Policing and Crime Bill

Debate between Norman Lamb and Andy Burnham

Monday 13th June 2016 Commons Chamber

[Andy Burnham (Leigh) (Lab)]

I would like to begin by agreeing with the Minister that some good progress has been made in the course of our deliberations on the Bill. There have been improvements, which we will discuss later, on tackling child sexual exploitation and on the police bail regime—particularly as it applies to those suspected of being involved in terrorism activity. As he has just indicated, there has also been progress on police misconduct, which I will come to.

However, the Bill presents an opportunity to do much more to improve police accountability, and that is an opportunity that we in the House now need to grab. Today, I want to present a package of proposals that respond to the historic verdict of the Hillsborough inquest, which finally concluded, after 27 years, that, as the families had known from day one, the loss of their loved ones was not an accident and they had been unlawfully killed, but that that fact had been covered up for all those years.

This package seeks to rebalance this country and to make it fairer. It seeks to rebalance it away from the establishment and in favour of ordinary families. It is a package that will stand as a permanent tribute to the dignity and determination of the Hillsborough families. Knowing them as I do, they would want nothing more than that no other family in the future should go through what they have gone through.

Let me take the House briefly through this package of proposals. New clause 63 would give bereaved families equal funding for legal representation at inquests where the police are involved. It seeks to establish the crucial principle that there should be parity between the two sides. The reason that is important is that it says very clearly that the public interest lies in finding the truth. That is how public resources should be directed: they should not be directed towards creating an unbalanced contest at an inquest, with public money used to protect vested interests in the public sector.

[Norman Lamb (North Norfolk) (LD)]

I am happy to confirm that the Liberal Democrats will support this proposal. Does the right hon. Gentleman agree that, had it been in place at the time of the first inquest, the truth might have emerged at that stage, and the families would not have had to go through such a dire long wait to get to the truth?

[Andy Burnham]

I am grateful to the right hon. Gentleman for his support. He is absolutely right. I will come on to explain precisely how this would have helped to even the playing field and give the families the chance to get truth at the first time of asking. The original inquest catastrophically failed on that account, and that needs to be very clearly understood as we consider this amendment.

Amendment 126 seeks to close the long-standing loophole of retirement being used by police officers as a route to evade misconduct proceedings. New clause 64 seeks to hold the Government to their promise to the victims of press intrusion to hold a second-stage inquiry looking at the culture of relations between police and the press. New clause 66 seeks to legislate for a code of practice with regard to the media relations policy of each police force, and to spell out that attributable briefing by police forces, which was so damaging in the case of Hillsborough, is not permitted unless it is in the most exceptional circumstances. Amendments 127 and 128 seek to strengthen the Independent Police Complaints Commission. New clause 67, which will be considered later, seeks to strengthen the offence of misconduct in public office.

Let me start with the area where there is greatest consensus—police misconduct. I listened carefully to what the Minister said, and I am grateful for the movement that he indicated to the shadow Policing Minister, my hon. Friend the Member for Birmingham, Erdington (Jack Dromey), in Committee whereby there should not merely be an arbitrary 12-month period after retirement, because, as we know, police wrongdoing may come to light much later. We are glad that the Government have indicated that they are prepared to move on this matter in the other place and table an amendment to that effect. While I will not press my amendment to a vote, I would still like to press the Minister a little further on this point. He is saying that this should be applied only in the most exceptional circumstances, but that potentially rules out many people who might be guilty of gross misconduct but would not be caught by his “exceptional” test. He needs to reassure the House on this point.

National Health Service

Debate between Norman Lamb and Andy Burnham

Wednesday 21st January 2015 Commons Chamber

[Norman Lamb]

Let me make this point.

If Labour Members are concerned about the interests of patients, why do they not agree to the suggestion by Professor Bruce Keogh, a respected clinician, for an investigation into safety in the Welsh NHS? Why do they remain silent?

[Andy Burnham]

The Minister accuses us of bringing politics into the NHS, but did not he and his colleagues put politics at its heart when they signed up to a Tory agenda to put market forces at the heart of the national health service?

