NHS and Future Trade Deals

Debate between Mike Hill and Rachael Maskell

Monday 22nd July 2019 Westminster Hall

[Mike Hill (Hartlepool) (Lab)]

I beg to move,

That this House has considered e-petition 242300 relating to future trade deals and the National Health Service.

It is a pleasure to speak under your chairmanship, Sir Roger. I thank Mr Byron Davis for starting the petition, which to date has attracted 166,998 signatures, including more than 200 from my constituency. The petition is entitled, “Don’t put our NHS up for negotiation”, and it asks the Government to,

“Please introduce concrete safeguards that will make sure our NHS is kept out of any future trade deals after Brexit.”

It goes on to say:

“Words aren’t enough—we want watertight protections that will keep our NHS off the negotiating table. Why is this important? When done well, trade deals can be good for the UK. They can help create jobs and build opportunities… But this plan would put our health service at risk.”

The Government responded on 17 June 2019:

“The Government has been clear: the NHS is not, and never will be, for sale to the private sector. The Government will ensure no trade agreements will ever be able to alter this fundamental fact.”

The Department for International Trade went on to provide a detailed 491-word response to the petition, which can be found on the Petitions Committee website. It includes commitments such as:

“the NHS is not, and never will be, for sale to the private sector, whether overseas or domestic.”

[Rachael Maskell (York Central) (Lab/Co-op)]

This is a crucial debate. The Government have already awarded £9 billion-worth of contracts. Section 75 of the Health and Social Care Act 2012 is the biggest threat to the NHS, as it opens up the whole NHS to the market. Does my hon. Friend agree that the Government must urgently repeal section 75 to safeguard our NHS?

[Mike Hill]

My hon. Friend makes a powerful point, and I completely agree that the Government need to pay urgent to attention to that.

The Government’s response continued:

“the Government will continue to ensure that decisions on how to run public services are made by UK Governments, including the Devolved Administrations, and not our trade partners.”

It also said:

“Trade agreements do not prevent governments from regulating as they see fit, and they also do not require governments to privatise any services… The Government will ensure that nothing in our future trade agreements dilutes the powers of UK regulators to maintain the NHS’s position as the best health service in the world.”

However, as the petitioner says, words are not enough. By tomorrow, we will have a new Prime Minister; by the end of the week, we will probably have a new Cabinet, a new Secretary of State for Health and Social Care and possibly a new Government position on these matters. Although we hear time and again, from across the Benches, support for the great institution that is the national health service and for its abiding principle of being free at the point of need, those are only words without deeds.

--- Later in debate ---

[Mike Hill]

As always, my hon. Friend makes a powerful point. Let us not forget the millions spent compensating private companies that lose contracts and take the Government to court.

Trade deals are not only dangerous for the future of the NHS, as they would entrench privatisation, but undermine our democracy, as future Governments would be shackled by their binding provisions. That is why some say the only way to fully protect our NHS from trade deals is to fully exclude it from them.

[Rachael Maskell]

Does my hon. Friend agree that the riskiest point of entry for privatisation in our NHS is big pharma? Clearly, big pharma will seek to run other services in our NHS. It is essential that any trade deal takes seriously the threat big pharma poses to our NHS, given the service’s extensive drugs bill.

[Mike Hill]

Again, I agree with my hon. Friend and bow to her knowledge. We all know that pharmaceuticals is one of the major gateways to the potential privatisation of NHS services. I say again that the only way to fully protect our NHS from trade deals is to fully exclude it from them. As far as I and, I am sure, the petitioners are concerned, that is precisely what we should do.

Health and Care Professions Council: Registration Fees

Debate between Mike Hill and Rachael Maskell

Thursday 14th March 2019 Westminster Hall

[Rachael Maskell (York Central) (Lab/Co-op)]

It is a pleasure to serve under you in the Chair, Mr McCabe. I was also registered with the HCPC and the preceding bodies. Although I am no longer registered, I recognise the impact this issue has on NHS staff.

