National Health Service (Amended Duties and Powers) Bill

Mark Reckless Excerpts

Friday 21st November 2014 Commons Chamber

[Mark Reckless (Rochester and Strood) (UKIP)]

It is a pleasure to speak on this Bill.

[Mr Ronnie Campbell (Blyth Valley) (Lab)]

On this side of the House.

[Mark Reckless]

And indeed on this side of the House.

It is a particular pleasure to speak on a Bill introduced by the hon. Member for Eltham (Clive Efford), because I have spent time in the past few weeks defending myself following allegations from the Conservative party that I grew up in his constituency, in SE9.

[Clive Efford]

You should be proud.

[Mark Reckless]

Indeed, I am proud, and many people in my constituency have moved down from Eltham and the surrounding areas, and I am delighted that they returned me to the House in the early hours of this morning.

I found the hon. Gentleman’s speech compelling. At half-past 4 this morning or thereabouts, I was extolling the virtues of the Levellers and the Chartists. I can only think that I had a premonition of the speech that the hon. Gentleman was to make in the House this morning.

The other reason for my presence here is that, in the by-election I have just fought, we had in Naushabah Khan a Labour candidate who made—quite eloquently, I thought —the case against fragmentation and privatisation of the NHS, and she and others in Medway Labour commended the Bill to me.

[Grahame M. Morris]

I was not in Rochester last night. I joined a vigil outside Parliament by groups who are campaigning to save our NHS, and I had a conversation with a consultant oncologist on that very issue of fragmentation. He said that the only competition we should have in the NHS is the competition to defeat disease. Does the hon. Gentleman agree with that?

[Mark Reckless]

That sounds a good statement. I myself feel a certain degree of scepticism, as the hon. Member for Southport (John Pugh) said, about internal markets in the NHS and other public services. Much depends on the circumstances of the service provided, and an ideological predisposition either against or in favour of internal markets is probably not wise.

The Labour candidate in the by-election opposed fragmentation and privatisation of the NHS, and the Bill appears to do so as well. I have discovered that this is now the Labour party’s position. I had assumed that the Labour party was in favour of fragmentation and privatisation in the NHS, because that was my understanding of what the record had been.

[Andy McDonald]

Perhaps the hon. Gentleman would like to clarify, for the benefit of the House, whether his party is in favour of a private insurance-backed approach to health care or whether it actually believes in the NHS.

[Mark Reckless]

My party believes in the NHS as a service that is free at the point of delivery. My father is a doctor, and my mother is a nurse. That belief is core to my values, and to the values of my party. [Interruption.] That is our policy. Our policy is determined by our party, and it is to support an NHS that is free at the point of delivery.

[Mr Anderson]

When did the hon. Gentleman come to that conclusion?

[Mark Reckless]

I think that the hon. Gentleman may be referring to the answer to a question that was asked two years ago, which is now being taken out of context. Our party is not quite like the Liberal Democrats with their federal policy executive, but we have formal measures for the making of policy, and UKIP has decided—

[Mr Anderson]

Will the hon. Gentleman give way?

[Mark Reckless]

I will continue, if I may.

[Dr Huppert]

rose—

[Mark Reckless]

I will give way to the hon. Gentleman.

[Dr Huppert]

Although I do not agree with the hon. Gentleman on many things, I welcome him back to the House. He has talked about the history and the evidence. He might be interested to know that, according to the House of Commons Library, the amount spent by NHS England on buying health care from outside the NHS rose from £1.1 billion in 1997-98 to £7.5 billion in 2009-10. Those are the facts, according to the Library.

[Mark Reckless]

The hon. Gentleman is correct. There was a great deal of privatisation and, indeed, fragmentation of the NHS under Labour, and I do not deny that there has been more of it under the current Government. I think that it is a problem that has afflicted both main parties.

[Mr Anderson]

rose—

[Mr Donohoe]

rose—

[Mark Reckless]

I will continue for a bit, if I may.

Let me explain how I view the issue from a local perspective. As far as I can see, Darent Valley hospital, which is near my constituency, was privatised under Labour in one of the most disastrous private finance initiatives experienced by the NHS. Medway NHS Foundation Trust became a foundation trust on the basis of what was largely a box-ticking exercise, which focused on finances and appeared to ignore the fact that by that stage the hospital’s standardised mortality rate was some 10% above the norm: one in 10 more patients were dying that should have been expected.

