Health and Social Care Bill

John Bercow Excerpts

Tuesday 20th March 2012 Commons Chamber

[Several hon. Members]

rose—

[Mr Speaker]

Order. The Secretary of State has indicated that he wishes to speak later in the debate—[Interruption.] Order. That is his absolute prerogative. In view of the level of interest in the debate, it will be helpful for the House to know at this point that a five-minute limit on Back-Bench speeches is to be imposed immediately. I call Dr Daniel Poulter.

[Dr Daniel Poulter (Central Suffolk and North Ipswich) (Con)]

indicated dissent.

[Mr Speaker]

He was in, on the list and at the top. If he does not wish to speak, so be it.

--- Later in debate ---

[Tony Baldry]

No.

All I am saying to my hon. Friend is that this is a debate about the relationship between civil servants and Ministers, a relationship that has worked very well and very effectively in this country.

Here we have heads of the civil service advising Parliament that this move, which the Opposition would seek to force upon us, is not in the best interests of the relationship between civil servants and Ministers and is not in the best interests of the good running of government.

[Mr Speaker]

Do I take it that the hon. Gentleman has concluded his speech?

[Tony Baldry]

I have, Mr Speaker, and I hope that I have made my point.

--- Later in debate ---

[Grahame M. Morris]

Absolutely; I completely agree with my right hon. Friend. These are huge structural changes to a beloved organisation, and it is in the public interest that we know precisely what is in the transition risk register.

A little while ago, I tabled early-day motion 2659, which called on the Health Secretary

“to respect the ruling by the Information Commissioner and to publish the risk register associated with the Health and Social Care Bill reforms in advance of Report Stage in the House of Lords”,

so that we could have proper scrutiny in the Lords and in the House of Commons. We have not seen what is in the transition risk register, but we are aware of the existence of other risk registers. While the Health Secretary has been fighting tooth and nail to prevent the publication of the transition risk register and, in the process, hiding the risks to the NHS in England, other NHS bodies and clinical groups have been compiling their own risk registers into the impact of the Health and Social Care Bill.

One such body is the Faculty of Public Health, the body for specialists in public health, which is a joint faculty of the three Royal Colleges of Physicians of the United Kingdom. I am grateful to Professor Clare Bambra, from the north-east, and Professor John Ashton, from the north-west, for providing this information. In a letter to The Independent, Professor Lindsey Davies, the president of the Faculty of Public Health, outlined his concerns about the pressure that clinicians were now under from their employers for criticising the Government’s plans to reform the NHS. He wrote:

“Public health professionals have the right and duty to speak out on issues which they perceive as threatening the health of the population they serve”.

The bunker mentality of the Health Secretary, and his determination to silence clinical and public opposition, have astounded the country as a whole.

In response to the Department of Health’s refusal to publish its own strategic risk assessment of the impact of the Bill, the Faculty of Public Health has undertaken its own study, in which it has highlighted a number of significant risks, not least the potential for a postcode lottery. It states:

“Clinical Commissioning Group flexibility to determine services will lead to an increase in geographical variation in service provision.”

It identifies the possibility of costs being pushed up, and states that the

“development of more overt market mechanisms, and the greater role for the independent sector in the provision of healthcare is likely to increase the overall cost of providing healthcare.”

It also raises concerns about issues of quality as a consequence of the reforms. If the transition risk register indicates that, we should know about it.

The delaying tactics employed by the Secretary of State are, to my mind, holding Parliament in contempt. He should publish and employ no further delaying tactics. Reports that Tory-Lib Dem Cabinet members banged their Cabinet table in delight and glee at the prospect of the health Bill finally being rammed through and becoming law at the end of today leave a very sour taste in the mouth. I urge all Members to support this motion and get the risk register published.

[Mr Speaker]

I inform the House that there is a slight discrepancy between the clock time shown on the annunciator screen and that shown on the digital display panels on either side of the Chamber. For the avoidance of doubt, this debate began at 3.44 pm and has to end at or before 5.14 pm. For the purposes of deciding when we reach the end time, the Chair will use the time on the Chamber digital display panels. I hope that that is helpful. Given the level of interest in the debate, the time limit for Back Benchers will be reduced to three minutes with immediate effect.