Organ Donation (Deemed Consent) Bill

Julie Elliott Excerpts

2nd reading: House of Commons
Friday 23rd February 2018 Commons Chamber

[Julie Elliott (Sunderland Central) (Lab)]

I congratulate my hon. Friend the Member for Coventry North West (Mr Robinson) on his success in the private Members’ Bills ballot, which is no mean achievement, and on choosing this most important topic. I have always supported an opt-out system, as opposed to an opt-in system. What I will talk about today has not resulted in my decision that an opt-out system is right, but it has amplified the importance of my decision.

I pay tribute to my hon. Friend the Member for Barnsley Central (Dan Jarvis), who has done so much good campaigning on this issue. I also pay tribute to the Daily Mirror, which has already been mentioned, for its campaign, and to the Prime Minister and the Government for their statement this week in support of the campaign—that is very important.

Today I will talk about my family’s story. I rarely talk about my family in public, because it is me, not them, who entered public life. There is nothing special or unusual about my family, and what has happened to us over the past 18 months could happen to anyone. Young or old, rich or poor, there is no differentiation when such things happen, and they highlight the reality of the need to change the law to deemed consent.

I have four grown-up children, all now either married or with long-term partners, and five wonderful grandchildren. We are a very close family, and I am lucky that we all live within two miles of each other in Sunderland—when I am not down here. My eldest daughter, Rebecca, is now 36. She is married and has a six-year-old daughter, and she was referred to the renal unit of the Freeman Hospital in Newcastle after routine blood tests showed a problem with her kidney function. That was in October 2016, so not that long ago.

After Rebecca spent a week or so in hospital, it became clear that she was quite ill with significantly reduced kidney function that could at some point lead to her needing a transplant. That was where we thought we were, which was a big enough shock in itself, but the medical team at the Freeman thought that they could stabilise her condition.

Rebecca had been reasonably okay until that point. She had had a few issues health-wise, but she was okay, so the diagnosis of chronic kidney disease came as a huge shock to her, to me and to our family and friends. To face the reality of the fragility of life is very hard at any time, but facing it for one of my children, although she is an adult, is one of the hardest things I have ever had to do.

My daughter had until recently been a healthy, happy young woman. She was quite a serious runner in her spare time, and she regularly ran half-marathons and, occasionally, marathons. In fact, in the weeks before she took ill in October 2016, she had gained a place at the 2017 London marathon—she did not run it, obviously. It is impossible to describe the shock of someone like that suddenly becoming so ill. I have to say that she did not get her fitness drive from her mother, who goes to watch her run but does not run herself.

Sadly, Rebecca’s condition deteriorated very quickly, and in June 2017 she had surgery to enable her to start dialysis. One of the few positive parts of the general election campaign for me was that I was at home for six weeks, so during the time when her health was deteriorating rapidly I was able to drop everything and get to the hospital quickly. It is a lot harder to do that when I am 300 miles away.

Rebecca started dialysis last July, and I want to talk a little about the daily reality of her life. In the two or three months leading up to her having surgery she became increasingly unwell, to a point where, daily during those last few weeks, she was just lying on the sofa after she got up and she was not eating particularly well, if at all. She had the odd slice of toast or bowl of cereal. One thing that happens when people have kidney failure is that they feel very sick and generally unwell, with no energy. She could not really walk to the end of the street and she certainly could not take part in all the things that her daughter did on a day-to-day basis.

When dialysis was first mentioned to us, it was a terrifying prospect, but its arrival has given Rebecca a quality of life again. She does PD—peritoneal dialysis. She has a machine at home and links on to it every night, and for eight hours her body dialyses on it. That means that she has got some quality of life back. She is back at work, but she does have restrictions. She has to have a restricted diet, which for her means no coffee, chocolate or cheese—three things she loves. She gets two of those from her mother, but I am a tea drinker, not a coffee drinker. She is here and she is alive. Whenever she has a bad day—she does have bad days emotionally, because this is a difficult thing to be dealing with—and she says, “I am sick of this dialysis”, I say, “Just think: what’s the alternative, Rebecca?” That quickly focuses the mind and she picks herself up.

As a family, and with close friends, we have all rallied round to support Rebecca and each other through this challenging time.

