Health and Social Care Bill

Simon Burns Excerpts

Tuesday 13th March 2012 Commons Chamber

[Andy Burnham]

Dr Chand is not an adviser to the Labour party, and the Secretary of State, in seeking to inject that party political note so early on in today’s debate and to claim that the petition of 170,000 people is a political petition, continues, it suggests to me, to misread the mood of this country on his unnecessary Bill.

[The Minister of State, Department of Health (Mr Simon Burns)]

Will the right hon. Gentleman give way?

[Andy Burnham]

No, I will not.

We have arrived at a dangerous moment, not only for the NHS but for our democracy. To recap, this is a Bill for which nobody voted at the general election and which does not have a mandate, a Bill ruled out by the coalition agreement, and a Bill that has been so heavily amended in another place that in effect the unelected Chamber has written a new legal structure for the national health service that we are being asked to rubber-stamp. Yet despite all that, it could be rammed through this House in just seven days’ time, in defiance of an outstanding legal ruling from the Information Tribunal and in the teeth of overwhelming professional and public opposition.

This is an intolerable situation, and it is no way to treat our country’s most valued institution. Far-ranging changes to the NHS of the kind proposed by the Secretary of State can be made only by public consent and professional consensus, and it is plain for all to see that the Government have achieved neither of those things.

--- Later in debate ---

[Joan Walley]

No, I will not.

I agree with the right hon. Member for Charnwood (Mr Dorrell), who chairs the Health Committee, that some aspects of the Bill are very worthy, particularly those on public health, and we do not want to lose them, but four issues need urgent clarification, and I hope the Minister will address them when he replies.

First, why are my constituents not entitled to know what is on the risk register? What is there to hide? Why can we not have it laid before us when we are making important decisions about the future of the NHS? I am quite content for there to be service changes, but not structural, top-down reform, which the Prime Minister himself, in one of his commitments before the general election, said he was not going to introduce.

The key issue for the House is whether the NHS will be subject to the full force of domestic and EU competition law, and that has not yet been clarified. The Government maintain that it will not, but the changes brought about by the Bill make certain that it will. In any event, it is not in the Government’s gift to decide, because the issue will be decided in the courts, so I genuinely believe that we are entitled to clarification on that issue—[Interruption.] I will not give way on that point. It is absolutely essential that the Government, not the law courts of this country, determine NHS policy.

Secondly, what safeguards are there against private companies using loss leaders to replace NHS services and then, once the NHS service has been eliminated, maximising profits by reducing quality? We have heard from the Secretary of State on that, but once the service is eliminated, the private companies that come in will surely have a free hand. The Government say that there will be no competition on price, but private companies will still be able to use loss-leader tactics by overloading a bid with quality for the specified price, so we must have regard to the real concerns about that.

Thirdly, how will the Government stop cherry-picking in practice? If they attempt to exclude private companies from bidding for a particular contract, will they not face court action, and in those circumstances will not services be put on hold while the courts deal with how NHS care is to be provided?

Finally, again when the Minister replies—

[Mr Simon Burns]

In 10 minutes?

[Joan Walley]

Yes, in 10 minutes, because we need time to sort out the NHS. What will the Government do about foundation trusts once they become unsustainable—once they have been undermined by cherry-picking and by loss leaders?

There are huge issues, our constituents’ health is at stake, and this is an important debate, one in which the Government need to take account of what we are saying so that Parliament can have a say in how the NHS goes forward.

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[Jonathan Reynolds (Stalybridge and Hyde) (Lab/Co-op)]

I will speak in favour of the Government dropping this truly awful piece of legislation.

Before I do so, I will say a few words about my constituent, Dr Kailash Chand, who began the e-petition against the Bill, which has reached 174,000 signatures. Kailash has been a GP in my area for 27 years. He has been awarded an OBE for his work and in 2009 he was named north-west GP of the year. He has dedicated his life to public health. At times he has spoken out against Government policy, whoever has been in charge. His motivation in creating the e-petition was solely his love for and belief in the NHS. We should be grateful for such public servants. I am delighted that he is here to listen to this debate.

