NHS Annual Report and Care Objectives

Kevin Barron Excerpts

Wednesday 4th July 2012 Commons Chamber

[Mr Lansley]

I am grateful to my hon. Friend. There are many ways in which we can improve the control that patients can exercise, including greater opportunities for patients to exercise choice. In my announcement today, that includes the opportunity for patients to choose alternative providers of NHS care if, for example, the standard of 18 weeks that the constitution sets is not met. I might say that, at the last election, 209,000 patients were waiting for treatment beyond 18 weeks. That number has been brought down to 160,000.

My hon. Friend makes an important point about the exercise of control on the part of patients, who have an opportunity to access clinically appropriate care through the NHS. We will make sure that that is available and, as he knows, in relation to homeopathic treatments, for example, we have maintained clinicians’ ability across the service to make such treatments available through the NHS when they think that it is appropriate to do so.

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

I have not been able to read the annual report in the last few minutes, but may I ask the Secretary of State for Health whether it gives any information on the benefits of high-street pharmacy companies taking over the running of hospital pharmacies?

[Mr Lansley]

No, the annual report makes no reference to that. It refers—I hope, for the first time—in detail to the performance of the NHS over the past year. If the right hon. Gentleman wishes to raise any issues about that, I shall be glad to respond to him separately.

Cigarette Packaging

Kevin Barron Excerpts

Tuesday 17th April 2012 Commons Chamber

[Mr Robinson]

I agree entirely with the hon. Gentleman, and I am very pleased to say so. He mentions some of the advertising gimmicks and marketing subterfuges to which the industry has stooped. The evidence that this is achieving success lies in the fact that two thirds of those currently smoking started when they were younger than 18. That is why we have to deal with this matter and take measures to deal more effectively with the counterfeiting problem.

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

Will my hon. Friend give way on that point?

[Mr Robinson]

For the very last time.

[Mr Barron]

I congratulate my hon. Friend on securing this debate. Some countries have managed to deal with counterfeiting quite well. There are barcodes on all cigarette packages; the problem is the policing of them. Counterfeit cigarettes are not all sold out of car boots, as they are sold in some retail outlets, too. We need enforcement in those areas and to confiscate any smuggled cigarettes.

[Mr Robinson]

I agree entirely that the barcoding and other anti-illicit sales measures are not being policed readily enough, which brings me back to the need for Government action at the local level in enforcing the required measures. That can be done only when the group of agencies that I mentioned work together with that sole purpose in a truly linked-up manner. It will not work on any other basis.

I have given way many times, but I know that our debate is restricted to half an hour. I am sure that we will have occasion in future to debate the issue more fully on the Floor of the House almost certainly at the end of the consultation period. I look forward to those debates and to my participation in them. Let me make my own position clear, as all right hon. and hon. Members, the Government, the Opposition and other parties will have to do the same. On balance, I believe that plain packaging would help to reduce smoking, which we desperately need to do. Indeed, I would go further and say that plain packaging could be an important milestone in making cigarettes and their brands pariah products—a status that is richly deserved.

Oral Answers to Questions

Kevin Barron Excerpts

Tuesday 27th March 2012 Commons Chamber

[Paul Burstow]

There is not a nationally mandated programme of walk-in centres; rather, it will be for local commissioners to make decisions based on the evidence and their evaluation, and ensuring that they fulfil their contractual obligations.

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

Is it not the case that the walk-in centre that opened in Rotherham a few years ago has given communities that are higher on bad health indices access to health care 12 hours a day, seven days a week? Getting rid of it—it was opposed by some local doctors, because it threatened their business—would be a backwards step. Can we expect the new commissioning groups to start commissioning GPs in areas such as mine, which are higher on bad health indices and do not have enough general practitioners?

[Paul Burstow]

I am grateful to the right hon. Gentleman for his question, because he outlines the need to reduce health inequalities—something that the party of which he is a member failed to do in government. I can assure him that the Bill, which has now gone through all its parliamentary stages, will place a duty on clinical commissioning groups to seek to reduce health inequalities —something that his Government never did.

Health and Social Care Bill

Kevin Barron Excerpts

Tuesday 28th February 2012 Commons Chamber

[Mr Lansley]

I am grateful to my right hon. Friend and thank him for his positive remarks about my noble Friend Earl Howe. I attach to that my appreciation to Baroness Northover for the work she has been doing in another place and to the Minister of State, Department of Health, my hon. Friend the Member for Sutton and Cheam (Paul Burstow), who is responsible for care services, who has been heavily engaged in discussing some of the amendments. I recall that nearly a year ago there was a clear expression of interest from the Liberal Democrats, as a party, on how they felt the Bill should be improved. I was pleased that we were able to bring forward changes that reflected virtually all those. Indeed, they are reflected directly in what my right hon. Friend the Deputy Prime Minister said in his letter yesterday.

