Health and Social Care Bill

Stephen Dorrell Excerpts

Tuesday 20th March 2012 Commons Chamber

[Andy Burnham]

I am grateful to the hon. Lady for her point. The Liberal Democrats once derided the Freedom of Information Act as too weak. Today they cower behind it, trying to use any scrap of protection they can find within it to prevent the publication of the information that patients and the public deserve to have. That says everything that people need to know about today’s Liberal Democrat party.

[Mr Stephen Dorrell (Charnwood) (Con)]

Will the right hon. Gentleman give way?

[Andy Burnham]

I will not give way. I will now bring my remarks to a close.

We are clear that the risks in the Bill arise not just from the organisational turbulence that the Secretary of State is inflicting on the NHS, but from the specific policies in the Bill. Today we table a package of amendments in a last-ditch attempt to provide the necessary safeguards that the Liberal Democrats failed to secure in another place—

[Mr Dorrell]

On that point, will the right hon. Gentleman give way?

[Andy Burnham]

They are safeguards in light of the huge potential for the conflict of interests in the award of contracts under the “any qualified provider” provisions, which will not be addressed by a simple register of interests, and safeguards on a stronger local HealthWatch—the Government have watered that down since the Bill left this House of Commons. There are safeguards too—

[Mr Dorrell]

Will the right hon. Gentleman give way?

[Andy Burnham]

I will give way for one last time.

[Mr Dorrell]

I am grateful to the right hon. Gentleman. Will he just clarify one issue of principle for the House? Are Labour Front Benchers now arguing that every Government Department should publish its strategic risk register? If not, can he justify his proposition that the Department of Health should do so uniquely?

[Andy Burnham]

I refer the right hon. Gentleman to the Information Commissioner’s ruling on the decision about a third runway at Heathrow. That is the precedent his Government should be following, but instead they have chosen to defy the commissioner. It was the Labour party that published the decision on a third runway at Heathrow, and I refer him to the ruling from the Information Rights Tribunal, which made a clear distinction between the strategic risk register, which covers all the uncontrollable risks that any Department will face, and the transition risk register, which deals specifically with the effects of Ministers’ decisions, in this case on the NHS. There is a real difference between the two. The tribunal said that the transition register should be published. His Government should respect the law and publish today.

We will table amendments to provide safeguards today, but in future it will not just be the cover-up of the risk register that we will have to worry about—that is just a taste of things to come in the new NHS. Members will have to get used to the words “commercial confidentiality” when inquiring about local services, because that is what they will find in the NHS that Ministers are creating. Let us look at the risks inherent in the proposed relaxation of the private patient income cap. One risk assessment that Ministers have published—the revised impact assessment—states that

“there is a risk that private patients may be prioritised above NHS patients, resulting in a growth in waiting times for NHS patients.”

That is all they have told us, but that alone is reason enough to oppose the Bill.

The only hope I can give people worried about the future of the NHS is that this might be the end of the Bill, but it is just the beginning of our campaign. The NHS will find a way of working around these changes and will not deteriorate overnight. We will be working to mitigate the worst effects of the Bill. This is the eleventh hour; our only hope would be a change of heart from the Liberal Democrats. We will call a vote on this motion and ask people to vote against it to show that we have not had enough time to debate these important issues.

I respect those Liberal Democrat Members who have had the courage to defy their orange book leadership, and I respect their grass-roots members who did the same at their spring conference, but the truth is that from today the Liberal Democrats will be remembered not only for tuition fees, but as the party that stole people’s votes in May 2012 in order to secure jobs for themselves and sell out the national health service. They could have stood up to the Prime Minister and enforced the coalition agreement, but they chose not to do so.

That brings us back to where we started: a Bill that nobody voted for, rammed through this place tonight in the teeth of near-universal professional opposition and in defiance of a major legal ruling; a Bill about which no Member of this House can look their constituents in the eye and say they have a mandate to support. Tonight Government Members will inflict this Bill on the NHS without knowing the potential damage it can do to the health service in their constituencies. They have made their choice; I have made ours. Although on a day like today it is hard for me to give any encouragement to people worried about what the Government are doing, I can at least say this: we will repeal this legislation at the first opportunity and restore the N in NHS. We have given this fight everything that we had. All I can say is that our fight will go on to protect and restore the Labour party’s finest achievement.

