Health and Care Bill

Lord Desai Excerpts

2nd reading
Tuesday 7th December 2021 Lords Chamber

[Lord Desai (Non-Afl)]

My Lords, I add my congratulations to everybody else’s on the brilliant maiden speech made by the noble Lord, Lord Stevens. The noble Lord, Lord Patel, described many of his achievements, but he failed to mention that he was a member of the Holloway ward Labour Party many years ago, of which I had the honour to be chairman. I am sure he gained lots of knowledge at that time.

There are some great constants in British political life. One is that we always say that our NHS staff are marvellous, and they are, but we do not meet their wage demands; they have to be underpaid to be marvellous. The NHS is always in crisis, and we all love it. This is the great contradiction of British political life: everybody praises the NHS, Governments never pay NHS staff adequate wages, but we all love it.

I worry that this Government’s ambition, as set by the Chancellor, whom I respect very much, is to be a tax-cutting Government. A tax-cutting Government will never adequately fund the NHS. I also worry that when there is a funding crisis, all Governments reorganise the service, because somebody says, “There’s a lot of waste in the NHS, and we must cut the loss and get more managers”, or, “We want more integration”, and so on. So I somewhat welcome this Bill, but I do not think it will solve anything very much.

The biggest failure of the NHS, if I may say so, has been that health inequalities have not been corrected as much as we hoped when it was established. When the pandemic happened, you did not need a computer to predict who was going to be last in the queue. The postcode lottery always works. Women, the elderly and racial minorities will always be the last in the queue and will suffer. This should not happen in a universal healthcare system. Unless we make that the primary concern of any reform of the health service, we will still be waiting for the next reorganisation, and the next.

This is, I am sure, a very good Bill. Lots of professionals and others who have engaged themselves with the National Health Service will find good things to say or good things to change in it. However, I would like to have seen a 15-year funding plan for the NHS, guaranteed by the Government, which would say: “We cannot do it now but within five or 10 years we assure you that, given the increasing needs of the population for health services due to age and other problems, we will meet those needs adequately and remove inequalities and problems at least by date X.” That is not happening, and I do not think it will happen any time soon.

Let me say one more thing. I am an economist and have to say something about economics. One thing I said many years ago when I was on the shadow Front Bench as spokesperson for health is that, while the NHS is free at the point of service, we have to make people aware that it is not costless. We have to make patients aware that everything they do costs money somewhere in the system. At that time, I wanted to propose a smart card. Each time anybody uses the National Health Service, it tells them how much it costs, not how much money they have to pay. They just tap it and it shows the cost so that people are aware that not going to an appointment costs money and calling an ambulance costs money. If people become aware of how much it costs, we may get a little help from the patients as well as from the service.