Health and Social Care Bill

Nadine Dorries Excerpts

Monday 31st January 2011 Commons Chamber

[Mr Lansley]

First, I have just answered the point about John Appleby. It is true in a number of respects, as I have made clear, that although there have often been improvements in the NHS, they have not been what they ought to have been. It was a Labour Prime Minister, back in 2001, who said that we must raise resources for the NHS to the European average, but he did not achieve results that compared with the European average.

Let me give the hon. Gentleman some examples. A recent National Audit Office report showed that as many as 600 lives a year could be saved in England if trauma care were managed more effectively. Too often, the latest interventions, which are routine in other countries, take too long to happen here. John Appleby used heart disease to illustrate his point. Primary PCI— percutaneous coronary intervention—using a balloon and stent as a primary intervention to respond to heart attack was proven to be a better first response years ago. I knew that because cardiologists across the country told me so several years ago. I remember a cardiologist at Charing Cross telling me, “I have a Czech registrar working for me who says that in the Czech Republic PCI as a response to a heart attack is routine, but it hardly ever happens in this country.” Since then, it has been better implemented in this country, but that started to happen only when the Department of Health gave permission for its adoption.

The same was true of thrombolysis for stroke. That happened too late in this country, after such changes had taken place in other countries, because health care professionals there were empowered to apply innovation to the best interests of patients earlier.

[Nadine Dorries (Mid Bedfordshire) (Con)]

Does my right hon. Friend agree that, given the disparity in survival rates in trauma care and in many illnesses, including cancer care and heart attacks—citizens in this country are twice as likely to die of a heart attack as those in France—the NHS is in desperate need of modernisation?

[Mr Lansley]

My hon. Friend is right. We need not only to match European spending, as we do now, but to ensure that we achieve European-level results. It is not just about benchmarking, which we know we must do. We must benchmark ourselves against the best in the world if we are to deliver the best results for patients. We must also constantly make sure that we achieve a modernised health service that delivers the best possible care—sometimes going ahead of what others achieve, and applying innovation more quickly.

In some ways, as we know—for example, in mortality rates from accidents and from self-harm, and in equity of access to health care—the NHS leads the world, but our doctors and nurses are regularly hobbled by a system that treats equality as sufficient, when what we need is both equity and excellence.

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[Jim Dowd (Lewisham West and Penge) (Lab)]

It is a pleasure to follow the hon. Member for Boston and Skegness (Mark Simmonds). Although I do not agree with much of what he said—I certainly do not agree with his rationale for supporting the Bill—he made a few genuine points that, in the calmer atmosphere of a Committee, could be looked at in detail.

I agree with the hon. Gentleman that the difference between the two Front Benches could hardly be starker. This is about the view of what the national health service should be. I am not disappointed for one moment that the view of the Labour party is different from that of the Conservative party and its followers from the Liberal camp. Much has been made of that great event on 5 July 1948, when the national health service came into being. Of course, at the time, it was ferociously opposed by the Conservative party. At the beginning, it was also opposed by large parts, although not all, of the medical profession.

[Nadine Dorries]

rose—

[Jim Dowd]

I will not give way, for one good reason: I might get injury time for it, but others would lose out.

The medical profession has changed its view, as has the Conservative party. The Conservative party has changed its view largely because the NHS and the principles that underpin it resound so clearly with the British people. This has been a difficulty for the Conservative party over the years.

I have seen a few Conservative party reorganisations of the health service. Thirty-five years ago, I was appointed to the Lambeth, Southwark and Lewisham area health authority, which included such hospitals as our local one over the river, St Thomas’s, Guy’s, King’s College and Lewisham. The AHAs were set up as a consequence of the Heath Government’s reforms in the early ’70s. They were abolished, but not before Lord Jenkin suspended the Lambeth, Southwark and Lewisham AHA for refusing to accept the cuts in the budgets that the then Government were trying to inflict.

The Tories reorganised the health service again and brought in district health authorities. I served on Lewisham and North Southwark district health authority for some time, until in 1990 I was thrown off for having the temerity to be a local councillor. I am sure that there are others around the Chamber who suffered similarly. Who engineered that amazing transformation? It was none other than the current Secretary of State for Justice. I think that he just sacked anybody who was not on his Christmas card list, quite frankly, because nothing in that reform of the health service did anything to improve its accountability or performance. It did hand over the health service, more than ever, to central control and direction, which, we are asked to believe, the Conservative party today decries so readily.

The Conservative party, of course, contains members who believe—and who go on foreign broadcasting stations to announce—that the national health service is a 60-year-old mistake. That is what was said by an MEP who was advising Republicans in the United States to oppose the Obama reforms. He was slapped down quite quickly, unsurprisingly. It is the great embarrassment of the Conservative party that it cannot reconcile its atavistic feelings towards the health service and belief in the free market with the feelings of the vast majority of the British people.

In recent years, as my right hon. Friend the Member for Holborn and St Pancras (Frank Dobson) pointed out, waiting times for most specialisms have come down almost to the point where they are no longer a consideration. I will tell the House briefly about the experience I had towards the end of 2009. I suffered chest pains of various kinds. I went to A and E at Lewisham hospital on 28 July. I was referred to the chest pain clinic at the same hospital the following week. I went for an angiogram at King’s College hospital two weeks after that, where the consultant advised me that I needed bypass surgery. I asked how long it would take—I did not mean the operation, obviously, but the wait. He said, “When can you come in?” I could not make the first date that I was offered, so I had to put it back. My experience was repeated millions of times across this country when the Labour party had stewardship of the NHS. It is that relationship that is so critically under attack.

