Health and Social Care Bill

Rosie Cooper Excerpts

Monday 31st January 2011 Commons Chamber

[Gordon Birtwistle (Burnley) (LD)]

I shall support the Bill, because it will mean an end to the disruption and devastation of local hospital services owing to overpaid, faceless bureaucrats in palatial offices many miles from people’s local hospitals deciding that a particular service is no longer needed or is better off elsewhere. The Bill’s local democratic legitimacy policy strives to ensure that decisions on serious hospital reconfigurations never again ride roughshod over the wishes of the local community.

[Rosie Cooper (West Lancashire) (Lab)]

When I asked the Secretary of State who would make the decision if the consortium and the health and wellbeing board disagreed on the reconfiguration of hospitals, he said the reconfiguration panel as it exists today—no difference.

--- Later in debate ---

[Henry Smith]

I do not see how multiple providers is a definition of a monopoly. However, I must make progress in the short time left to me.

My constituents are pleased that for the first time in many years health decisions will be made in Crawley, rather than, as has happened up until now, on the south coast, in east Surrey or up in Whitehall, and that more decisions will be made by local people.

[Rosie Cooper]

Will the hon. Gentleman give way?

[Henry Smith]

I am sorry, but I have not got enough time.

I will support the measures in the Bill, as should all right hon. and hon. Members. However, I would like briefly to ask for clarification on two points from those on the Treasury Bench. First, hospices are greatly valued in our local area—on Friday, I was privileged to visit the Chestnut Tree House children’s hospital, which serves my constituency—so some clarity over future support for hospices would be greatly appreciated. Secondly, I would also like an assurance that the merry-go-round of failing managers in our acute sector will be addressed. I regret to say that on new year’s eve, at East Surrey hospital—the acute hospital for my constituency— 14 ambulances were queuing to get into accident and emergency. That is not good enough. It is another area of the sector that needs to be reformed.

Forgive me, Mr Speaker, because in the seven seconds I have left, I would like to report that there is well-being in Crawley today, because they are due to play at Old Trafford in about three weeks’ time.

--- Later in debate ---

[Nadine Dorries]

Absolutely, and the Bill will address that, in as much as care will be more easily accessed by the GP and the patient, in a much more streamlined process.

When nurses sat their medical exams 62 years ago, when the NHS was first established, the answer to each question had to begin and end with the words: “Reassure the patient”. It did not matter what someone said in the answer; if they did not emphasise the fact that the patient had to be reassured, they failed. That has gone. That demonstrates exactly how the patient has become invisible in today’s NHS.

I support the Bill because I support GPs working in consortia. A common myth—an urban myth—that we have heard in the few weeks leading up to this debate, and which has been thrown at us from the Opposition Benches, is that GPs are simply not up to the task of becoming business managers. The truth is that they already are business managers, because they all manage their own businesses. They will not be working as individuals or in individual practices; they will be working as part of a consortium, which is quite different from the impression given by the Opposition. Right now, 141 pathfinder consortia are demonstrating that they are ready and able to take on commissioning, and that they endorse patient involvement in the decision-making process. As a result of the “any willing provider” provisions, there will be a genuinely wider choice of care options available to the GP and the patient.

I would like to rebut the argument that the private sector will come in and undercut the NHS. That is complete nonsense. There will be no undercutting of the NHS whatever. Services will be—[Interruption.] I can only say that Opposition Members have not read the Bill, because there will be a tariff. Charities and the private sector will be able to provide services, but with a tariff. I shall give an example. If a patient requires a surgical procedure, which they discuss with their GP, and the local hospital has no bed available for six weeks, two months or however long, but if the local private hospital can provide a bed the next morning at the same price, are the Opposition really saying that an ideological obstruction should be put in the way of that patient being admitted to that private bed for that procedure the following day?

[Rosie Cooper]

Will the hon. Lady give way?

[Nadine Dorries]

I cannot, because I have given way twice and I have no more time.

If that patient were in pain, why should they not be admitted into that bed if it were available? That is how the market will be opened up by GPs, to the benefit of patients.

