The National Health Service Debate
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Jonathan Ashworth
Main Page: Jonathan Ashworth (Labour (Co-op) - Leicester South)Department Debates - View all Jonathan Ashworth's debates with the Department of Health and Social Care
(5 years, 1 month ago)
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Jonathan Ashworth (Leicester South) (Lab/Co-op)
I beg to move an amendment, at the end of the Question to add:
“but respectfully regrets that the Gracious Speech does not repeal the Health and Social Care Act 2012 to restore a publicly provided and administered National Health Service and protect it from future trade agreements that would allow private companies competing for services who put profit before public health and that could restrict policy decisions taken in the public interest.”
I am grateful to the Leader of the House for finding time to schedule this important debate. I associate myself with the condolences and sorrow expressed about the horrific tragedy in Essex. I pay tribute to all the emergency services, who must have had to confront the most unspeakable of sights in Essex in the past 24 hours.
In a similar vein, I pay tribute to our hard-working national health service and social care staff, who every day go beyond the call of duty, going the extra mile for each and every one of our constituents, ourselves and our loved ones. They do it after a decade of cutbacks and of the tightest financial squeeze in the history of the NHS, but despite that, our NHS staff are treating more patients every day than ever before. I am afraid, however, that we have a Government who are still expecting our staff to deliver care in the most intolerable working conditions, from bed cuts to staffing shortages and equipment breaking down every day. The dismal consequence of this decade of underfunding and cuts sees patient care suffering and standards of care deteriorating.
Let me share a couple of examples with the House. Somebody from another part of the country got in touch with me and asked me to raise this directly with the Secretary of State, although she asked that we anonymise these exchanges. Her 91-year-old mother fell in her house on a Sunday at around 2.40 pm. She waited two and a half hours for an ambulance. When she got to the hospital, she waited an hour and a half in a cold corridor before being admitted to a bay. Eight hours later, she was seen by a doctor, who recommended an X-ray and scan. She got the result of the X-ray at 1.15 am. Only then was she given pain relief and put on a drip. By 3 am, she still had not been admitted to a ward. At 9 am, she was sent back to her care home—her daughter was not told—with no pain relief or any prescription.
Perhaps I can tell another heartbreaking story, from today’s edition of Pulse. It reveals that a teenage boy—a 16-year-old—was referred to child and adolescent mental health services by his GP, but because his condition was not considered serious enough, CAMHS turned him away. The boy later died by suicide. These are heartbreaking stories, but stories like that are happening far too often in a health system that is under intense pressure.
Kevin Brennan (Cardiff West) (Lab)
My hon. Friend is telling tragic stories about the impact on real patients of what is happening in the NHS. Other families who are suffering are those often with children who have very severe conditions, such as epilepsy, who would benefit from access to medical cannabis. The Government have indicated that that access should be available, but it is just not getting to these families, and the children and families are suffering, both because of the pain and financially as a result. Does he agree that the Government should do much more to fast-track availability?
Jonathan Ashworth
I completely agree, and I pay tribute to my hon. Friend and to hon. Members such as the right hon. Member for Hemel Hempstead (Sir Mike Penning) who have led the charge in this debate. If medicinal cannabis has a medicinal, therapeutic value, it should be allowed. If there are issues in the bureaucracy that are slowing it down, and if that needs legislation, we will work with the Secretary of State to get it through, if that is where the blockage is. If the blockage is in some other area and he needs our co-operation, we will co-operate with him. We need to resolve this, because too many young people are going without the help they need.
Sir Mike Penning (Hemel Hempstead) (Con)
The shadow Secretary of State is being very generous, and I thank him for his comments—the families, who are the most important people, will be very conscious of what he has said—but we have to be very careful when describing this: we are after the medical use of cannabis on prescription. The medical use of cannabis often relates to cases where people have felt they would take it in other ways. We are not talking about the casual use of cannabis, about a spliff in the armchair. I will raise this with the Secretary of State when he is on his feet: we are saying that where a qualified consultant feels that cannabis on prescription would benefit the child, particularly if they have epilepsy and fits, it should be available free on the NHS. I think that is what the hon. Gentleman is saying.
Jonathan Ashworth
Absolutely. There appear to be blockages in the system, however, and my offer to the Secretary of State is this: if those blockages are there because of legislative or regulatory issues that need resolving in this House, I will co-operate with him to get those resolved. If it is not about regulatory issues in this House, I will continue to reinforce the issues that the right hon. Gentleman is putting to him and urge him to intervene using his good offices.
