Heart Surgery (Leeds)

Karl Turner Excerpts

Monday 15th April 2013 Commons Chamber

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

Come on Jeremy, answer the question.

[Mr Hunt]

Whenever he receives information, the medical director is under an absolute obligation to act. What he did was absolutely correct: he said that he would look at the data and get to the bottom of them and that if it turned out that the data were not as accurate as they should have been, surgery would resume. That is exactly what happened.

Health and Social Care Bill

Karl Turner Excerpts

Tuesday 20th March 2012 Commons Chamber

[Paul Burstow]

I am responding to my hon. Friend and, if the hon. Gentleman does not mind, I am going to carry on doing so.

In addition, the Office of Fair Trading has published guidance that is consistent with the view that the Department has expressed on this matter. I will write to my hon. Friend with the detailed case law, so that I can quote the case reference for him.

Claims have also been made that part 3 does something else. Specifically, it has been suggested that it introduces competition and competition law into the NHS, as if that were the case for the first time. Part 3 does not do that, nor does anything else in the Bill. The NHS will, as a result of the Bill, be better insulated against the inappropriate application of competition law, particularly as it develops more integrated services, which are now embedded throughout this legislation. Without Part 3, the NHS would continue to be exposed to price competition and the preferential treatment of private providers introduced by the previous Labour Government. Indeed, Labour’s 2006 procurement regulations assume that public authorities will be securing services from a market—that will not always be appropriate in the NHS—and so, under the existing regulations from the 2006 legislation, commissioners are placed at greater risk of legal challenge whenever they decide to secure services without competition.

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

Will the Minister say whether Monitor will keep its role as an independent regulator of foundation trusts?

[Paul Burstow]

I am coming on to deal with a whole section of amendments that were made in the other House and which this Government have accepted, when I will address that very point. If the hon. Gentleman is patient, he will get an answer to his question.

--- Later in debate ---

[Paul Burstow]

I am grateful to my right hon. Friend for his questions. Let me start with the issue of Hinchingbrooke, which is an important one. It is worth remembering that the vast majority of the process that led to that franchise arrangement was completed under the Labour Government, not by the current Administration, and was part of the arrangements put in place by the Labour Health Act 2006 and Health and Social Care Act 2008. The Bill makes sure that in future there can be no scope for sweetheart deals to incentivise new entrants into the NHS, it ensures that there cannot be price competition of the sort that was allowed under the 2006 Act, and it ensures a protection for commissioners to decide when and if it is appropriate to use competition. That is not a protection that they enjoy under the 2006 or the 2008 Acts.

[Karl Turner]

Will the Minister give way?

[Paul Burstow]

I have answered the hon. Gentleman’s question. He should read Hansard later.

I was asked, finally, whether there is a cap of 49%. Let us go back to the deliberations in another place before Christmas, when the issue first came up. Our noble Friends were concerned to make sure that we put it beyond doubt that foundation trusts were protected from the full force of competition law and that those organisations would continue to have as their principal purpose their service of NHS patients. That is why we have further amendments, which I shall come to shortly, about how a 5% increase would trigger further consultations and votes by the governors.

--- Later in debate ---

[Paul Burstow]

No. I shall make some progress, if the hon. Lady does not mind.

In addition, Monitor could also, in exceptional circumstances, use the enduring powers that I was describing to direct a foundation trust to remove its directors or governors. In other words, a direct intervention power is preserved by the amendments and changes that we have made.

The Government’s ambition is that eventually foundation trusts should have more responsibility for their governance than they do under the current arrangements. This will depend, in particular, on strengthening the role of foundation trust governors in holding their boards to account. We have listened to the concerns about the pace of change. Hence, we have amended the Bill so that Monitor will also have, on a transitional basis, express powers to remove, suspend or replace directors or governors of a foundation trust directly, without the prospect of an appeal to the first-tier tribunal. We would expect Monitor to use these powers to address failure of governance, which puts the trust at risk of not meeting its licence conditions, such as the requirements that I have already described.

[Karl Turner]

Is it right that the only provision preventing privatisation is the requirement in clause 161 that foundation trusts must use the NHS more than they use private providers? Is that not, in effect, the 49% cap?