[Andrea Jenkyns (Morley and Outwood) (Con)]

My heart goes out to the hon. Lady for what she has been going through, and I am sure everyone in the House today would say the same. She mentioned dialysis, and I am going to mention a constituent of mine, a very young girl. This Facebook post hits home:

“Today 1,608 days with total kidney failure. Today 19,296 Hours spent on Dialysis. Today waiting for the precious call, a match has been found.”

Does the hon. Lady agree that when we think of such children, and people like her daughter, it is very hard not to support the Bill today?

[Julie Elliott]

Absolutely. As I have said, this sort of illness strikes indiscriminately, and when we attend appointments—I attend just about every appointment with Rebecca—we see everyone from very young people through to older people; we see people from all walks of life. It is heartbreaking seeing people with this sort of illness. Every one of those people has a family, has a story and has loved ones, and it is very difficult.

I want to talk a little about the impact of this kind of illness on the wider family. As Rebecca’s health rapidly deteriorated, she had to be off work sick quite a lot. She has had some considerable time off sick. Even though she is now back at work, she still gets days when, as happened this week, she is not very well in the middle of the day and has to come home. Dialysis does not mean that someone is fit, well, healthy and leading an absolutely normal life. She has been very lucky, as her employers, True Solicitors of Newcastle, have been an amazing support to her. They have done everything they can to help her. They have done fundraisers for kidney charities—I am thinking particularly of her colleagues Kay and Lindsey. If I am trying to get to the hospital from wherever I am when Rebecca suddenly takes ill, they will take her to hospital from work and sit with her until one of the family can get there. I want to thank them publicly, because many people in this situation are not so lucky and face losing their jobs, with all the hardships and problems that creates. So it is important to say thank you to people who have been fantastic.

Next I want to mention the renal unit at the Freeman Hospital in Newcastle. Not only is that a world-class unit, but it has some of the most amazing and dedicated staff I have ever come across. From the time someone walks through the door at the out-patients unit, the receptionist, Ann, is always smiling, always welcoming and always looking after them, and the same is true of everyone right through to the most senior doctors. We have seen a lot of different doctors as this illness has progressed. The whole team are amazing, particularly the PD nurses who are looking after Rebecca’s dialysis. They look after Rebecca, but they also look after her family and they have got to know us all, because we have all been there with her at different stages. They are the essence of everything that is great about our health service. They are working under enormous pressures on their time and resources, but they always have time for us. I want to say a personal thank you to them.

I know that this is not a political debate as such, but I am a politician, so I hope Members will give me a moment’s licence. I am going to say that I think the health service staff need a pay rise and the NHS needs more investment, because they are such amazing people and they literally make the difference every day between people living and dying.

The impact on our family has been huge. You go through a period of shock, disbelief and anger as to, “Why Rebecca?” More than one doctor has said to us through that period that it should not be happening to her, as she has been a fit, healthy young woman who has done everything right in looking after her health. They cannot find the reason this has happened. The emotions and journey you go through are like a rollercoaster, because we have to deal not just with the direct impact of what is happening medically to Rebecca, but with the emotional impact of seeing that what is happening to her might mean that my daughter might not be there when I am still here. That is not something any parent ever wants to consider. Although all my children are grown up, they are having to deal with seeing their mother coping less than I normally do. I am a fairly strident, coping kind of woman normally. All of them are dealing with the idea that their sister might not be here. That is all very, very difficult. So we have rallied round and all supported each other, and we remain very positive. Rebecca is very lucky that she has a brother and sisters, my sister, her husband and a great mother-in-law, who have all played their role in supporting this journey we are on, and continue to do so.

It is very difficult being on call for a phone call. My phone is with me all the time. It is very difficult working 300 miles away when you are in this situation. As we all know, we sometimes travel out of this country in this job, so whenever I travel out of the country on business with Parliament, I have a plan of how I am going to get back. It is important to thank colleagues in this place, from all parts of the House, who have given me a huge amount of support. The Whips have been fantastic; they have basically said, “Just go. Text us and tell us you’ve gone.” There is a slight personal thing in that as well, because our Deputy Chief Whip, my right hon. Friend the Member for Tynemouth (Mr Campbell), has known Rebecca since she was a child. As many Members will know, I was his agent in 1997 when he got elected to this place, and Rebecca, being my daughter, ran one of the committee rooms. The support has been really lovely. A lot of the time in this place the differences that we have are highlighted, but at the end of the day we are all people trying to do the best for our constituents and we all care about people.