--- Later in debate ---

[Mr Stephen Dorrell (Charnwood) (Con)]

Thank you for calling me, Mr Speaker, for what I hope will be a brief intervention prompted by the remarks of my hon. Friend the Member for Banbury (Tony Baldry) and the right hon. Member for Wentworth and Dearne (John Healey).

Later this evening, the House will consider—yet again, many of us would say—the Health and Social Care Bill, but the issue for consideration now is whether the Government should publish the transitional risk register on the Bill. The right hon. Member for Wentworth and Dearne was explicit that he was not arguing that all strategic risk registers should be published, and acknowledged the argument that there needed to be private space in which civil servants could give advice to Ministers secure in the knowledge that it would remain private, because there was an important interest of good government that that discipline and space should exist. That is an argument that he explicitly accepted and of which I am a strong supporter.

My hon. Friend the Member for Banbury reminded the House that only yesterday two retired former heads of the civil service told peers in the other place of the importance of the principle that Ministers must be able to receive advice from civil servants on policy issues, including the risks associated with them, without that advice later becoming public. The issue that the right hon. Member for Wentworth and Dearne did not cover but which is important is that there needs to be confidence within the civil service about which side of the line advice will fall. If civil servants can give advice to Ministers believing that it will remain confidential and if, after the advice is given, the line is moved and the advice falls to be published, we run the risk that across Whitehall the space that he advocates will, in truth, not exist, because there will not be the confidence that the advice will not later fall to be published.

[Barbara Keeley (Worsley and Eccles South) (Lab)]

The right hon. Gentleman is talking about advice. It has been made clear that this is not advice but a management assessment of risks relating to the Bill and the reorganisation. It is not about policy or advice, which is why it is important that it is released.

[Mr Dorrell]

It is an interesting debate whether a risk register about a transition related to a policy is advice about policy or advice about management. The issue is that there is doubt. If the Government surrender this line without arguing the case to its conclusion, there is space for doubt about whether these risk registers will remain confidential or whether they will be published. The important principle is certainty.

[Andrew George]

Will my right hon. Friend give way?

[Mr Dorrell]

I will give way to my hon. Friend in a moment.

The important principle—it is always an important principle in the law—is certainty: the certainty that people can be clear whether the advice or the register that is being given to a Minister will remain confidential or whether it will be published. My concern is that this motion is seeking to move that line retrospectively, in a way that two distinguished former heads of the home civil service clearly believe would prejudice the space that the right hon. Member for Wentworth and Dearne said was important.

[John Healey]

rose—

[Mr Dorrell]

As I have quoted the right hon. Gentleman, I shall give way to him.

[John Healey]

The right hon. Gentleman is making an argument for blanket secrecy. However, this is less about his view or even mine; rather, the point is that the Information Commissioner and the judge, along with his two wing members on the tribunal, all of whom have seen and studied the risk register, have determined that, in their legal judgment, the balance of interest lies in publishing and not withholding it. Those are the facts of this case.

[Mr Dorrell]

The right hon. Gentleman is correct, but he does not go to the end of the process, because the reasons for that decision have not yet been published. The House is therefore being asked to make a decision on the basis of a judgment that has not yet been published, which cannot be right.

[Andrew George]

My right hon. Friend has argued the case on behalf of retired senior civil servants and Government Front Benchers. However, as the Chair of the Select Committee on Health, and therefore as someone who is deeply interested in effective scrutiny, does he not agree that if the Committee, of which I am a member, wishes properly to understand the potential impact of fragmentation, the conflicted nature of clinical commissioning groups, and so on, we need to find a way of getting behind the declaratory reassurances from the Front Bench?

[Mr Dorrell]

Of course I agree with the proposition in the way that my hon. Friend puts it. However, the proposition before the House is a rather more precise one: that a register drawn up in the expectation that it would remain private should retrospectively be put into the public space. The proposition that I am advancing to the House is that that is an area where we should proceed with care. We should embrace the principle that when advice is given to Ministers, it should be clear to those giving it whether it is being given confidentially or whether it will later be given over for publication. That is the simple principle that I wanted to set out.