Many vulnerable people are waiting longer for treatment or being denied treatment, sometimes, sadly, with devasting and tragic consequences. The standards of care enshrined in the NHS constitution are simply not being delivered. A&E waits in September were the worst they have been outside of winter since 2010. Our hospitals have just been through a summer crisis, and with flu outbreaks in Australia expected to hit us here, our NHS is bracing itself for a winter of enormous strain yet again.
Last year, 2.9 million people waited beyond four hours in A&E. Since 2010, over 15,000 beds have been cut from the NHS and bed occupancy levels have risen to 98% under this Government. The number of patients moved from cubicles to corridors and left languishing on trolleys has ballooned under this Government. When Labour left office, around 62,000 patients were designated as trolley waits, which was unacceptable, but today under this Government that number is 629,000.
What about cancer?
Gareth Thomas (Harrow West) (Lab/Co-op)
Before my hon. Friend moves on from the situation in A&E departments, can I bring to his attention the situation at Northwick Park Hospital, which serves my constituents? The last time it met the four-hour target was in August 2014 —over five years ago now. Does he have any sense that the Government are still committed to that four-hour target, or will it be another five years before my constituents can expect that target to be met in our hospital?
Jonathan Ashworth
My hon. Friend makes a very good point. The targets were routinely met under the last Labour Government—and they were stricter targets as well.
The Secretary of State looked surprised when I mentioned cancer, but he should not be, because we have the worst waiting times on record under this Secretary of State. Every single measure of performance is worse than last year. Shamefully, 34,200 patients are waiting longer than two months for cancer treatment. What about the waiting lists for consultant-led treatment? We now have 4.4 million people waiting for treatment—an ever-growing list of our constituents waiting longer for knee replacements, hip replacements, valve operations or cataract removals. Clinical commissioning groups are rationing more and trusts delaying surgery, which is leaving patients in pain and distress.
Anna Turley (Redcar) (Lab/Co-op)
My hon. Friend is absolutely right about the pressure on trusts. The chief executive of my NHS in South Tees has recently resigned, calling the current situation underfunded and unsustainable and warning that any more efficiencies would be a step too far. Does he agree that beneath this spin services are at breaking point?
Jonathan Ashworth
I completely agree. I am not surprised that my hon. Friend’s trust’s chief executive has taken that action. We have just been through a decade of the tightest financial squeeze in the history of the NHS. That is why standards of care have so deteriorated. Since the right hon. Gentleman became Health Secretary, the number of patients waiting more than 18 weeks for treatment has jumped from 504,000 to 662,000. Every day he is Health Secretary, another 330 people wait beyond 18 weeks for treatment. People waiting longer for treatment under him—that is his personal record.
Tom Tugendhat (Tonbridge and Malling) (Con)
The hon. Gentleman is right to identify the delays that are inevitable in a massive state-led system. Would he agree that there is a huge opportunity for individuals to get treatment in other ways? I have the privilege to represent a couple who have taken themselves to a hospital in Portugal, where they live half the year, and got care there. Their care has been refunded by the NHS at a rate significantly cheaper than that available in the UK. Should we not welcome individuals who are able to do this? Of course it is not for everybody, but should we not welcome it as a possibility?
Jonathan Ashworth
I am genuinely pleased for the hon. Gentleman’s constituents, but there are 4.4 million people on the waiting list. There used to be around 2 million. Every day, another 330 people wait longer than 18 weeks for treatment, and when people wait longer than 18 weeks, not only do they wait longer in pain, distress and anxiety, but they run the serious risk that their health will deteriorate further. That is what is going on in the NHS today under this Government.
The Queen’s Speech was heavily spun as being about—[Interruption.] The Secretary of State will get his chance in a moment. The Queen’s Speech was heavily spun as being about the NHS. [Interruption.] He says I am talking nonsense. These are the official figures. He wants to run away from his own failure, from the fact that so many more people are waiting beyond 18 weeks for treatment and from the A&E crisis that he is doing nothing about. He thinks an app will solve it all. That is not a serious approach to the NHS. [Interruption.] And he is not as good as George Osborne used to be.