For me, as a mother, my natural instinct has always been to make things better for my children—that is what we all do. Rebecca is always going to be the baby I gave birth to 36 years ago; you love that child instantly and unconditionally, and that never changes. It is terrible to be in a situation where I cannot fix something that has gone terribly wrong. But what I can do, from the privileged position I have of being a Member of this place, is raise awareness and campaign for a change in the law, to that of deemed consent. The change in the law needs to come, and I want to touch on the investment that needs to happen on the back of that change—this has been alluded to in a number of contributions today.

This issue needs to be discussed in schools and among families, so that transplantation becomes a normal part of the conversation of life. We also need investment in the health service to support what I believe will be an increase in the number of available donor organs.

[Andrew Percy (Brigg and Goole) (Con)]

I wish the hon. Lady and Rebecca all the very best for the future. The Bill is really important, which is why I am here to support it, but will she also acknowledge, as I am sure she will, those live donors who give an organ? My friend Jane has recently given a kidney to her nephew-in-law. That is an incredible thing to have done—for many of us, it is difficult to imagine it—and it has turned around the life of her nephew-in-law, in the same way that, I hope, Rebecca’s life will be turned around eventually. Although the Bill does not cover such people, they also deserve the House’s praise. Hopefully, another good thing that will come out of this debate is raised awareness of that possibility.

[Julie Elliott]

Absolutely. Five members of my family, including me, put ourselves forward to be donors, but none of us matched. Matching is really difficult. One family member is now entering a pool situation, which is a bit like a swap shop of organs, in case somebody has an organ that fits Rebecca and my family member’s fits somebody else. That is a marvellous thing to do and the hon. Gentleman is absolutely right to draw attention to it.

As has been mentioned, presumed consent does mean that people have the right to opt out of giving their organs, and some people will. It is very important for that to be in the legislation. I absolutely respect people’s decision to opt out, because it is not the right thing for everybody. That is as important as changing the law.

My final words are for the families of donors: your selflessness in donating your loved ones’ organs at a time of such personal grief, to save the lives of people you do not know, is such a wonderful thing. Everybody should be grateful for that and thank those people. The grief of having lost a loved one carries on forever, but I am sure that there is some comfort in the fact that their family has helped and their loved one’s organs have gone to help someone else. It is important to say thank you. As a family member of, hopefully one day, a recipient, I want to say thank you from the bottom of my heart. They are very special people.

Let us send the Bill to Committee and change the law to save more lives, for the thousands who are waiting for transplants. Today, we see Parliament at its best, overcoming political differences for something that just needs to change. It is a day we should be proud of.

Breast Cancer Drugs

Julie Elliott Excerpts

Thursday 26th January 2017 Commons Chamber

[Siobhain McDonagh]

I completely agree with my hon. Friend. I wish her constituent, David, all the best.

How can we withdraw a drug from the NHS that is working, especially when we are offering nothing in its place? It seems senseless to me, and it is truly devastating to those for whom it really matters. Of course, as my hon. Friend says, Kadcyla is just one drug that we need to look at. What will happen with other key breast cancer drugs now and in the future? I wish to consider just two more examples. Perjeta is currently available through the cancer drugs fund, but unlike Kadcyla it has not yet been re-appraised, although it will be soon. Perjeta is used for HER2 positive secondary breast cancer patients. In many ways it is even more effective than Kadcyla, as it enables women to live for an additional six months without their breast cancer progressing, and can extend life by an additional six months or more. However, because it is administered with two other drugs—Herceptin and Docetaxel—it would not be considered cost-effective under NICE standards even if the drug manufacturer gave it away for free.

The other drug is Palbociclib, which is used on women with hormone receptor positive and HER2 negative breast cancer. It is a new drug, which is being assessed for the first time by NICE. It is extremely effective and enables women to live for at least an additional 10 months without their breast cancer progressing. However, because women are living longer, robust overall survival data are not yet available. Perversely, that will count against it in the NICE appraisal. Overall survival data are given greater weight than progression-free survival in NICE appraisals, despite the fact that the outcome is the same—a longer, more enriched life.

We are seeing effective treatment after effective treatment being rejected or facing rejection by NICE. I want to know this: is it really right that we have a health service that plans to take away those lifelines? How is the decision to take away these life-extending drugs beneficial for people living with cancer, or for any of us who might one day need access to them? Who makes these decisions, and how can we be sure that they are the right ones?