[Mr Donohoe]

I know that the hon. Gentleman had a late night, but can he tell us what is his party’s view of the health service in Scotland?

--- Later in debate ---

[Mark Reckless]

I will clarify the view of my party on the NHS in general, but I am afraid that I am not yet in a position to give details of its policy on the NHS in Scotland. I should be happy to seek to assist the hon. Gentleman on another occasion.

What happened in Medway was fragmentation. The hospital was cut loose by the Department of Health, and is now essentially run by an independent board. When there are problems and it is in special measures, there is now a potential for greater intervention, but we have in Monitor what appears to be a backstop regulator, rather than a regulator that is able to come in and run the hospital and turn it around. It can get rid of the chair and the chief executive, but it cannot make constructive improvements.

[Mr Anderson]

Will the hon. Gentleman give way?

[Mark Reckless]

I will continue, if I may.

The independence of such hospitals, the inability of the House or the Secretary of State to drive improvements, and the decision to allow a hospital to become a foundation trust although one in 10 more people were dying than should have been the case, constitute an indictment of the last Government’s policy. I was delighted to hear from the Labour candidate whom I have faced in recent weeks that Labour is now against fragmentation and privatisation of the NHS. I welcome the Bill, and I am pleased to be able to support it.

[Clive Efford]

I welcome support for my Bill from all quarters, but why should anyone believe what the hon. Gentleman says about the NHS? Does he accept that the Government were elected with no mandate to introduce the 2012 Act, and that he voted for it?

[Mark Reckless]

I think that that is probably correct. I may be guilty of having believed the undertakings I was given by those on the Government Front Bench.

[The Parliamentary Under-Secretary of State for Health (Dr Daniel Poulter)]

It might be helpful for the hon. Gentleman to bear in mind the words of his colleague, the hon. Member for Clacton (Douglas Carswell), who said:

“Never one to slavishly support the party line, I would be quite prepared to oppose these reforms”—

the 2012 Act—

“if I felt they were a step back. But I won’t. These changes are necessary—and contrary to much of the mainstream media coverage, in my experience they are quietly supported by many doctors too.”

Does the hon. Gentleman support what his colleague said, or does he not?

[Mark Reckless]

I think that my hon. Friend the Member for Clacton (Douglas Carswell) was right in saying that some doctors supported the Bill that became the 2012 Act. During the early stages of that Bill, a number of representative bodies supported it, or were presented as doing so. As the Bill proceeded, however, some of what had been claimed to be support from organisations such as the British Medical Association seemed to fall away. I believe that the Bill ran to 460 pages.

The problem was the way in which legislation is made in the House. The coalition agreement promised us a House business committee, but no such committee deals with the allocation of time for legislation. We have a Committee of Selection, but it is run by the usual channels—the Whips on either side of the House—and people with expertise such as the hon. Member for Totnes (Dr Wollaston), who might actually have improved the Bill, were excluded from it.

[Dr Poulter]

I feel I should quote further from what was said by the hon. Member for Clacton, when much of the Committee stage of the Health and Social Care Bill had been completed. He went on to say—on 11 February 2012, on his TalkCarswell.com website—

“If these proposals were defeated, it would be a setback for all those of us who would like to see public service reform. We need to keep our nerve.”

That rather contradicts what the hon. Member for Rochester and Strood (Mark Reckless) has just said, does it not?

[Mark Reckless]

That is an excellent website, which I recommend to all Members. The Minister has said that my hon. Friend made those observations when most of the Committee stage of the Bill had been completed. Was that during the “pause” that had been invented as a new mechanism for Parliament? My hon. Friend is not here at the moment, but I think he would agree with me that the 2012 Act is not as it was billed to us by those on the Government Front Bench. It has led to an extraordinary degree of additional complexity in the NHS, and the introduction of competition bodies—and, in particular, European competition law—into the NHS is not welcome.

[Philip Davies]

Will the hon. Gentleman give way?

[Mark Reckless]

No, I will continue for a bit, if I may.