There are nine different regulators in the NHS, regulating 32 different professions. They provide a very important function: this is about protecting not only the public, but health professionals themselves in the course of their practice. The regulators are there to set, maintain and raise standards and to give confidence to the public, as well as to hold a register and protect the title of a profession, so that other people cannot set up a business pretending that they hold the professional qualifications, which people across the NHS work hard for.

Increasingly, regulators also ensure continuing professional development. The most advanced programme of professional development has been put in place by the Nursing and Midwifery Council in recent times. The regulations around that ensure that registrants are compliant with continuing professional development. The function of regulators is to ensure that professionals who fail to uphold professional standards and their duty of care are called to account, so that sanction is applied where necessary and recourse is taken.

We have already heard that—thankfully—a miniscule number of professionals are taken through disciplinary processes. That is a tribute to the great professionalism across the NHS. However, such cases do occur, and it is appropriate that rigorous processes are in place so that individuals can defend their position and have recourse to justice before appropriate action is taken. To have someone practising who is not fit for practice risks the whole profession, so it is vital that that is put in place.

However, the cost of that process has escalated substantially, as hon. Members have mentioned. When I first registered as a physio, I had to pay only £17. In 2015, the last year that I was registered, there was a huge increase—from £80 to £90. The suggested increase to £106 is, quite frankly, unacceptable, particularly given the background, as set out by hon. Members, of a decade of pay regression, pension cuts and student loan repayments. In my time we had grants, so things have changed significantly.

More and more burdens are being placed on health professionals. That means that more risk is placed on health professionals. When we had adequate staffing in the NHS, mistakes were less frequent and caseloads were safer. Unfortunately, in many professions people’s caseloads are now too big. The pressure on those individuals increases.

I was formerly head of health at Unite. We focused on organisations’ duty of care. Managers in particular must say no to the organisation and argue the case for more staff, rather than increase the pressure on health professionals by making their caseloads unsafe—that would mean that managers were failing in their duty of care, in breach of their standards of professional conduct.

[Mike Hill]

I am also a former Unison official. In view of that, does my hon. Friend agree that, as my hon. Friend the Member for Heywood and Middleton (Liz McInnes) rightly pointed out, the professional bodies cover not only full-time and part-time staff, but student social workers and student nurses? They are under the same constraints.

[Rachael Maskell]

Students do have responsibility, but the registered health professional is responsible for ensuring that they are safe under their practice while they are training in their profession. Training the future workforce is an incredibly important additional function of health professionals.

The Law Commission came forward with a set of recommendations for registrant bodies in 2012. In 2019, we still have not seen the implementation of those recommendations in full. I would like the Minister to explain why that is the case. Implementing a substantial piece of work about ensuring patient safety should surely be at the forefront of the Minister’s agenda. I am interested to hear the reasons for the delay, and what plans there are to put those recommendations in place. Training programmes for health professionals need to focus on the ethics, behaviour and conduct of health professionals, if we want to see a reduction in the number of cases. Managing that risk is really important.

I want to raise a number of points to move this case forward. First, as we have heard, 38,000 people signed a petition to register their discontent with the fee rise. That cannot be ignored. These are valuable NHS workers. Their call must be heard and reflected on. However, the HCPC hardly seems to have taken that into consideration. As my hon. Friend the Member for Heywood and Middleton (Liz McInnes) said, the number of fitness-to-practise cases being taken forward—currently, 59% of them involve social workers—will disappear. Therefore, surely the registrant body’s costs will decrease. We want to hear how that will benefit health professionals.

This is a tax on professionals. Will the Minister consider funding that regulation fee through the NHS? It does not make sense for nurses, physios and speech therapists, for example, to pay a different amount. That is a tax on professionals who have put in the training and the hours, and go over and above the hours. Why can the Government not pay the amount for each health professional? More than a gesture, it is a responsibility of the NHS to ensure that its registrants, including part-time workers, have that support. I completely concur with the suggestion made by my hon. Friend the Member for Heywood and Middleton that there should be a part-time rate.