We have a drug appraisal process, which is certainly valuable and necessary, but I question the factors that constitute that process. It is too easy to assume that the experts must automatically be right. The process is: numbers in, formula used, and then a yes or no answer. Let us not forget that we are talking about people’s lives. The lives of those affected and those for whom this decision is all too real are in the hands of a formula—the NICE appraisal process—and yet this life-changing formula has had little examination for many years. How many of us actually understand what factors are taken into account in these life-or-death decisions? The drug Palbociclib is proving so effective that, at present, it only has data on how long people are living without their breast cancer progressing.

[Julie Elliott (Sunderland Central) (Lab)]

Does my hon. Friend agree that the fact that that drug is routinely available in France, Germany, Austria and Canada shows that our appraisal system is not working in this country.

[Siobhain McDonagh]

I agree with my hon. Friend. It is amazing to think that, for this particular drug, it will take longer to get overall survival data because people are living longer without their cancer spreading. That obvious success is seen as a big disadvantage in the NICE appraisal system. The cost of Palbociclib will appear to be much higher in the NICE formula because overall survival data are given much more weight than progression-free survival. That seems illogical to me.

Consider also the criteria for determining end-of-life treatment. If a treatment is end-of-life, it is allowed double the quality-adjusted life year costings of other drugs. End-of-life is considered to be two years, but why not three? How have we ended up with such an arbitrary, fixed figure, especially when the figure in Scotland is three years? There is no cure for secondary breast cancer, but as people start to live longer it will place them at a disadvantage when accessing treatments, because it will be harder for those treatments to become approved, as they are no longer considered under the end-of-life criteria.

Therefore, how can the Minister be sure that the NICE process is still fit for purpose? Will she respond specifically on two suggestions: first, to review the weighting for progression-free survival when overall survival is not available because a treatment is so effective; and secondly, to change the criteria for end-of-life treatment to three years’ survival instead of two?

I want to return to the issue of off-patent treatments. In recent years there have been two private Members’ Bills on the topic, one of which was introduced by my hon. Friend the Member for Torfaen (Nick Thomas-Symonds). We heard many commitments from the then Minister for Life Sciences, but we have not yet seen any improvement in access, which is hugely disappointing. The Minister committed to establishing a working group to investigate what could be done to enable the routine use of such treatments. I believe that the working group is due to conclude its work next month and publish its report. Will the report introduce a clear pathway for off-patent treatments, and will the Minister write to me with the details of the pathway and state explicitly how it will work for bisphosphonate drugs for the prevention of secondary breast cancer?

Breast Cancer Now and others have been disappointed by the extremely patchy availability of this treatment for eligible women. As a result, it recently launched the “43p a day” campaign to highlight the low cost of the treatment and the fact that it would save over 1,000 lives every year in the UK if it was routinely available, not to mention millions of pounds for the NHS.

Oral Answers to Questions

Julie Elliott Excerpts

Tuesday 11th October 2016 Commons Chamber

The Secretary of State was asked—

[Julie Elliott (Sunderland Central) (Lab)]

1. What steps he has taken to support GPs in prescribing effective interventions to change behaviour and promote physical activity.

[The Parliamentary Under-Secretary of State for Health (Nicola Blackwood)]

The National Institute for Health and Care Excellence recommends that exercise referral schemes should be provided for people at increased risk of ill health, and it is right that such schemes are developed on a local basis to meet the needs of the population. Our NHS five year forward view strategy prioritises prevention, and the GP physical activity clinical champion programme has taught more than 4,500 healthcare professionals to provide advice on physical activity in routine clinical consultations.

[Julie Elliott]

In the north-east, only 33% of adults participate in weekly sport, compared with 38% in London. This has a knock-on effect on people’s health throughout their lives. What are the Government doing to address these geographical health inequalities?

[Nicola Blackwood]

The hon. Lady is absolutely right to raise this question. Inactivity costs England an estimated £7.4 billion a year, and regular physical activity reduces the risk of developing many health conditions by between 20% and 40%. People who exercise regularly can reduce their risk of developing certain kinds of cancer. We are particularly pleased that, in addition to the GP physical activity clinical champion programme, Public Health England has secured funding from Sport England to pilot an education cascade model involving midwives, physiotherapists and mental health nurses and, with the support of the Burdett Trust for Nursing, will soon be launching a pilot involving 21 clinical nurse champion programmes to embed this knowledge in practising nurses. It will, however, be up to local areas to ensure that they make the best of these programmes by targeting them at their local area.

