Winterbourne View Care Home

Malcolm Wicks Excerpts

Tuesday 7th June 2011 Commons Chamber

[Paul Burstow]

It is essential to establish a statutory basis for safeguarding adults boards, but it is not sufficient, as other issues must be addressed in the review, which is why various aspects of the work are progressing. However, it is right that we should respond quickly to the Law Commission, which recommends that we should put the boards on a statutory basis, and that is what we will do when legislation is introduced.

[Malcolm Wicks (Croydon North) (Lab)]

If, as is often said almost as a cliché, a test of a civilised society is how we care for the most vulnerable—sadly, it is likely that Winterbourne is not an isolated example, and that even today many frail elderly people, often with dementia, and people with mental illnesses or learning difficulties are being abused and neglected—we must all think hard about how to move forward. Strong and unannounced inspections are clearly a significant part of the answer, but are there ways in which we can involve local communities and concerned citizens in safeguarding the well-being of people in homes—often private homes? If around every home there were two or three citizens who had rights to enter and could befriend some of the people there, that might be another way in which the community could add to the statutory services to try to prevent occurrences in future.

[Paul Burstow]

I am grateful to the right hon. Gentleman for his question. We must acknowledge that there will never be a time when there is an inspector in every room of every care home for every minute of every day. We must therefore make sure that the systems in place are robust, and that organisations are recruiting the right people and delivering the right training and supervision. However, the right hon. Gentleman’s point about the involvement of the community is spot-on. That is why we are proposing the establishment of HealthWatch and why we see that as an opportunity for citizens to become involved in the provision and scrutiny of health and social care in their communities.

NHS Reform

Malcolm Wicks Excerpts

Monday 4th April 2011 Commons Chamber

[Mr Lansley]

I am very grateful to my hon. Friend. This is born not of political opportunism, as it seems to have been characterised by the Opposition, but of a determination to support those people in constituencies that my hon. Friends on this side of the House have been talking to and listening to. As he knows, GPs in his area have come together. For example, when I met people at Southampton hospital recently, they were able to talk about how they were working together on improving the clinical design of services for patients in his area.

[Malcolm Wicks (Croydon North) (Lab)]

Why has the Secretary of State waited until now, after the passing of the Bill through its Committee stage, to announce a so-called natural break in which to listen to and engage with the public? Perhaps I am old-fashioned, but would not the normal process involve getting the brain into gear to avoid putting the foot in the mouth?

[Mr Lansley]

If I did not come to the House to make a statement, I would be accused of not doing so, but when I do so, the Opposition ask why. The reason is very simple: it is because we are going to listen, and to engage with people actively over the course of the coming weeks, and I did not want the House to see that happening during the recess without having been told about it beforehand.

NHS Reorganisation

Malcolm Wicks Excerpts

Wednesday 16th March 2011 Commons Chamber

[Mr Lansley]

My hon. Friend makes a very important point. I caution Labour Members not to put political opportunism in place of the relationships that they should have in future with GPs, doctors and nurses and local foundation trusts in their constituencies. They are not speaking for their constituencies—they are just speaking for the trade unions.

The coalition Government are listening to patient groups, professional bodies and independent experts. We have had eight separate substantial consultations on our proposals, and we have changed policy as a result. For example, we have amended the Health and Social Care Bill on an important point, which greatly concerned the BMA, and clarified that the measure supports competition on quality, not price. At the point when a patient exercises choice or a GP undertakes a referral, the price of providers will be the same. By extension, competition must be on the basis of quality. That is important.

[Malcolm Wicks (Croydon North) (Lab)]

Given the removal of the limit on private patients who can go to an NHS hospital, my constituents will be concerned that, in conditions of scarcity, clinical need for a bed will be trumped by the weight of a wallet. Will the Secretary of State reassure my constituents that money will not trump the needs of patients?

[Mr Lansley]

Yes. I can entirely reassure the right hon. Gentleman’s constituents because the Bill makes it clear that even if private patient income is available to foundation trusts, it must support the principal purpose, which is provision of services to patients through the NHS. If the right hon. Gentleman wants an example, he might like to go along the road into the constituency of the Minister of State, Department of Health, my hon. Friend the Member for Sutton and Cheam (Paul Burstow), and meet people from the Royal Marsden, which is a foundation trust that attracts, from memory—I may not be entirely up to date—approximately 25% of income from private patients. It has consistently recorded the highest scores of excellence for its quality of service to patients.

