NHS Outsourcing and Privatisation

Debate between Maria Caulfield and Jonathan Ashworth

Wednesday 23rd May 2018 Commons Chamber

[Jonathan Ashworth]

If Members will forgive me, I will make a little bit of progress, and then hopefully we will get a chance for more to come in later.

Labour has been calling for a long-term economic plan for the NHS. We are led to believe that the Secretary of State agrees with us, because according to The Guardian, in an article headed “Hammond and Hunt in battle over NHS funding boost”, the Secretary of State and Chancellor are reported to be “at loggerheads”, with the Secretary of State calling for £5.3 billion extra, but the Chancellor only wanting to offer £3.25 billion. Of course, neither is quite as generous as the extra £45 billion for the NHS and social care across the Parliament that Labour was offering, but we will watch carefully.

Our plans would have been funded from increasing taxation on the top 5% of the wealthiest in society. Perhaps the Secretary of State can tell us how he proposes to fund his extra £5 billion. Will it be an increase in national insurance for pensioners, as has been floated? Or will other Departments be cut? Will the defence budget be cut to fund the extra £5 billion increase in the NHS? Will it be a move towards co-payment and charges? Or will it be another conjuring trick from the Secretary of State, whereby he claims to be increasing the funds going into the health service, only for us to subsequently find out that public health budgets, training budgets and infrastructure budgets have been cut and the settlement is not quite as generous as we have been led to believe? According to tomorrow’s Spectator, there will be a Tory splurge on the NHS, so he should honour the House today with his confidence and tell us where he thinks this splurge will come from—tax rises, cuts elsewhere, or charges and co-payments.

I remind the right hon. Gentleman: it was a Labour Government with Gordon Brown who increased taxation to pay for the NHS and helped us treble funding in cash terms, and it will be the next Labour Government who will increase taxation for the very wealthiest in society to fund a long-term, sustainable plan for the NHS. When we face the demographic challenges of an ageing population, with people living longer, the disease burden shifting and people living with co-morbidities, and when we are on the cusp of great advances and innovations from artificial intelligence and genomics, is it not clear that the current fragmented structures of the NHS are wasting energy, wasting time and wasting resources?

We are now led to believe that, according to the BBC, the Prime Minister and the Secretary of State, despite both having sat in a Cabinet that agreed the Health and Social Care Act 2012, have realised that the structures produced by that Act have been a dismal failure. I do not like to say, “We told you so,” but we did actually tell you so. The Act has created a fragmented mess, with healthcare leaders trying to work around it. I say to the Secretary of State that it does not need amending—it simply needs consigning to the dustbin of history to be included in the next edition of “The Blunders of Our Governments”.

We will test any new legislation that the Secretary of State brings forward to see if it moves towards greater collaboration—away from a purchaser-provider split model in favour of partnership and planning. Any new legislation should bring an end to the creeping, toxic privatisation of the NHS and instead restore and reinstate a public universal national health service. The Health and Social Care Act has contributed to the reality today where, according to the Department of Health’s own figures, £9 billion is spent on private providers—a doubling in cash terms since 2010. Indeed, we have seen about £25 billion of contracts awarded through the market since the Act came into force.

Of course, there has always been a role for the private sector in providing services, as I said to the hon. Member for East Worthing and Shoreham (Tim Loughton), who is no longer in his place, as indeed there has always been a role for the voluntary and co-operative sector. But the combination of years of underfunding alongside the constant tendering of contracts via the any qualified provider arrangements has led to creeping privatisation. Before Government Members tell us that this is just 8% of the total budget—in fact, the Secretary of State told the House in January that it is “not huge”—let me point out that the problem is that that 8% is located almost exclusively in areas like elective care, community services and patient transport, meaning that the private sector is disproportionately influential in those areas. Moreover, the way in which the funding mechanism works restricts NHS income from those areas and leaves NHS providers picking up the more complex, costly cases—emergencies and the chronic sick. In other words, outsourcing and privatisation is increasingly a false economy where supposed savings are easily outweighed by the costs.

But more importantly than that, privatisation has first and foremost a detrimental impact on patient care.

[Maria Caulfield (Lewes) (Con)]

rose—

[Jonathan Ashworth]

I will give way to the hon. Lady because she is a nurse.

[Maria Caulfield]

Does the hon. Gentleman not agree that the any qualified provider system was brought in under the previous Labour Government in 2009?

[Jonathan Ashworth]

I remind the hon. Lady, whom I greatly respect in this House because of her work in the NHS, that we moved away from that system to a preferred provider mechanism because we knew that the any qualified provider mechanism did not work and was not in the interests of patient care or the interests of the taxpayer.