The Queen’s Speech was heavily spun as being about the NHS, but in fact it was a missed opportunity to rebuild confidence in the NHS and provide the health services we want. We will scrutinise carefully the Bills in the Queen’s Speech and engage constructively. We are pleased that the Health Service Safety Investigations Bill has not been abandoned and is back. We will engage on it and explore with Ministers how to strengthen the independence and effectiveness of medical examiners.
If the Secretary of State wants to deliver safe care, however, we need safe staffing legislation and a fully funded workforce plan. Pressures on staff are immense. He will know that suicide rates for nurses are higher than the national average and that among doctors the rate is rising. I congratulate Clare Gerada on her leadership on mental health support, but yesterday the Secretary of State suggested on Twitter that all NHS staff would be eligible for this new mental health support, when it is actually just doctors and dentists. I hope he will clarify his remarks at the Dispatch Box and tell us when 24-hour support for all NHS staff will be available.
I also hope the Secretary of State will tell us how he will resolve the staffing crisis. As he knows, we have 100,000 vacancies across the NHS. We are short of over 40,000 nurses. Under this Government, we have seen cuts to community and district nurses, learning disability nurses, mental health nurses, health visitors and school nurses. On current trends, we will be short of 108,000 nurses in 10 years, according to the King’s Fund and the Nuffield Trust.
Andy Slaughter (Hammersmith) (Lab)
My hon. Friend is making an excellent speech. He is right to talk about rationing. My CCG has started rationing referrals to consultants to clear one of the biggest deficits in the country. Will he also talk about the massive backlog of capital? As he knows, I have two world-class hospitals in my constituency, Hammersmith and Charing Cross. It will cost half a billion pounds to bring them up to standard, but there was not a penny of that in the money the Secretary of State allocated. They are lucky they get a few million pounds of seed money to plan for work for which there is not the money to pay.
Jonathan Ashworth
My hon. Friend is absolutely right. Imperial College Healthcare NHS Trust has one of the worst maintenance backlogs of all trusts. I congratulate him and Labour-controlled Hammersmith and Fulham Borough Council on leading the campaign to save Charing Cross Hospital; it is because of the pressure he exerted that it was saved.
Emma Hardy (Kingston upon Hull West and Hessle) (Lab)
My hon. Friend may be aware that, just today, the Education Committee published its report on children with special educational needs and disabilities. One of our findings was that the staff shortages are having a serious impact on those children, because the plans that are drawn up for them are now being drawn up on the basis of what is rationed and what is available, rather than on the basis of what they actually need. Does he agree that there should be a review of therapy services around the country, so that we can ensure that, wherever a child lives, it gets the support it needs?
Jonathan Ashworth
My hon. Friend is absolutely right. She has brought home the extent of the impact of staff shortages on service delivery at every turn.
Several hon. Members rose—
Jonathan Ashworth
I am going to make a bit of progress. The Whips are looking slightly askance at me because of the number of Members who want to speak.
There is one Bill that will have a fundamental impact on staffing, and that is the proposed immigration Bill, which will end freedom of movement and introduce a points-based system. Does the Secretary of State recognise that freedom of movement has allowed thousands of staff from Europe—doctors, nurses, paramedics, care workers, hospital porters and cleaners—to come to the UK to care for our sick and elderly? Does he recognise that our NHS and care sector needs that ongoing flow of workers from the EU? How does he reconcile the need for the NHS to continue to recruit with the rhetoric and the proposed restrictive policies of the Home Secretary?
The Secretary of State will know that Conservative campaigners have lobbied for a salary threshold of £36,700. If that were applied, 60,000 current staff in the NHS who are not covered by the shortage occupation list would be affected. Is the Secretary of State really going to allow the Home Secretary to introduce a salary threshold of that order, which will have a huge impact on the ability of the national health service to fill vacancies and recruit, and therefore have an impact on patient care?
Conor McGinn (St Helens North) (Lab)
Will my hon. Friend join me and, I am sure, all other Labour Members, in conveying our solidarity to NHS workers—Unison members—in St Helens and other parts of the country who are on strike this week? Despite doing the same job in the same place and wearing the same uniform, they are paid less than their colleagues because they work for an agency. Will my hon. Friend urge Compass to do the right thing and pay those workers properly, and will he commit a Labour Government to ensuring that there is equal pay for equal work in our NHS?
Jonathan Ashworth
My hon. Friend is absolutely right. That is what happens when privatisation and outsourcing go wrong: workers are worse off. We should bring an end to it.