[Paul Burstow]

No, because the overarching duty is that the service remains free at the point of use. Also, there are protections—[Interruption.] The hon. Gentleman asks a question, but when I try to give him an answer, he shouts and screams at me. That does not help the debate. What I wanted to say was that when it comes to mergers and acquisitions, there are clear requirements to protect NHS assets from a transfer out of the NHS and out of the state sector. The powers that I was describing would be retained as long as Parliament considered necessary, and they could not be removed before 2016 at the earliest and would then be subject to criteria that Monitor determines, with the Secretary of State’s approval.

Health and Social Care Bill

Karl Turner Excerpts

Tuesday 20th March 2012 Commons Chamber

[Tony Baldry]

I can assure my hon. Friend that what I am saying is true. All he has to do is walk a few feet to the Vote Office and pick up a copy of Lords Hansard and read for himself the speeches of Lord Wilson of Dinton and Lord Armstrong of Ilminster. All I am saying to my hon. Friend—

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

Will the hon. Gentleman give way?

[Tony Baldry]

No.

All I am saying to my hon. Friend is that this is a debate about the relationship between civil servants and Ministers, a relationship that has worked very well and very effectively in this country.

Here we have heads of the civil service advising Parliament that this move, which the Opposition would seek to force upon us, is not in the best interests of the relationship between civil servants and Ministers and is not in the best interests of the good running of government.

--- Later in debate ---

[John Pugh (Southport) (LD)]

It is a sure sign of a deranged mind when one starts to repeat oneself. I have said previously that the Bill is a huge mistake, that not releasing the risk register merely creates further alarm, and that abandoning the Bill could be the safer option. I have also said that the Secretary of State’s intentions are noble and that the Opposition’s objections are—in part, at any rate—considered and compelling. However, I have clearly failed to persuade many of my parliamentary colleagues to share that point of view, as last night’s voting showed.

[Karl Turner]

I am grateful to the hon. Gentleman for giving way. He says that he has been opposed to the Bill from the outset. As he knows, I served on the Public Bill Committee with him. Why did he not vote against it? He had ample opportunity to make the Government drop the Bill.

[John Pugh]

If the hon. Gentleman checks Hansard carefully, he will find that there were occasions when I did. We must all agree, whether sadly or happily, that the vote in the Lords last night was conclusive, even if some, like Baroness Williams, were voting for legislation that they said they did not particularly like. That is in part because of the modifying genius—I put it as strongly as that—of Earl Howe.

There are risks attached to the legislation. The risks that I face are small in comparison with those faced by the Secretary of State. I risk being found out for having fears that are misplaced. I risk having my forebodings exposed. He risks a great deal more than that. The House does not need a risk register to find out what those risks are. If he proceeds rapidly at a time of huge upheaval in the NHS, he will actually promote that upheaval. If he goes ahead, he will be doing so at a time of austerity, in the teeth of wholesale professional opposition and in a climate of genuine legal uncertainty, with legislation that has, in part, been cobbled together. We will soon find out what has been scaremongering and what is plain scary. Crucial to mitigating the risks will be the pace and the extent of enactment and implementation. There will be a mopping-up phase. It will be crucial for the Government to woo back professional opinion. The risk register would have told us, to some extent, how easy or difficult that will be.

Already we hear that the Government are struggling with the central plank of the legislation: GP commissioning. We wait with interest to see the regulations on that. It is hard to see how GPs can commission basic out-of-hospital services in primary care, which is a central thrust of the Government’s legislation, and not be seen, as small businesses or associations of undertakings, to be benefiting themselves with public money. In the legislation, we have made the biggest provider the biggest commissioner as well. GPs will have no problem commissioning hospital services without any legal obstacle, but they will lack the expertise to do so. That is what primary care trusts found when they did the commissioning. The risk is that we will end up with GPs not being able to commission what they do understand, and being asked to commission what they do not understand. We therefore await the regulations with considerable interest.

I suggest that although Cabinet members have been banging the table today, they may well be banging their heads against the wall in the years to come.

