Health and Social Care Bill (Programme) (No. 2)
Lindsay Hoyle Excerpts(15 years, 1 month ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Mr Deputy Speaker (Mr Lindsay Hoyle)
Order. There is very little time as it is, and screaming at each other does not help.
Chris Bryant
If the Deputy Leader of the House had allowed more than an hour for debate today, I would give way to him, but I am not going to give way now. We have already heard from a Minister for 15 minutes.
It is a bizarre selection of clauses that the Committee will be allowed to discuss. For instance, it will not be allowed to discuss clause 239 on NICE’s charter, nor clause 240 on its functions, but it will be allowed to consider clause 242, on the failure of NICE to discharge its functions. There is absolutely no logic to what is being presented to us.
In addition, the programme motion does not allow enough time. The Prime Minister is profoundly confused about all this, because he said many times this morning that 10 days would be allowed. Indeed, he said:
“Ten days… I don’t want to sort of misquote the Monty Python sketch but when we were in opposition we used to dream of tens days to debate a government bill”.
Well, yes, we are dreaming of 10 days now. We would love to have 10 days, but there will not be 10 days; there will be 10 sittings.
Andrew Percy
We have discussed where these procedures come from and who is accountable for them, and that certainly cannot be laid at the door of this Government. Over the past few months, we have heard first that there has been too much delay, and now that there is not enough delay.
As we have heard, professionals in the health service and the public have been saying that they wanted to know where we were heading and that they needed some clarity. The Government wanted that brought to an end, and they have had their listening exercise. On that basis alone, although I do not like the idea of curtailing debate, I hope that we can get on with this so that we all know what the changes are going to be, and that we end up with an NHS that is on a stable footing for the long term and do not have any more reorganisation for a considerable time.
NHS Reorganisation
Lindsay Hoyle Excerpts(15 years, 4 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.
Health and Social Care Bill
Lindsay Hoyle Excerpts(15 years, 5 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Dr Wollaston
I am confident that commissioners will consider the impact of those decisions across the health care spectrum, which is very important.
In the limited time I have left, I should like to ask the Secretary of State to consider how we will monitor the quality of primary care. Who will be responsible for performers’ lists, audit, and identifying poorly performing doctors? As I understand it, all GP contracts will be held with the NHS commissioning board. What powers will GPs within consortia have to deal with those whom they feel are underperforming if they have no control over their contracts? What will be done about the ongoing, disgraceful situation regarding doctors from the EU with poor English skills, over whom we have few powers to protect patients until there has been a problem?
Professionals are also concerned about the make-up of consortia. Will they have the flexibility to include consultants and other specialists—
Contaminated Blood and Blood Products
Lindsay Hoyle Excerpts(15 years, 9 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Alun Cairns (Vale of Glamorgan) (Con)
I pay tribute to the hon. Gentleman for pressing for the motion today. I am obviously keen to support him. On the debate about parity with the Republic of Ireland, the Minister in her statement talked about working with the UK’s devolved Administrations and with their Health Ministers. Does the hon. Gentleman also support the need for parity within the UK? Will he urge the Minister before us and the Minister in Wales, because we are both Welsh Members, to work on the review with the Department of Health in order to come up with at least some parity within the UK?
Mr Deputy Speaker (Mr Lindsay Hoyle)
Order. It is up to Members to decide on the number of times that they give way to interventions, but I am concerned that that is going to stop other Members getting in. If we are going to have interventions, Mr Cairns, we need to make them very brief.
Owen Smith
I agree with the hon. Gentleman’s excellent point. One thing that I was slightly disappointed about in the ministerial statement was the fact that those discussions clearly have not taken place. Some of the statement’s specifics are very welcome, particularly its point about the terms of reference and, notably, the fact that the level of payment to people with hepatitis C might be equalised.
Ms Abbott
On a point of order, Mr Deputy Speaker. You will be aware that “Mr Secretary Lansley” and “Anne Milton” tabled an amendment that is on the Order Paper and includes the figure “£3 billion”. Some Opposition Members feel that this debate cannot go forward until we have some clarification of its accuracy.
Mr Deputy Speaker
A point of order takes up valuable time, too. I recognise that you wanted to make it, but you will have the opportunity to put the case a little later. What we ought to try to do is respect all Members. I want to try to get in all those Members who are here; I do not want disappoint them.
Owen Smith
Thank you, Mr Deputy Speaker. I now have very little time left, so I shall speak a little faster, if I may.
