National Health Service

Kevin Barron Excerpts

Wednesday 26th October 2011 Commons Chamber

[Andy Burnham]

Let me first acknowledge the hon. Gentleman’s courage in standing up and voting against the Health and Social Care Bill. I just wish that more of his Liberal Democrat colleagues had similar conviction and principle, and could stand up to the Government on a Bill that he knows—and which, in their heart of hearts, many of them know—will seriously damage the NHS.

The hon. Gentleman also asked me about the introduction of private sector capacity. I will not apologise for that, because that additional capacity was brought in to bring down NHS waiting lists, something that benefited his constituents. By bringing in that extra capacity we brought down NHS waiting lists to an all-time low and delivered the 18-week target. I am not going to apologise for that. The reason the NHS commands such strong support in the country today is that people’s experience of it improved in those years. I mentioned the preferred provider policy a moment ago. I believe that the private sector has a role to play in delivering world-class care to patients, and I am happy to put that on record.

[Mr Kevin Barron (Rother Valley) (Lab)]

At the heart of the current Bill are the 98 clauses that introduce competition law into the national health service—something that the last Government did not pass even one clause to do. Is not the ideology lying at the heart of the Bill what will wreck our national health service?

[Andy Burnham]

My right hon. Friend makes an incredibly important point. Make no mistake: if the Bill passes, the NHS will never be the same again. The Bill will unpick the fabric of a public national health care system—a planned system—and turn it into a free-for-all, as he says. Indeed, it is unbelievable to see a letter in The Guardian today from senior Liberal Democrats—many of whom made the same argument a few weeks ago as my right hon. Friend—now saying that, because of a few tweaks to the Secretary of State’s powers, the time has come to abandon all their concerns about the provisions. That is a ridiculous statement to make. If they still have concerns about competition and privatisation, they should have the courage of their convictions and stand up against the Bill, instead of writing sanctimonious letters to The Guardian.

Grip has been lost; the NHS is drifting. However, the Government cannot say that they were not warned. Sir David Nicholson, the chief executive of the NHS, told the Public Accounts Committee that the reorganisation had increased the scale of the financial challenge:

“I’ll not sit here and tell you that the risks have not gone up. They have. The risks of delivering the totality of…the efficiency savings that we need over the next four years have gone up because of the big changes that are going on in the NHS as a whole.”

This has been a lost year in the NHS—a crucial year, when it needed to face up to the financial challenge—but things are not getting better. We face months of further uncertainty, as the Secretary of State battles on with his complicated and unwanted Bill. Four-hundred and ninety pages, 70-page letters to peers, amendments made on the hoof: it is a total mess. The NHS deserves better than this. Even the man the Secretary of State brought in to run his new NHS Commissioning Board describes his Bill as “completely unintelligible,” and went on to say:

“It is going to be messy as we go through a very complex transitional programme.”

And this from the Secretary of State’s friends.

The harsh truth is that the Secretary of State has comprehensively failed to build the consensus he needs behind his Bill. GPs do not want it; nurses do not want it; midwives do not want it; patients do not want it. I say to the Prime Minister and the Health Secretary today: stop digging in. Drop this Bill. If they do, my offer still stands, as our motion makes clear. We will work with the Secretary of State to reform NHS commissioning, giving GPs and other clinicians a bigger role. That can be achieved without legislation and a major structural upheaval of the entire NHS. It can be done through existing legal structures, giving immediate stability and saving millions.

We make our offer again today, as it is time for all politicians to put the NHS first. It is slipping backwards, and the warning signs are there for all to see. Waiting lists and waiting times are getting longer, with a 48% rise in the last year in the numbers of patients waiting more than 18 weeks. When patients are waiting longer, it is unforgivable that £2 billion to £3 billion has been set aside to pay for the costs of reorganisation. It is also unforgivable that £850 million is being spent on making people redundant who will end up being re-employed elsewhere in the system, in the new clinical commissioning groups.

We are witnessing a return to the bad old days of waiting longer or paying to go private. This is just a glimpse of the future. If the Bill passes, the NHS will never be the same again. We have all seen the adverts on television for the health lottery. Is this the right hon. Gentleman’s early marketing and his new brand name for our NHS?

--- Later in debate ---

[Mr Kevin Barron (Rother Valley) (Lab)]

I support the motion on the Order Paper this afternoon, and I am very sorry that the hon. Member for Kingswood (Chris Skidmore) has left his seat, because he was coming out with a load of reasons why the NHS is in the mess it is in now, saying that it was to do with the previous Labour Government. He mentioned Adrian Mole, but I would have advised him not to use such arguments when, in the same breath, he was talking about the money that was spent on the NHS IT programme. It was nowhere near the £12 billion that he mentioned. People would be wise to look at the IT system, because it was ambitious in terms of creating a national database, and given my experience on the Health Committee that looked at the issue in the previous Parliament, I must say that if we want to make the national health service efficient, we will do so with IT. Currently, there are few programmes that manage people with long-term conditions, yet they consume between 75% and 80% of the moneys spent on the NHS, so batting arguments around on that basis, as the current Government did in opposition in relation to IT will not make health care better or the national health service more efficient for people in this country.

Members have mentioned three issues with the coalition agreement. I am going to leave the one on finance as it stands, because there is an argument about the Treasury figures. We will see in the next year or two, if the next election is in 2015, exactly where the issue goes, and then we will be able to comment a little more than we are able to at the moment.

On moratoriums, I saw a very embarrassed Secretary of State at the Dispatch Box today, and I am going to be consistent, because when I was Chair of the Health Committee and sitting on the Government Benches, I criticised on two occasions then Government Front Benchers for such stunts. I did not criticise Health Ministers, but I did make one criticism in a closed place, after a Secretary of State—not for Health, but a Scottish Member who no longer sits in the House—stood on the picket line against the closure of a hospital in Scotland near his constituency.