Health and Social Care Bill

Karl Turner Excerpts

Tuesday 13th March 2012 Commons Chamber

[Mr Lansley]

My hon. Friend is absolutely right, and I will come to some of those points. However, I might just say that, in the space of the last few days, we have had an opportunity to demonstrate that Labour signed up to an enormous, centralised, top-down NHS IT scheme that was never going to deliver, was failing to deliver and was costing billions.

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

Will the Secretary of State give way?

[Mr Lansley]

No.

In the space of under two years, my right hon. and hon. Friends at the Department and I have delivered a reduction approaching £2 billion in the cost of the NHS IT programme. That will enable us to empower services right across the country to be better users and deliver better IT systems.

--- Later in debate ---

[Andrew Selous]

I will make a little progress.

I also say to Opposition Members that the GPs of Bedfordshire are thoroughly behind these proposals. Dr Paul Hassan, a long-standing Dunstable GP, will be the leader of the clinical commissioning group in my area. He is an excellent GP who has the interests of his patients at heart and he will do an extremely good job.

[Karl Turner]

The hon. Gentleman says that he met 400 people in his constituency, not one of whom mentioned their opposition to the Bill. Has he had any communication from any health service professional who has concerns about the Bill? I and many Opposition Members have received numerous e-mails and a great deal of correspondence from such people, as well as from constituents.

[Andrew Selous]

I am aware of one GP in my constituency who has concerns about the reforms. The overwhelming majority of GPs are thoroughly behind them. I find it troubling that Opposition Members do not trust our nation’s GPs, with their wisdom, good sense and commitment to patients, to do the right thing by their patients. They will look at the powers in the Bill and use them for the good of their patients where it is wise and appropriate to do so.

I have to tell Opposition Members that the clinical commissioning group in Bedfordshire has already established a new team to deal with emergency calls from elderly people in care homes. That has resulted in a 40% reduction in hospital admissions and has enabled vulnerable elderly people to be treated at home. That is just one example of the sort of thing that we will see when doctors make use of the powers that they are given in the Bill.

I will cite a few areas of the NHS in which, if Opposition Members think honestly, they will recognise that there were problems when they left office. I will use three brief examples from my constituency. As we heard from the Chairman of the Health Committee and others, one of the important things that the Bill will do, under part 1, is to integrate health and social care. I am extremely grateful to the Minister of State, Department of Health, my right hon. Friend the Member for Chelmsford (Mr Burns), who has been looking at the issue of delayed transfers of care at Luton and Dunstable hospital. The new structures that will be introduced under the Bill, with the full integration of health and social care, will be helpful in that area and will deal with the serious issue of delayed transfers of care.

--- Later in debate ---

[Nicky Morgan (Loughborough) (Con)]

I rise tonight to oppose the motion and the amendment. The motion is clear on the e-petition, on calling on the Government to drop the Health and Social Care Bill, and on declining to support the Bill in its current form. I see no mention of the risk register, yet when we debated it several weeks ago the shadow Secretary of State did not want to talk about it; he wanted to talk about the Bill. I shall come to the very confused position of the Opposition on this issue.

I will obviously not support the amendment—that will come as no great surprise to the hon. Member for St Ives (Andrew George)—but I agree with his reference to patients’ organisations. Such references have been missing from the speeches of Opposition Members. I would prefer a reference to patients and service users, because my first point is that the voice of patients has not been heard. Those are not my words, but those of somebody who gave evidence to the all-party parliamentary group on mental health last week. We have not heard the voices of patients in the debate so far—[Interruption.] Opposition Members are welcome to stand to correct me, but I have heard no mention from them of the words and views of patients.

[Karl Turner]

I am obliged to the hon. Lady for giving way. The mere fact that more than 170,000 people have signed the e-petition surely must speak volumes to her.

[Nicky Morgan]

If the hon. Gentleman wants to talk about maths or numbers—

[Karl Turner]

I am not talking about maths.

[Nicky Morgan]

We could talk about the number of people who have taken part in the Royal Colleges petitions.