Health and Social Care Bill

Malcolm Wicks Excerpts

Monday 31st January 2011 Commons Chamber

[Malcolm Wicks (Croydon North) (Lab)]

The status quo in British health care is certainly no serious option. Improving the NHS is, of course, a continuing challenge, not least because of the ageing of our population, rising medical costs in many sectors and rising public expectations, which are sometimes fuelled by information on the internet. If one adds to that the new public health agenda and the need to bring health and social care into better alignment, one can see the scale of the challenge. However, that is not to say that a top-down reorganisation is the answer.

I want to ask Ministers some specific questions about how the Bill will impact on some of the values and underlying principles of the NHS. The first is the principle that the health service should be based on need, not income or wealth, which is perhaps the essence of the NHS. How do the proposals relating to private patients in hospitals relate to that ethical principle? The proposal is to remove any limit on the use of NHS beds and staff to treat privately paying patients. Unless the Government somehow envisage surplus hospital resources, spare staff and empty beds—a far-fetched proposition—will not more private patients create longer waiting times for NHS patients and/or poorer care? What is the Minister’s judgment on that?

My second question concerns the profit motive, which jars, at least for many of us, with the principle of patient care. Will Ministers confirm that private companies might in practice commission on behalf of GPs, possibly including US companies, while other companies will be awarded contracts? Have I understood that correctly? What is to stop companies competing on price for relatively straightforward procedures, perhaps initially cherry-picking as a loss-leader while leaving NHS hospitals with, frankly, the more difficult medical territories? What proportion of the NHS budget might effectively be in private hands? Of the £80 billion annual expenditure that we hear about, what sums might end up as profits for private shareholders? Ministers must have some idea of the answers to those questions, so I would be pleased to hear their answers or guesstimates.

[Margaret Hodge]

Does my right hon. Friend agree that there is another issue with privatisation? If a private, BUPA-run, hospital that provides health care gets into financial difficulties and is forced to close, does it not behove the commissioning body—the publicly run commissioning body—to take over the failing private hospital to ensure that the designated services are available to local people? Is that not an outrageous way of using public money?

[Malcolm Wicks]

Certainly, I can see that the commissioners might feel that someone had to look after the patients, and the financial implications of that pose another question for Ministers.

Given that the Bill allows for the new commissioning board to make payments to a commissioning consortium if performance is good, what happens exactly to that payment? Who benefits from it? Does it go to improved patient care, which is fine, or to bonuses for those working in the consortiums—the GP practices?

My third set of questions concerns accountability and parliamentary oversight. In this brave new world of competition, profits and privatisation, with the fearsome economic regulator, where does the NHS buck stop? Is the Secretary of State still responsible? Is he or she still accountable to this Parliament? If not, who is? If my Croydon constituent has to wait too long for surgery, are Ministers accountable? Can I ask questions? Will I get answers? If constituents cannot access mental health services, can MPs still expect Ministers to intervene and to act? Are they accountable? Will Parliament and public still be able to access the information, the data, the monitoring and the evaluative statistics to comment on performance? Is the publication and integrity of health statistics guaranteed by the legislation?

A further question concerns the relationship between patients and GPs. The Secretary of State and his colleagues wax lyrical about how decisions will now be taken by GPs and patients, and I remember that refrain during the general election, but what exactly does that mean for patients? How will those decisions be taken by patients as well as by GPs? How will patients be involved in commissioning? Will they be part of the commissioning body?

Moreover, will GP commissioners meet in public, like primary care trusts? If not, why not? Where is the accountability? If a patient wishes to complain about services, to whom do they complain—to their own GP, who does the commissioning? Where is the patient’s complaint procedure in all that?

This Bill—[Interruption.] There is no point in the Minister just whispering at me. We have a winding-up procedure, whereby serious questions can be answered— I would hope—rather seriously by the Minister. [Interruption.] She has not wound me up so far.

The Bill is somewhere between a relapse into market ideology and an untried, untested leap in the dark. For the national health service, it is a fearful time. As we have heard, the Government wish to cut public expenditure, yet they are embarking on this top-down reorganisation that no responsible body seems to welcome.

The Bill will also be shown to be a fearful leap in the dark for the Conservative party, just when in recent years it has been making some headway in convincing the British public that the national health service might be safe with it. It is a fearful step for the Conservatives, and they will learn that in the coming years.