Health and Care Bill

Rachael Maskell Excerpts

2nd reading
Wednesday 14th July 2021 Commons Chamber

[Sajid Javid]

Clinical decisions should always be made by those with clinical expertise—I think everyone in the House would agree on that—and that should be independent of any outside interference. The Bill does nothing to alter that. What it does is recognise that the NHS is one of the public’s top priorities. We spend over £140 billion of taxpayers’ money on the NHS, and it is right that there is proper accountability for that spending to Ministers and therefore to the House. I think that most people would welcome that.

[Rachael Maskell (York Central) (Lab/Co-op)]

The Secretary of State has talked about people he has consulted, so would he confirm that he has consulted the trade unions, particularly on schedule 2, which says that integrated care boards may appoint employees to address remuneration, pensions and terms and conditions. Can he confirm that that is a departure from Agenda for Change terms?

[Sajid Javid]

There have been wide-ranging consultations on the Bill, as I mentioned, which have taken place over the past two years. While I cannot say specifically which trade union or which particular organisation has been spoken to, as I was not in the Department at the time, I know that the conversations have been wide ranging.

The Bill is not the limit of our ambitions on the nation’s health. We are also transforming public health; we are bringing the Mental Health Act into the 21st century; and, by the end of this year, we will set out plans putting adult social care on a sustainable footing for the future.

We are also ambitious for our workforce. I have commissioned Health Education England to refresh its strategic framework for health and social care workforce planning. HEE will work in partnership across the sector and gather views from the widest possible range of stakeholders to help us to shape a workforce with the right skills, the right knowledge and the right values for the year ahead.

--- Later in debate ---

[Rachael Maskell (York Central) (Lab/Co-op)]

This Health and Care Bill has been conceived in bunkers behind screens within echo chambers. It is straight from the US health market, and its architects are immune to objection from the frontline leaders who are expected to deliver a new health and care system. In case the Government had not observed it, those people are in the midst of managing a pandemic, its resurgence and its aftermath. They are holding together a fragile workforce, traumatised by the pressure and sacrifice of the covid war. They are vaccinating a nation while seeing others fall to preventable diseases. They are embracing those with broken minds as they try desperately to hold on to their own.

It is no time to strip out the NHS’s infrastructure and replace it—eager as we are to do so—with something as ill-defined, void of detail and illiterate as the Bill presents. The Bill will shift the blame for an imploding NHS and shattered care system from the impervious Prime Minister to NHS workers. The backlogs will be their fault. They will be to blame for service cuts, and the Government will shrug their shoulders at the postcode lottery and rationing. We have more than 5 million people waiting for hospital appointments. We are unable to see a GP for weeks. We are waiting longer than ever at A&E and, when the care system fleeces people for all they have and fails to restore their dignity in their fading years of life, the Bill scapegoats local health and care teams while the Government wash their hands.

We are in this mess because, in 2012, the Government—and, let us not forget, their Lib Dem chums—messed with our NHS, ignored clinicians and seeded the failures that we have witnessed throughout the pandemic. History repeats itself. The market-driven system enabled Ministers to sign away billions of pounds on crony contracts while frontline staff were wrapped in bin bags—and some, tragically, in body bags. The Bill lets the Government off the hook. When things go wrong, they will simply blame others as they avoid shame. But, worse, private companies are already sitting round the tables of the shadow integrated care systems to profit further. Nothing has changed. If the Bill changes nothing, we do not need it to further destroy the remnants of Labour’s precious NHS. At the one time we need certainty, there is none.

The Bill fails to provide the vital stability, funding, accountability or transparency that is needed. It fails on prevention and the advances that patients need. It has more private commissioning, not less, no workforce planning or vital staff pay and, crucially, no social care, yet the NHS will integrate with it. Labour believes that people deserve better. We must have integrated health and social care, free to all in need, wholly delivered in our public sector by fairly rewarded staff and accountable to this Parliament and to the people. Now is not the time and this is not the Bill. I will vote against it.