NHS Reorganisation Debate
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Lindsay Hoyle
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NHS Reorganisation
Lindsay Hoyle Excerpts(13 years, 9 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Mr Deputy Speaker (Mr Lindsay Hoyle)
Order. Come on; we want to see the debate continue. A lot of Members want to speak and to intervene, but we cannot have so many of them on their feet at once.
Mr Lansley
I remember that if we ask the public whom they trust in public service, we find that general practitioners are at the top of the list. Members of Parliament and politicians are pretty near to the bottom of the list, so the public might take it pretty amiss that Labour politicians are insulting general practitioners by thinking that they are in it for the money. They are not; they are in it for the patients.
Mr Deputy Speaker (Mr Lindsay Hoyle)
Order. The Secretary of State has decided that he is not going to give way. That is his decision. He has given way already. We need to have a little less noise so that we can hear the Secretary of State.
Mr Lansley
Thank you, Mr Deputy Speaker. I have to conclude to ensure that we do not trample on Members’ time.
We will hold the NHS to account for what it achieves, but not tell it how to achieve it. We want continuous improvements in outcomes and more personalised care. We are going to change accountability in the NHS. In the past, the only question in accident and emergency was whether people were seen within four hours. We will ask whether a patient was seen by the right person, whether the quality of care they received was appropriate, and whether they recovered. From April, we will know those things for the first time. On mental health, we will ask whether we are helping people with serious mental health problems to live longer, and whether we are helping them to get a job. We will ensure that we find out those things and that we know which services provide the right care.
Beyond the NHS, we will make changes that increase accountability. As of today, 134 local authorities with social care responsibilities—almost 90% of such local authorities in England—have signed up to be early implementers of health and well-being boards. Those are the bodies that will finally tear down the walls between the NHS, public health and social care; and they will strengthen local accountability to the public and patients. Local authorities will finally have the powers that they need to scrutinise all NHS-funded providers of care, be they public, voluntary or private sector providers.
The coalition Government were elected to protect the NHS and that is what we are doing. We are protecting the NHS in this Parliament through increased investment, and protecting it for future generations through modernisation. We need an NHS in which every system, process and incentive encourages excellence in health care and weeds out poor performance. Labour now opposes that. It has turned its back on the NHS. It wants to drag the NHS back into politics; I want the NHS to be freed from political interference so that it can deliver the best possible care and results for patients. This Government will always support the NHS. We have a simple aim: to create an NHS that is up there with the best in the world. Our modernisation plans will do just that.
Mr Deputy Speaker (Mr Lindsay Hoyle)
Order. I remind Members that there is a six-minute limit.
Mr Deputy Speaker (Mr Lindsay Hoyle)
Order. The hon. Lady will have to sit down during the hon. Gentleman’s intervention.
Graham Evans
I am new to the House, but I seem to recall the right hon. Member for Leigh (Andy Burnham), who was then the Secretary of State for Health, saying that we should
“celebrate the role of the private sector in the NHS.”
What has changed for Labour Members? [Interruption.]
Mr Deputy Speaker (Mr Lindsay Hoyle)
Order. That is not a point of order, because the accusation was not against individual Members.
Rosie Cooper
Oh how the truth hurts! Michael Portillo could not have been more clear that the Government intended to misrepresent their position and to mislead voters.
I believe very clearly that you are playing Russian roulette with people’s futures, but the gallery is empty and you are on your own. I still believe that you have no mandate for these ill-advised reforms. You do not have that support, and it seems to me you do not have a clue—[Interruption.] It is impossible to make a speech with that noise.
I shall just recap. I do not believe that you have any mandate for these reforms. You do not have the support out there and it seems to me that you do not have a clue. For goodness’ sake, stop now before you kill the NHS.
Mr Deputy Speaker (Mr Lindsay Hoyle)
Order. May I just remind Members that the Chair is not responsible? I would be pleased if we did not use the word “you”.
Debbie Abrahams
No, I am sorry, I want to make some progress—[Hon. Members: “Give way!”]
Debbie Abrahams
Not only are the founding principles of the NHS in danger of being wiped out, but its culture—the reason that most of its employees work for the NHS—will go as well. The whole ethos of the NHS will change. It will now be driven by competition and consumer interests—[Interruption.]
Debbie Abrahams
My first question to the Secretary of State was about the proposal that the NHS commissioning board will be able to award bonuses to the GP consortia that it deems to be adopting innovative measures. The Bill states:
“The Board may make payments as prizes to promote innovation in the provision of health services.”
That means bonuses within the NHS based on innovation, which is anathema to the NHS and not what we want for it. This is indicative of the Bill as a whole. Central to the reforms are increasing competition across the NHS and opening it up to providers from the private and voluntary sectors. The Government claim that increasing competition drives down costs and improves quality, but there is evidence from across the world—in the US and Europe—that that is not the case. It does not improve quality at all in health care systems.
Although I am glad to see that the Government have reversed their position on price competition, as of yesterday they were still wedded to establishing Monitor as a powerful economic regulator with the duty to promote competition. As has been pointed out, our health services will be subject to EU competition law for the first time. By forcing these GP consortia to put any services out to competitive tender—even if they are working well and patients and the public are happy with them—the Bill encourages “any willing provider” to—
Grahame M. Morris
We have heard about the layers of bureaucracy that the coalition Government propose to take away, but what does the hon. Gentleman have to say about the additional layers that they are imposing through the exponential growth of Monitor, which will be the economic regulator? They are increasing its budget from £21 million a year to as much as £140 million a year. How many more thousands of people will it employ? How many lawyers? It will cost £600 million over the course of a Parliament.
Dr Poulter
This is very much the point. Let us not forget that Monitor was introduced by the Labour party to regulate competition in foundations trusts, and the Government are looking at giving it a slightly increased role while also cutting £5 billion-worth of bureaucracy in the NHS, which has to be a good thing. I hope that the hon. Gentleman agrees that that £5 billion would be much better spent on patients rather than on management and paper trails.
The core of the issue is that Government Members would like GPs to be placed at the heart of the commissioning process. Giving power to doctors and health care professionals is undoubtedly a good thing because the best advocates for patients are undoubtedly doctors and other health care professionals rather than faceless NHS bureaucrats. I am delighted that my hon. Friend the Member for Ipswich (Ben Gummer) is sitting next to me because far too often in Suffolk damaging decisions to remove vital cardiac and cancer care services from Ipswich hospital have been taken by the strategic health authority and the primary care trust, against the advice of front-line professionals. Community hospitals in my constituency in Hartismere have been closed despite GP advice that we need to look after older people and the growing older population. Putting GPs and health care professionals in charge of the new system will bring better joined-up thinking between primary and secondary care, which does not happen at the moment because GPs are often hindered in what they are trying to do and are unable to communicate effectively with the hospital doctors and trusts they need to talk to because of PCTs intervening in the process. Bureaucrats are getting in the way of good medical decisions and the Bill will deal with that problem.
I am aware that others want to speak in this debate so I shall not speak for much longer. I think that all Government Members must oppose the motion. The hypocrisy of the Labour party in its dealings with health care and the NHS has been ably exposed by my right hon. Friends the Member for Charnwood (Mr Dorrell) and the Secretary of State. Government Members want to cut bureaucracy and put money into front-line patient care and helping patients. We believe that GPs and health care professionals are the best people to do that. We want a patient-centred NHS that is locally responsive to local health care needs and that will properly address the fact that we have an ageing population. We want joined-up thinking between adult social care and the NHS, which did not happen under the previous Government. For all those reasons, I commend the health care reforms to the House, and I beg the Conservative party to oppose the motion.