[Norman Lamb]

That is absolute rubbish. Indeed, one of the right hon. Gentleman’s predecessors, the right hon. Member for Hull West and somewhere—

Health

Debate between Norman Lamb and Andy Burnham

Monday 9th June 2014 Commons Chamber

[Norman Lamb]

Well, let us just make sure that Opposition Front Benchers listen to the hon. Gentleman.

We can be justifiably proud, it seems to me, of the action we have taken in health and care over the course of this Parliament. The hon. Member for Scunthorpe (Nic Dakin) made a speech that faded away from agreement, but at the very start he made the point that we should all pay tribute to a really remarkable work force in the NHS—1.3 million people doing incredible work. We want to free those people up as much as possible to do the very best they can.

[Andy Burnham]

Would not the best way to pay tribute to those thousands of staff in the NHS be to honour the 1% pay increase that the Chancellor promised them?

[Norman Lamb]

That is equivalent to about 6,000 nurses a year. The right hon. Gentleman has to demonstrate how that would be paid for. The fact is that there is an average wage increase of 3% as a result of annual pay increments under Agenda for Change. We have ensured that at least everyone will get a 1% increase. If he is arguing for something different, he has to say where the money would come from to pay for it and how he would cope with 6,000 fewer nurses, which would be the result of his action.

For the first time, it is this Government who have made decisive moves to join up the care and health system and focus more on preventing ill health. Contrary to the shadow Secretary of State’s claims, the better care fund has been widely welcomed, and it has initiated action across the country to join up a very fragmented system. We have sent out the signal that we encourage innovation and change, driven by clinicians from the bottom up, not from the top down. Brilliant pioneers across the country are ending this fragmented system that has interrupted patient care for so long and failed patients. Those pioneers are combating loneliness, which my hon. Friend the Member for Burnley (Gordon Birtwistle) spoke passionately about. It is so far removed from the caricature offered by the shadow Secretary of State and the tired old refrain about privatisation. It was, after all, a Labour Government who mortgaged the future of the NHS to the tune of billions of pounds with their private finance initiative programme, giving massive windfall profits to private consortiums—a scandal of historic proportions. Yet Labour Members continue to argue that the Government are privatising—an argument that is based on thin air, not substance.

Care Bill [Lords]

Debate between Norman Lamb and Andy Burnham

Tuesday 11th March 2014 Commons Chamber

[Andy Burnham]

I do not think that the right hon. Gentleman is in a very strong position to talk about Members’ abstaining in votes on amendments. I shall say more about that shortly.

Let me now list three reasons for our argument that the Bill is not what it seems. First, as I have said, it is no answer to the care crisis. It proposes that a cap should be paid for by the restriction of eligibility for care, and the removal of care from some people who are already receiving it. Last week we heard from Age Concern that 800,000 people who had previously received support no longer received it. The problem is that local authorities are being asked to implement the system with no additional resources, and are therefore having to move funding from preventive social care to the administration and funding of the cap and the deferred payment scheme. Rather than taking from one area of social care to give to another, the Government should have put new resources into social care.

[The Minister of State, Department of Health (Norman Lamb)]

The right hon. Gentleman said a moment ago that the Bill removed care from some people by restricting eligibility criteria. Does he accept that although there is a national eligibility criterion—which is long overdue—any councils that choose to be more generous can do so, just as they can now?

[Andy Burnham]

If the Minister gave councils budgets that enabled them to be more generous, they might have a chance, but drastic cuts mean that they cannot provide care that is worthy of the name. He will know of the fears of organisations that represent disabled adults of working age. The Royal National Institute of Blind People, for instance, fears that the move to retrench eligibility criteria to cover only substantial and critical needs will remove care from people with moderate needs whose support currently enables them to continue to work.

