Care Bill [Lords]

Debate between Stephen Dorrell and Simon Burns

Tuesday 11th March 2014 Commons Chamber

[Mr Burns]

I am grateful to my right hon.—or, rather, the right hon. Gentleman; I nearly made a Freudian slip—for that question. I can unequivocally say to him that I believe it as strongly and firmly today as I did when I was one of the Ministers taking the Health and Social Care Bill through this House three years ago. And I shall tell the right hon. Gentleman why I believe it.

I was saying that politicians of all parties must strengthen their backbone and be prepared to look at each case of reconfiguration on its merits, and then take difficult decisions if they are in the best interests of patients. I believe that reconfigurations should initially be determined at local level—[Interruption.] If the right hon. Member for Leigh will wait, I will get to his point. They should be determined by local commissioners in consultation with local people and with the health and wellbeing boards, which play a vital part in keeping local communities and local health interests plugged in and represented, and in ensuring the delivery of the necessary services locally.

However—this is where I get to the right hon. Gentleman’s point—there will be a few rare and exceptional circumstances in which a TSA will have to be appointed. That is what happened in the case of South London. At that time, I happened to be privy to all the discussions that led up to what was, if I remember correctly, the unprecedented decision taken by the then Secretary of State, my right hon. Friend the Member for South Cambridgeshire (Mr Lansley).

[Mr Dorrell]

My right hon. Friend is making the key point in this debate. He is describing a locally rooted, clinically led consultation process that engages the professional community as well as the local political community. It must be right that we deliver change in the health and care system in that way. The Health and Social Care Act was motivated by exactly that thought process, as my hon. Friend the Member for Wycombe (Steve Baker) said. That is not what clause 119 is about, however. It covers how we should deal with the very confined circumstances in which all those processes have failed. Are we really going to say that a trust special administrator can only look at the circumstances of an institution that has been proved to be unviable? Or are we going to allow him to look outside those circumstances, in order to deliver better care for patients? That is the question the House has to decide on this evening.

[Mr Burns]

As always, my right hon. Friend anticipates what I am about to say and says it in a far more straightforward way. He is absolutely right to say that there will be exceptional circumstances; there has been one instance so far. In such circumstances, the health economy in a particular area will need to be looked at—not in isolation; that is impossible owing to the nature of patient flows and the delivery of care—in order to get to the bottom of the problem and solve it on the ground.

A number of hon. Members said that clause 119 was a vehicle for closing down hospitals or services while totally disregarding the wishes and needs of the local health economy and local people. I say to them with the greatest respect that they have—probably for genuine reasons—misunderstood the purpose of the TSA. I ask them to think again, because this is too important an issue to be politicised and used in a game of ping-pong between political parties, or groups within those parties, to try to score political points. Our sole aim must be to ensure the improvement and viability of services. Sometimes, tough decisions will have to be taken—because of changing patterns, or whatever—and in the overwhelming majority of cases, they will be taken through consultation and through the decision-making process in the local health economy.

We have been talking about the power of the TSA. I must point out, in the friendliest and gentlest way, that that power was not introduced into the health service by this Government. It was done, I think I am right in saying, by the right hon. Member for Leigh’s predecessor, and he did it for very good reasons. He accepted, as my right hon. Friend the Member for Charnwood (Mr Dorrell), the Chair of the Select Committee, said in his intervention, that there will be rare occasions when everything else has failed and this measure of last resort must be used. It is viable and reasonable to have that power as a measure of last resort, as the previous Government obviously thought; otherwise, they would never have put it on the statute book in their legislation.

NHS (Private Sector)

Debate between Stephen Dorrell and Simon Burns

Monday 16th January 2012 Commons Chamber

[Mr Dorrell]

rose—

[Mr Simon Burns]

rose—

[Andy Burnham]

I shall give way to the Chairman of the Select Committee on Health once more and then to the Minister.

Oral Answers to Questions

Debate between Stephen Dorrell and Simon Burns

Tuesday 10th January 2012 Commons Chamber

[Mr Burns]

Throughout the consultation process there have been comments and responses to proposals across the whole of the health area, including on children’s health and well-being. Obviously, I cannot comment on a report that will not be published until later this week, but I or one of my ministerial colleagues would be more than happy to meet the Children’s Society once the report has been published if the society thinks that a meeting to discuss the report’s contents would be worth while.

