Health and Social Care Bill

Stephen Dorrell Excerpts

Tuesday 13th March 2012 Commons Chamber

[Mr Stephen Dorrell (Charnwood) (Con)]

It is a pleasure to follow the right hon. Member for South Shields (David Miliband) and it was notable that his hon. and right hon. Friends were listening to his words, rapt, possibly reflecting on what they had missed out on. The kernel of his argument for this side of the House appeared to be the offering of advice to us about where our party advantage lay. He will forgive me if I say that I think we should look elsewhere for advice about where our party advantage lies.

The right hon. Gentleman was raising a voice for Blairite reform of the NHS, and that is a theme to which I want to return. Some opponents of the Bill can claim the virtue of consistency. Some opponents of the Bill can claim that they always opposed the development of structures in the health services that encouraged flexibility and encouraged a focus on the patient voice and on general practitioners and the wider clinical community as an effective voice for patients in the health service.

Some can claim that they have always opposed having a health service open to private and independent sector provision alongside the national health service provision—that they have always preferred a centrally planned, state-provided service. The right hon. Member for Holborn and St Pancras (Frank Dobson), who is not in his place, can claim the virtue of consistency on that argument, but the shadow Health Secretary cannot claim that consistency because he, like the right hon. Member for South Shields, was once a Blairite. As my right hon. Friend the Secretary of State has shown with the quotations he gave from the shadow Health Secretary when he was at the Department, the shadow Health Secretary used to be an advocate of the policies that underlie this Bill. The Bill will deliver effective practice-based commissioning —a policy that the shadow Secretary of State used to espouse.

[Andy Burnham]

If this Bill simply continues our policy, why does it rewrite the entire legal structure of the national health service over 500 pages?

[Mr Dorrell]

The right hon. Gentleman knows that there is room for more than one view about the extent to which there is a need to rewrite the full statutory basis of the Bill, but that is not the issue now. The question is how, if we went down his route, had a summit and talked for another 12 months about what the institutional structure of the health service should be, that would serve the policy objective that he seeks to espouse, of greater clinical engagement in commissioning. How would it serve the policy objective of which he says he is in favour, of engaging local authorities and the wider political community in decisions that shape the future of the health service?

One issue that the right hon. Gentleman did not mention in his speech is the shift of public health out of the relatively narrow interpretation that is implicit when it is located in the national health service. Instead, public health can properly be understood as being part of the wider range of local government. Those changes do not justify some of the more ambitious rhetoric being used in support of the Bill but they certainly do not come close to justifying the rhetoric being used against it. If half the things being said about the Bill by Opposition Members were true, I and most of my right hon. and hon. Friends, and certainly my right hon. Friend the Secretary of State, would not support it.

[Dame Joan Ruddock]

In answer to a recent parliamentary question I asked about waiting lists, Ministers told me that they had no information on waiting lists for private patients. How does the right hon. Gentleman think it will be possible for NHS patients to believe that their waiting times are consistent with their need for treatment when there are no figures to indicate what happens in the private sector?

[Mr Dorrell]

One of the effects of the Bill will be to integrate the private sector more fully in the delivery of public sector services in order to meet better standards for the national health service patient whose services are commissioned by the NHS commissioner. I should have thought the right hon. Lady would welcome the fact that there was greater opportunity for the national health service patient to enjoy the benefits that have previously been available on too exclusive a basis to the private sector patient. With a proper, open-minded commissioner, those benefits ought to be available, as the Blairite doctrine advocated when the Labour party believed in it, to all patients, including, pre-eminently, the vast majority of patients who rely on the national health service.

It is claimed by the Bill’s opponents that it is in favour of privatisation, but as my right hon. Friend the Secretary of State says, there is not a single provision in it that promotes privatisation. It is said to be a Bill that promotes fragmentation. The service already suffers too much fragmentation. The Bill writes into the law an obligation to deliver integrated, more collaborative, joined-up services. That addresses the problem that has been identified, which is attributed by its opponents to the Bill. It is said to be a Bill that promotes unbridled competition. That is absurd.

It is not only the shadow Secretary of State, the right hon. Member for Leigh, who can be quoted from the past. The hon. Member for Leicester West (Liz Kendall), who is seated alongside him, has said some very useful positive things in the past. I quote from the hon. Lady in 2010:

“I’ve always believed that there needs to be some competition and challenge in the system. . . I am also a strong champion of giving patients more voice and a greater say, not only over which hospital they go to but all aspects of their treatment and care.”

I am sure the hon. Lady was speaking on behalf of those on her Front Bench. The whole Labour party used to believe in that. We believe in that. That is what the Bill provides. It builds on the policy that the right hon. Gentleman used to believe in and used to advocate. He should have the courage of those convictions.