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[Andy Burnham]

The Secretary of State says yes, but I am afraid that it will not. The £72,000 cap is based on a local authority average, not on the actual amount that people will pay for care. So no, the Bill will not give them that certainty. The Secretary of State also said that people would not lose everything to pay for care. Let us take him at his word, and assume that £72,000 is the maximum that a person can pay, and £144,000 is the maximum for a couple. In my constituency, that would indeed mean people losing everything that they had worked for, although it might not mean that in the Secretary of State’s constituency or in other parts of the country. The Secretary of State needs to be honest with people. That is why we are saying that the Bill is not what it seems.

[Norman Lamb]

Will the hon. Gentleman give way?

[Andy Burnham]

I will, but I think that the Minister should take account of that point, because it is quite important.

[Norman Lamb]

The right hon. Gentleman says that he would like the eligibility criteria to be more generous. Is he now committing himself to funding that?

[Andy Burnham]

I am not writing a budget at the Dispatch Box this evening. I will stand by our record of giving real-terms increases to local government. I warned at the start of this Parliament that if the effect of the Government’s promise of real-terms increases for the NHS—which have actually never materialised—was a raid on local government, that would be a short-term policy. It would mean more older people ending up in hospital and who then could not be discharged because there was not the care at home. That is exactly what is happening. It is a false economy. That is what we warned them about and they failed to listen.

NHS

Debate between Norman Lamb and Andy Burnham

Wednesday 5th February 2014 Commons Chamber

[Andy Burnham]

My hon. Friend’s point was also made powerfully by ambulance staff at an A and E summit held by the shadow Front-Bench team in Parliament before Christmas when a paramedic spoke of the phenomenon she has just described. He mentioned an occasion when staff were at the door of A and E waiting to hand over a patient to A and E staff, when the patient had a heart attack. The staff did not know what to do and had to go back to the ambulance to try to stabilise the patient. Those sorts of joining points or disconnects in the system are leading to real pressure on staff who do not know what to do in those difficult circumstances. The system is in danger of being overwhelmed, and the pressure on staff must be addressed urgently.

[The Minister of State, Department of Health (Norman Lamb)]

I share the right hon. Gentleman’s view that delays in handover at A and E are not acceptable, and I remember well that last decade, under the previous Government, ambulances were stacking up outside the A and E at the Norfolk and Norwich hospital. Does he welcome the fact that this winter, delays of longer than 30 minutes are down by more than 30% compared with last year?

[Andy Burnham]

Yes, there has always been pressure on the ambulance service at this time of year, but if the Minister wants me to join in with his complacency, I am afraid I will not. The past 12 months have been the worst in A and E in a decade, and there are reports of ambulances across the country held in queues. Is the Minister satisfied with the performance of the ambulance service in his region of east England? Was he satisfied with the way the case I mentioned was handled? I do not believe he was or that his complacency at the Dispatch Box will be appreciated by his constituents.

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[The Minister of State, Department of Health (Norman Lamb)]

This afternoon, we have been presented with more of the same from the Labour party—the same scaremongering, the same misinformation, the same unwillingness to offer solutions. In short, it is the same old Labour party.

Earlier this week, we heard from the right hon. Member for Leigh (Andy Burnham) that the N was being wrenched off the NHS and that it was being sold to any company, but in reality only 6% of expenditure in the NHS goes to private providers. He talks about “market madness running riot through the NHS”, but listen to the facts: between 2006 and 2010, under Labour, total spending on the independent and private sector more than doubled; and between 2007-08 and 2010-11, under Labour, the number of operations conducted by the independent sector tripled. Since then, the figure has been around 46%.

Labour is desperately trying to make the public believe that its skewed vision is the reality of the NHS, but this view is of course total nonsense, and I am happy to try to set the record straight.

[Andy Burnham]

I think the Minister was in the Chamber when his predecessor as care Minister held his hands up and admitted he got it wrong on competition when the Health and Social Care Bill went through the House. He has given hints to newspapers that he feels the same way. Would he care to step into the confessional and admit that the Liberal Democrats got it wrong on competition in the NHS?