Jonathan Ashworth
I am going to make some progress.
We need clarification from the Secretary of State on whether he will exempt all NHS staff and all care staff from the shortage occupation list in the immigration Bill.
Safe care also depends on safe facilities, but after years of cuts in capital budgets, hospitals are crumbling and equipment is out of date.
Jonathan Ashworth
In a few moments.
The repair bill facing the NHS has now risen to £6.5 billion, more than half of which relates to what is considered to be serious risk. NHS capital investment has fallen by 17% per healthcare worker since 2010. Across the NHS, the estate relies on old, outdated equipment, which is having an effect on, for instance, diagnostics. The number of patients waiting longer than six weeks for diagnostic tests and scans has increased from 3,500 under Labour to more than 43,000 under this Government.
Jonathan Ashworth
I will give way in a few moments.
Even if the Secretary of State replaces all the MRI scanners that are more than 10 years old—he has adopted our policy on that—we will still be struggling with the lowest numbers of MRI and CT scanners per head of population in Europe. Is it not time for a proper strategic health review?
Jonathan Ashworth
In a few moments.
The Secretary of State will say that he has announced plans for six new hospital reconfigurations and seed funding for other acute trusts to prepare bids, but there is no guarantee that that funding is in place and that the Department will give trusts the go- ahead. “Seed funding” is a curious phrase. Can the Secretary of State confirm that there will be no role for private capital in that seed funding? In their 2017 manifesto, the Government promised £3 billion of capital funding from the private sector. Does that still hold? They claim to have abandoned the private finance initiative. We need clarity today.
Jonathan Ashworth
I will give way in a few moments. Let me just finish this point.
When the Secretary of State announces new hospitals in press releases from Conservative campaign headquarters, he should also announce where he is downgrading hospitals. He should go to Telford and explain why the accident and emergency department there is closing and being replaced by an “A&E local”, which is presumably something like a Tesco Express. We would save that A&E department. The Secretary of State went to Chorley recently. The A&E department there is not open overnight. We would provide a rescue package for Chorley. I wonder whether the Secretary of State will also be visiting Canterbury to apologise, because the Prime Minister promised—
Rosie Duffield
Does my hon. Friend agree that the Prime Minister’s recent false promise of a brand-new hospital in Canterbury was extremely irresponsible? It turned out to be fake news, which left my desperate constituents confused and bitterly disappointed.
Jonathan Ashworth
The Prime Minister promised that new hospital at the Tory party conference, only for the Department to confirm later that Canterbury was not actually on the list.
Jonathan Ashworth
In a few moments.
The Tory candidate for Canterbury, one Anna Firth, helpfully explained that the Prime Minister had “clearly made a mistake”. After all,
“He can’t be on top of every little detail”.
We are talking about the £450 million rebuilding of a hospital.
Neil O’Brien
On the subject of £450 million investments, I wonder whether we could have a moment of cross-party positivity, and whether the hon. Gentleman welcomes the £450 million investment in the hospital from which both his constituents and mine will benefit. It is a transformative investment, and we are doing it without PFI. I am sure he agrees that that is wonderful news.
Jonathan Ashworth
Of course I welcome that £450 million. [Interruption.] It just shows what an effective Member of Parliament for Leicester South I am.
I know that the Secretary of State gets very excitable about this Leicester point, rather like a semi-house-trained pet rabbit. Let me tell him about Leicester. I did not see him on “Question Time” in Oadby the other evening—I do not often watch “Question Time”. I do not want to be disorderly, so I shall be careful about how I read out the transcript. The audience started shouting—well, it is unparliamentary, but essentially they started shouting that the Secretary of State was not being entirely truthful in what he was saying. I do not want to fall out with him, or to be disorderly, but according to the transcript, there were “jeers” from the audience.
One audience member said that hospitals in Leicester were “falling apart”. Another said, “It’s shameful.” A third said,
“It’s not a case of throwing money at it.”
A fourth said that the Secretary of State was
“saying you will invest loads…into Leicester Royal Infirmary, what about…the General?”
What, that audience member continued, about
“the benefit in terms of beds…as a whole?”
The Secretary of State replied:
“We will do all of those things and we’ve guaranteed the money to Leicester and it’s coming in the next couple of years.”
There was then audience “laughter”.
Jonathan Ashworth
Let me deal with this point first.