[Karl Turner]

I am talking about the 170,000 people who signed the petition. What are you talking about?

[Nicky Morgan]

Well, 175,000 have signed the petition, but there are nigh on 60 million people in this country.

NHS Risk Register

Karl Turner Excerpts

Wednesday 22nd February 2012 Commons Chamber

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

Let me put a quotation to the shadow Secretary of State again:

“Putting the risk register in the public domain would be likely to reduce the detail and utility of its contents. This would inhibit the free and frank exchange of views about significant risks and their management, and inhibit the provision of advice to Ministers.”—[Official Report, 23 March 2007; Vol. 458, c. 1192W.]

I asked in an intervention on the shadow Secretary of State whether he recalled that quotation. It is what he said in an answer to this House in Hansard on 23 March 2007.

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

Will the Secretary of State give way?

[Mr Lansley]

I will in a moment.

Frankly, this is a broken-bat debate in the first place, because the shadow Secretary of State is trying to suggest that this Government should do something that he as a Minister and then as a Secretary of State steadfastly refused to do, using exactly the same arguments that the present Government have used.

I am afraid that the shadow Secretary of State’s bat was broken before he came to the crease, because at Prime Minister’s questions the Prime Minister put it to the Leader of the Opposition that, as he was devoting a whole Opposition day to this debate, he might want to make some argument or put some question to him on this subject, but such a point from the Leader of the Opposition came there none. The shadow Secretary of State is standing at the Dispatch Box without the support of his own leader.

[Karl Turner]

Does the Secretary of State think that his job is at risk and that it should perhaps be on a risk register?

[Mr Lansley]

I do not know about the debate being bad-tempered, Mr Deputy Speaker, but we at least have jokers in the House.

The shadow Secretary of State is out on his own. I will be kind to him and say that at least opposition is coming naturally to him. Whatever we propose, he opposes it, even to the extent of directly contradicting what he and his colleagues said in government. His contribution today was another shameless example. We have seen this before. The last Opposition day debate on this subject was a travesty of his previous views about the role of the private sector, the need for the private finance initiative and the role of competition in the NHS that he espoused in government. He has done a U-turn on those matters and now holds the polar opposite views from those that he held before. That may be a luxury of opposition and he may enjoy it for the moment—actually, I am not sure that he did enjoy it that much—but that kind of inconsistency will keep him in opposition for a very long time.

The shadow Secretary of State spoke for about 50 minutes and I heard not a word of appreciation for the staff of the NHS. We are asking the staff of the NHS to live in financially challenging times, but it is not mission impossible. He said that saving money in the NHS was mission impossible. That is certainly how the Labour party treated it in government. Spending money was about the only thing that it seemed to be capable of doing, but it never spent it well. We are asking the staff of the NHS to save and to reinvest, and to improve performance at the same time.

Did I hear one scintilla of appreciation from the shadow Secretary of State for what NHS staff are doing, or for the fact that we have the lowest number of hospital-acquired infections on record and the lowest ever numbers of patients waiting more than six months and more than one year for treatment? I did not. I put it on record again that whether we compare May 2010 with December 2011, during which time the number of patients waiting more than a year for treatment more than halved, or December 2010 with December 2011, in which time it went down from more than 14,000 to nearly 9,000, the number has gone down. For the shadow Secretary of State to stand at the Dispatch Box and say that it has doubled, which is transparently wrong, is a misrepresentation to the House and a travesty to the staff of the service. He ought to come to the Dispatch Box and withdraw it.

--- Later in debate ---

[Ben Gummer (Ipswich) (Con)]

Your predecessor in the Chair, Madam Deputy Speaker, noted that this has been an intemperate debate, and so it has, reflecting a wider debate about the NHS that has become increasingly intemperate with every day that has passed. The reason is in large part the terrible myths, put about by the Opposition and their co-agitators in the health care unions, which we have heard again perpetuated in the leadership, and in the sponsor and proposer of the motion today.

As any demagogue will know, it is always difficult to present a travesty of the truth in a calm and reasonable voice, and that is precisely why the manner in which the Opposition have conducted this debate, and the entire debate about the NHS, belies the fact that they are interested not in a calm and reasonable debate, but merely in smearing the Government and in bringing into disrepute this long-needed reform of the NHS.