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

If the competition in the Bill is just an extension of what the previous Government did by introducing independent sector treatment centres and everything else, why are more than 90 clauses writing into the law of the land that competition policy should run the NHS, not the NHS, as has been the case in the past?

[Mr Lansley]

I would not characterise this as an extension of the independent sector treatment centres programme. That is precisely what we do not need to do with the private sector. Under the Labour Government, the private sector was paid 11% more than the NHS, which was wrong, and in another place there is a legislative provision that will prevent discrimination in favour of the private sector. The Bill will carry forward exactly the principles and rules of co-operation and competition, as reflected in the panel set up under the previous Government. As NHS Future Forum set out, the reason for having that in the Bill, with Monitor exercising those responsibilities, is so that there will be a health sector regulator, rather than that being done without health expertise by the Office of Fair Trading.

Oral Answers to Questions

Kevin Barron Excerpts

Tuesday 21st February 2012 Commons Chamber

[Mr Burns]

My hon. Friend is absolutely right, because we need to drive up the quality of care. What we are doing with the Health and Social Care Bill is closing a loophole so that there can be no favouritism towards the private sector, so the travesty introduced under the previous Government, including the right hon. Member for Leigh (Andy Burnham), whereby independent treatment centres had an advantage that put the NHS at a disadvantage in providing care, and were paid more than the NHS, will stop, because it is unacceptable.

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

Part 3 of the Health and Social Care Bill will introduce competition policy to the NHS by law for the first time in its history. Does the Minister think that that is likely to lead to more private care in this country or less?

[Mr Burns]

I am sorry, but the right hon. Gentleman, who always asks this question, is wrong. We have not introduced competition into the NHS; it was there under the previous Administration.

Oral Answers to Questions

Kevin Barron Excerpts

Tuesday 10th January 2012 Commons Chamber

[Mr Lansley]

I am grateful to my hon. Friend. He rightly highlights an area where we are clear that innovation can be considerably supported, and not only by the academic health science centres, which were established under the last Government. As the life sciences strategy set out in early September made clear, we want to create academic health science networks across the NHS so that higher education, industry and the NHS can work together to bring about the greatest possible innovation to the benefit of patients.

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

The current pharmaceutical price regulation scheme is able to recognise the fact that pharmaceutical companies based here and developing drugs here should be paid a little bit more for their drugs by the NHS on the basis of their worth for the general economy. Will the Secretary of State tell us whether his proposals for value-based prices will affect that?

[Mr Lansley]

The right hon. Gentleman will be aware that the existing PPRS does not in any sense directly fund innovation in the United Kingdom. Although it takes account of expenditure on innovation, it cannot identify that expenditure in the United Kingdom as a beneficiary through pharmaceutical pricing. As the right hon. Gentleman knows, we are continuing to discuss with the industry the shape of value-based pricing from January 2014, the purpose being to ensure that we fund the value associated with new medicines: the therapeutic value to patients, the innovative value—which will highlight the UK as a base for research and development—and the societal value.

Life Sciences

Kevin Barron Excerpts

Monday 5th December 2011 Commons Chamber

[Mr Lansley]

I am grateful to my hon. Friend and heartily welcome his support for the opportunities in regenerative medicine. I was fortunate enough to meet at the UK Stroke Forum last Thursday, among those exhibiting, a company that is based in England but undertaking trials and research activity in Scotland and is looking precisely at how it can use foetal-derived stem cells for regenerative purposes. The right hon. Member for Leigh (Andy Burnham) talked about Pfizer. In my constituency, it has been one of the companies leading the development of new regenerative medicine techniques. That is clearly one of the areas that this country has tremendous potential in developing. The technology innovation centre for regenerative medicine was announced in the “Plan for Growth” published alongside the Budget earlier this year, and I hope that it will be one of the areas in which we will see those developments.

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

The Health Committee, in its report on the electronic patient record, published in September 2007, stated that the highly detailed data captured had “outstanding” prospects for new and improved research, but it also asked that the best balance be found between

“the opportunity to improve access for research purposes with the ongoing need to safeguard patient privacy”.