We recently heard from my right hon. Friend the Prime Minister about an extra £60 million that will be available to fund the latest bowel cancer screening technology, with wider deployment of the flexible sigmoidoscope. That does not need to be provided in secondary care in a hospital; it could be provided in the GP practice under the “any willing provider” provisions, perhaps via charities with specialised trained technicians. The Bill will ensure a new approach to providing services to the patient. “Any willing provider” will give patients the choice that they have not had for 62 years, empowering them to make decisions over that choice and opening up health care that patients in this country have not had, certainly for the past 15 years. With new technologies coming on stream and new ways of delivering care, both in the patient’s home and in the GP practice, that has to be welcomed. The Bill has to be welcomed, and Government Members will vote for it because the most important person in the Bill is the patient. That is why I support it wholeheartedly.

--- Later in debate ---

[Rosie Cooper (West Lancashire) (Lab)]

I am delighted to follow a fellow member of the Health Committee. I, too, am looking forward to the answers to the very many questions asked by the Select Committee that were not answered comprehensively. The issues have been elucidated today by my right hon. Friend the Member for Croydon North (Malcolm Wicks) and my hon. Friend the Member for York Central (Hugh Bayley), so I will not rehearse the arguments again.

I fear that today marks a watershed in the future of the NHS, and I say that as one who has proudly dedicated 30 years of my life to the service. Today is the day that the broken promises of the Tory-led Government will lead us down a path that, sadly, will end with a broken NHS. I characterise the Department of Health’s policy position on the most far-reaching reforms since the inception of the national health service as, “Don’t ask us about the detail; we haven’t made it up yet.” I am not sure what is more worrying—not having the detail or now seeing an outline of what the Tory-led Administration plan to do with the national health service.

I do not know why it took so long to bring the Bill to the House. It cannot be because of extensive consultation and discussion with professionals and advisers, because we cannot seem to find any body willing to own up to advising or having had discussions with the Secretary of State about the future direction of health services. If he had had such discussions, he would have heard the resounding message that his reform package is not what the NHS needs right now.

We should have built on the best in an evolutionary way. Instead, the Secretary of State has inflicted on the NHS a massive structural change while it has to cope with the Nicholson challenge, which we are led to believe are the 4% compound cost savings for the next four years. As David Nicholson acknowledged to the Health Committee, the scale of the productivity challenge is huge and has never been done on this scale either in the NHS or elsewhere in the world, and it is all taking place during a transition into the new NHS commissioning world.

It now transpires that the feat that the Health Secretary set for the NHS has been made even more improbable—some might say, impossible—to achieve because of decisions being taken below the radar. For example, there is the reduction in the market forces factor, which means a reduction in some NHS hospitals’ budgets. Instead of the 4% that the Government have talked about, the reality of the cuts to some hospital budgets is closer to 5%, and perhaps even 5.5% in some cases—mission impossible.

At the same time, we hear about wards having to be closed because of budget cuts. The NHS Confederation says that some hospitals might need to close under the reforms. Yet this weekend’s newspapers talked about the Department of Health having meetings with private sector providers who have 10,000 beds at their disposal.

When will the Secretary of State stop peddling myths and start dealing with the reality, before it is too late for the NHS? The Bill will deliver a service that is low on accountability and high on autonomy. I do not have time to go into this in detail, but I am certainly not persuaded by the accountability measures in the Bill. I am not convinced by the wellbeing boards, local healthwatch or national HealthWatch. We have no evidence that they will be able to deal with accountability or respond to patients themselves. The issue is very clear. If we as Members of Parliament want to ask questions, whom should we ask?

As far as I am concerned, the Secretary of State has a nice little soundbite that he often wheels out—“No decisions about me without me”. Government Members have stated that over and over, but have not demonstrated any evidence base for it. To me it is clear: the fundamental principles of the Bill are about taking decisions “about me without me”. I am really not persuaded by the democratic accountability provisions. A whole series of decisions have already been made about my health care, our health care and this nation’s health care—and they have been made without us.

It has taken until today for us to be able to debate these proposals properly, and in six minutes I am not able to deal with the points that I should like to cover. This Bill comes to us now after many of the fundamental decisions have already been taken and are being implemented. It is a set of short-term measures that will have long-term consequences for the future of the NHS, the quality of health care, and the accessibility of services available to people in communities across this country.

The Prime Minister and the Secretary of State deny breaking their promises, but like the emperor and his new clothes, they can fool themselves for as long as they like, but they are not going to fool the people. As people’s services disappear, as they wait longer for their operations, and as things get more difficult, they will know who to blame, and Government Members will really need to worry about it. Last time I spoke in this Chamber on health matters, I accused the Secretary of State of glibness; today, I accuse him of hubris.