[Norman Lamb]

I certainly think we have to avoid any repeat of what happened in Bournemouth. It is absolutely right for politicians to make that clear.

The Labour party has tried to paint a picture of crisis in A and E. We know that there is more pressure on this vital service.

Care Bill [Lords]

Debate between Norman Lamb and Andy Burnham

Monday 16th December 2013 Commons Chamber

[Andy Burnham]

I shall in a moment.

What are the direct and practical effects of those cuts to council budgets? First, councils have cut eligibility criteria, so more people are exposed to care charges in a way that they were not before. Secondly, those care charges are now rising above inflation year on year, so more people are exposed to higher charges. This means that they are now more likely to pay right up to the new cap that the Government are introducing. That will not feel like progress to the public, and that is why we are making our reasoned objection to the Bill.

[The Minister of State, Department of Health (Norman Lamb)]

I am sure the right hon. Gentleman agrees it is important that we are accurate about these matters. He suggested that the Bill “restricts”—that is the word he used—eligibility for substantial or critical care. Does he accept that it does not do that, and that any council that wants to have more generous eligibility can continue to do so?

[Andy Burnham]

I do not disagree with the approach of setting national eligibility criteria and taking a national view, so I agree with the Minister on that. The problem, however, is that if the Government legislate for just critical and substantial levels, they are sending a very clear message to local government that they believe they can only afford to fund it at those levels. Surely the criteria would have been set higher if they were funding local government better.

The truth is that when this Government came to office, many more councils in England were providing social care at “moderate” level. That has been slowly cut back and now only about 23 councils are still providing support to people with moderate needs. It is a fair bet that those councils will soon be unable to provide moderate care and shrink back to providing only critical and substantial care.

[Norman Lamb]

Does the right hon. Gentleman accept that more than 100 councils were setting the eligibility criteria at “substantial” when his party left office? Is he saying that a future Labour Government would fund eligibility criteria at moderate level? If so, how would he fund it?

[Andy Burnham]

That is a political point; let me deal with it. When we left government, 38 councils were providing some free care to people with either low or moderate needs. I correct the figure I gave a moment ago: it is, in fact, 15 councils that are now doing that. The care system is being scaled back. Therefore, people are more liable to charges and are more likely to have to pay them, because support is being withdrawn from people in the home.

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[Andy Burnham]

The right hon. Gentleman shakes his head, but a £72,000 cap is not what Dilnot recommended. That is the Government’s problem. As I said before, the cap will not cover hotel and accommodation costs, either. When both factors are taken into account, an average person in England will take almost five years to hit the so-called cap. Based on average stays in care homes, that means that six out of seven elderly people will have died before they reach it.

If that were not bad enough, people are about to find out that the promises that they will not have to sell their home are also a con. The ability to defer payment for care was one of Andrew Dilnot’s central proposals designed to stop people worrying about selling their home while they were alive. He said that old people would be able to borrow from the local council and repay care bills from what they left behind. The Government initially said that they would implement that proposal and introduce what they called a universal deferred payments scheme. I remember when they used to call that type of proposal a death tax, but things have seemingly moved on for the better.

However, on the day when Parliament rose for the summer recess, the Department sneaked out a consultation document saying that pensioners would not qualify for any help under the universal deferred payment scheme until their savings and other assets, such as valuable possessions, had been run down to below £23,250. That new condition will prevent almost half of those who would otherwise have been able to take advantage of that apparently universal scheme from accessing it.

[Norman Lamb]

Does the right hon. Gentleman accept that that was exactly the same proposal as his party’s Government put forward just before they left office?

[Andy Burnham]

Just as the Government’s proposal is not the Dilnot report, it is not my national care service proposal. I had a range of different proposals, and that one has to be considered in that context.

As the Minister knows, I proposed a universal approach in which everybody would contribute on the NHS principle—I seem to remember that he and I were in some agreement about that. That was a deferred payment, but this proposal is different. The Government are talking about a universal deferred payment scheme in which people will pay from what they leave behind, but—and this is the point—it will not be available to everybody. That was the promise the Minister has broken.