Another criticism I made was of a Member—who is still in the House but, again, not a Health Minister—who was against changes to health care in Greater Manchester. I was asked by the media—I think it was the BBC—and I said that, if the issue is being looked at locally and it is recommended that such reconfiguration will improve patient services, it should go ahead and politicians should not speak out against it. I then received the quickest response I have ever had on any issue from No 10 Downing street, but I stick to what I said then: the matter had been looked at locally.

I listened to the Secretary of State—I am sorry he is not in his place now—when he talked about stopping top-down decision making and letting local commissioners have a look at the clinical evidence and safety aspects, but the independent review panel has been looking at those matters for years. The interference of people at the top has been the real issue.

Politicians have to get away from the idea that they must defend the national health service in its current configuration at all costs. That will not improve it—[Interruption.] The Minister of State, Department of Health, the right hon. Member for Chelmsford (Mr Burns) laughs, but I am talking to him, and to the Secretary of State who stood holding up placards saying things would not happen which have happened. We should not do that. My right hon. Friend the Member for Leigh (Andy Burnham) has the image of that in his hand, but this is a lesson for all people in politics.

When the Health Committee in the previous Parliament looked at NHS deficits, it found that many years ago the major problem with deficits was in the east of England, because many small parts of the NHS were spread around marginal seats that had been fought for one way or another over the previous 20 or 30 years. That level of political interference does nothing for patient care. I am being even-handed in saying that, and I genuinely believe it.

I am going to move on from moratoriums. Ministers put well their arguments on those issues when they were in opposition, but now, given the decisions they are having to take in government, they are having to eat humble pie. It serves them right, as it served the last lot right.

I want to go on to the coalition agreement’s statement that there will be no top-down reorganisation in the national health service, because this current reorganisation is the worst, the biggest and the most savage. It has been defended again today on the basis, as the hon. Member for Southport (John Pugh) said, that GPs are going to be in charge, but they are going to get about £80 billion, and they are small, private, independent contractors, so the idea that there will not be any conflict of interest in some of the work that is going to take place is nonsense. It will be a matter for the courts.

I was also amazed when the hon. Gentleman said that we have competition now inside the national health service, because we do not in clinical services, and he will have to explain why there are 97 clauses in the Health and Social Care Bill which put competition law in clinical services on to the statue book of this land. Can somebody find me one country in the European Union which has competition law in clinical services? I have found none.

I sat on the Public Bill Committee for six months, and, on Third Reading, I asked the Minister who will make the winding-up speech today—I will ask him again, because I have to sit down in a couple of minutes—what the Competition Commission and the Office of Fair Trading had got to do with the merger of national health service trusts. That provision is written into the Bill, and it was not changed when the future forum looked at it; indeed, of the 97 clauses, only seven were changed. The Minister has not answered that question, and I asked Professor Steve Field when he went back to the Public Bill Committee what that had to do with the merger of NHS trusts.

I ask the Minister to answer this question when he winds up the debate. What have the Office of Fair Trading and the Competition Commission got to do with the merger of national health service trusts? I await the answer. I am fed up of asking the question.

The Secretary of State says, “We’re abolishing PCTs,” and indeed we are, but what PCTs do will be taken over by not one body but five different ones: clinical commissioning groups, health and wellbeing boards, clinical senates, the NHS Commissioning Board and local authorities—and that is how we get rid of bureaucracy! That is what the Secretary of State said at the Dispatch Box just a while ago, but five different organisations—some of them new—are going to be involved.

This is the biggest mistake that any Government have made with the NHS since it was brought in 60 years ago, and this Government would be well advised to take the Bill away and get on with serving the nation’s health care needs, not bringing in this competition law, which will be the end of the NHS as we know it.

--- Later in debate ---

[Liz Kendall]

rose—

[Mr Barron]

rose—

[Mr Burns]

I am not giving way, as I have only five minutes left.

Across the country, local health services are coming together to redesign services, thinking creatively to give patients better treatment and very often also making significant cost savings.

[Mr Barron]

Will the Minister give way?

[Mr Burns]

In Torbay, for example, by enhancing the role of the discharge co-ordinator across health and social care, the average length of stay in hospital has been cut by more than 10%, freeing up nurses to spend more time on patient care.

[Mr Barron]

rose—

[Mr Burns]

In Yorkshire and the Humber, the ambulance service gives PCTs a monthly list of their top 10 most frequent callers. These people are then given intensive personalised help, including the use of modern telemedicine to monitor their vital signs. The result is better care for patients as well as—

[Mr Barron]

On a point of order, Mr Deputy Speaker. As you know, I took part in this debate and I asked the Minister a question and requested him to answer it in his winding-up speech. Yet he will not even acknowledge that I spoke in the debate. Is there anything you can do, Mr Deputy Speaker, to help Back Benchers keep the Executive in check?

[Mr Deputy Speaker (Mr Nigel Evans)]

Absolutely nothing. I am sure, however, that the Minister will have heard the point.

[Mr Burns]

Did I hear the right hon. Gentleman’s point, Mr Deputy Speaker? I heard it about three times in Committee and I heard it on Report; I replied each time, as well as writing to the right hon. Gentleman. He does not like the answer, so there is no point in taking the intervention again.

As I was saying, in Yorkshire and the Humber the ambulance service gives PCTs—[Interruption.] I know I have already said it, but there was so much disruption and noise that Labour Members did not hear it. In Yorkshire and the Humber, the ambulance service gives PCTs a monthly list of their top 10 most frequent callers so that they can talk to them and help them in future, saving money and staff time that can be concentrated elsewhere.

[Mr Barron]

rose—

[Liz Kendall]

rose—