[Mr Stephen Dorrell (Charnwood) (Con)]

Against the background of the recommendation of the NHS Future Forum that a key priority for the future is greater integration between health care and social care—a priority that was explicitly endorsed last week by the Prime Minister—does my right hon. Friend agree that the key opportunity in the Bill, through the health and wellbeing boards, is to drive that agenda, which has been much talked about for many, many years now, and actually to start to deliver on that rhetoric?

[Mr Burns]

My right hon. Friend is absolutely right; of course, when he was Secretary of State he did a considerable amount of work to lay the ground rules for the move towards greater integration, because that is the way forward. My right hon. Friend makes a very valid point: it is the way forward and we fully recognise that. We are deeply committed to achieving that aim, and that is why my right hon. Friend the Secretary of State has added an extra £150 million to the existing £300 million, to facilitate progress towards it.

Oral Answers to Questions

Debate between Stephen Dorrell and Simon Burns

Tuesday 18th October 2011 Commons Chamber

[Mr Burns]

I am afraid that the right hon. Gentleman is wrong. It is not holding back the national health service; it is moving it forward with things such as the establishment of the 111 service and the reconfiguration proposals, which are based on the four tests that my right hon. Friend the Secretary of State introduced in May last year. That not only links reconfiguration to the needs of the local health economy but takes into account the wishes and needs of the local community and medical staff.

[Mr Stephen Dorrell (Charnwood) (Con)]

Does my right hon. Friend agree that the improved delivery of urgent care right across the health service is one of the great challenges facing the new commissioning structure and one of the great opportunities to deliver more integrated services that deliver better value and better quality to patients?

[Mr Burns]

I am extremely grateful to my right hon. Friend; speaking with the authority of the Chair of the Health Committee, he is absolutely right. It is the way forward to drive improvements in service, raise standards and ensure that there is high-class, quality care at an urgent care level and across the acute sector.

Health and Social Care (Re-committed) Bill

Debate between Stephen Dorrell and Simon Burns

Tuesday 6th September 2011 Commons Chamber

[Mr Dorrell]

Ministers can correct me, but my understanding is that, under the obligation being introduced, they “must” meet in public. I have no authority to speak for the Government, but I believe that that is what the Government intend. For myself, as a patient of a trust or other NHS provider, whether in the public or private sector, my interest lies in ensuring that the information about my—

[The Minister of State, Department of Health (Mr Simon Burns)]

Will my right hon. Friend give way?

[Mr Dorrell]

Of course.

[Mr Burns]

I am grateful to my right hon. Friend for giving way and allowing me to clarify the point. Let me reassure him that, yes, such meetings must be held in public.

[Mr Dorrell]

I am grateful to my right hon. Friend, who answers the hon. Member for Worsley and Eccles South (Barbara Keeley) with very much more authority than is at my disposal.

I want to make one final point and it is a direct response to the hon. Member for Oldham East and Saddleworth (Debbie Abrahams). Of all the misrepresentations about the intentions of this Bill that we have listened to since the White Paper was published over a year ago, the most persistent is that this is somehow a Bill—a ramp—for the privatisation of the health service.

I was first a Health Minister more than 21 years ago. Throughout that period I have listened to speeches directed first at my right hon. and learned Friend the current Justice Secretary, when he was Health Secretary, and subsequently at all his Labour and Tory successors, including me, although probably excluding the right hon. Member for Holborn and St Pancras (Frank Dobson). All their legislative and other proposals to introduce more flexible and patient and standards-oriented structures in the health service were opposed by somebody or other on the grounds that they were going to privatise the health service. If that was the purpose of those policy initiatives, the one thing that they all have in common is that they have been singularly unsuccessful. If it is the policy purpose of this Bill to privatise the health service—which I do not for one moment believe it is—it will, I am sure, be as unsuccessful as all the other measures that went before it.

