Health and Social Care Bill

Nigel Evans Excerpts

Tuesday 20th March 2012 Commons Chamber

[Grahame M. Morris]

On a point of order, Mr Deputy Speaker. I wonder whether I might seek your advice in relation to a declaration of interest. The hon. Member for Boston and Skegness (Mark Simmonds) has made two interventions on the private patient cap and has made a declaration of interest. He is a director of Circle, a private health care company. Is it your ruling that every Member must make such a declaration if they speak during the course of this debate?

[Mr Deputy Speaker (Mr Nigel Evans)]

It is up to each individual Member to make whichever declaration of interest they wish during a debate, but ultimately it is up then to the Member and the Commissioner if the Member wished to take that further.

[Andy Burnham]

The amendment gives us no protection at all, and it gives us no protection from the NHS cross-subsidising private care. There is nothing in the Bill which says, “The whole costs of the provision of that care have to be reimbursed to the national health service”, as the Financial Times has again demonstrated, and that is why we object to what is happening. We are going back to the old days of the NHS, whereby patients are told, “You can go private or you can go to the back of the queue and wait longer.” That is the choice which we removed from the NHS during our 13 years in government, and we will not accept any return of it.

--- Later in debate ---

[Paul Burstow]

I beg to move, That this House agrees with Lords amendment 11.

[Mr Deputy Speaker (Mr Nigel Evans)]

With this we will consider Lords amendments 12, 43 to 53, 61, 62, 168 to 241, 243 to 245, 247, 249 to 251, 253 to 286, 288 to 291, 327, 333, 334 and 366 to 374.

--- Later in debate ---

[Liz Kendall]

On a point of order, Mr Deputy Speaker. Is it in order for the Minister who moved these particularly important amendments, which will abolish a statutory organisation, HealthWatch, to be absent from the debate? If it is in order, is it not a huge discourtesy to Members on both sides of the House?

[Mr Deputy Speaker (Mr Nigel Evans)]

I thank the hon. Lady for her point of order. It is in order for the Minister not to be here at this moment in time, and it is up to each Member’s judgment as to what to make of that.

[Andrew George]

It is a pleasure to follow the right hon. Member for Wentworth and Dearne (John Healey), who has taken us round a number of issues, particularly in relation to the public’s ability to scrutinise, through the proposed healthwatch organisations, the effective delivery of commissioning in their areas.

As my right hon. Friend the Member for Bermondsey and Old Southwark (Simon Hughes) suggested, there is a desperate need for provision within our procedures whereby important Bills such as this, which have been significantly altered in another place, can be reviewed on Third Reading. Our earlier debate about the still unpublished transitional risk register was, in a sense, a proxy for that lack of a Third Reading debate.

This debate has placed public health and the role of HealthWatch, particularly local healthwatch, in the context of local health services being placed at risk. We have already discussed how clinical commissioning groups may be fundamentally conflicted. In my contribution to that debate, I posed questions about the conflicts that intrinsically exist within those organisations. I believe that HealthWatch should be there to provide scrutiny of those conflicts. Throughout the debates on the Bill, fundamental concerns have been expressed about the fragmentation of local health services. We need a strong and independent-minded local healthwatch in all our areas to be watching for that and looking out for opportunities to maintain the integration of local services.

I fear that one of the effects of such a major reorganisation of the health service nationally and locally will be to make it more difficult to deliver the £20 billion efficiency gain that the previous Government proposed and that the coalition Government intend should be delivered. That issue needs to be considered at national level, with HealthWatch, and at local level. I believe that we need an independent body that is capable of ensuring that efficiency gains are being achieved at local level and that keeps an eye on the commissioning and delivery of local health services.

The Royal College of Nursing has said today that there is a need to look carefully at staffing levels in front-line health services, including in acute hospitals. There is a debate about whether that should be mandatory. That has long been a concern of mine when looking at the delivery of local health services and it is identified by people when they visit hospitals. There are staff-to-patient ratios that, in my view, are barely tenable and barely safe. Qualified nurses are struggling to provide the support and care that patients require, simply because the staffing ratios are inadequate. The same ratios may have been adequate in the past when the throughput of patients and the acute status of patients were lower, but with the current turnaround of patients and their acute status, it is no surprise that the RCN’s survey has identified the need to review staffing levels in our wards.