[Mr Simon Burns]

So that everyone fully understands the background, will the hon. Gentleman confirm that this same doctor wants to be a Labour MP, has been appointed by the leader of the Labour party to review Labour party policy on older people, and has worked for the right hon. Member for Wentworth and Dearne (John Healey) in a research capacity?

[Jonathan Reynolds]

The Government are just not willing to listen to the people who will be affected by the Bill. Kailash is not alone in opposing it. If I read out the name of every organisation that opposes the Bill, I would run out of time.

[Mr Burns]

Will the hon. Gentleman give way?

[Jonathan Reynolds]

No, sit down and listen for once.

It is clear that the majority of non-biased, objective opinion is against the Bill proceeding. Never in the field of public policy have so many opposed so much and been listened to so little.

Should the Government not be asking themselves this: if the Health Secretary cannot convince the people who he wants to devolve power to, and if the Deputy Prime Minister cannot convince his own party members to support the Bill, maybe—just maybe—there is not that much going for it? The Health Secretary cannot even visit an NHS hospital, so low has his reputation sunk.

As has been said, the people who oppose the Bill, whether the royal colleges or Opposition Members, do not oppose all reform. Of course, NHS services will have to change over time, particularly in the provision of specialist services. The Labour Government introduced reforms, which used the private sector to the advantage of the NHS. The Bill does the opposite and uses the NHS for the benefit of the private sector. The problem is not reform, but these reforms. To say that anyone who opposes the Bill is against all reform is crass and simplistic.

Let us please put an end to the nonsense that the reforms are just an evolutionary approach following what has happened in the past. If that were the case, would there be an unprecedented groundswell of opinion against them? Once the Bill is passed, the primary care trusts and the strategic health authorities will be gone, and clinical commissioning consortia will be responsible for the whole NHS budget. Local authorities will take public health, and Monitor and the NHS Commissioning Board, not the Department of Health, will be responsible for the health system. That is a fundamental, top-down restructuring of the NHS, and no one wants it.

To justify that revolution, the Government started by rubbishing the success of the NHS. It began with the cancer survival rates and carried on from there, and every time the Government’s case has been knocked down. The King’s Fund, the respected health think-tank, in its review of NHS performance since 1997, clearly showed dramatic falls in waiting times; lower infant mortality; increased life expectancy across every social group; cancer deaths steadily declining; infection rates down, and in mental health services, access to specialist help, which is considered among the best in Europe. Again, I put it to the Government that they have no justification for the revolution that the Bill brings about.

The Government’s other justification has been that the NHS has too many managers, yet their reforms create a structure so confusing that, when an organogram of the new structure was published, it became a viral hit on the internet because it looked so ludicrous. What do the experts in the King’s Fund say about this? The myths section about the Bill on its website says:

“If anything, our analysis seems to suggest that the NHS, particularly given the complexity of health care, is under-rather than over-managed”.

--- Later in debate ---

[The Minister of State, Department of Health (Mr Simon Burns)]

I agree with my hon. Friend the Member for Witham (Priti Patel), who observed in her vigorous and punchy speech that there was an element of déjà vu in the debate.

I was delighted to listen to the speech of the right hon. Member for South Shields (David Miliband). As I listened to it, and to the speech of the right hon. Member for Leigh (Andy Burnham), I reflected on how odd changes in political fortunes are. Those two were the über-Blair reformers, but it was clear from their speeches—both thoughtful in their different ways—that they had turned away from their reforming zeal. I can only put that down to “what a difference a leadership election makes”.

I congratulate my right hon. Friend the Member for Charnwood (Mr Dorrell) on another good and compelling contribution. I also congratulate my hon. Friends the Members for Kingswood (Chris Skidmore), for South West Bedfordshire (Andrew Selous), for Loughborough (Nicky Morgan) and for Witham, as well as the hon. Member for Burnley (Gordon Birtwistle). It seems that in his part of the world they call a spade a spade.