Tobacco Products (Plain Packaging)

Julie Elliott Excerpts

Tuesday 3rd September 2013 Westminster Hall

[Alex Cunningham (Stockton North) (Lab)]

It is a pleasure, Mr Hollobone, to speak under your chairmanship. I assure you that I will have my hearing tested.

I congratulate the hon. Member for Harrow East (Bob Blackman) on securing this debate. As he and colleagues throughout the House who are concerned about the Government’s decision not to implement standardised packaging for tobacco products said, this debate is not about scoring political points, but about holding the Government to account for what many of us consider to be a wrong move.

Clearly, the Government have recognised the negative consequences arising from ready access to non-standardised packaging, yet they drag their feet, are adamant that the evidence is not substantial enough and insist that non-legislative solutions are better suited to the task in hand. Pressure on smoking must be continuous and relentless because we are fighting a pervasive, lethal and powerful addiction. Plain packaging fits the bill. Not only is there a real need for it, but it is a solution that is both wanted and workable. Tobacco is the only consumer product that, if used as instructed, kills half of its long-term users. All tobacco products damage health, so it is right that they are treated differently from other consumer products.

I shall make it clear what that means. In my local authority area of Stockton, more than 250 people die prematurely every year from smoking-related diseases. We have a lung cancer rate of 67.1 per 100,000 people, which is a staggering 40% higher than the national average.

[Julie Elliott (Sunderland Central) (Lab)]

Does my hon. Friend agree that the way to protect children is to act now? Around 50 studies say that the measure would have an impact, so the Government need not wait for the results of the Australian change in the law.

[Alex Cunningham]

That is certainly the case. Children are the most vulnerable group and they need protection from exposure to lethal smoking in closed spaces such as cars and the tobacco industry’s never-ending search for new addicts. Marketing is known to pull children into smoking and the pack is just another marketing tool.

The tobacco industry is now prevented from conventional advertising in this country, so we must look abroad to discover its true intentions. I have been sent the wording on a US internet site advertising Vogue cigarettes, a brand that is owned by British American Tobacco and aimed at young women. They are on sale throughout the UK. One US site says:

“Vogue Cigarettes stand out among other cigarette brands for both their appearance and their unique recognisable taste...The all-white box design with a tiny coloured branch and different coloured leaves reflects the romantic essence that is Vogue Cigarettes”.

Another site says that

“the Vogue cigarette’s style was based on the 1950s couture…The length and the…appearance…is an attribute of the femininity”.

What crass nonsense! The tobacco industry calls these cigarettes “romantic” and “feminine”; I call them addictive and deadly. The real concern of the tobacco industry about standard packaging is, of course, that it would prevent them from marketing their products and recruiting new smokers, and there is a standard litany of excuses.

One is that standard packs would increase illicit trade. That myth has already been dealt with by the hon. Member for Harrow East. Another is that standard packs would put the packaging industry out of business, but let us not forget that we need to worry about the good health of the nation, and tough as it would be on employees and others involved in production and supplies, if that good health is to be achieved, we should not really be focusing on the downside. There are many other excuses too, from the damage that will be done to retailers and the loss of tax revenues, to the amazing claim from some in the industry that packaging does not really matter. So many excuses, so little evidence.

The case for standard packs is strong, and the need for action is urgent. On one side there is the rich and utterly cynical industry that is quite happy to market products that still kill more than 100,000 people across the UK every year—more than the next six most common causes of preventable death. On the other side is the medical and health community, politicians from all parties, and the general public. In the middle are the Government: they have lost the political will to act, so they must let Parliament decide.

Induced Abortion

Julie Elliott Excerpts

Wednesday 31st October 2012 Westminster Hall

[Julie Elliott (Sunderland Central) (Lab)]

I thank the hon. Member for Mid Bedfordshire (Nadine Dorries) for introducing the debate, although I wonder why now. I listened to hon. Members’ contributions, and I agree with some of the arguments from both sides. I agree that abortion should available on demand until 12 weeks, and that there are serious issues about termination on gender grounds that need looking at, but the crux of the matter is about reducing the termination limit from 24 to 20 weeks, and I keep asking why now. There is no new medical evidence. The majority of professional bodies support a 24-week limit, including the British Medical Association, the Royal College of Obstetricians and Gynaecologists, the Royal College of Midwives, the British Association of Perinatal Medicine, and the general public.

