be one of, if not the, best health service in the world is about to be inexplicably and unjustifiably broken apart by an ideological Bill ending 63 years of NHS history.

This is a difficult day, but what makes it all the harder to stomach for people watching is the manner in which things are happening. People outside will struggle to understand how Members of this House could make such momentous decisions without having carefully considered all the facts and all the evidence. The truth is that Members will go through the Lobby tonight without knowing the full implications of what it means for the NHS in their constituencies. How do they begin to justify that to their constituents, to patients who depend on the NHS and to staff who devote their lives to it? We have argued from the beginning that the Government’s decision to combine an unprecedented financial challenge in the NHS with the biggest ever top-down reorganisation has exposed the NHS to greater risk, and the truth is that we are beginning to see the effects of that. In our constituencies, they have already dismantled the existing structures of the NHS before the new ones are in place, leading to a loss of grip just when it was most needed. So we are seeing A and E waits getting longer, staff shortages leading towards A and E closures, and patients in our surgeries beginning to complain of treatments being restricted or of longer waits.

We have also heard from the health professions—from GPs, nurses, midwives and physios—who one by one have made clear their considered professional judgment that, on the balance of risks, it would be safer to abandon the Bill than to proceed with the upheaval of reorganisation. Ministers by their actions are putting the NHS at greater risk, but even today this House does not know the assessment that was given to Ministers or the precise nature and scale of those risks.

[Mr John Redwood (Wokingham) (Con)]

Will the right hon. Gentleman give way?

[Andy Burnham]

I do not plan to give way because I want other Members to have the chance to contribute to the debate.

Ministers want the House to back the gamble they are taking with the NHS without having the courtesy to tell it the odds. The Information Commissioner thinks we should see the risk register and so does the Information Rights Tribunal, which brought forward its ruling so that it could influence our proceedings. If the NHS starts to struggle because of all the change being thrown at it and if services in some parts of the country start to fail, how will Members of the House respond when people come to our surgeries and ask whether we did everything we could to anticipate the dangers? We will remind them of the truth—that Government Members put politics before the national health service and signed up to a reckless reorganisation without knowing all the facts.

[Mr Redwood]

rose—

[Andy Burnham]

I will give way once to the right hon. Gentleman and then I will finish my remarks.

[Mr Redwood]

I am very grateful. When Labour introduced private contractors to carry out NHS treatments, did that undermine the NHS?

[Andy Burnham]

No, because we brought down NHS waiting lists to their lowest ever levels and we left patient satisfaction at its highest ever level. Those same waiting lists are going up under the right hon. Gentleman’s Government and he should be ashamed of that. He will not publish the information about the risk to waiting times because he is frightened of putting it before the House and the public, but we will remind them of the truth.

The Government proclaimed that they were going to be the most open and transparent Government in history. Today, it still says on the Treasury website in a statement of the Government’s principles for risk management:

“Government will make available its assessments of risks that affect the public, how it has reached its decisions, and how it will handle the risk. It will also do so where the development of new policies poses a potential risk to the public.”

May I suggest that the Government take down that misleading statement of policy? Their actions have left it in tatters, together with the grand claims of openness and transparency. The tribunal, they will say today, has not given us its reasons. Ministers will try to argue that the public and Parliament’s right to know about the impact of their policy decisions is outweighed by the public interest in the preservation of a safe space for policy advice.

Those arguments were considered, first, by the Information Commissioner, and subsequently by the Information Rights Tribunal. They found the opposite to be the case: that the public interest lay in full disclosure. But it does not matter; Ministers are simply re-running the arguments of a case that they have lost. They have no leave to reopen the substance of that argument, but they are not the only arguments that they have lost.

In an attempt to rescue the Bill last year, the Prime Minister made a number of claims for it. They cover issues that we know are in the local and regional risk registers which have been published. First, he said the Bill was needed as the NHS does not

“deliver the patient-centred, responsive care we all want to see”.

He cited heart services and claimed that someone in this country is twice as likely to die from a heart attack as someone in France. That was before new research in January reported a 50% fall in heart attack deaths in the past decade.

Then the Prime Minister said that cancer services were failing people, compared with other countries. That was before new research in November 2011 which showed that the NHS in the past decade achieved the biggest drop in cancer deaths of any comparable health system in the world. Thirdly, the Prime Minister and all the Ministers on the Government Front Bench have routinely trotted out the same script for years—that NHS productivity has declined in the past decade. That was before new research on NHS productivity from Professor Nick Black published in February in The Lancet showed that, far from falling, NHS productivity increased in the past decade at the same time as the NHS achieved patient satisfaction.

One by one the Government’s arguments for the Bill have fallen apart. They have comprehensively lost the argument. They have convinced nobody and now they are running scared, resorting to the only remaining option of ramming the Bill through Parliament before they are required in law to publish the real assessment of their policies.

Health and Social Care Bill

John Redwood Excerpts

Tuesday 28th February 2012 Commons Chamber

[Mr Speaker]

Order. If I am to accommodate anywhere near the level of interest in this important matter, I shall require brevity—to be led, as so often, by Mr John Redwood.

[Mr John Redwood (Wokingham) (Con)]

Am I right to tell my constituents that the purpose of this reform is to give more choice of care to patients, and to give more power to GPs to deliver better free treatment?

[Mr Lansley]

Yes, absolutely right.

NHS Risk Register

John Redwood Excerpts

Wednesday 22nd February 2012 Commons Chamber

[Liz Kendall]

I have outlined what local NHS services have said about the risk register. If the hon. Gentleman had been in the debate earlier, he would have heard Government Members saying that we are not focusing on patient care or setting out how the NHS needs to change. The point that I am making is that the Bill will prevent the strategic changes that the NHS needs.

There is no evidence that smaller, GP-led commissioning groups can deliver major changes to hospital services. The organisations that have done so, such as NHS London, are being abolished. The real risk is that the full, free and unfettered market that will be introduced by part 3 of the Bill will stop the NHS from making the changes that patients desperately need. It risks preventing hospitals from working together to centralise stroke or trauma care; it risks preventing hospitals from running local community services or working with GPs and local councils to better integrate care, for fear that they will fall foul of UK and EU competition law; and it risks putting power into the hands not of patients and clinicians, but of lawyers and the courts.

[Mr John Redwood (Wokingham) (Con)]

I am delighted by the conversion of the Opposition to more transparency now that they are out of office. Can they show the Government how to do it by publishing the internal documents that are critical of their leader’s strategy for change in the Labour party?

[Liz Kendall]

With the greatest respect to the right hon. Gentleman, I will not waste my time on that point when we have important issues about the future of the NHS to discuss.

Government Members should realise that GPs, nurses, midwives, health visitors, public health professionals, psychiatrists, physiotherapists, radiologists and Opposition Members are against the Bill, not because we are against change, but because it will prevent the changes that the NHS needs.

Government Members do not want to talk about part 3 of the Bill, because they know that people do not want their NHS run like any other market. The Secretary of State and the Prime Minister claim that their Bill is all about cutting bureaucracy and putting patients and clinicians in control, yet the Department of Health now admits in its fascinating document, “Design of the NHS Commissioning Board”, that there will be five layers of management in the Government’s new NHS, except in the performance and operations directorate, in which

“an additional layer (or layers) will be required”.

In place of strategic health authorities and primary care trusts, we will now have the NHS Commissioning Board, four commissioning sectors, 50 local offices, commissioning support units, clinical senates and clinical commissioning groups, as well as Public Health England and the health and wellbeing boards. Patients and staff have been left completely confused about who is responsible for running different services and how they will be held to account.

The Government say that the new structure will cost £492 million a year.