Health and Care Bill

Martyn Day Excerpts

Consideration of Lords amendments
Monday 25th April 2022 Commons Chamber

[Madam Deputy Speaker (Dame Rosie Winterton)]

I call the SNP spokesperson.

[Martyn Day (Linlithgow and East Falkirk) (SNP)]

I will be brief, Madam Deputy Speaker.

Operational procurement is a devolved matter but, given our interest in trade policies, we welcome the progress on procurement to ensure that healthcare supply chains are not linked to modern slavery and human trafficking. We support UK Government amendment 48A in lieu of Lords amendment 48, and we also support Lords amendment 48B in lieu. It is perhaps worth reflecting on the fact that in Scotland half of all PPE is now produced locally and that the overall costs of pandemic procurement were a third less than those of the UK. Such measures can, then, be cost-effective and help to safeguard against global supply chain issues.

[Matt Hancock (West Suffolk) (Con)]

I rise to support the compromise measure on reconfigurations and to ask the Government to take forward the work on UK-wide statistics with vigour and gusto.

First, on reconfigurations, it is right and reasonable that the largest organisation in the country, which is funded by taxpayers through the taxes that every single citizen pays, should be accountable to Ministers who are in turn accountable to this House. Although that principle has been accepted in the Bill across the board and in general terms, the other place has decided that it should not apply in the specific circumstances of reconfigurations. It is vital that when a reconfiguration happens, not only the clinical voices but the voice of the local community should be heard. The two need to go together. The best way to make happen any reconfiguration that is needed on clinical grounds is to engage the local community and get it onside. If we are to save lives through a reconfiguration, we can win the argument, but only if we engage and make the argument. In my experience, too often a reconfiguration was put on the table, perhaps for good clinical reasons but without enough local engagement, and in practice the process just ran into the sand.

I welcome the six-month delay—I hope the Secretary of State will work quicker than six months most of the time, but it is a good backstop; I welcome the de minimis threshold, because relatively small reconfigurations happen all the time; and I welcome the removal of some of the bureaucracy in the amendment. To my hon. Friend the Minister, who has done a magnificent job on the Bill right from the start, before it even came to this House—I thank all his officials for their service—I say: let us take this compromise but say clearly to the other place, “Thus far and no further.” The principle of democratic responsibility for the NHS and for winning the argument with the public about its local design is at the heart of the Bill and it must stand.

In the final minute I have in which to speak, let me make a point about statistics. Those on the Treasury Bench have decided not to include in the Bill measures on the UK-wide measurement of health services and on the interoperability of data in the four nations of the UK, but I put on the record the importance—I hope the Minister reiterates this—of getting UK-wide measurements. In Wales, it was decided to discontinue the measurement of some aspects, especially in respect of A&E performance. A suspicion was raised—I am sure this could not possibly have been true—that those measurements were discontinued so that unfavourable comparisons with England could no longer be made. If that were true, it would be an outrage. I very much hope that it is not, but we should put it right anyway and measure NHS service delivery throughout the UK on the same basis, so that comparisons can be made, so that we can learn about and improve services across all four nations, and so that accountability can properly apply to the four different Governments who run the four parts of the one NHS, which operates across this United Kingdom.