[Kate Green]

This is the first time that public opinion has been mentioned in the debate. Is my hon. Friend aware of the recent YouGov survey report about a week ago which showed that 47% of the public support a 24-week limit, 4% believe it should be even later than 24 weeks, and 33% want it reduced?

[Julie Elliott]

I thank my hon. Friend for her contribution. I am aware of the report, but it was worth telling hon. Members.

Is the answer to “Why have the debate now?” that there are more late abortions? No. The contrary is true, and 91% of abortions take place at less than 12 weeks, which is when most of us want them to occur. Only 1% take place after 20 weeks, and the figure is falling every year. There has been mention of whether a foetus feels pain, and I refer to a report from the Select Committee on Science and Technology in 2010. The Royal College of Obstetricians and Gynaecologists was commissioned by the Department of Health to update the report on foetal awareness. It concluded:

“The fetus cannot experience pain before 24 weeks gestation due to lack of development of essential parts of the brain required for pain perception.”

I turn to improving survival rates. They are improving at more than 24 weeks, and during the 20 years since the limit was changed, they have improved significantly. When I had my twins in 1991, the 28-week survival rate was quite low, and that has improved, but that is not the case below 24 weeks.

Have the people presenting for late abortion changed? No, they have not. In the main, they are still the most vulnerable people in our society—the very young, older women who may not have realised that they were pregnant until a very late stage, pregnancy deniers, and people suffering domestic abuse. The list goes on. I suspect that many of those people do not realise how many weeks pregnant they are when they present to the medical profession.

The issue is so sensitive that we should consider the impact of our debate on the general population. As medical evidence has not changed since 2008, I wonder why we are discussing the matter now. Our discussions today will have an impact on vulnerable people in our society, because the subject is upsetting, distressing and worrying for them. They may just read the headlines of the debate, which I suspect will be on the scaremongering side, because that is what has happened in the past, and that can make people feel even more vulnerable.

[John Pugh]

Why are we discussing now matters that we could have discussed in 2008? The hon. Lady is relatively new to the House. She will be aware that whenever the issue has been raised formally in the House, the lid has been put on it pretty quickly, so there has not been a thorough and exhaustive debate that might help matters.

[Julie Elliott]

I thank the hon. Gentleman for his intervention.

MPs must act with responsibility, and always consider the impact on our constituents and the wider population of issues that we bring to the House. We must not scaremonger, or involve issues of guilt, which has happened in some contributions today. I am wholly opposed to that.

I return to what I said at the beginning—why have this debate now? I cannot see any medical or logical reason for it now because no new evidence has come forward since it was last discussed in 2008. If there was new evidence, I would be happy to have the debate. My mind is not closed to changing the limit ever, and if medical evidence suggests strongly that survival rates may be lower than at 24 weeks, that would be the time to consider the issue, not now.

[Mark Durkan (Foyle) (SDLP)]

Will the hon. Lady give way?

[Julie Elliott]

No.

Members of Parliament must always be aware of the impact of our discussions. I conclude by saying, not just as a Member of Parliament, but as the mother of four adult children, and grandmother of two gorgeous little granddaughters, that for their future—this does not impact on me because I am far too old—we should keep medical evidence under review. We should debate such issues sensitively when they change, not on a whim or for emotional reasons. When medical evidence clearly changes, that is the point at which to discuss the matter. I am sad that this debate is taking place today.

NHS (Private Sector)

Julie Elliott Excerpts

Monday 16th January 2012 Commons Chamber

[Rosie Cooper (West Lancashire) (Lab)]

There is no escaping the fact that the role of the private sector in the national health service is one of the most contentious issues to arise when discussing or debating the health service. Some people would suggest that there was no appreciable difference between the policies of the Labour Opposition and the Conservative Government, especially on the use of private companies to deliver services.

I believe that there is a huge chasm of difference, which has been borne out by this debate. It comes down to this: what we saw under previous Labour Governments was the private sector being used to add grit to the system. It operated in the system with strict limitations, and it was deployed, for example, to drive down waiting times from 18 months to 18 weeks. In tandem with targets, the private sector offered a means of improving the efficiency and effectiveness of the NHS, delivering choice and quality to patients. That is where our policies and those of the Government diverge.