I do not think that the extent of the difficulties that doctors and others would encounter as a result of section 75 of the Act and the bureaucratic, market-based—or quasi-market-based—commissioning rules that it requires was any more apparent to my hon. Friend the Member for Clacton than it was to other Members, although some Opposition Members may have had premonitions of it. I thought that the Bill was intended to allow the various local bodies to get on with running the NHS in their areas. Some would run it better than others; there would be local decision-making and discretion, and people would learn from each other. Now, however, there are centrally determined rules that force everyone into, in particular, commissioning or contracting behaviour, but do not make sense in the context of the service that is being delivered.

[Philip Davies]

I congratulate the hon. Gentleman on his victory in last night’s by-election. It was an excellent result for him and it would be churlish not to point that out. I know that he is a long-standing believer in localism. Is he not worried by the British Medical Association’s concerns that the Bill would give much wider powers to the Secretary of State, thereby centralising powers and taking the day-to-day running of the NHS away from clinical staff and putting it in the Secretary of State’s hands? As a champion of localism, is he not worried by that?

[Mark Reckless]

I am grateful to the hon. Gentleman for his congratulations; that is very decent of him. I am not a fan of quasi-autonomous bodies, of great amounts of regulators or of overlapping layers of bureaucracy; they rarely work. Given the degree of complexity that has now been brought into the NHS, I think it is possible—although I am not certain—that the centralisation of power in a single Secretary of State who is at least accountable to the House might be better than the current diffusion and fragmentation of powers, which does not seem to be working effectively. My party would like to replace the alphabet soup of regulators and the overlapping layers of bureaucracy with a single, elected health board for each county area. That would give a degree of clarity to the oversight and management of the NHS.

[Mr Donohoe]

Why does the hon. Gentleman not think that health boards should be taken back into local authority control, where a democratic ticket is already involved, rather than creating a separate vote for stand-alone health boards?

[Mark Reckless]

There is an argument for doing that, and a judgment has to be made. It might be possible, depending on the different areas of the countries—particularly in the devolved Administrations—that the solution to that question might be different. My general view is that it is much better to have democratic accountability than not to have it, and in many areas I would prefer that to be local. My party wants to see health boards elected on a county basis.

My party also wants European competition law to be taken out of the NHS, and the Bill is exemplary in that regard. I strongly support that provision.

I have signed a pledge on TTIP, along with most other candidates in the by-election, except for the Conservative—[Interruption.] No, not the Liberal one—that was not a good one to sign—although I did vote against tuition fees, along with most Opposition Members. I would like to see the NHS excluded from TTIP. There are arguments as to whether it will be or not, but those arguments should be settled in the House as per this Bill, rather than being left to the unpredictability of future legal actions.

[Philip Davies]

Will the hon. Gentleman give way?

[Mark Reckless]

I am just reaching my conclusion, if I may.

The hon. Member for Eltham made a mistake in talking about the UK negotiating on TTIP. That is an area of exclusive competence for the European Community, and it is therefore the EU Commission that will negotiate with the United States on that matter. When I first heard about TTIP, it sounded as though it would be all about free trade and I thought that it would be broadly a good thing. The more I looked into it, however, the more it seemed to be not about free trade but about the creation of a single set of transnational regulations between the US and the European Union, and that it would be illegal for anyone not complying with them to sell goods and services. I am therefore very sceptical about TTIP and I am not sure it is something that I would want to support. I certainly do not want to see the NHS included in it.

I congratulate the hon. Member for Eltham on his Bill, and I look forward to supporting him in the Lobby.

--- Later in debate ---

[Andy Burnham]

We have spineless Government MPs who will not come here today to argue for the Act.

I congratulate the hon. Member for Rochester and Strood (Mark Reckless) on his victory and on being here today, despite being up all night—I cannot imagine that he managed to get any sleep. His party leader has said that when the hon. Gentleman is tired he says things that he does not mean—I think that he just nodded there. Given that he has been up all night, I can only conclude that he does not actually believe what he said in the speech we just heard. In three days he has gone from being in favour of the repatriation of European citizens to being against the privatisation of the NHS. That is a pretty big political distance to cover in just three days.

[Mark Reckless]

I have only ever argued for European citizens to be able to stay; any other words came from others, not me. It is the right hon. Gentleman’s party that has reversed its position, having previously privatised the Darent Valley hospital and fragmented the Medway Foundation Trust, but it now seems to have a better policy, which I am happy to support.