The people of Leicester can see what is happening. Although the Secretary of State is putting money into Leicester Royal Infirmary, Leicester General Hospital in the constituency next door loses maternity services, loses the hydrotherapy pool, loses renal services, loses—[Interruption.]
Madam Deputy Speaker (Dame Eleanor Laing)
Order. Remember that we were all going to try to be polite. The hon. Gentleman is talking about hospitals that people care about, and we must listen to him.
Jonathan Ashworth
It loses elective orthopaedics, loses urology, loses brain injury and neurological services, loses gynaecology, and loses podiatry.
Jonathan Ashworth
Let me just finish this point and then I will bring in the hon. Gentleman. [Interruption.] He is a Leicester Member of Parliament, after all.
The Leicester General can have a sustainable future under this Secretary of State only if he moves the midwifery unit from St Mary’s Hospital in Melton Mowbray. If that is what he is proposing, I hope he is making it clear to Leicestershire MPs.
David Tredinnick
I am most grateful to the hon. Gentleman, who is a Leicester Member, but I have to say that I am astonished by his tone. Almost the entire county and city welcomed this huge, major investment and reorganisation. Years ago, my former right hon. Friend Stephen Dorrell—he is no longer in the House—explained why the General was likely to close. That is not the case—the hon. Gentleman should recognise that massive investment.
Jonathan Ashworth
Well, the General is essentially being downgraded and I want a sustainable future for Leicester.
Jonathan Ashworth
This will be the last intervention I take because I have to get to the end of my speech, but let me just finish this point: the Leicester General is essentially being downgraded. The only thing that remains at the Leicester General is the diabetes unit, unless the Secretary of State is moving midwifery services from St Mary’s in Melton Mowbray to Leicester and, if he is doing that, he should be clear with the right hon. Member for Rutland and Melton (Sir Alan Duncan).
Neil O’Brien
I appreciate the hon. Gentleman being generous with his time. My family used maternity services at the General just last week. We sat on a couch. My wife had not eaten for nearly 24 hours because the General does not have an all-electives list for caesarean sections. That service will be better when services come together in the new maternity hospital that is going to be built. By the way we also used St Mary’s birthing unit in Melton Mowbray. It is a brilliant midwife-led unit and we are not going to close it.
Jonathan Ashworth
There we go, but the only way the Leicester General has a sustainable future in their own plans—these are the plans the Secretary of State has signed off from the Leicester trust—is if that midwifery unit at St Mary’s moves to the Leicester General. I am sorry that the hon. Gentleman’s family got a poor service at the Leicester General. My daughter was born at the Leicester General as well and we got an excellent service.
Several hon. Members rose—
Jonathan Ashworth
I need to move on because I think the House is getting slightly tired of our focusing on our constituency issues and I am abusing my position. I will try to give way again shortly, but I am testing the indulgence of the House on the issue of Leicester.
In the Queen’s Speech, there are also proposals on mental health, and we look forward to the mental health White Paper and hope that Sir Simon Wessely’s review is quickly implemented. He also called for significant capital investment in the mental health estate, yet none of the hospitals the Secretary of State has announced includes mental health trusts.
The Secretary of State for Health and Social Care (Matt Hancock)
Yes they do.
Jonathan Ashworth
No they don’t; none of the hospitals the right hon. Gentleman announced at the Tory party conference includes mental health trusts. He knows there are 1,000 beds in old-style dormitory-style wards in desperate need of upgrade. He knows that we have problems with anti-ligature works that desperately need doing in mental health trusts because they are putting lives at risk every day.
On social care, we were told we were going to have the big solution to social care. The Secretary of State was briefing that a previous Chancellor, the right hon. Member for Runnymede and Weybridge (Mr Hammond), was holding him back and he was going to give us a solution on social care. And what do the Government say? They say, “We have not got a social care Green Paper, we have not got social care proposals, we will get proposals on social care in due course.” The Secretary of State is kicking the can on social care down the road again.
Let me come to the Health and Social Care Act 2012. On Second Reading, it was described by the new Minister, the hon. Member for Mid Bedfordshire (Ms Dorries)—I welcome her to her elevation to the Treasury Bench; it was remiss of me not to do that earlier—as one of the most exciting Bills to be put before Parliament in the 62 years since the NHS was established. We were told that there was going to be legislation to undo the worst excesses of that Lansley Act, but all we are getting apparently is draft legislation, again, “in due course”—that is the wording in the explanatory notes to the Queen’s Speech.