The inconsistency of the Opposition’s position is evident even in the motion, which asks for the Government to respect the decision of the Information Commissioner, yet that is based on an Act, the Freedom of Information Act, which the previous Government brought in, and on which I have to say the Conservative party was wrong. This is not just about the decision of the Information Commissioner; the Act describes a process that must be respected in its entirety. We are in the middle of a quasi-judicial tribunal, and it would have been right and respectful to the spirit of the Act if the Opposition had waited until the decision-making process was complete before making this point. Far from dragging it out, as the former shadow Health Secretary, the right hon. Member for Wentworth and Dearne (John Healey), claimed earlier, and as the current shadow Health Secretary says from a sedentary position, the Government have brought forward the tribunal date to expedite it. That is entirely consistent with the Government’s track record on transparency.

Yesterday, in the Justice Committee, we took evidence from Maurice Frankel, who is well known to Labour Members as a champion of freedom of information. He said that we as a Government are doing reasonably well, and that we are certainly ahead of Australia, Canada, the United States and Sweden. When the hon. Member for Kingston upon Hull East (Karl Turner), for whom I have great respect, asked how FOI in England and Wales compares with that in similar jurisdictions, Professor Hazell of the UCL constitution unit said that we compare very well and have a rather more generous regime than in Australia and Canada. We are now improving on that as a Government.

[Karl Turner]

Would the hon. Gentleman say that the question was put in relation to this particular issue? He is rather suggesting that it was, but it certainly was not.

[Ben Gummer]

The hon. Gentleman is entirely correct. I am trying to put in the round the position of this Government on freedom of information—that is, respecting the Act brought in by the previous Government in going through the necessary process, and in the meantime showing greater transparency in their dealings with the public than any previous Government. One need not look only at the transparency inherent in departmental business plans and departmental spending above £5,000. The risk registers quoted by the shadow Secretary of State, which he revealed with a flourish as though he were some latter-day Carl Bernstein, came from the websites of local PCTs and were revealed as a result of transparency initiatives by this Government. In their motion and in their attack on the Government, the Opposition have shown inconsistency that reveals their true intent.

The shadow Secretary of State repeatedly called into question the Government’s motivation for not releasing the risk register. Their motivation is precisely the same as that which drove him to refuse to release a risk register in 2009. In turn, I question his motivation for calling this debate and picking a fight on this matter. It is not, as the motion might suggest, to inform the public debate, but to fuel the misinformation campaign that has been the basis of the Opposition’s attack on the NHS reforms; to take out of context statements from a document that, by its very nature, considers risks rather than benefits; and to use that in an effort to undermine a programme of reform that has the support of increasing numbers of health care professionals in my constituency to whom I have spoken, and is showing real results.

--- Later in debate ---

[Mr Jones]

I absolutely agree. The points that they are making today are just as confused and incoherent as the rest of their policies. They seem to just cut and paste their policy with some frequency to suit the bandwagon that they wish to jump on at a particular point.

[Karl Turner]

Will the hon. Gentleman give way?

[Mr Jones]

I will continue, if I may.

The motion is something of a red herring, in that it does nothing to meet my constituents’ concerns about the delivery of health care. When I speak to them, it is quite obvious that they want choice about where they are treated and access to high-quality health services that can be provided locally. They want less management and bureaucracy in the NHS and more money to go to the front line.

My constituents certainly do not want to go back to the PCT-type commissioning that we had under the previous Government, because Nuneaton was completely disadvantaged under that system. Nuneaton is one of the most disadvantaged areas of Warwickshire and has one of the worst health inequalities. Despite that, NHS Warwickshire did not support Nuneaton and health funding dissipated elsewhere in the county. The huge PFI scheme in Coventry drained the life out of the Warwickshire health economy and caused a threat to constant service reorganisation, which could have caused the loss of A and E and maternity, and other women and children’s services, in the George Eliot hospital in Nuneaton.

