A Plan for the NHS and Social Care

Stephen Crabb Excerpts

Wednesday 19th May 2021 Commons Chamber

[Stephen Crabb (Preseli Pembrokeshire) (Con)]

May I start by saying what a pleasure it is to follow the hon. Member for Airdrie and Shotts (Anum Qaisar-Javed)? It was an outstanding maiden speech, and we congratulate her on her success and wish her every success during her time in this House. We wish our best to her predecessor, whom many of us enjoyed chatting to on many different subjects.

I would like to begin my short speech by paying tribute to and thanking the local NHS teams in west Wales, particularly Pembrokeshire, for their outstanding work over the past 12 months, particularly the teams working at Withybush Hospital in Haverfordwest. The national health service occupies a unique place in our national life. It is an institution—more correctly, it is an idea—that fosters national unity in our society. It is an idea that is wrapped in a fair degree of mythology, and one of the key myths about the NHS today is that we have a single national health service. The truth is that we do not have a single NHS, not in a legal sense nor, increasingly, in a practical sense. If someone logs on to www.nhs.uk they will find a website with no information about any UK-wide health services, and no signposting for residents who live in Wales, Scotland or Northern Ireland—there is precious little of the UK about it at all. Increasingly, the NHS across the UK is about a different set of institutions, a different set of published core values, different policies, different approaches and different governance arrangements.

When I speak to staff in the NHS I get the sense that they genuinely believe that they are working for one integrated, unified organisation and movement, but increasingly the truth is that that is not the case. The point that I want to make is not an active devolution point at all—that is not where I am coming from—but I believe that the experience of the past 12 months has reinforced the importance of better co-ordination and communication, as well as the importance of data. An early argument made by proponents of devolution was that it would enable different policies to be tested in different parts of the United Kingdom, and there may be some truth in that. We should also recognise, however, that we have no meaningful way of judging those different policies—there is no set of UK-wide health metrics. The Nuffield Foundation and the Health Foundation both tried in the past to do studies looking at comparative data on different health services in different parts of the UK, but doing so has become more difficult given the increasing divergence that is under way.

We do not have meaningful debates about the performance of health systems in different parts of the UK, and the debate by Members from different parts of the UK is akin to cheerleading for their party if it is in power in their part of the United Kingdom. I thought the contribution from the hon. Member for Central Ayrshire (Dr Whitford), who is usually very good, characterised that. She seemed to be saying, “The NHS in Scotland is much better than anywhere else,” without any real evidence or information to back that up.

There are things that can be done to strengthen the NHS and create a more unified service without undermining the devolution settlement. I believe that we can strengthen the data sharing protocols between different parts of the system across the UK. The Secretary of State himself spoke about the importance of data. “Data saves lives,” he said. Well, we need to strengthen the way in which the NHS can communicate data between different parts of the UK. We need to improve the way we collect and publish truly comparative data across the UK. I will go even further: I would introduce a more unified inspection regime across the UK. I believe that we should develop stronger, UK-wide health standards so that it should not matter where someone is in the UK—they should have the same right to basic standards of healthcare, whether that relates to cancer care, bereavement care or child and adolescent mental health services. I do not believe that developing a more unified UK approach undermines devolution one bit.

When it comes to learning from the pandemic, I strongly welcome the Prime Minister’s commitment to a public inquiry, which must not tiptoe around the issue of the four-nations approach to the pandemic. This morning, the National Audit Office published a report about its initial learnings from the Government response to the pandemic, and talked about a mixture of devolved competencies and UK-wide competencies, but not once did it mention devolved government. If we are truly to have a meaningful inquiry we need to meet that challenge head-on and have a genuine UK-wide debate.