It is absolutely critical that the Minister makes it very clear in her response that she is talking about equalising the payment to people with hepatitis C with the previous payments to victims of HIV. It is also important that she consider the specificity of the recommendations, including the terms of reference. Victims’ access to nursing care and to the NHS ought to be looked at differentially. They were infected by the NHS, in effect, and therefore they ought to be treated differently when looked after by the NHS.
In the last minute of my speech, I want to pay tribute to some people in the Public Gallery today. The reason I am so interested in today’s debate is that a very brave constituent of mine, Leigh Sugar, died earlier this year. His family came to see me just days after his death to express their desire for him to be the last person who suffers in their dying days, having not been looked after properly by the NHS, and having been infected through NHS treatment.
Leigh is a classic example of a person who, as a mild haemophiliac, went to hospital—he, in his teens—to be treated for the condition and came out with a devastating disease. That disease ultimately led to his death from liver cancer. Far too many people have died before we have seen this House deliver justice, and it is absolutely critical that justice be seen to be done today. This is a moral issue, it is a matter of conscience and of justice, and we owe it to the victims, whatever the difficulties of the CSR, to see justice served so that they might be properly recognised and properly recompensed.
Mr Robinson
On a point of order, Mr Deputy Speaker. We are conducting a Back-Bench debate that is being coloured by a figure in an amendment that the Government have tabled, which has not been selected. It suggests that £3 billion would be the cost of what my motion proposes. If the exact figure is in the order of 1% of that, or £300 million, as I think the hon. Member for Bracknell (Dr Lee), a medical doctor, suggested—[Hon. Members: “No, £1 billion.”] Does it come to £1 billion? I think that ought to be clarified before we go further in the debate.
Mr Deputy Speaker
In fairness, the Minister is going to speak and there will be an opportunity to intervene on her. I am sure she will want to point out the figure at that stage. What I want to do is get on with the debate until she comes to speak, and then I am sure Members in all parts of the House will be able to intervene.
Mr Deputy Speaker
I am getting the nod from the Minister that that will be dealt with in due course.
Mr Deputy Speaker (Mr Lindsay Hoyle)
Order. We have nine speakers to fit in, and I intend to call the Front-Bench speakers at 3.40 pm, which gives us 30 minutes. I ask for as much discipline as possible, as I want to ensure that everyone who wants to speak can be called.
Richard Fuller (Bedford) (Con)
Thank you for allowing me to speak for a couple of minutes, Mr Deputy Speaker. The actions at the root of this debate take us back many years. For many of us—including me—they take us back to a period that stirs great emotions. It was a period when an illness was ignored, when people’s deaths and suffering were marked by stigma, when Governments were in disarray and, too often, in denial and when life-changing mistakes were being made.
Everyone in this House commends the campaigners on this issue for their vigilance and persistence over the years. The debate relates to a judgment between principle and practicality in the operation of our Government, but also to individual lives, such as that of a family that lives in Kempston in my constituency. The issue of principle appears to be accepted and clear to all sides: a group of our own citizens, who had already suffered greatly, have been denied justice for many—too many—years. It is the responsibility of all hon. Members to challenge the Government to bring that period of injustice to a close. If December it is, Minister, then December it must be.
The main practical argument concerns cost, which is wrapped in the real pressures of affordability given the current pressures on the public purse. The written ministerial statement contains welcome indications for those affected by hepatitis, but I urge the Minister to consider the point made by my hon. Friend the Member for Blackpool North and Cleveleys (Paul Maynard) in clearing up other anomalies.
My constituent, Lisa, wrote to me urging me to attend this debate. She stated:
“We must trust in the democratic process to enable us to bring about change”.
It is my honour to represent her today. She wrote movingly about how she lost her husband when he was just 32—her son was just two years old at the time; about the pain as his body struggled in his failing battle with HIV and hepatitis; about the consequential financial pressures of losing her home; and about the sadness of a family life denied but which lives on in her heart and that of her son.
Lord Winston described the issue of contaminated blood as “a disaster”, which is surely the right description. Yesterday, we witnessed on our television screens another country come together to overcome the consequences of another disaster and painstakingly rescue 33 heroes who had suffered entrapment below ground and return them to their loved ones. Too many of the heroes who have fought for justice cannot be here today and cannot be returned to their loved ones. However, many of them are here, and many of the loved ones of those affected by this disaster are present, too.
It is time for the Government to show their mettle and demonstrate their principles, if not their culpability. I wait with anticipation to hear the Minister’s reply and place my trust and that of my constituents in her resolve.
Mr Deputy Speaker (Mr Lindsay Hoyle)
I shall move on to the Front-Bench speakers. I have the pleasure of calling Diane Abbott. It has taken since 1987 for her to reach the Front Bench, which is a long time, so we look forward to this experience.