Debbie Abrahams (Oldham East and Saddleworth) (Lab)
I had the privilege of sitting on both Committees that considered the Health and Social Care Bill, as it was then. Section 75 is particularly punitive in terms of its requirements for clinical commissioning groups to put all contracts out to tender. Some £25 billion-worth of public money has gone to the private sector, with the implications of an increase in health inequality, both in access and outcomes. Does my hon. Friend agree that this is an absolute travesty?
Madam Deputy Speaker (Dame Eleanor Laing)
Order. Let me say before the hon. Gentleman answers the intervention, that he has been very generous in taking interventions, and that is good for the debate, but I am sure he will bear in mind that he has been at the Dispatch Box for nearly half an hour, and I just say to him gently that that is all right with me, but he will incur the wrath of those who are waiting to speak later in the debate when they only get three minutes.
Jonathan Ashworth
Thank you for your guidance, Madam Deputy Speaker. You are absolutely right. I will not take any more interventions and I will move to wrap up.
My hon. Friend the Member for Oldham East and Saddleworth (Debbie Abrahams) is absolutely right that the compulsory competitive tendering provisions of that Act have forced through the privatisation of £9 billion-worth of contracts. Everything that was promised in the Act, from delivering on health inequalities to delivering more integrated care, has not come to fruition, which is why everybody understands that it needs to be repealed.
But there is another reason why the Act needs to be repealed: while it is on the statute book, it runs the risk of the NHS being sold off in a Trump trade deal. Under the World Trade Organisation, public services can only be excluded from trade deals where there is no competition with private providers or where they are not run for profit, but the enforced competitive tendering of contracts through the Lansley Act means private health providers already operate in competition with public NHS providers, and the so-called standstill ratchet clauses and the inter-state dispute mechanisms would mean a Trump trade deal would lock in the privatisation of our NHS ushered in by the Health and Social Care Act.
Several hon. Members rose—
Jonathan Ashworth
I am going to finish.
Any Government seeking to undo that privatisation in a trade deal are liable to get sued in an international tribunal by private international investors, and there is no appeal. It happened in Slovakia, it happened in Canada and it happened in Australia. It is not taking back control—it is a democratic outrage. It is not just about selling off the NHS; we know that Donald Trump wants to break our pharmaceutical market as well, forcing us to buy more expensive drugs from the US and crippling our national health service.
So if Tory MPs want to save the NHS, they should vote with us in the Lobby tonight, because the party that created the NHS, the party that has always rebuilt the NHS, and the party that will end the privatisation of the NHS is the Labour party and no one will trust the Tories with the NHS.
Matt Hancock
I will debate the hon. Gentleman’s involvement in PFI, which hamstrung the hospitals, every day of the week. Now, however, I wish to—
Jonathan Ashworth
I am delighted that the Secretary of State has elevated me; I was a 25-year-old adviser in the Treasury at the time. I remember sitting in that box as a special adviser listening to Tory shadow Health Secretaries calling for more PFIs in the NHS. The right hon. Gentleman was an adviser to George Osborne, so what about this quote from 2011:
“George Osborne backs 61 PFI projects…the chancellor, is pressing ahead with private finance initiative…on a multibillion-pound scale”.
The right hon. Gentleman should be apologising for PFI.
Matt Hancock
In 2011, I was the MP for West Suffolk. I opposed PFI in opposition and I have opposed it ever since, and I am delighted that the Government are cancelling it. It is just such a shame that the hon. Gentleman spent so many years driving through PFI when we could have built better hospitals for less money if we had properly put them on the books of the nation’s balance sheet, as we are doing now.
Matt Hancock
I very much agree with my hon. Friend. In many trusts, things have gone very well over the past few years and there is a much more open and less hierarchical culture, with less bullying and more openness to challenge. However, that is not the case in every part of the NHS, and that needs to change. The Health Service Safety Investigations Bill addresses that directly. After the welcome given by the shadow Secretary of State, I hope that Bill will proceed on an essentially consensual basis.
Matt Hancock
The hon. Gentleman is saying yes, which I am grateful for. I am open-minded to changes and improvements, and to listening to the experts and those with constituency cases that they can bring to bear, to make sure that the Bill is the best it possibly can be.