Virtual Participation in Debate

Debate between Lilian Greenwood and Valerie Vaz

Tuesday 24th November 2020 Commons Chamber

[Valerie Vaz]

That was a point of clarification. Perhaps we can include those in the procedure in future.

Let me deal with the point that the hon. Member for West Bromwich West (Shaun Bailey) made. The point is that hon. Members cannot take part in the most important part of what we do, which is debate. We are excluding a whole group of hon. Members from taking part in a debate, and to take part in a debate is what they want. The fact is we had this process and we had this procedure and it worked.

[Lilian Greenwood (Nottingham South) (Lab)]

I think it is important to recognise that we do not just have to go back to the situation that pertained in May. The Procedure Committee’s report makes it absolutely clear that, because of the substantial work undertaken by the parliamentary audio-visual service since the discontinuation of hybrid proceedings, we have

“a more resilient broadcast infrastructure, with the capacity to facilitate virtual contributions to debate”

in a much more proper way. Is not that quite a change that needs to be reflected in our decision making?

[Valerie Vaz]

My hon. Friend is right and that is the point that I was just about to come on to. As I started to say, we were the first Parliament to become a virtual Parliament and we were the envy of the world. Other Parliaments have tried to do what we are doing now and what we did previously and what we are sort of on the way to doing. But I think we are doing a great discourtesy to the people who have worked so hard to get us to this stage. Yes, the Leader of the House will say that we broke down; that the House of Lords broke down. They are able to participate in every aspect of their work virtually. They broke down only once in 62 votes. We had a failure at the card reader, too. I do not think that we broke down whenever we had debates and people took part.

The point is that the broadcasters have worked so hard to get us to this place. One of the broadcasters said to me, “Please say that we are now doing seven to eight hours of virtual proceedings in the House of Lords and they are able to have two Chambers—they are able to have two sets of proceedings going on at the same time.” We have a huge amount of talent, not just in the House, but in the country. We can use that talent to ensure that we here in this Parliament, every single person, no matter what happens, can take part. People will have seen the hon. Member for Chatham and Aylesford (Tracey Crouch), but there are others who perhaps do not want to ask questions and state what their medical conditions are, but who also want to take part. We all have a responsibility to our constituents because we were elected. This is a democracy and we want to take part in every single aspect of our work, and we can.

Future of the NHS

Debate between Lilian Greenwood and Valerie Vaz

Monday 9th May 2011 Commons Chamber

[Valerie Vaz (Walsall South) (Lab)]

It is always a pleasure to follow the hon. Member for Totnes (Dr Wollaston) and to serve with her on the Select Committee on Health.

I welcome this debate, which is the first chance that the House has had to debate the NHS after the pause—the listening, reflecting and engaging exercise—since Second Reading of the Health and Social Care Bill. Something about this debate made me think of the words of The Beatles song “Hello, Goodbye”. Madam Deputy Speaker, you can imagine the discussion in No. 10 between the Secretary of State for Health and the Prime Minister: “You say stop, I say go. You say, ‘Why?’ I say, ‘I don’t know.’” I promise it sounds better when sung. We can see now why The Daily Telegraph said this Saturday that the Secretary of State was to get first aid from the No. 10 spin doctors.

It is right that the Government should take on board the voices in this House and outside—those of the experts, the patients, our constituents—not in reselling their proposals, but in fundamentally changing them. I wish to cover three main areas: accountability, costs and other concerns. On accountability, as a member of the Health Committee, which is so ably chaired by the right hon. Member for Charnwood (Mr Dorrell), we have heard evidence from expert after expert—from the BMA, which I promise was not whingeing, to GPs, nurses and public health clinicians—all of whom expressed concerns about the lack of detail on the ideas in the White Paper. Matters did not become much clearer even on Second Reading.

Our latest report, “Commissioning: further issues”, published on 5 April, said that there should be no doubt that the Secretary of State has ultimate responsibility, but that is not clear from the Bill. We have concerns about accountability and the governance arrangements for the consortia that will be responsible for £60 billion of public money, but that issue is not clear in the Bill. There are concerns that private and voluntary providers will not be covered by the Freedom of Information Act 2000, which is not dealt with in the Bill either. Concerns remain about conflicts of interest in respect of GPs who are commissioners and providers, but that is not clear in the Bill.

Some PCTs were working with clinicians to provide a more integrated service. A more evolutionary and cost-effective approach would be to remove the non-executive directors of the PCT boards and replace them with GPs. That would have been not a top-down reorganisation, but a progressive and less disruptive approach.

I am staggered by the uncertainty surrounding how much this reorganisation will cost the taxpayer. The proposals in the White Paper were neither costed nor explained, and the spending is not committed, so it must come out of revenue. Professor Kieran Walshe, of Manchester Business School, put the cost at £2 billion to £3 billion, but the Government’s figure is £1.4 billion. The redundancy costs alone amount to £852 million. Sir David Nicholson said that the running-cost envelope was £5.1 billion for the running of the current service and the development of the consortia. In an written parliamentary answer to me, the Minister said that the spend and operational arrangements of pathfinder consortia are not being monitored. That smacks of fiscal incompetence and a Department that has lost control of its budget. It is so out of control that the head of Monitor wrote to foundation trusts, telling them that the NHS must find savings of 6.5% rather than 4%. That is an extra £1.1 billion on top of the savings demanded by the Department.

Members will be interested to know that the head of Monitor compared the NHS under the Government’s proposals to privatised utilities. Does Ofgem have trouble regulating the utilities? It was ineffective in dealing with companies’ unfair pricing practices and companies that made large profits during the recent severe weather.

[Lilian Greenwood (Nottingham South) (Lab)]

Does my hon. Friend agree that the Government’s plan to abolish the cap on income from private patients is a real concern when hospitals are starved of cash, because it could result in them putting private, fee-paying patients ahead of NHS patients?

[Valerie Vaz]

I absolutely agree with my hon. Friend.

We were told by Sir David Nicolson that very little work has been done on what will happen in 2013-14. Just for the record, the UK had the second-lowest debt in the G7 in 2007-08, before the global financial crisis. Which Government are out of control with their spending?

Finally, there are many unanswered questions. I have tried to obtain the legal advice on whether EU competition law applies to the provisions of the Bill from the Secretary of State, but apparently, it is in the public interest not to disclose that to the public. However, in a recent article in the British Medical Journal, Rupert Dunbar-Rees, a GP, and Robert McGough, a solicitor, say that

“the technical argument reinforces the logical argument that the reforms further open up the NHS to EU competition law.”

Who will account for the training of doctors, and indeed health care professionals? That cannot be left at a local level. In A and E, an increased percentage of patients wait more than four hours, the maternity service in Maidstone has been closed despite GP opposition—