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[Norman Lamb]

I note the position in Salford, and I recognise that finances in local government are tight. However, the Opposition have not recognised that 108 councils were already providing social care with substantial need as the eligibility criterion before the general election. They never mention that, but it is the truth.

Baroness Campbell has called the continuity of care provisions a “landmark reform”. Although we have heard the suggestion that we have somehow moved away from what Andrew Dilnot suggested, he has said:

“For the first time you don’t have to be terrified of the consequences of needing care…this system will radically reduce anxiety…It doesn’t seem to me that it’s so different from what we wanted.”

Several references have been made to the funding of social care, and as I have said, I fully recognise the tough financial settlement that local government has faced. However, that has been necessary because of the dire state of the public finances that we inherited from the Labour Government, and we have sought to protect social care. Despite what the hon. Member for Easington (Grahame M. Morris) and others have said, a recent budget survey by the Association of Directors of Adult Social Services showed that most of the savings that local councils have made have come through efficiency changes, and that services have largely been protected. [Interruption.] Well, that is what the survey showed.

As the population continues to age, our health needs become more complex, and it is essential that we continue to adapt. We need to ensure that the care and support system is sustainable, and the Bill lays the foundation for that sustainable system. At the top of the agenda has been the issue of how we pay for care. The current system simply does not work and is not fit for the 21st century. Too many people have faced catastrophic care costs and had to make impossible financial decisions at a time of huge personal crisis. It is deeply unfair. If someone who has worked hard all their life and budgeted carefully is unlucky enough to be diagnosed with dementia or some other condition, they lose pretty much everything they have ever worked for.

Through the Bill, we are putting an end to that unfair system. We have addressed how people can plan and pay for their care, following on from Andrew Dilnot’s recommendations. We have listened carefully to what he and his colleagues have said, and we have been absolutely consistent about how these reforms will support people to plan for their future effectively. From April 2016, extending the means-test support to £118,000 will immediately result in 35,000 more elderly people receiving financial help with their care costs. That figure will rise to 100,000 people getting extra help by 2024-25.

[Andy Burnham]

Can the Minister guarantee to older people listening to the debate this evening that nobody will pay more than £72,000 for their care—yes or no?

[Norman Lamb]

Of course we have made it clear that people can choose to spend more, but I can say absolutely that by 2024-25, far more people—100,000 people—will be getting more financial support than under the system we inherited from the Labour Government. Everyone will be protected from catastrophic costs through the reassurance provided by the cap on care costs.

Oral Answers to Questions

Debate between Norman Lamb and Andy Burnham

Tuesday 16th April 2013 Commons Chamber

[Andy Burnham (Leigh) (Lab)]

Here comes another request for a meeting with the very obliging Minister. Last month he promised the House that he would rewrite the section 75 regulations to rule out enforced competitive tendering in the NHS. However, before Easter the respected House of Lords Secondary Legislation Scrutiny Committee said this of his redraft:

“The substitute Regulations are substantially the same as the original Regulations.”

It is no surprise that it seems to many that the Government are intent on privatisation by the back door, putting large parts of the NHS up for sale. With a crunch vote in the Lords next week, it is turning into another shambles. I make this offer to the Minister: will he again agree to withdraw the regulations and to sit down with us and the professions this week and come up with wording that is acceptable to all?

[Norman Lamb]

This really is the most outrageous scaremongering from the Labour party. In March 2010, the Labour Government issued guidance on European procurement law that described the limited circumstances in which one could avoid going out to tender. The wording used in these regulations is exactly the same as that used by Labour in March 2010, yet Labour Members will not admit that. There are also added safeguards in the redrafted regulations to ensure that there is a clear incentive for integrating and co-ordinating services for the benefit of patients.

