Health and Social Care Bill
Debate between Stephen Dorrell and John Healey(12 years, 9 months ago)
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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
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.
Future of the NHS
Debate between Stephen Dorrell and John Healey(13 years, 7 months ago)
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John Healey
It is in the impact assessment; I suggest that the right hon. Gentleman take a good look at it.
Mr Stephen Dorrell (Charnwood) (Con)
The right hon. Gentleman has just implied that the Government were proposing to introduce, for the first time, private sector expertise into the commissioning process of the health service. Will he correct that statement to the House by confirming that under the world-class commissioning programme, the previous Government explored exactly that proposal?
John Healey
No. What I am referring to is the provision in the Bill to allow the job of commissioning to be outsourced to private companies. That has never been done before. It is there in the Bill and it is a big risk for the future.
The Prime Minister made the NHS his most personal pledge before the election.
Health and Social Care Bill
Debate between Stephen Dorrell and John Healey(13 years, 10 months ago)
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John Healey
The point made by my right hon. Friend the Member for South Shields is based on page 42 onwards of the Health Secretary’s impact assessment of the Bill, which mentions a premium for private providers of £14 per £100. The Bill allows the system to pay a premium and a bung to private sector providers.
Mr Stephen Dorrell (Charnwood) (Con)
Will the right hon. Gentleman now answer the question put to him by my right hon. Friend the Health Secretary? Does he agree or disagree with the maximum price tariff principle that was set out in December 2009 by the previous Labour Health Secretary?
John Healey
We operated an NHS with a set tariff, not a maximum tariff. In government, we operated an NHS in which price could not be the factor that drove decisions about what services patients received and by whom they were provided. My right hon. Friend the Member for South Shields is absolutely right to point out that the Bill will introduce price competition and the flexing of the price so that there is no longer a set tariff for treatments and patients but a maximum price that can be undercut by providers coming into the field. The Government will not talk about that.
The Prime Minister is not helping the Health Secretary, because the changes the Bill makes were not in his election manifesto, not on his election posters and not in his election speeches. I have the Conservative manifesto here. There is no mention of axing all limits on NHS hospitals treating private patients, so that NHS patients lose out; no talk or mention of undercutting on price, so that established NHS services are hit as new private companies cherry-pick easier patients and services; no mention of guaranteeing only selective hospital services, so that others can be closed and lost to local people without public consultation; and no mention of putting a new market regulator at the heart of the NHS with the principal job of promoting and enforcing competition. There is no mention in the Conservative manifesto of the biggest reorganisation of the NHS since it was set up more than 60 years ago. They did not tell people about their plans before the election and they promised not to introduce such measures in the coalition agreement after the election. There is no mandate from the election or the coalition agreement for this fundamental and far-reaching reorganisation. That is not a debating point, but a point of democratic principle.
Mr Stephen Dorrell (Charnwood) (Con)
I rise to support the Bill. The shadow Secretary of State started by saying that my right hon. Friend the Secretary of State struggled to explain his reasons for introducing the Bill, but I think that the shadow Secretary of State struggled to explain why he opposes it. He struggled from the moment that my hon. Friend the Member for Grantham and Stamford (Nick Boles) intervened to draw his attention to the fact that the Bill represents an evolution of policy that has been consistently developed by every Secretary of State since 1990, with a single exception in the form of the right hon. Member for Holborn and St Pancras (Frank Dobson), who sits on the Labour Back Benches. The question that the shadow Secretary of State has to answer is this.
Mr Dorrell
Let me pose the question and I shall be delighted to give way. Which of the key themes does the right hon. Gentleman oppose? Is it the practice-based commissioning or the “any willing provider” model? Is it the introduction of private sector expertise into commissioning, which was first articulated in the world class commissioning programme, or is it the principle of the maximum tariff? Let me help him by quoting from the operating framework of 2009, to which my right hon. Friend the Secretary of State referred. It states:
“After 2010/11, we shall move to a position where national tariffs represent the maximum price payable to a commissioner, as opposed to the mandated price for a particular activity.”
With which of those four key policies does the right hon. Gentleman disagree?
John Healey
The right hon. Gentleman started by saying that the policies are an evolution. If that is the case, why did he say:
“I thought we were looking to develop existing institutions rather than starting again, and that appeared to be confirmed in the coalition agreement.”
John Healey
The right hon. Gentleman, who is nodding, went on:
“Then in July that approach was changed. That came as a surprise.”
Mr Dorrell
Indeed it did. I offered the right hon. Gentleman four consistent themes of policy. He accurately quoted my comments about a specific element of bureaucracy. One of the questions that the Select Committee addressed was why, since all these broad themes are so broadly supported, we went down the road of replacing the PCTs with the consortia. That is a question that the Select Committee said in its report had not been adequately explained, but that is a relatively minor question of bureaucratic presentation when compared with the broad themes of policy that were articulated in the debate by my hon. Friend the Member for Grantham and Stamford. Which of these key policies does Labour now wish to dissent from?
NHS Reorganisation
Debate between Stephen Dorrell and John Healey(14 years, 1 month ago)
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John Healey
Of course Sir David was talking about the two together, because the Select Committee was understandably probing both matters. In the quote that I gave, he was talking about the significant efficiency savings required of the health service at this time of an unprecedented financial squeeze. Many would say that that is the toughest financial test in the NHS’s history.
John Healey
Of course I will give way to the Chairman of the Health Committee.
Mr Dorrell
The right hon. Gentleman is right to say that Sir David was talking about the £15 billion to £20 billion efficiency challenge, and as my right hon. Friend the Secretary of State said, that programme has its roots in the time of the last Government. Will the right hon. Gentleman confirm that his party still supports the QIPP challenge—quality, improvement, productivity, prevention—that was first articulated when his right hon. Friend the Member for Leigh (Andy Burnham) was Secretary of State?
John Healey
If the right hon. Gentleman reads the official record, he will see I have just said that I will back plans to get the efficiency savings out of the NHS. They are needed and they have to happen, and I will back them as long as all the savings are reused for front-line services to patients.
Faced with the toughest test in its history, the least NHS patients and staff can expect is that the Government keep their funding promise. At this time of all times, the last thing the NHS needs is a big internal reorganisation. The Prime Minister ruled out such a reorganisation before the election, saying:
“With the Conservatives there will be no more of the tiresome, meddlesome, top-down re-structures that have dominated the last decade of the NHS”.
The right hon. Gentleman, now the Secretary of State, ruled it out, saying that the NHS
“needs no more top-down reorganisations”.
The coalition agreement was clear and reassuring on this point. In it, the Prime Minister and the Deputy Prime Minister pledged:
“We will stop the top-down reorganisations of the NHS that have got in the way of patient care”.
That was before the Secretary of State’s White Paper plans, which the head of the King’s Fund has called
“the biggest organisational upheaval in the health service, probably since its inception”.
Promise made in May, broken in July. Promise made by the Prime Minister, broken by the Secretary of State.
There is a story doing the rounds in the media of a journalist being briefed by No. 10, early on the morning of the publication of the White Paper, and told
“there’s nothing much new in it.”
When did the Secretary of State tell the Prime Minister that he was breaking his promise? When did he tell the Prime Minister that he was not only breaking the Government’s promise but forcing the NHS through the biggest reorganisation in its history, with a £3 billion bill attached, at a time when all efforts should be dedicated to achieving sound efficiencies and improving care for patients? This is high cost and high risk; it is untested and unnecessary.