We need to battle and fight against the problems that we encountered under the PCT, but at least under the new system, the local GP commissioning consortia are helping. They want to work with the George Eliot hospital and are making efforts to support and maintain those services in Nuneaton.

NHS (Private Sector)

Karl Turner Excerpts

Monday 16th January 2012 Commons Chamber

[Mr Lansley]

Answer came there none. The truth is, we are doing exactly what the right hon. Gentleman and his party intended to do. At the election, Labour said in its manifesto:

“Foundation Trusts will be given the freedom to expand their provision into primary and community care, and to increase their private services—where these are consistent with NHS values, and provided they generate surpluses that are invested directly into the NHS”.

That is what we are doing.

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

Will the Secretary of State give way?

[Mr Lansley]

No.

We are giving foundation trusts freedom to generate revenue from other sources that can be invested directly into the NHS. When Moorfields, for example, sets up a clinic in the middle east in a joint venture, should we say, “No, you’re not allowed to do that, because it might imperil your ability to support NHS patients”? Actually, it will help their ability to do so, with NHS Global encouraging the NHS.

I believe in the NHS and in the ability of NHS hospitals and providers, which in the past have had their horizons limited, to move beyond those horizons and deliver much better care. That can include turning them into international providers of choice in joint ventures across the world, and even joint ventures in this country, whether in research or the provision of additional services. However, as I explained to the right hon. Member for Leigh in an intervention, under the Health and Social Care Bill the principal purpose of any foundation trust will be the provision of NHS services. Doing anything that would be to the detriment of its provision of NHS services would be unlawful. Foundation trusts cannot cross-subsidise from NHS services into private services.

Oral Answers to Questions

Karl Turner Excerpts

Tuesday 10th January 2012 Commons Chamber

[Mr Lansley]

I do not agree with that characterisation of why we instituted the Health and Social Care Bill or of the current situation. For example, the OECD published in October its latest assessment of health in a number of countries. In too many respects—for example, in relation to serious respiratory disease—we have very poor outcomes relative to other countries. What we are setting out to do in any case is to deliver continuously improving outcomes and to get among the best in the world. In too many respects we are not yet among the best in the world.

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

T4. If the Prime Minister really wants to help nurses to focus on patient care, should the Secretary of State not listen to those nurses and drop this barmy, unnecessary Health and Social Care Bill?

[Mr Lansley]

It is precisely because the Prime Minister and I listen to nurses that we met them and made it clear that we will support best practice. The hon. Gentleman and his colleagues should support nurse leadership on the wards. Nurses can see—through best practice, if they talk to patients about their experience every hour—that they can deliver better care. We will support nurses to deliver better care; he should support us in doing so.

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

Karl Turner Excerpts

Tuesday 21st June 2011 Commons Chamber

[John Pugh]

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

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

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

[Several hon. Members]

None.

NHS Future Forum

Karl Turner Excerpts

Tuesday 14th June 2011 Commons Chamber

[Mr Lansley]

I believe that as a result of our proposals the NHS commissioning board will be able to provide more consistency in much specialised commissioning, and I hope that that will apply to people with spinal injuries. I am well acquainted with the work of the Spinal Injuries Association: I think that it has done terrific work, and we have already worked closely with it in trying to ensure that we improve commissioning and services for those with spinal injuries.

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

It is utterly disgraceful that Liberal Democrats and Tories are scrapping with each other to claim credit for the alleged listening exercise. Will the Secretary of State now apologise to my colleagues and me for not listening to us when the Bill was in Committee?

[Mr Lansley]

Yes, in relation to the changes we are now bringing forward, I do indeed give credit to some of my colleagues—very much so—but I also give credit to the Prime Minister and the Deputy Prime Minister for the time and trouble they have taken; they have spent a great deal of time listening, and engaging with people across the health service. We give credit, too, to the NHS Future Forum and the thousands of people across the NHS who have now made their contribution to the NHS’s future, and I think they will be very disappointed to hear Opposition Members just wanting to denigrate that, and to make political capital out of it, rather than supporting the NHS in its future objectives.