NHS Commissioning Board

Debate between Norman Lamb and Andy Burnham

Tuesday 5th March 2013 Commons Chamber

[Andy Burnham (Leigh) (Lab)]

(Urgent Question): To ask the Secretary of State for Health if he will make a statement on comments by the deputy medical director of the NHS Commissioning Board on the regulations on procurement, patient choice and competition under section 75 of the Health and Social Care Act 2012.

[The Minister of State, Department of Health (Norman Lamb)]

I know that the right hon. Member for Leigh (Andy Burnham) and others have raised concerns about the effect of the regulations and I would like to address them in my response. First, however, I would like to make it absolutely clear that the regulations must be fully in line with the assurances given to the House during the passage of the Health and Social Care Bill. The former Secretary of State, my right hon. Friend the Member for South Cambridgeshire (Mr Lansley), said to clinical commissioning groups in 2012 that

“commissioners, not the Secretary of State and not the regulators, should decide when and how competition should be used to serve…patients interests”.

That must be the case. I made it clear in Health questions last week that we would review the regulations to ensure that that was the case and that they were not open to any misinterpretation.

The right hon. Member for Leigh himself gave guidance to primary care trusts which made this clear in 2010:

“Where there is only one capable provider for a particular bundle of services or the objective of the procurement is to secure services to meet an immediate interim clinical need there will be a case for Single Tender Action (i.e. uncontested procurement). By definition, an immediate or urgent scenario will be exceptional and likely to only arise on clinical safety grounds or for example, where existing services have been suspended following intervention by the Care Quality Commission.”

The next bit is very important.

“A decision to procure through single tender should always take account of the potential to secure better value by investing in a competitive process, as long as this is justified by the scale and importance of the opportunity (i.e. it has to be worth it).”

[Interruption.] Those were the comments of the right hon. Member for Leigh.

In the Government’s response to the Future Forum report, we committed to ensuring that the regulations would simply continue that approach. However, I fully recognise that the wording of the regulations has inadvertently created confusion and generated significant concerns about their effect. I have therefore listened to people’s concerns and my Department is acting quickly to improve the drafting so that there can be no doubt that the regulations go no further than the set of principles and rules that we inherited from the previous Labour Government. Following our commitment in response to the Future Forum report, the co-operation and competition panel has been transferred to Monitor. That will ensure consistency in the application of the rules.

Concerns have been raised that commissioners would need to tender all services. That is not our intention and we will amend the regulations to remove any doubt and to clarify that the position remains the same as at present and as stated in my right hon. Friend the former Secretary of State’s letter of 2012.

Concerns have been raised that Monitor would use the regulations to force commissioners to tender competitively. However, I recognise that the wording of the regulations has created uncertainty, so we will amend them to put this beyond doubt. Concerns have also been raised that competition would be allowed to trump integration and co-operation. The Future Forum recognised that competition and integration are not mutually exclusive. Competition, as the Government made clear during the passage of the Bill, can only be a means to improve services for patients—not an end in itself. What is important is what is in patients’ best interests. Where there is co-operation and integration, there would be nothing in the regulations to prevent this. Integration is a key tool that commissioners are under a duty to use to improve services for patients. We will amend the regulations to make that point absolutely clear.

[Andy Burnham]

In less than four weeks’ time, new GP commissioners take control, yet today there is complete confusion about the job they are being asked to do. Following comments by the deputy medical director of the NHS Commissioning Board and the statement we have just heard, coalition policy on competition in the NHS is in utter chaos. It beggars belief that almost three years after the White Paper introduced by the right hon. Member for South Cambridgeshire (Mr Lansley) and after all the upheaval he inflicted on the NHS, there is still no clarity on policy today. They are in this mess because the “doctors will decide” mantra was always a fig leaf for their true ideological purpose of driving competition and privatisation into the heart of the NHS.

We notice that the Secretary of State is not here today, but perhaps the Minister will remind him of the statement his predecessor made to GPs:

“I know many of you may have read that you will be forced to fragment services, or to put services out to tender. This is absolutely not the case.”