Let me give some examples. On support services, GPs have warned repeatedly of the dangers of NHS England outsourcing primary care services to Capita, in a contract designed to save £40 million. Those fears proved well founded, as the National Audit Office found that there was a real risk of “serious patient harm” stemming from Capita’s handling of the contract, with major problems around the secure transfer of patient notes, with notes going missing or delivered to the wrong surgery. Capita’s work in providing back-office services such as payment administration, cervical screening tests, medical records and supplies orders had fallen

“well below an acceptable standard.”

On patient transport contracts, I mentioned to the right hon. Member for Mid Sussex (Sir Nicholas Soames) what happened with Coperforma. This was a contract worth £63.5 million.

[Maria Caulfield]

rose—

[Jonathan Ashworth]

And the CCGs are still paying out to Coperforma—is that not correct?

[Maria Caulfield]

With regard to Sussex—I am sure that my right hon. Friend the Member for Mid Sussex (Sir Nicholas Soames) would agree with me—the last time Labour was in government it proposed to close the Princess Royal Hospital in Haywards Heath.

[Jonathan Ashworth]

I am sure that the hon. Lady accepts that it is a scandal that the CCGs—her local health economy—are still paying out to Coperforma. She should be getting up and complaining about that.

What about support services? Interserve was brought in to provide facilities management across 550 NHS buildings across Leicestershire, with a seven-year, £300 million contract. The contract was scrapped four years early because of reports of patients receiving meals up to three hours late, bloodstains in the corridors and bins not emptied. How about Carillion, which won a £200 million, five-year estates and facilities management contract with Nottingham University Hospitals NHS Trust? It failed to clean the hospitals properly, with reports that infectious waste was seen overflowing in the children’s ward.

NHS Pay

Debate between Maria Caulfield and Jonathan Ashworth

Wednesday 13th September 2017 Commons Chamber

[Maria Caulfield (Lewes) (Con)]

rose—

[Jonathan Ashworth]

The hon. Lady has often spoken out on this matter, so I feel I should take her intervention, but then I will make progress, if the House will indulge me.

[Maria Caulfield]

It is generous of the hon. Gentleman to give way. As he says, I support the lifting of the pay cap and I am pleased that the Government are moving on this. My concern about supporting this motion is that Labour do not seem to have learned the lessons from crashing the economy in the first place. Could he outline what level of pay rise the Labour party is proposing for public sector workers—1.5%, 2% or 3%—and how it will be paid for? That is crucial to influencing the voting intentions of Members like me.

[Jonathan Ashworth]

I have a huge amount of respect for the hon. Lady; we have had conversations outside the rough and tumble of this Chamber, and I know she takes these matters extremely seriously. I would ever so gently say to her that she has been telling newspapers that she supports getting rid of the cap; she has been hosting nurses in Parliament, saying that she would get rid of the cap; well, this evening she has an opportunity to take a stance, ignore the Tory Whips and vote for getting rid of the cap.

[Maria Caulfield]

In this debate, we must be honest with the British public about how we are going pay for the lifting of the pay cap. If Labour wants to lift the pay cap, can the hon. Gentleman explain how the Labour party will pay for it? Will it be through increased taxation or more public borrowing, or will Labour shift spending priorities? We need to know the detail in order to be able to support this policy.

NHS and Social Care Funding

Debate between Maria Caulfield and Jonathan Ashworth

Wednesday 11th January 2017 Commons Chamber

[Jonathan Ashworth]

If I may, I will make a little progress. I promise to try to give way to as many hon. Members as possible.

I assure the Secretary of State that I will pass on the names of the trusts and hospitals that I highlighted, so perhaps he can look into them. Let us be absolutely clear that these desperate stories are not the words of politicians trying to score political points but are the honest, heartfelt, considered testimonies of doctors and clinicians on the frontline in our hospitals. They simply want to do the very best for their patients. Indeed, many clinicians want to speak out but feel that they cannot, which is why the remarks were made anonymously.

According to reports on the BBC’s “You and Yours”, the Prime Minister has sent instructions to hospital trust chief executives telling them not to speak out. I would be grateful if the Secretary of State verified those reports.

[Maria Caulfield (Lewes) (Con)]

I worked in the NHS over the Christmas period. Although it has been a very tough winter so far, this is nothing new. I have worked in the NHS for more than 20 years, and under previous Governments we had ambulances queuing around the block to get into A&E. Major incidents were declared in A&Es because they were too full. Will the hon. Gentleman accept that this is not a new problem?

[Jonathan Ashworth]

I entirely respect the hon. Lady’s work as a nurse before she came into this place—[Hon. Members: “She still is.”] I beg her pardon. She is still a nurse, and I genuinely respect her, but if we are not raising these matters on behalf of our constituents, we are failing in our responsibility as Members of Parliament. We must never forget that this is not just about the staff in our NHS; it is about patients and their safety, which must always be our absolute priority.