Do the Government believe they can get that right, so that we can go ahead and use the enormous amount of data that we have in this country to improve health care for patients not just here, but throughout the world?

[Mr Lansley]

I am glad that the right hon. Gentleman is here and able to ask that question, because he was the Chair of the Health Committee in September 2007, when it stated that the secondary use of data in the NHS was “vital” for the development of the NHS, including for research use. I hope that he is one of those who recognise that what we are setting out in the life sciences strategy—in particular, with the clinical practice research datalink—will enable precisely all those secondary uses for research to be developed.

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—

Oral Answers to Questions

Kevin Barron Excerpts

Tuesday 18th October 2011 Commons Chamber

[Mr Lansley]

I am confident that we will make the progress that we seek. If we are not ready in any location, we will not be able to proceed with that procurement, but the PCTs will act on the basis of an evaluation of four pilots. To that extent, the character of what they are procuring through the 111 system will be well defined through piloting.

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

What progress has been made since the launch of the Secretary of State’s tobacco control plan last March in changing the behaviour of people who smoke in cars in the presence of children?

[The Parliamentary Under-Secretary of State for Health (Anne Milton)]

The right hon. Gentleman has a long-standing interest in this subject. We are working on a number of areas, but I think that the extension of public health duties to local authorities will open up many opportunities to persuade parents to think carefully about where they smoke, whether it is in cars or in their own homes.

Health and Social Care (Re-committed) Bill

Kevin Barron Excerpts

Wednesday 7th September 2011 Commons Chamber

[Ms Abbott]

I am afraid that we are an hour into an hour-and-a-half debate, and I am anxious to allow time for other Members to speak.

The case that the amendment is intended to make is that tens of thousands of women every year are either not getting counselling that they request, or are getting counselling that is so poor that only new legislation can remedy the situation. I might say, after many years in the House, that in matters of this kind, if legislation is the answer we have almost certainly asked the wrong question.

The amendment is the opposite of evidence-based policy making. We know that the British Medical Association advises its members:

“A decision to terminate a pregnancy is never an easy one. In making these decisions, patients and doctors should ensure that the decision is supported by appropriate information and counselling about the options and implications.”

We know that the Royal College of Obstetricians and Gynaecologists guidance on abortion states:

“Women should be given counselling according to their need—including post-abortion if she needs it. All women should be offered standalone counselling. The counselling should include: implications counselling (aims to enable the person concerned to understand the…course of action…); support counselling (aims to give emotional support in times of particular stress) and therapeutic counselling (aims to help people with the consequences of their decision and to help them resolve problems which may arise as a result)”.

We know that Department of Health regulations state:

“Counselling must be offered to women who request or appear to need help in deciding on the management of the pregnancy or who are having difficulty in coping emotionally”.

We also know that all the clinics that have been discussed in the debate are inspected and regulated.

Yet the proposers of the amendment are asking us to believe, on the basis of purely anecdotal evidence, that tens of thousands of doctors, nurses and charity workers involved in the 190,000 abortions a year are wilfully ignoring both the law and the guidance of the British Medical Association and the Royal Colleges. They go further than that, arguing that tens of thousands of doctors, nurses and charity workers are merely in it for the money. They imply that those men and women are involved in some sort of grotesque piecework. It is almost as though they were paid per abortion. The proposers of the amendment, I might add, also seem to be arguing that thousands of women do not actually know what they are doing. It tells us something about the validity of their claims that they are obliged to smear tens of thousands of doctors and nurses to make any kind of case. No wonder that a journalist for The Sunday Times—no friend of the liberal left, but one who happens to have served as a lay member of the Royal College of Obstetricians and Gynaecologists—last weekend described the amendments as a “senseless and sinister bid” to cut abortions.

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

I agree with my hon. Friend. Any evidence that we have heard has been anecdotal—we have heard of a 16-year-old’s journey and of e-mails that hon. Members have seen but that I have not. However, my hon. Friend makes a real point. The conclusion of the consultation might be that a termination takes place, but this is the only procedure in this country that requires the informed consent of two doctors. Government Members besmirch doctors by saying that such things happen daily, but that is not true. From my nine years on the General Medical Council, I recognise that we have good ethical guidelines for doctors. Nothing is done without the informed consent of two medical practitioners.

[Ms Abbott]

My right hon. Friend makes an excellent point.

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[Owen Smith]

The very simple question to be asked is “Why the delay?” Why could the Minister not have introduced it earlier? We have known about the problem for eight months and more. The Secretary of State, who has been keen on changes such as this for a long time, must have given some thought to what he was going to do about staff training and work force planning in the NHS.

