Health and Social Care Bill

Lord Greaves Excerpts

Monday 19th March 2012 Lords Chamber

[Baroness Finlay of Llandaff]

My Lords, it is with a very heavy heart that I feel I must stand up and record that many of the voices outside, who are very scared about this Bill and what it means, are people who are of no particular political persuasion. Yet they are worried about the problem of lack of financial transparency, about the number of private healthcare companies incorporated in offshore jurisdictions—which they see may evade taxes of various types—and about the commissioning process. They are also concerned that the use of public money in the healthcare system will slowly be obscured like a great iceberg wrapped in fog. They will work to deliver whatever is needed for the patients in front of them. The vast majority of them stand to gain nothing by this Bill passing, but to gain nothing either if it does not pass. They want to improve the standards for their patients, and indeed they argue for change.

The noble Earl has worked tirelessly and has confidence across the whole House. Everybody, however much they have been concerned about this Bill, owes him an enormous debt of gratitude for the way that he has listened to every single one of us, at all times of the day and night, and weekends and so on. But we should not let this Bill pass without recognising the enormous concerns there are outside this House among those who will be delivering healthcare, now and into the future, in whatever form it takes.

[Lord Greaves]

My Lords, this has been an extraordinary parliamentary process. When this Bill was introduced, I said at Second Reading that it was a bad Bill. It was a bad Bill when it came here; there has been a growing tide of opposition to it and concern throughout the process while it was in the Commons and the Lords. There was the pause in the Commons and the Future Forum, which resulted in a large number of changes, and at that time Nick Clegg said that no Bill is better than a bad Bill. What we all individually have to do now—I speak very much for myself and not my party—is to assess whether it has now moved over from being a bad Bill to perhaps being, as Nick Clegg said last week, a much better Bill.

There is no doubt at all that on a spectrum of bad to good, it has shifted very considerably. It shifted in the Commons; it shifted far more here in the House of Lords. I believe that the process in your Lordships’ House has been the House of Lords at its best. This House can be proud of the work that it has done throughout the gruelling Committee stage, then during Report and again today. I regret that I could not take a detailed part in much of that, because I was then spending time as a patient of the NHS, but I have been watching it all and I believe that the work this House has done has been absolutely superb.

If I can make a party political point here for a moment, the work that our team has done on the Bill, led by my noble friend Lady Jolly with all my other noble friends who have taken part, has contributed well. I refer not only to the Liberal Democrats but to Cross Benchers and everybody around the House. Tribute has been paid to the Minister. I pay particular tribute as a Liberal Democrat to our person on the ministerial team, my noble friend Lady Northover, who from our point of view has played a very important part by being a link into the Government and getting many of the changes which have taken place.

It is about not just the changes to the Bill but the implementation—the work that starts after this Bill has been passed, as no doubt it will be today. A huge number of ministerial assurances have been made, which may or may not be put upon people’s bedroom walls as the noble Baroness, Lady Cumberlege, wants to do with hers. Nevertheless, this is a Bill which has had more outside scrutiny and involvement from people out there, as far as the House of Lords is concerned, than any other Bill I can remember in 12 years in your Lordships’ House. That will continue with the implementation, and it is absolutely crucial how the Government now implement this Bill. Will it be gung-ho privatisation, which is what people were very frightened of when the Bill was first introduced and many are still frightened about, or will it be implemented in a cautious and careful way to allow the health service to breathe and to cope with the changes? This will be absolutely crucial, and we will know the answer to that in a year or two’s time.

The noble Earl, Lord Howe, said that we have had debates of unparalleled length and scope, and that is true. However, as I have just said, the public interest and lobbying on this from outside has been unprecedented. One of the lessons that we all have to learn is that we—whether the House of Lords, members of the Government or our party—have not coped with that very well. I do not think that the Opposition coped with it terribly well either because, even this morning, I was getting e-mails telling me what the Bill did, some of which was absolutely untrue. They were still telling me that the Bill removes the duty on the Secretary of State to provide health services. We are still getting that, and the amount of education or information which goes out from debates within this Chamber to the outside world is pretty poor.

Several people have said, “We have been trying to follow this Bill. We have been trying to follow your Marshalled Lists, having discovered where to find them on the internet. We have been trying to follow the parliament channel, and we haven’t understood a word of it. It is interesting, but we can’t understand it”. I have to tell them that that applies to quite a lot of Members of your Lordships’ House while the Bill is going through.

[Lord Winston]

Could the noble Lord tell us whether he intends to vote for or against the amendment?

[Lord Greaves]

I am coming to that. So having said all this, why am I going to vote for the amendment moved by the noble Baroness, Lady Thornton? I will do so very unhappily because I do not like voting against my noble friends, particularly when they have done so much hard work and achieved so much. I do not like voting against the party anyway but, having looked at it, it seems to me that the safeguards which have been achieved are not sufficient. Having read the latest version of the Bill which we got at Third Reading, I think it is inevitable that this Bill will lead to greater commercialisation. It will lead to a greater emphasis on competition rather than integration, and to a continuing incursion of private sector-based companies into the provision of NHS services. It is undoubtedly a radical top-down restructuring, in direct contradiction of the coalition agreement that I signed up to. That is being imposed on the health service at the same time as it is struggling with the biggest financial problems that it has had for many years. This is all in the face of the overwhelming opposition of NHS staff, professional groups, patient groups, public opinion and, indeed, a majority of people in my own party and of people who vote for us.

I believe that the new structures at local level will be no less bureaucratic, less open and accountable—

[Noble Lords]

Sit down.

[Lord Greaves]

I am just saying what I think, and I have a right to do that. I believe that my party is being extremely brave in supporting this Bill as it now exists. I also believe that my party has had a bit too much of being extremely brave in recent times, but nevertheless, it is. I voted against this Bill at Second Reading; I will do so again now in favour of this amendment.

Now I feel very much like little Johnny, marching along, and all the rest of my party are out of step. I think that I am in step, and I think very hard indeed about this. Your Lordships’ House as a whole, and the Government, are the people out of step—certainly out of step with opinion in the country and in the health service. However, I agree entirely with what the noble Baroness, Lady Thornton, said, about what now matters if the Bill is passed—[Interruption.] I do not know whose phone that is; it is not mine. That is someone who is out of step.

There has been a lot of alarmist talk. It probably will not amount to much, but it is up to everyone in the health service, and to us here as we scrutinise the regulations, to ensure that it does not. I am frightened by this Bill and I shall vote against it.

[Noble Lords]

Hear, hear!