[Andy Burnham]

The hon. Gentleman said that he could not understand Labour’s position, but surely he remembers 2012, when Opposition Members spoke with force against that legislation, which he then voted for in the Lobby. I know that it has been a long night, but he really should try to remember these things, because they are quite important.

[Andy Burnham]

It is a tiring business being an MP and it is possible to forget things, particularly when one drinks as many pints as UKIP Members do, but they should try to remember. Their party leader once said that he would give the NHS budget to insurance companies; apparently, he does not believe that now. The deputy leader, a Mr Nuttall, said that the right hon. Member for South Cambridgeshire was to be congratulated on bringing a whiff—just a whiff—of privatisation to the NHS, and the hon. Member for Clacton (Douglas Carswell), whom the Minister quoted earlier, described the Lansley reforms as “fairly modest”. He chided his Tory colleagues who were sniping against him at the time and said that the reforms must not be derailed. The party says it is anti-politics in the way things are done. This is sheer opportunism and dishonesty.

[Mark Reckless]

I recall much of what the right hon. Gentleman said from the Dispatch Box in 2012, and I would like to credit him because a lot of it has come to pass. He was perspicacious in much of what he said and many of the assurances that I was given from the Government Front Bench have been found wanting.

[Andy Burnham]

I appreciate what the hon. Gentleman says—it would be churlish for me to say otherwise—and I am grateful for the way he said it. The things Opposition Members were saying back then have happened, and we can see the effects of the Government’s reorganisation in the NHS. With the new figures that came out this morning, we see that A and E has missed the Government’s target for 70 weeks in a row. The A and E figures are the barometer of the health and care system. They are the best place to look if we want to see whether there are problems in the health and care system. The fact that the target has been missed for 70 weeks in a row tells us that severe storms are building over the NHS.

--- Later in debate ---

[Dr Poulter]

I have just dealt with it, and I am going to make a little progress.

I want to deal with the contribution made by the hon. Member for Rochester and Strood (Mark Reckless). He failed to address the issues that I had raised earlier about the support that the hon. Member for Clacton (Douglas Carswell), his party colleague, gave to the Health and Social Bill—now the Health and Social Care Act. In fact, as the right hon. Member for Leigh (Andy Burnham) said, the hon. Member for Clacton thought that the reforms did not go far enough. Indeed, the leader of his party is on record as talking about the need, in effect, to privatise our NHS. I would like to reaffirm the commitment that that will absolutely never happen under this Government or any Conservative Government.

Another important point needs to be made. Earlier this week, the hon. Member for Rochester and Strood expressed frankly unacceptable and distasteful views on repatriation. We must of course bear in mind that 40% of staff in our NHS come from very diverse, multicultural backgrounds. We very much value the contribution that doctors, nurses and health care staff from all over the world make to our NHS. I do not want to see those people repatriated; I want to see them continuing to deliver high-quality care for patients in our NHS—something that UKIP clearly opposes.

[Mark Reckless]

I have made absolutely no such remarks; I have said only that we wanted such people to be able to stay. The disgraceful remarks were actually made by the Conservative candidate, who juxtaposed the issues of unlimited immigration and fear of crime.

--- Later in debate ---

[Dr Poulter]

Thank you, Madam Deputy Speaker. I am sure that Members in all parts of the House—although perhaps not the hon. Member for Rochester and Strood—would like to reaffirm their commitment to and the value they place on all NHS staff, no matter what background or culture they come from. We want those staff to continue to practise in and work for our NHS to the benefit of patients.

[Mark Reckless]

rose—

[Dr Poulter]

I think that the hon. Gentleman has said quite enough already, and I need to make some progress.

Let me move on to the second, substantive, point in this debate, on which I hope there will be a large amount of agreement. It was articulated—

[Mark Reckless]

rose—

[Madam Deputy Speaker]

Order. The Minister is not giving way.

[Dr Poulter]

Thank you, Madam Deputy Speaker.

The point was articulated very well by my right hon. Friend the Member for Banbury (Sir Tony Baldry) in one of the best and most accurate speeches of this Parliament in an NHS debate.

[Mark Reckless]

On a point of order, Madam Deputy Speaker. The Minister has made a false allegation to which he has not given me the right of reply. Of course I welcome all those immigrants in the NHS. They are very welcome and we want them to stay as much as he does.