[Mr Barron]

It was clear from the day of its publication that the Bill, which abolishes the structure that had kept education and training in place, would create chaos in the national health service. Here we are, hundreds of amendments later, with a resubmitted Bill. Our debate on the outcome has been crammed into two days, which is wholly unsatisfactory, and the Government still cannot tell us what will replace the structure that has been in place for so many years. That is a nonsense.

I listened to the Minister’s speech earlier. He was telling people—people outside, including professionals who want this kind of professional development on a continuing basis—to have faith in what might happen at some stage. I have to say that I have little faith in what the Government have done with the Bill from the very beginning.

[Owen Smith]

I entirely agree, and my faith is diminishing by the minute. I do not understand why the Government cannot simply concede that they have signally failed to deal with this crucial aspect of the Bill. It took them months to produce the revised failure regime. They managed to drag that out in time for Report, but they have not produced the impact assessment, they have not produced any figures showing how much this will cost the public purse, although we know that the amount is rising—I should love the Minister to tell us by how much—and they have not produced a solution to the crucial problem of staff training and work force planning. That is a disgrace. They could have and should have done it by now.

New clause 13 would place a further duty on providers, related to what is in the earlier new clause. It would oblige them to make provision for training and work force planning for their own staff, thus filling another gaping hole in the Bill. As the Minister might say if he intervened on me, Monitor may well have powers, under the pricing clauses, to pay less under the tariff to providers who do not engage in training, but nothing in the Bill compels new entrants—especially private providers—to give their staff any training, or to deal with any costs that the NHS has traditionally had to bear for the education of the work force.

We all know that in the incredibly fast-moving and innovative world of health care, keeping staff up to date is absolutely crucial. That is why—I hate to say it—despite the news that we are to have an amendment ín the Lords, we will attempt to press amendment 7 to a vote. It proposes the retention of SHAs until and unless we know precisely what the Government will put in their place in respect of training and administration.

NHS staff is another group that is profoundly concerned by the shambles, chaos and confusion that Ministers have overseen. Under the Bill, they are described as assets and will be transferred lock, stock and barrel between new providers. The new providers may be a private company—such as Helios, Bupa, UnitedHealth, or whoever else decides it is interested in running the NHS in future—and the staff may be transferred to the new providers. The Minister shrugs, suggesting that that is a misrepresentation, so I challenge him to intervene on me and state what he seemed to imply earlier: that what I have just said is not the case.

Schedule 23 makes that explicit, however. It provides for the transfer of NHS staff and other assets. It allows such so-called assets to be passed in future from NHS entities to the new CCGs. That can happen to any

“person who provides services as part of the health service in England and consents to the transfer”.

Under schedule 23, any NHS member of staff—or a building or intellectual property—can, so long as they agree, be transferred to anybody else who is licensed to provide services to the NHS. I find that extraordinary, but not quite as extraordinary as the next provision, which refers to NHS bodies being able to transfer all such assets—what a delightful way to refer to people—to a “qualifying company”, whatever that means. I will be delighted if the Minister tells us what the term “qualifying company” in schedule 23 means.

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[Mr Barron]

I have been a Member of this House for 28 years and I have been active in different parts of health policy for many years, and I have never seen any Bill—not just any health Bill—come to this House so ill-prepared to be put on to the statute book. I served during the two stages of the Public Bill Committee. Largely, I asked questions where I wanted explanations, but I got very few answers. As was said earlier today, part 3 remains in this Bill and its 97 clauses bring in economic regulation. Only nine of those clauses have been amended since the Future Forum met and said that we were in deep trouble with this.

What did the Future Forum ask for? It recommended that Monitor’s powers should

“promote choice, collaboration and integration.”

Monitor’s powers have changed somewhat, but the major change that occurred during the second part of the Committee stage was that the Government took away Monitor’s power to promote competition and gave it a new power to prevent anti-competitive behaviour. Perhaps, at some stage, somebody will be able to tell me what that means. Perhaps somebody will also be able to tell me the answer to something I asked in the first sitting of the Public Bill Committee: what do the Competition Commission and the Office of Fair Trading have to do with the mergers of two NHS trusts? The relevant Minister said at the time that that was a good question, but I have not heard it answered since.

I must say, with all due respect, that no Labour Member argued that the NHS is perfect, nor would I do so. But this Bill is a dog’s dinner. The national health service and the nation do not deserve it, and I will vote against it tonight.