Oral Answers to Questions

Debate between Stephen Dorrell and Simon Burns

Tuesday 8th March 2011 Commons Chamber

[Mr Burns]

I can categorically give that assurance to the hon. Gentleman, because there is no two-track system. Where the private sector may provide care, it is to help to raise standards. I imagine he would agree with that, because he fought the general election on this manifesto commitment:

“Patients requiring elective care will have the right…to choose from any provider who meets NHS standards of quality at”

the NHS level.

[Mr Stephen Dorrell (Charnwood) (Con)]

Will my right hon. Friend tell the House how many representations the Government have received arguing the case in favour of the PCTs in the structure that we inherited at last year’s general election? If, as I suspect, the answer to that question is not very many, is that not because there was a shared commitment between this Government and the previous Government to introduce genuine clinical engagement to the commissioning process?

[Mr Burns]

I am grateful to my right hon. Friend for that question. I can go a little further and say that, to the best of my knowledge, we received no representations to keep the PCTs. He is right when he talks about what the previous Government were seeking to do, and we want commissioning to go to the local level—to GP commissioners, who have the best knowledge of the needs of their patients. The fact that we have so many pathfinders shows that GPs are signing up voluntarily, with enthusiasm, to take part in the scheme.

Oral Answers to Questions

Debate between Stephen Dorrell and Simon Burns

Tuesday 2nd November 2010 Commons Chamber

[Mr Burns]

May I explain to the hon. Lady that, no, councillors will not be on the GP consortiums? They will have a full and active role to play on the health and well-being boards, so that they can take a full part in determining the local needs of the local health economy. That is the right venue for them.

[Mr Stephen Dorrell (Charnwood) (Con)]

Does my hon. Friend agree that as those commissioning consortiums are established, it will be important to ensure that they are subject to proper financial assurance, in the same way as Monitor applies such principles to foundation trusts? Can he assure the House that that will be one of the responsibilities of the NHS commissioning board?

[Mr Burns]

There is not altogether the same comparison to be made with Monitor and foundation trusts, but I certainly understand and take on board the general principle behind my right hon. Friend’s question. I think that it is important that there is accountability.

Oral Answers to Questions

Debate between Stephen Dorrell and Simon Burns

Tuesday 7th September 2010 Commons Chamber

[Mr Burns]

May I reassure the hon. Gentleman’s constituents that they will be just as pleased with the responses that they receive from a 111 line, where professional advice and help will be given to people who need to contact it about their health needs? May I also reassure his constituents on the question of four-hour targets? The target that was introduced caused distortions; it was a political target. We are relying on clinical decisions and activity to ensure that people are seen as quickly and relevantly as possible.

[Mr Stephen Dorrell (Charnwood) (Con)]

Does my hon. Friend agree that in addition to the proper funding of A and E departments, it is also important to take steps to manage the demand on those departments? In particular in urban areas, that means that commissioners should accept the responsibility to look for improvements in the delivery of primary care so that patients have more easy access to less urgent care in the primary care context, thus reducing the demand on A and E departments.

Oral Answers to Questions

Debate between Stephen Dorrell and Simon Burns

Tuesday 29th June 2010 Commons Chamber

[Mr Burns]

I am sorry, but the hon. Gentleman, for whom I have considerable respect, is just plain wrong. There have been a number of representations over the last seven weeks or so. In addition, as my right hon. Friend the Secretary of State and his shadow team went round the country over the past five years, they were constantly told by GPs and clinicians from hospital to hospital that politically motivated targets were distorting clinical decisions and patient care.

[Mr Stephen Dorrell (Charnwood) (Con)]

Does my hon. Friend agree that by far the most important way of improving the service delivered by the NHS is to focus on the three key indicators of clinical outcomes, patient experience and value for money? Can he assure the House that the Government will pursue those, particularly against the background of increasingly scarce resources, in order to deliver the objective we all have: a better-quality NHS?

[Mr Burns]

I am extremely grateful to my right hon. Friend, who is absolutely right, and I can give him the categorical assurances he is seeking, but I would also like to add one more: we need information to empower patients, because if patients are going to be at the heart of the NHS they must have the information to take the decisions that are important to their health care.