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.

NHS (Private Sector)

John Redwood Excerpts

Monday 16th January 2012 Commons Chamber

[Andy Burnham (Leigh) (Lab)]

I beg to move,

That this House believes there is an important role for the private sector in supporting the delivery of NHS care; welcomes the contribution made by private providers to the delivery of the historic 18-week maximum wait for NHS patients; recognises a need, however, for agreed limits on private sector involvement in the NHS; notes with concern the Government’s plans to open up the NHS as a regulated market, increasing private sector involvement in both commissioning and provision of NHS services; urges the Government to revisit its plans, learning from the recent problems with PIP implants and the private cosmetic surgery industry; believes its plan for a 49 per cent. private income cap for Foundation Trusts, in the context of the hospitals as autonomous business units and a ‘no bail-outs’ culture, signals a fundamental departure from established practice in NHS hospitals; fears that the Government’s plans will lead to longer waiting times, will increase health inequalities and risk putting profits before patients; is concerned that this House has not been given an opportunity to consider such a significant policy change; and calls on the Government to revise significantly downwards its proposed cap on the level of private income that can be generated by NHS hospitals.

It is a year this week since the Health and Social Care Bill was introduced in this House. Unlike the Government, we wanted to mark the anniversary, and having this Opposition debate seemed the right way to do it. It is being held because the Government have effectively sidelined this elected House from the debate about the future of the national health service. No single issue matters more to the people who put us all here, but what the future holds for the hospitals in our constituencies is no longer up to us. Instead, it is the unelected House that is right now carving up England’s NHS through back-room coalition deals. Ministers are making a series of desperate concessions in the other place to try to preserve the pitiful levels of support that remain for this unwanted and unnecessary Bill.

For the avoidance of doubt, let me summarise this scandalous situation. Here we have a Bill that nobody voted for. It was not in either the Tory or the Lib Dem manifestos, and it was ruled out specifically by the coalition agreement, yet it was rammed through this elected House so that the real decisions could be taken down the corridor in the unelected House. It is truly an affront to democracy that our nation’s most valued institution should be treated in this way. It thus falls to the Opposition to let this House take a view this evening on the far-reaching amendments to the Bill that are now being tabled, which Ministers were clearly too scared to table in this House.

[Mr John Redwood (Wokingham) (Con)]

As we are debating the role of the private sector in health, does the right hon. Gentleman agree with the former Labour Health Secretary who said “PFI or bust”, and should he not have said “PFI and bust” given the way Labour ran PFI?

[Andy Burnham]

No, I would not agree. I shall explain the policy that our Government adopted on the private sector and how different it was from that of the Government whom the right hon. Gentleman supports. In making our argument we will expose the terrifying gap between the Prime Minister’s rhetoric on the NHS and what he is doing in reality. People will recall the efforts that went into rebranding the nasty party. The Conservatives were at great pains to tell us that they would be pro-environment, a bit less tough on crime and pro-NHS going forward. Many photo calls were arranged to send those messages to the public, but it was poor old NHS staff who featured far more than huskies or hoodies in being brought in to promote hastily made political promises. We were told there would be real-terms increases for the NHS, a moratorium on accident and emergency department closures, thousands more midwives and, famously, no top-down reorganisation—four promises made in opposition: four promises broken in government. I still have not worked out how a Prime Minister can go from agreeing there should be no top-down reorganisation with his coalition partners after the election to bringing forward just weeks later the biggest top-down reorganisation ever in the history of the NHS. How does that work? Perhaps Lib Dem Members will enlighten us this evening.

Our evasive Prime Minister is the master of making statements that sound good at the time only to turn out to be meaningless in practice. Tonight we will focus on his most outrageous yet. On Monday 16 May last year, under pressure to reassure people about the Health and Social Care Bill and in the middle of the enforced pause, the Prime Minister said, in a speech:

“That’s why, when I think about what our NHS will look like in five years time, I don’t picture some space-age institution, a million miles away from what we have now. Let me make clear: there will be no privatisation”.

Those were his words—“no privatisation”.

--- Later in debate ---

[Mr Redwood]

On the point about implants, why did the NHS under Labour buy the same difficult implants that the private sector bought?

[Andy Burnham]

The point that I am making is about how to manage the system, how to ensure proper regulation and how to ensure that NHS providers and the system work in the interests of NHS patients. If the right hon. Gentleman is arguing that there would be the same control managing the system through a series of fragmented commercial contracts, I would be interested to have that debate with him. Frankly, I do not believe that he is being serious, if that is his point.

NHS Reform

John Redwood Excerpts

Monday 4th April 2011 Commons Chamber

[Mr Lansley]

If the hon. Lady reads the Bill, she will see that one of its changes that has been most widely supported, including by local authorities across England, has been the transfer of public health leadership into the health and well-being boards, with ring-fenced budgets for local authorities. The previous Government could have done that, but they did not. Such an approach will allow continued engagement with general practitioners and their practices, both because they are participants in the health and well-being boards and because Public Health England and the local health and well-being board will be able to influence directly the quality and outcomes framework, which incentivises GPs in the work that they do.

[Mr John Redwood (Wokingham) (Con)]

Colleagues on this side of the House will know that the Secretary of State has a great passion for the health service, and great mastery of his brief. Will he confirm, for the sake of all hon. Members, that the object of getting rid of PCTs and top-down targets is to free a lot of money for patient care? That should be in the interests of all hon. Members and their constituents.

[Mr Lansley]

I am grateful to my right hon. Friend. Before the election, the previous Labour Government said that it was necessary to save up to £20 billion in efficiencies in the NHS, but they never said they would reinvest that money in the NHS. We have said that we will reinvest it. In order to deliver those efficiencies, 10% of that gain will be achieved by cutting the costs of bureaucracy and administration. We have set out how we will do that, but the previous Government never did.