It is clear that the intention of the Conservative-led Government is completely different. The NHS is under siege from the Government, who regard the private sector as a means to undermine and weaken the NHS. For all the rhetoric of the Prime Minister and the Health Secretary about their love of the NHS, I would assert that their actions have shown only that they do not fundamentally believe in the principles, values and ethos of the NHS. Those actions attack its very purpose and everything that people hold dear in that world-revered service.

The Government are pushing ahead with their Bill in the face of widespread opposition. Along with the majority of health professionals and the British public, I believe that the Bill should be stopped. Let me make it clear: nothing that I have heard from Health Ministers is reassuring for anyone who has fought to save the NHS. When the Government talk about a regulated market for the NHS people are, and should be, filled with fear.

There will be an increasing role for the private sector, and organisations can be both providers and commissioners. Any A-level business student could explain that that leads to a conflict of interest, and it contradicts and inhibits the notion of introducing genuine competition in the NHS, if that was the intention. I think that the Health Secretary may be mixing up words beginning with “c”. Instead of “competition”, I believe that the word he has been looking for is “cartel”. However it is dressed up, there is one thing I am certain of: allowing such a situation to develop is not in patients’ best interests. There are many questions that need answering. With the private income cap set at 49%, what guarantees are there that hospitals will be able to deliver choice and meet waiting times? What assurance can the Secretary of State give the House that private providers will not cherry-pick the best income-generation services, leaving cost-intensive services such as—

[Julie Elliott (Sunderland Central) (Lab)]

Does my hon. Friend agree that removing the cap will do nothing to help the problem of health inequalities and that it will in fact exacerbate the problem?

[Rosie Cooper]

National health services should be provided on the basis of need, not the ability to pay, so I agree.

I was saying that cost-intensive services such as accident and emergency services may well be threatened. How will the overall capacity of the health care market be managed effectively? How would the Government ensure that the proposal did not impact on the ability of hospitals to deliver urgent care?

We have had to proceed very quickly, but there are some major issues to consider. In conclusion, I urge Members to support the motion for the simple reason that it shines a light on how, once again, the Government are developing policy based on ideology and not on what is best for patients. The people’s trust was hard won and the Government have broken that trust yet again. It is another example of ill conceived, poorly developed, incomprehensible policy that we have come to expect from the Government, which leaves Members, the medical profession and our constituents with more questions than answers. A commentator said that the NHS was on the verge of a nervous breakdown. I believe that the way to save it is to kill the Bill.

Oral Answers to Questions

Julie Elliott Excerpts

Tuesday 2nd November 2010 Commons Chamber

[Mr Burns]

I am sure that my hon. Friend, through the tremendous work done by him and his colleagues on the all-party group, will appreciate that my right hon. Friend the Secretary of State’s initiative—providing £50 million for the rest of this year and £200 million from next year for the cancer fund—is an important step forward in helping those who suffer from cancer. I am sure that my hon. Friend will also welcome the fact that work is ongoing on refining, following the review, the cancer reform strategy, and we are looking at the scope for improving survival rates by the increased use of diagnostic tests and at improving care across the board, so that we raise our standards to the highest in Europe rather than being the poor relation.

[Julie Elliott (Sunderland Central) (Lab)]

T1. If he will make a statement on his departmental responsibilities.

[The Secretary of State for Health (Mr Andrew Lansley)]

My responsibility is to lead the NHS in delivering improved health outcomes in England, to lead a public health service that improves the health of the nation and reduces health inequalities, and to lead the reform of adult social care, which supports and protects vulnerable people.

[Julie Elliott]

In the light of the 0.5% real cut in the NHS after the social care switch, to which my right hon. Friend the Member for Wentworth and Dearne (John Healey) referred, may I ask when the Secretary of State decided to break his promise on a real-terms funding increase for the NHS? Does he accept that that is not what my constituents expected when they heard the Prime Minister promise real increases for the NHS?

[Mr Lansley]

The hon. Lady’s constituents expect the truth, which is that we are providing increased resources for the NHS in real terms, taking it from £104 billion to £114 billion. That is completely contrary to what we were advised to do by the Labour party, which said that we should cut the NHS budget. We did not do that; we increased it.