(5 years, 4 months ago)
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I do not entirely disagree. Certainly that 13% or 14% of the electorate may have felt disenfranchised by the result to some extent, but during that election I think we all recognised the extremist nature of some of the views held by that party and some of its candidates.
The hon. Gentleman is correct on the broader issue. We now have a much more fractured politics than we did half a century ago, when there was a stronger argument for first past the post, and many groups do not feel represented in their constituencies. For example, I received more than 60% of the vote in my constituency at the last election, but consistently about 15% to 20% of that electorate have voted for the Labour party. Indeed, in Suffolk as a whole in 2010 and 2015, 25% of the electorate voted for Labour and yet seven Conservative MPs were returned. That is not representative of the general feelings of Suffolk residents.
The hon. Gentleman is making an important point. Does he recognise that proportional representation is about more than electoral outcomes and that, actually, proportional systems change political culture in a way that delivers more effective social outcomes? Societies with PR are more likely to have lower income inequality, better developed welfare systems, higher social expenditure, better distribution of public goods and better environmental controls. It is a much wider issue.
The hon. Gentleman is right. Broadly, there is a strong case and good evidence that in countries with proportional representation, or a more proportional system, there tends to be more consensus government, which tends to recognise certain common goods. Today, there is an urgent question in the main Chamber on climate change. In many other countries in Europe, climate change’s importance in the legislative agenda is reinforced by that sort of consensus politics.
For example, the work done by the former leader of the Labour party, the right hon. Member for Doncaster North (Edward Miliband), when he was Secretary of State for Energy and Climate Change in the latter part of the last decade, was broadly supported across the House, but if there had been a sudden lurch to a Government who perhaps did not believe in climate change, a lot of that work could have been undone under the British system. That is much harder to do under a proportional system, under which there has to be much more work through consensus between political parties. The hon. Gentleman is absolutely right to make that point about the sort of politics that many of us here would like to see.
I want to allow other hon. Members to speak, so I will be very quick. In my view, if we are to have a PR system that is effective, it has to maintain the constituency link. It also has to ensure that we deal with the issue of having a potential threshold, even under PR, for election, be it 5% of the electorate in a particular area or whatever. The best way of doing that, I believe, is by doing something broadly along the lines of what we have currently for the European elections—perhaps not on the basis of a large-scale region, but on a county basis or a city-regional basis. That would allow people in, for example, London, where boroughs identify together, to elect from those boroughs a proportional number of MPs from different parties, according to how those electors voted.
That strikes me, in comparison with our current political settlement, as a much fairer way of electing people. It certainly would have given a voice in 2010 and 2015 to the 25% of constituents in Suffolk who voted for the Labour party but did not have any MP to represent them. I hope that, going forward, it would also give rise to the more consensus-based politics on the big issues of the day, such as climate change, and other forms of policy making that all of us here, I hope, believe in.
(9 years, 6 months ago)
Commons ChamberT8. When I asked the Minister last June what guarantees he would give to GP practices at risk because of the withdrawal of the minimum practice income guarantee, I was told that NHS England would ensure threatened practices “get to the right place.”—[Official Report, 10 June 2014; Vol. 582, c. 400.]Over the past seven months, those discussions have not alleviated the threat to two highly regarded practices in my constituency that face closure. Will the Minister agree to meet me and representatives of the practices to discuss what is really happening, and to consider what can be done to save them?
I am very happy to meet the hon. Gentleman, but he will be aware that the move away from the historical funding formula towards a per head or capitation formula is a move in the right direction. If there are certain local concerns, I am very happy to meet him to discuss them.
(10 years, 2 months ago)
Commons Chamber11. What assessment he has made of the potential effect on health outcomes of phasing out minimum practice income guarantee funding from GP practices in England.
The minimum practice income guarantee payment is unfair because practices serving very similar populations are paid very different amounts per patient. The payments are being phased out over a seven-year period to allow practices time to adjust. The money released by doing this will be reinvested in the basic payments made to all general medical services practices, which are based on numbers of patients and key determinants of practice workload, such as the age and health needs of patients.
The minimum practice income guarantee was introduced to meet the specific needs of specific practices. Those needs have not changed. NHS England has drawn up a list of 100 practices across the country that will be threatened by its withdrawal. Five are in Sheffield and two are in my constituency. Will the Minister give a guarantee that no practice will close as a result of the withdrawal of the minimum practice income guarantee, and will he provide the funding to achieve that?
The point is this: the funding system set up by the previous Government was based on historical funding and did not necessarily recognise the needs of patients. One practice might have been paid more for historical reasons than another practice next door that might have been treating more patients. That was unfair; we have changed it. NHS England is working at local level with practices that are, for whatever reason, in financial difficulties to make sure that it can help them get to the right place.
(13 years, 5 months ago)
Commons ChamberWhat bears eloquent testimony to who really cares about the NHS is our record. Before 1997, I remember patients being stacked up in hospital corridors in Sheffield every winter because the hospitals could not find beds. That situation has been transformed under Labour over the past 13 years.
The Prime Minister has tried hard to reassure the public that the NHS is safe in Tory hands, but he has failed. In January, a major survey of the British public demonstrated that only 27% of people back moves to allow profit-making companies to increase their role in the NHS. That reflects the way in which our people treasure the NHS and its values, and that is why the Government did not have the confidence to say at the general election what their real intention was: the deconstruction and privatisation of the NHS by stealth.
It is not only the public whom the Prime Minister has failed to convince. The Secretary of State told us again today, as the Government have done many times during discourse on the issue, that we should trust doctors—those who understand the NHS.
I am afraid that I will not; I said that I would give way once and then make progress.
I hope that the Government will take their own advice and listen to doctors, because yesterday the doctors spoke clearly and powerfully with one voice, despite reports that we have seen that under the proposals, doctors could earn up to £300,000. At the first emergency conference of the British Medical Association in 19 years, they sent a clear message to the Government: “Think again.”
Five of Sheffield’s hospitals are in my constituency, and I want to focus on the consequences of ending the cap on private income earned by hospital trusts without providing any safeguards. As hospitals face squeezed budgets, they will inevitably look at every opportunity to enhance their income. At one level, they might see the chance of offering additional services such as en suite facilities to those who can afford to pay, but at another, more damaging level, we need to recognise that in Sheffield and across the country, patients are now being refused non-urgent elective surgery. There are increases in waiting times for knee and hip replacements, and for cataract, hernia and similar operations. Those are not operations for life-threatening problems, but they are hugely important for people’s quality of life. Access to that sort of surgery at the earliest point of need transformed the lives of tens of thousands of people under Labour. Those operations may not be life-critical, but delaying them condemns people to pain and immobility.