The NHS is about patients—of course it is. Everybody knows that patients come first and that it must be patient-centred. Those things are meaningless clichés. Patient care and patient choice matter, but what matters more is patient trust. Patients must trust that any therapy, drug or treatment that is suggested by their clinicians and medical advisers is what is best for them—not what is cheapest or what has been contracted for. It is that critical, basic relationship in the national health service that is most under threat from this Bill and that Government.

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[Nadine Dorries (Mid Bedfordshire) (Con)]

I rise to support a Bill that I believe is perhaps one of the most exciting, if controversial, Bills to have been put before Parliament in the 62 years since the NHS was established. It is a fact that a resident in this country today is twice as likely to die from a heart attack as a resident in France. In this country, we also fail to reach European averages for stroke care. In fact, 4,000 stroke victims a year lose their lives because our NHS is not up to European standards in stroke care. If we delivered trauma care slightly differently, we could also save 600 more lives a year, but we do not. Those figures alone show that it is now time, 62 years since it was established, for the NHS to be modernised.

In those 62 years, drug research and development have advanced hugely. Medical technologies have advanced in a way that could not even have been imagined 62 years ago. As a result of the internet and the information now available, patients expect and demand to have a say in how their condition is managed. They want more information and they want to discuss their care with their GPs. The Bill will put the patient right at the heart of the NHS, and that is why I so passionately support it. The central tenet of the Bill is: “No decision about me without me”. It will ensure that, for the first time, each and every patient can almost become their own lobbyist, sitting in front of their GP and discussing their condition and treatment in an open way, where they have information and the GP will have to engage with them. That does not happen today, and certainly not in hospitals.

I would like to give an example—something that I heard about this weekend from a patient—that clearly epitomises why the patient has become invisible in the NHS today. That patient was in hospital at the weekend when a doctor walked up to him, lifted his arm, took blood, put his arm back down and walked away without saying a single word to him.

[Catherine McKinnell]

It strikes me that despite what the hon. Lady is saying about the patient becoming the heart of the NHS, it will instead be the GP who becomes the heart of the NHS. Is she suggesting that the GP will be in the hospital with that patient to hold their hand at every stage of their treatment?

[Nadine Dorries]

I wish that that had been a more sensible question, because then I would have been delighted to give the hon. Lady an answer.

That patient was in hospital when the doctor walked up, took blood and put his arm back down without even a word of acknowledgment. A nurse then came and put his tray of food at the end of the bed. The patient was attached to a heart monitor and a drip, and could not reach the food. The patient was distressed, vulnerable and in pain, yet he was invisible to the health care professionals who were treating him. He was invisible because what is important in today’s NHS is the process—the management, not the patient. The humanity of the patient has almost been lost, and there is no way to put it back into the NHS other than to tip the understanding of who is important in the NHS on its head. The Bill does that in a way that has never been done before and which is now needed.

[Anne Marie Morris (Newton Abbot) (Con)]

One of the concerns that I have come across is from health professionals who would be delighted to see red tape removed. I have spoken to directors of nursing who spend more time on red tape than they do with their patients, and they are deeply frustrated. Does my hon. Friend agree?

[Nadine Dorries]

Absolutely, and the Bill will address that, in as much as care will be more easily accessed by the GP and the patient, in a much more streamlined process.

When nurses sat their medical exams 62 years ago, when the NHS was first established, the answer to each question had to begin and end with the words: “Reassure the patient”. It did not matter what someone said in the answer; if they did not emphasise the fact that the patient had to be reassured, they failed. That has gone. That demonstrates exactly how the patient has become invisible in today’s NHS.

I support the Bill because I support GPs working in consortia. A common myth—an urban myth—that we have heard in the few weeks leading up to this debate, and which has been thrown at us from the Opposition Benches, is that GPs are simply not up to the task of becoming business managers. The truth is that they already are business managers, because they all manage their own businesses. They will not be working as individuals or in individual practices; they will be working as part of a consortium, which is quite different from the impression given by the Opposition. Right now, 141 pathfinder consortia are demonstrating that they are ready and able to take on commissioning, and that they endorse patient involvement in the decision-making process. As a result of the “any willing provider” provisions, there will be a genuinely wider choice of care options available to the GP and the patient.

I would like to rebut the argument that the private sector will come in and undercut the NHS. That is complete nonsense. There will be no undercutting of the NHS whatever. Services will be—[Interruption.] I can only say that Opposition Members have not read the Bill, because there will be a tariff. Charities and the private sector will be able to provide services, but with a tariff. I shall give an example. If a patient requires a surgical procedure, which they discuss with their GP, and the local hospital has no bed available for six weeks, two months or however long, but if the local private hospital can provide a bed the next morning at the same price, are the Opposition really saying that an ideological obstruction should be put in the way of that patient being admitted to that private bed for that procedure the following day?

[Rosie Cooper]

Will the hon. Lady give way?

[Nadine Dorries]

I cannot, because I have given way twice and I have no more time.

If that patient were in pain, why should they not be admitted into that bed if it were available? That is how the market will be opened up by GPs, to the benefit of patients.

We recently heard from my right hon. Friend the Prime Minister about an extra £60 million that will be available to fund the latest bowel cancer screening technology, with wider deployment of the flexible sigmoidoscope. That does not need to be provided in secondary care in a hospital; it could be provided in the GP practice under the “any willing provider” provisions, perhaps via charities with specialised trained technicians. The Bill will ensure a new approach to providing services to the patient. “Any willing provider” will give patients the choice that they have not had for 62 years, empowering them to make decisions over that choice and opening up health care that patients in this country have not had, certainly for the past 15 years. With new technologies coming on stream and new ways of delivering care, both in the patient’s home and in the GP practice, that has to be welcomed. The Bill has to be welcomed, and Government Members will vote for it because the most important person in the Bill is the patient. That is why I support it wholeheartedly.