NHS Reorganisation Debate
Full Debate: Read Full DebateDepartment: Department of Health and Social Care
Owen Smith
Main Page: Owen Smith (Labour - Pontypridd)Department Debates - View all Owen Smith's debates with the Department of Health and Social Care
(13 years, 8 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
John Healey
This is a debate. People in the country and in the NHS are worried not about what we did in government—they saw the massive improvements under Labour—but about the application of competition law, domestic and European, in full force to the NHS for the first time. The hon. Lady is serving on the Public Bill Committee. She will have the chance to get her head around that, as she clearly has not done so yet.
Owen Smith (Pontypridd) (Lab)
My right hon. Friend has anticipated the point that I was going to make. As we heard clearly in Committee yesterday—the Secretary of State ought to read the Official Report—his Minister, the right hon. Member for Chelmsford (Mr Burns), let the cat out of the bag. Hitherto the NHS has been insulated from European competition law. As there are more entrants to the market, competition law will have to apply—competition red in tooth and claw—followed by the break-up of the NHS.
John Healey
My hon. Friend is right. We have misinformation and confusion. If the Health Secretary disagrees with his Health Minister, I suggest that they have a word about it after the debate.
In the end, perhaps Nye Bevan was right. When Clement Attlee suggested that the NHS opening should be celebrated as a national institution supported by the whole nation, he said, “The Conservatives voted against the National Health Act, not only on second but the third reading. . . I don’t see why we should forget this.”
It is time for the Health Secretary to tell us why he is spending £2 billion on an NHS reorganisation when front-line staff and services are being cut. How many hospitals will be forced to close because of these reforms? Why is he handing such powers over our NHS to new national quangos, competition lawyers and the EU? Why is there no democratic voice in commissioning? Why is he allowing profit to be made in commissioning essential health services? Why is he removing any limit on private patients paying to jump the queue for treatment in NHS hospitals?
Mr Lansley
The hon. Gentleman has now learned that, if one is trying to pray somebody in aid, it is best not to insult them at the same time.
We have made it clear that we need to protect the NHS now and for future generations through modernisation. Under the Labour party—
Mr Lansley
Ah! Now we really do have somebody who can explain why in Wales the Labour party is cutting the NHS budget while we are increasing it. Come on!
Owen Smith
That is happening as a result of the very difficult decisions being taken in Wales, having seen the Welsh Assembly budget cut by £1.8 billion by the right hon. Gentleman’s Government. What we are not doing in Wales, however, is effectively privatising the NHS, exposing it to competition law or stuffing the mouths of private companies with public gold.
Mr Lansley
Let us remember that, when we decided to support the NHS here, through the Barnett formula by extension, money was provided to the devolved Administrations, but the hon. Gentleman confirms that a Labour-led Welsh Assembly Government chose not to invest in the NHS, while we in England chose to do so. I urge Welsh voters to remember that when they come to the elections in May.
Under the trade union thumb, Labour is turning its back on modernisation in the NHS, but the NHS cannot be preserved for the future and protected by neglect; it is not something that sits in a static format. It has to change to improve. When the number of managers in the NHS doubled under Labour, when results for patients in many conditions remain way below those achieved in other countries, and when the number of patients placed in mixed-sex accommodation runs into the thousands every month, the NHS needs to change.
Mr Lansley
No, I have given way to the hon. Gentleman before. [Interruption.] He only gets one shot.
Let me make it very clear. Our cuts in bureaucracy—
Dr Daniel Poulter (Central Suffolk and North Ipswich) (Con)
It is a great pleasure to speak after the great tour de force that we heard from my right hon. Friend the Member for Charnwood (Mr Dorrell). He dispelled a huge number of the myths that the Opposition have been trying to put forward today and during our entire Committee proceedings on the Health and Social Care Bill—one would almost believe that they had not been in power for the past 13 years. It is clear that one of the main reasons why we need to reform the NHS is not just to build on what the previous Government have done in terms of using private sector providers, but to make sure that we put a lot of things right. We are cutting bureaucracy and putting more money into front-line care—that is one of the main purposes of the Bill.
Before I develop my arguments about bureaucracy, I wish to pick up on what my hon. Friend the Member for Gainsborough (Mr Leigh) said in his intervention. He talked about the challenges of dealing with an ageing population. This country undoubtedly faces a big problem in providing health care as a result of many people living a lot longer, although that is a good thing. A lot of people have multiple medical comorbidities as they get older and they need to be looked after properly. The key financial challenge to the NHS is in ensuring that we look after our ageing population, and properly resource and fund their care, so when we cut bureaucracy and put more money into front-line patient care, that is what that is about.
When we talk about the need to ensure that the NHS has local health care and well-being boards—an NHS that is more responsive to local health care needs—it is a response to the fact that some parts of the country, such as, Eastbourne or my county of Suffolk, have an increasing older population, who need to be properly looked after in terms of funding. That is why it is so important that this Government have committed £1 billion to adult social care and are increasing that. It is also why we are putting an extra £10 billion into the NHS budget over the lifetime of this Parliament—the Labour party would not have done that.
On bureaucracy, it is worth reminding the Labour party of a few things it did when it was in power. Under Labour the number of managers in the NHS doubled. In 1999, there were 23,378 managers and senior managers in the NHS, but that figure had almost doubled by 2009, having increased to 42,509.
Dr Poulter
The hon. Gentleman might wish to listen to this, but I will take his intervention.
Owen Smith
The hon. Gentleman has returned to this point about bureaucracy many times during our proceedings in the Public Bill Committee. Does he not share my concern about our shared ignorance as to how many managers and how much bureaucracy there will be under the new structure in the GP consortia and in the regional presence of the national commissioning board? Does he know what bureaucracy there will be under this Bill, because I do not?
Dr Poulter
What we do know—the hon. Gentleman would do well to listen to this—is that the NHS currently spends £4.5 billion on bureaucracy, and that could be better spent on patient care. Under the previous Labour Government PCT management costs doubled by more than £1 billion to £2.5 billion, and that money could be better spent on patient care. By scrapping PCTs, we will have more money to give to GPs to spend on patients and front-line care, and that can only be a good thing.
Labour Members would do well to listen to a few more of the statistics on NHS bureaucracy that I am about to read to them. Under Labour, the number of managers increased faster than the number of nurses in the NHS. How can that possibly be right? Managers were paid better than nurses in the NHS. In 2008-09, top managers in NHS trusts received a 7% pay rise whereas front-line nurses received a rise of less than 3%. The Labour party was obsessed with bureaucracy, management and top-down targets, and we would much rather see that money spent on patients and front-line patient care.
Owen Smith (Pontypridd) (Lab)
On a point of order, Mr Deputy Speaker. You were not in the Chair at the conclusion of the Opposition day debate, but the Minister of State, the hon. Member for Sutton and Cheam (Paul Burstow), used barely half his allotted time in winding up, as he was clearly short of arguments to defend his position on the important subject under discussion. That left many of us who have plenty to say on the subject short of time to speak. Will you work through the usual channels, Mr Deputy Speaker, to make sure that in future either Ministers use all their time or Back Benchers are given more time to speak?
Mr Deputy Speaker (Mr Nigel Evans)
How long the Minister wishes to speak for is not a matter for the Chair. The Minister spoke, the debate came to an end, and a vote was taken.