I must also mention the speech of the hon. Member for Walsall South (Valerie Vaz), which was at times fanciful, that of the hon. Member for Stoke-on-Trent North (Joan Walley), that of the right hon. Member for Manchester, Gorton (Sir Gerald Kaufman), which was passionate but, I fear, misguided, and that of the hon. Member for Stallybridge—[Hon. Members: “Stalybridge!”] I mean the hon. Member for Stalybridge and Hyde (Jonathan Reynolds). I am afraid that I am from the south. I was disappointed that the hon. Gentleman did not answer my question about the political allegiance of Dr Chand, whom he prayed in aid, given that Dr Chand has had aspirations to become a Labour candidate. Indeed, I think he even had aspirations to fight the seat that the hon. Gentleman fought, so it was very generous of the hon. Gentleman to mention him.

Let me make clear to the House that no party has a monopoly on caring for the NHS. We all care for the NHS passionately, and I find it distressing when Opposition Members seek to misrepresent the position by accusing us of trying to privatise it. Let me tell them that this party, my party—this Government, the coalition Government—will never privatise the NHS, and let me tell my hon. Friends to reinforce that message. Clause 1 of the Bill gives the Secretary of State a duty to provide a comprehensive health service, and subsection (3) gives a commitment—just as Nye Bevan did in his original Act—that it will be free at the point of use.

Let me tell Opposition Members that what they are saying is scaremongering, that it is unfair, and that it is a gross distortion of the facts. Let me also tell them that shroud-waving does not do them any credit. Pulling out examples that have no basis in proof and are simply intended to misguide and mislead the public is a disgrace—

[Andy Burnham]

Will the Minister give way?

[Mr Burns]

No, because I have no time.

I urge hon. Members to reflect—

[Andy Burnham]

Will the hon. Gentleman give way?

[Mr Burns]

No, because I have no time. I have only five minutes.

The right hon. Gentleman was seductive in his speech. He came across as trying to be eminently reasonable by saying that he did not want this to be a party political football. I must say to him, however, that it is he and his friends who have turned the NHS into a party political football, and I must say to them that the NHS is too precious to be turned into a party political football simply for the purpose of trying to gain votes.

Our reforms will help to prepare the NHS for the future, making it more balanced and better suited to the demands of the 21st century so that it has a long and healthy life based on its founding principles. First, our reforms will give patients more choice, enabling them to choose where to go, see who they want to see, and influence the kind of services that they want in their communities. Secondly, they will give doctors more freedom to commission care for their patients, so that they can shape the NHS around the needs of their local communities. Thirdly, they will reduce bureaucracy so that money—£4.5 billion of it between now and 2015—can be saved and reinvested in front-line services. Those are the basic premises and that is the basic ethos of the Bill.

Not once during the speech of the shadow Secretary of State, and not once during the speeches of any of his right hon. and hon. Friends, did we hear a single answer to the question of what they would do. I do not know how many Members saw the right hon. Gentleman being interviewed on “Newsnight” by Jeremy Paxman two weeks ago. Some of us live in fear of that experience, while some of us come to enjoy it. Five times during that brief one-to-one interview, Mr Paxman asked the right hon. Gentleman “What would you do?” and answer came there none. That was because the right hon. Gentleman is prepared to criticise and try to scare people in order to win votes, but he is not prepared to confront, in a realistic and meaningful way, the challenges facing the NHS and the way in which it must move forward.

What we need is less carping, less criticism, and more constructive engagement. When the right hon. Gentleman says in his flowery way that he is prepared to engage in all-party discussions there is a hollowness in his claim, because he has no policies to discuss, and can identify no positive way in which to resolve the problems of the NHS and enable it to evolve to meet the pressures to which it is subject.

This Bill, which has been discussed at length in this House and in another place, is the Bill that will move the NHS forward and enable it to meet the challenges of an ageing population and an escalating drugs spend. I urge my hon. Friends to reject the motion and to reject the Liberal Democrats’ amendment if it is pressed to a vote, because neither is in the interests of the health service or those of the country.

Question put, That the amendment be made.