Care Bill [Lords]

Debate between Liz Kendall and John Redwood

Monday 10th March 2014 Commons Chamber

[Liz Kendall]

I am really sorry, but I want to make a bit more progress. I have a lot of new clauses to get through, and Back Benchers have also tabled new clauses and amendments.

We also know that many care workers do not even get the minimum wage at the end of the week, because they are not paid for their travel time, among other things. Her Majesty’s Revenue and Customs recently undertook an evaluation of minimum wage enforcement in the social care sector. It found that a staggering half of all care providers had failed to pay the minimum wage to at least one of their employees, yet despite Ministers’ insistence that such people will be named and shamed, not a single provider in the care sector has so far been identified.

We need to look at all those employment issues, which I think have a fundamental impact on the quality of care. If the Bill is to promote well-being, shift services towards prevention and improve standards, we must get to grips with those issues; otherwise, it will not work. New clause 17 would require the Secretary of State to conduct an overall review of the economic and financial factors affecting employment, publish the results and consult on the findings.

[Mr Redwood]

I quite agree that we need a high quality work force who are well trained and supported, but if the review concludes that they are not, is the hon. Lady saying that controls should be imposed on local authorities from the national level?

[Liz Kendall]

If the right hon. Gentleman reads our new clause 18, he will see what our approach is. Local councils commissioning social care and having to fulfil their obligations under the Bill will need to look at employment terms and conditions. We have tabled the new clause because unfortunately the Government are removing the Care Quality Commission’s role in assessing how well councils are commissioning services, which I think is a mistake.

NHS Risk Register

Debate between Liz Kendall and John Redwood

Wednesday 22nd February 2012 Commons Chamber

[Liz Kendall]

I have outlined what local NHS services have said about the risk register. If the hon. Gentleman had been in the debate earlier, he would have heard Government Members saying that we are not focusing on patient care or setting out how the NHS needs to change. The point that I am making is that the Bill will prevent the strategic changes that the NHS needs.

There is no evidence that smaller, GP-led commissioning groups can deliver major changes to hospital services. The organisations that have done so, such as NHS London, are being abolished. The real risk is that the full, free and unfettered market that will be introduced by part 3 of the Bill will stop the NHS from making the changes that patients desperately need. It risks preventing hospitals from working together to centralise stroke or trauma care; it risks preventing hospitals from running local community services or working with GPs and local councils to better integrate care, for fear that they will fall foul of UK and EU competition law; and it risks putting power into the hands not of patients and clinicians, but of lawyers and the courts.

[Mr John Redwood (Wokingham) (Con)]

I am delighted by the conversion of the Opposition to more transparency now that they are out of office. Can they show the Government how to do it by publishing the internal documents that are critical of their leader’s strategy for change in the Labour party?

[Liz Kendall]

With the greatest respect to the right hon. Gentleman, I will not waste my time on that point when we have important issues about the future of the NHS to discuss.

Government Members should realise that GPs, nurses, midwives, health visitors, public health professionals, psychiatrists, physiotherapists, radiologists and Opposition Members are against the Bill, not because we are against change, but because it will prevent the changes that the NHS needs.

Government Members do not want to talk about part 3 of the Bill, because they know that people do not want their NHS run like any other market. The Secretary of State and the Prime Minister claim that their Bill is all about cutting bureaucracy and putting patients and clinicians in control, yet the Department of Health now admits in its fascinating document, “Design of the NHS Commissioning Board”, that there will be five layers of management in the Government’s new NHS, except in the performance and operations directorate, in which

“an additional layer (or layers) will be required”.

In place of strategic health authorities and primary care trusts, we will now have the NHS Commissioning Board, four commissioning sectors, 50 local offices, commissioning support units, clinical senates and clinical commissioning groups, as well as Public Health England and the health and wellbeing boards. Patients and staff have been left completely confused about who is responsible for running different services and how they will be held to account.

The Government say that the new structure will cost £492 million a year.