Health and Social Care Bill

Lord Cotter Excerpts

Tuesday 11th October 2011 Lords Chamber

[Lord Cotter]

My Lords, today we have had the chance to debate just about the most important subject for the people of this country that could be facing us—health.

I pay tribute at this stage to those who work in the health service and who put their heart and soul into caring for us and our families. I also thank the many people in the health service who have sent us information about their concerns with and practical experiences of the health service, as well as their concerns about the treatment that they will receive in the future. It is easy to dismiss such information as lobbying. I do not see it as that; I think that we can make a judgment about what is and is not relevant. However, it has been very important for this debate to have received so much information from our own parts of the country, as well as nationally, about how people feel and about their concerns with what we are now addressing. We are also at a time when morale among staff in the health service is extremely low. That is the message that I get from them. Many people are waiting for the results of this Bill with some trepidation.

Regardless of going into the detail of the proposals, I wonder whether such detailed changes are right at this time—perhaps at any time—when we are so short of the money that is required to implement the measures. I liken it to throwing all the balls in the air and hoping that they will land the right way. I do not want to be too negative or at this late hour to repeat too much of what has already been said. However, there are worries about competition. Is it really the case that providers can be fined a considerable figure if they are not seen to be competing enough? How is that to be assessed? Competition in what way?

One of the big commitments of the coalition Government is to reduce red tape and bureaucracy in this country. That is good but, with all the myriad bodies that are being created to implement the Bill, are we sure that we are not adding more bureaucracy rather than having less? It has been suggested that the number of quangos will increase from 163 to more than 500. Is that so? If it is, is not the complexity, bureaucracy and red tape that that could create a matter of concern? It is of course necessary to have regulation but we need to be careful that it is the right sort of regulation.

The role of the Secretary of State has been raised more than once, having been put into question or, at least, been questioned. I am sure that the Minister will be able to provide an assurance in this area, because this is seen as a crucial point to be addressed.

Another point that has arisen in the debate today and has also been in evidence for a while, and on which we need clarification, is the situation regarding untrained health workers or healthcare assistants. Will they be covered by a voluntary register or, better still, have a binding code of conduct? This will give reassurance and perhaps raise the standards that we expect to receive from the health service.

For the 15 years or so that I have been in Parliament, I have been aware of the need for all Bills to have strong impact assessments. I remember in about 1998 or 1999 thinking that quite a lot of Bills which were not adequately supported by impact assessments were going through Parliament and, over time, that has been proved to be so. However, I have seen it expressed that the impact assessment associated with this Bill is perhaps not sufficient to cover all the different changes that will take place. I would be interested to hear from the Minister whether that is so.

It is late at night, but I would like to turn to a personal point. I hope that we can all consider the health service in respect of the alternative health sector. I have gained very much from being treated by Chinese medicine, acupuncture and herbal treatments, as have a number of members of my family. I know that acupuncture has been discussed quite a lot but not so many years ago it was dismissed out of hand as some sort of quaint treatment, which has not proved to be the case. Recently, I opened the World Congress of Chinese Medicine in London, and I was asked to speak as I have an interest in the subject. I stayed for a good part of the day and it was absolutely clear how much scientific work has been done to assess and to show that there are clear improvements to be had from acupuncture.

I have also gained very much from herbal treatments. My experience with alternative medicine is that you get a quick diagnosis and treatment on the same day. The experience of my friends and family is that the assessment is often very good and getting treatment right away is, of course, so vital and can result in improvement in people’s health much quicker than perhaps happens in the health service. I do not want to be too critical but when you go to a GP, they can be a bit puzzled about your condition and eventually they say after a month of trying this and that, “I will send you to a consultant”. But time elapses and my experience with the alternative medicine sector, particularly with Chinese medicine, is that it is very good in that respect. I throw this point out to the Minister to see whether we can formalise it for the future.

I have repeated some of the points that have been made during the debate, which has clearly indicated that there is much work to be done to address fears and concerns and, if necessary, to make corrections to the Bill. We have a big job and a big responsibility ahead of us to ensure that we in this House check the legislation and ensure that the NHS is safe in our hands.