NHS Reorganisation

Karl Turner Excerpts

Wednesday 16th March 2011 Commons Chamber

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

It is a privilege to follow the hon. Member for Southport (John Pugh). Like him, I am a member of the Public Bill Committee considering the Health and Social Care Bill, and I always listen intently to his well-informed and reasoned speeches. I think that many Opposition Members, at least, will agree with what he has said today.

The Government’s proposed changes will fundamentally alter the nature of the health care system for the worse. That opinion is held not only by Opposition Members but by numerous experts, including the British Medical Association, the Royal College of Nursing and the Royal College of Surgeons, to name but a few. I am pleased to say that we now know that the Liberal Democrats agree with us on this issue, but it is not enough for them to talk tough. They must do what they say they can do. They should not just sit on the fence. They have a real opportunity to prove to the electorate that they can change Government policy when it is damaging and destructive to their constituents.

The damage that this policy will do is, in my view, irrevocable. Let us make no mistake: the Government are ripping the N from the NHS. They are planning, by stealth, a wholesale change in the structure of our health service system. The plans are damaging and, without question, revolutionary rather than evolutionary.

[Nadine Dorries]

Will the hon. Gentleman give way?

[Karl Turner]

Not at the moment.

The Government Front-Bench team and its Lib Dem colleagues can argue against what I say until they are blue in the face, but we know what the reality is. The chief executive of the NHS, Sir David Nicholson, says:

“The scale of the change is enormous—beyond anything that anybody from the public or private sector has witnessed”.

When we bear in mind the context of the plans, the destruction to the NHS becomes very apparent. The plans are to be implemented at a time when the NHS is to make £20 billion in efficiency savings. This is a costly, unnecessary and reckless top-down reorganisation of the NHS, and it is without any real mandate. The coalition agreement clearly states that the new Government will stop the top-down reorganisation of the NHS. Instead, we are faced with a reorganisation that is described as being so big

“you can see it from space.”

[Christopher Pincher (Tamworth) (Con)]

The hon. Gentleman seems to favour top-down organisation of the NHS. Does he agree with his party’s shadow Health Minister, the hon. Member for Leicester West (Liz Kendall), who said:

“Many staff are disillusioned and disempowered by the top-down target driven approach that has dominated much of the last decade of health policy”—

his party’s policy?

[Karl Turner]

I am well aware of my hon. Friend’s remarks, and they were made in a very different context, but let us listen to the BMA. Yesterday, it held its first extraordinary meeting for 20 years. Interestingly, it has convened two emergency meetings in the past 20 years, both of them under a Tory Government. It is the same old Tory story: they cannot be trusted with the NHS.

The most damaging part of these plans is the competition aspect. The Secretary of State’s smokescreen about GP commissioning is designed simply to divert attention from the underlying plans, which are, as Baroness Williams has said, privatisation by stealth, and Professor Ham of the King’s Fund correctly asserts that the commissioning reforms

“are of secondary importance compared with the radical extension of competition”.

The Health and Social Care Bill brings the NHS within the remit of competition law for the first time, and Monitor, the new economic regulator, will be instructed actively to promote competition under clause 52. Placing a statutory obligation on Monitor to enforce competition creates a situation in which commissioners will not be able to act in the best interests of their patients, for fear of a costly legal challenge lurking in the shadows.

The Government’s approach to Monitor demonstrates how ill thought out these plans are. In a clamour to roll back the state and win favour with the private health companies that have bankrolled their party, the Government’s plans to introduce competition into the NHS will work against the integrated networks needed to ensure that the long-term ill receive the services they need and are entitled to.

The most worrying aspect of this policy is that the Government have ignored expert criticism—or, indeed, criticism of any kind. The divide is pretty stark. On one side there is the BMA, A National Voice, the Royal College of Nursing, the Stroke Association, the Royal College of Surgeons, the Chartered Society of Physiotherapy, the Royal Pharmaceutical Society, the Foundation Trust Network, the Royal Society of GPs, and, since the weekend, the Lib Dems. On the other side, there is the Secretary of State and the private health companies, who are bound to be rubbing their hands, waiting expectantly for their investment in him and his party to pay off.