I am tempted to ask: if the aim is to revert to the position we held, why on earth bring forward a 300 page Bill to rewrite the entire legal basis of the national health service? The truth is that they have been found out trying to sneak through the back door privatisation proposals that the Minister’s predecessors were forced to rule out to save their discredited Bill. In that light, does the Minister accept that it will not be good enough to bring these proposals back with a few cosmetic changes? Will he give a categorical assurance that there will now be a fundamental rewrite to reflect to the letter commitments given to the House and to the professions?

More broadly, we now need urgent clarification, in a full and detailed statement, of what Government policy on competition actually is. Will the Minister today send the clearest message to clinicians that they will control whether or not to use competitive tenders, and will he fulfil the pledge by his leader to protect the NHS from the full glare of EU competition law? If the Government still want to argue for more private providers in the NHS, is he confident that this will not restrict whistleblowing as it has in other outsourced public services?

Will they also respond today to the research of the Nuffield Trust, which shows that more competition in the NHS has resulted in falling productivity? A quarter of a million people who signed the 38 Degrees petition have forced the Government into yet another humiliating U-turn, but there will be lingering distrust at the fact that they had the audacity even to attempt this. The simple truth is this: the British public have never given them permission to put the NHS up for sale. Until they acknowledge that, we will never tire of reminding them.

[Norman Lamb]

I sense that the right hon. Gentleman’s speech was written before he heard what I had to say. If he had listened to it, he would know that we recognise concerns about the drafting and whether it absolutely meets the commitments already made. We want to be certain that the commitments made in this place during the passage of the Bill are met. Indeed, when the Secretary of State wrote to clinical commissioning groups in 2012, he made it absolutely clear that those groups would not be forced to go out to tender. We will make sure that that is met. [Interruption.] If Opposition Members had simply listened to what I said, they would have avoided coming up with a set of questions that completely ignored my points.

The right hon. Gentleman referred to the question of quality of care. From my point of view, poor care should be condemned wherever it happens, and he needs to remember that the scandal of Mid Staffordshire hospital happened under his and his party’s watch. The poor quality of care uncovered in that NHS hospital is completely unacceptable—just as unacceptable as poor quality care from any private provider at all. Let us be clear about that.

There will be no privatisation of the NHS under this Government. Furthermore, there will be no special favours for the private sector, which were provided under the right hon. Gentleman’s Government. It was his Government who gave £250 million to private providers of independent sector treatment centres—whether or not they delivered care. There will be no special favours under this Government’s new rules. No clinical commissioning group will be forced into competitive tender. The rules will be absolutely clear, and we shall publish the amended regulations shortly.

Mental Health (Approval Functions) Bill

Debate between Norman Lamb and Andy Burnham

Tuesday 30th October 2012 Commons Chamber

[The Minister of State, Department of Health (Norman Lamb)]

I will first set out what the clause seeks to do and then respond to the shadow Minister’s questions.

The clause directly addresses the issue that the Bill intends to resolve. Between 2002 and 2012, four strategic health authorities delegated to mental health trusts the function of approving doctors with responsibilities under the Mental Health Act 1983. The legal advice that we have obtained is that there are good arguments, as we have already discussed, that decisions to detain made by doctors who were approved in that irregular way are nevertheless lawful. The clause removes any doubt—that is its purpose. It clearly spells out that when mental health trusts gave approval in the past they are to be treated as having had the power to do so.

The clause has the effect of eliminating any irregularity from decisions made in complete good faith, and in the best interests of the patient, by doctors fully qualified to make them. It does so in a way that is fully consistent with the legal and clinical advice that we have received on the issue, and means that patients and their families do not have to undergo the process of assessment for detention under the Act again solely for the purpose of correcting a technical error made by a strategic health authority.

The hon. Lady asked why the clause was so broad as to refer to “Any person”. I understand her concern, but the point is that we do not yet know whether there were other issues before the establishment of the SHAs. Obviously, that is part of the work that the review will undertake, but to ensure that we resolve the problem absolutely and that all those patients have clarity the decision was made for the clause to refer to “Any person” in order to avoid any risk of our uncovering another problem that might need a separate resolution. This deals with the whole problem of the approval process for the doctors who made those decisions.

