(13 years, 5 months ago)
Commons ChamberI am grateful to my hon. Friend. During the engagement that we are undertaking, one of the areas that we should certainly pursue is the work force development strategy in relation to care and support—and we will do that.
Can the Secretary of State tell us why one part of the UK gets care free and the other has to pay? Is it because the other part—Scotland—pays more taxes?
(13 years, 6 months ago)
Commons ChamberMy hon. Friend makes an important point. General practice—not just general practitioners but general practice—has a central role for patients because there is a long-term relationship with patients and an understanding of the whole population and the health of a whole area. However, GPs recognise that in order to get the right services for patients, they have to design services alongside the range of professionals whose job it is to deliver them.
Let us be clear: this is just a dog’s dinner and these amendments have proved it. What we have here is a slow-privatisation-of-the-NHS Bill that is backed by the Rag, Tag and Bobtail party—the Liberal Democrats. This is the beginning of the privatisation of the health service and it is time it stopped.
This Bill and our proposals were never to support privatisation; they are not to support privatisation and they will not be to support privatisation. The hon. Gentleman should have attacked the Labour Government who gave the private sector £250 million for operations it never carried out; they paid it 11% more than they would have paid the NHS for that. They tried to push the NHS out of the provision of services when it could have provided them and competed. The Labour Government did that, and we shall legislate to make it illegal for a Secretary of State or any regulator to engage in that kind of preferential treatment for the private sector in future.
(13 years, 10 months ago)
Commons ChamberI just wish that the hon. Gentleman would look at the latest published data. Since the election, we have reduced the number of managers in the health service by almost 4,000 and increased the number of doctors. For the first time, there are more than 100,000 doctors in the NHS, and we are increasing the number of health visitors, after years of their numbers being reduced under the previous Government. He should get his facts right before he starts flinging accusations about.
No. I am going to make some progress.
The Labour party, when in government, pioneered patient choice; Labour said, “We must have patient choice.” I remember John Reid, when he was a Member, saying that the articulate and the well-off negotiated their way through the health service, and that he wanted to give choice to everybody in the health service. He was right. The social attitudes survey in 2009 found that more than 95% of people felt that they should have more choice, but that fewer than half of patients actually experienced it. The Labour party started down the road of extending choice; we will complete that journey.
I am grateful to my hon. Friend for that point. I have not previously been asked to comment on the matter, nor have I received information about it, but from my visits to Cornwall I entirely endorse his view about the importance of community hospitals in accessing services. He will see that, in the Bill, a specific duty is placed on the commissioning board and each commissioning consortium to reduce inequalities in access to health care. He will see also that, through the Bill, we will strengthen accountability where major service change takes place, because it will require not only the agreement of the commissioning consortium, representing as it were the professional view, but the endorsement of the health and wellbeing board, which includes direct, local, democratic accountability. Points have been made about what was in manifestos, but the Liberal Democrat manifesto was very clear about the need for democratic accountability in health service commissioning—and so there will be.
Let me return to the point, because the previous Government also went down the route of practice-based commissioning. It was their policy, but, as the shadow Health Minister, the hon. Member for Leicester West (Liz Kendall) said, many GPs felt that
“they didn’t always get the power, responsibility and resources they might have wanted.”
Well, now they will, and we will give it to them.
On our definition of quality, Opposition Members say “quality matters”. It does, and it was under the Labour Government that Ara Darzi pioneered the thought that quality must be at the heart and an organising principle of the health service. It is we now who are going to make that happen. We are publishing quality standards. We are putting into this legislation a duty to improve quality that extends to all the organisations that commission and provide NHS services.
Will there be public accountability for the private companies that will come in and do the commissioning for the doctors? I can see their people getting top salaries—the executive getting £200,000 and the financial officer getting £250,000. That is the sort of thing that we are trying to stop. What will happen when these companies run things for doctors?
The accountability in the NHS will be for the quality of the service being provided. The hon. Gentleman may not have agreed with the last Labour Government on this, and perhaps many in the Labour party are now changing their view on what was pursued by that Government, but it was that Government who introduced and encouraged a policy of “any willing provider”. In 2003, Alan Milburn said:
“If I can get a private-sector hospital to treat an NHS patient, then for me the person remains an NHS patient.”
Everybody in the NHS who provides NHS services will be accountable through the—[Interruption.] The money will follow. The Chair of the Public Accounts Committee is here. Where public money goes, accountability for its use will follow.