The hon. Lady then asked, correctly, whether decisions will be taken properly as we progress. I can confirm that all the doctors have already been re-approved according to a proper process, so every decision that is taken from hereon in cannot be challenged. As we have said, any patient who wants to question the clinical judgement can do so and their rights remain the same as they have always been. This simply addresses the technical issue that we have been debating today.

[Andy Burnham (Leigh) (Lab)]

The clause refers not only to “Any person” but one who

“has done anything in the purported exercise of an approval function”.

On both counts, it is incredibly widely drawn and could take us into the territory of other elements of the approval process that may have been defective. Will the Minister assure the Committee that the clause is as narrow as it needs to be? It seems to be uncomfortably wide and may well restrict somebody’s ability to challenge an element of their section other than the fact that the doctor was not approved by the SHA. It is very loose in its current form.

[Norman Lamb]

I am grateful to the shadow Secretary of State for that intervention. We have gone through a very careful process and have followed legal advice on what is necessary to regularise the position. This relates specifically to the approval function, which is defined in clause 1(2). As I have said, the legal advice is that this is the best way to regularise the issue that has been uncovered.

--- Later in debate ---

[Norman Lamb]

I absolutely take the right hon. Gentleman’s point, and I am grateful to him. We must be absolutely certain that everybody is now properly authorised to make decisions. We know that everybody outside the four affected SHAs has been properly authorised—that has been checked and confirmed by SHAs, which have undertaken a proper check of their procedures. We also know that the four affected SHAs have already regularised the position of all their authorised practising doctors. We therefore know that across the whole system, doctors who undertake sectioning from now onwards will be properly authorised in accordance with the Mental Health Act 1983. The Bill addresses the previous problems with the authorisation process, and we have addressed the problem for the future by ensuring that everybody is properly authorised. I hope that deals with that point.

[Andy Burnham]

rose—

[Norman Lamb]

It does not entirely seem to deal with it, so I give way to the shadow Secretary of State.

[Andy Burnham]

I am grateful. It is important to get clarity before we leave this clause.

I know that the Government have not yet undertaken a full case-by-case review of the up to 5,000 cases involved. That prompts the question how the Government can be sure that the whole team involved in each case was qualified to a suitable level, and that there were not some instances of under-qualified people making decisions. That gives rise to concern that we may be retrospectively approving processes that were defective.

[Norman Lamb]

I do not think there is any suggestion that any of the people who undertook sectioning were not medically qualified to do so. The issue is simply with the body that undertook the authorisation and the fact that SHAs delegated that responsibility to mental health trusts, which was not in accordance with the law. The Bill is intended to regularise the position of every clinician who was not properly authorised because of that flaw.

[Andy Burnham]

I do not want to detain the Committee unnecessarily, but because the clause is drawn so widely it will possibly take away some people’s right to challenge whether there was a deficiency in the process or whether someone involved in the sectioning decision was under-qualified. Given that the Government have not undertaken a case-by-case review, I wonder how we can have absolute confidence that the power in the Bill is not too widely drawn.

[Norman Lamb]

I am told that we have dealt, doctor by doctor, with all the doctors in question who are currently practising. The problem relates to the doctor, not the patient, because it is about their authorisation to undertake the duties in the 1983 Act. The only people who undertake the actions referred to in the clause are doctors, who were authorised but unfortunately by the wrong body. That is what we are seeking to regularise.

[Andy Burnham]

We must have absolute clarity about this. In that case, why does the Bill mention “Any person” rather than “any doctor”? Our understanding is that a broader team of people can be involved in a sectioning decision, such as a social worker. If it is only doctors, the Bill should just say “any doctor”, but it does not.

[Norman Lamb]

We are talking about the approval function. Subsection (2) mentions

“practitioners approved to give medical recommendations”,

so it clearly deals with practitioners who have already been authorised, but by the wrong body.