Health and Social Care Bill

Stephen Pound Excerpts

Tuesday 20th March 2012 Commons Chamber

[Grahame M. Morris]

I agree with my hon. Friend and am grateful for her intervention. Those points were exercised in a recent debate in Westminster Hall. The basic point that I seek to make—I will finish on this—is that in order to plan effective health interventions, we need an effective and reliable evidence base. I would like assurances from the Minister that the necessary funding will be in place to ensure that that is delivered as a consequence of that measure in the Bill.

[Stephen Pound (Ealing North) (Lab)]

May I trespass upon your good nature, Mr Speaker, to endeavour to speak on behalf of the House to praise my hon. Friend the Member for Easington (Grahame M. Morris), who is not well, but who has risen from his sick bed to join us today because this subject is of such importance?

Those of us who stood at the Bar in the other place listening to the debate—[Interruption.] Not that bar. Those of us who stood at the Bar of the other place listening to the debate on the Bill cannot help but to have been massively impressed by the breadth and depth of expertise that was displayed. We had past presidents of royal colleges and consultants, and people from every aspect of our glorious national health service, giving their expertise, passion and analysis.

I come from a slightly different perspective. I spent more than 10 years working in the national health service—this is specifically in relation to the issue of health and wellbeing boards, in case you are worried, Mr Speaker—before community health councils were established in 1974, when, frankly, the NHS was not run for patients, people or the local community, and when there was little or no consultation with democratically elected local authorities, let alone with special interest groups or people representing areas that were ill served by the NHS. Community health councils had not only statutory powers, but a budget. They enabled the voice of the people to be heard in wards, corridors and A and E departments throughout the national health service.

We have heard tonight an extraordinary, agonising attempt on the part of the junior section of the coalition to justify what had been for years their principled support of a public voice within the NHS. The Liberal Democrats say that they will scrutinise the measure having voted to destroy that for which they have stood for so long. It is like somebody setting fire to a house and saying that they will time how long the fire engine takes to get there—and then criticising it. It ill becomes Members to draw attention to the shortcomings of other Members, but one speaker reminded me of those people in Spain who, on Good Friday, flagellate themselves up and down mountains trying to display their agonies. All the time, the right hon. Member for Bermondsey and Old Southwark (Simon Hughes) tries to show us that he is not enjoying this—he is in agony but that agony will not deter him, I fear, from voting against the amendments.

[Helen Jones (Warrington North) (Lab)]

I hate to disagree with my hon. Friend but is not the difference between the right hon. Member for Bermondsey and Old Southwark (Simon Hughes) and the flagellants of Spain that they believe they have sins to expiate, whereas he believes that whatever position he adopts today, even if it is the opposite of yesterday’s, is entirely right and proper?

[Stephen Pound]

I yield to no one in my admiration for my hon. Friend and her knowledge of the slightly occult religious practices of south Spain—and possibly of parts of St Helens for all I know.

But we did not expect the Spanish inquisition. We expected a valid, proper, sensible voice to enable the people to engage with their national health service. The NHS must not be an isolated ivory tower dominated by the old consultant gods who used to run it. It must not be a matter of non-responsible bureaucrats in quangos sending letters of suggestion. The NHS must contain a proper mechanism for the people’s voice to be heard and, above all, for the involvement of the wider community. The NHS cannot be a stand-alone organisation; it has to be involved with local councils and local communities, but everything in the proposals for this mealy-mouthed, milquetoast healthwatch nonsense dilutes and destroys that.

All the proposal does is create a false illusion—a falsity; the suggestion that somehow the voice of the people will be heard through this mere sub-committee of the Care Quality Commission, a committee whose mighty weapons arrayed against the forces of reaction and conservatism consist of the ability to write a letter. Such a letter would have to be vast, powerful and extremely effective, and would have to do what no letter has ever done in the history of epistolatory warfare. It would somehow have to persuade people on this gentle nudge—I appreciate that there are those on the Government Benches much given to the modern, modish philosophy of the nudge, but there is nudging and there is fudging, and what we have heard tonight is a fudge-nudge.

Above all, however, there is a crucially significant and important point here.

[Jim Shannon]

Do the hon. Gentleman’s exhortations mean that the pen is not mightier than the sword?

[Stephen Pound]

I am not entirely sure, Mr Speaker, whether you would allow the debate to go down that line, but were anyone in Northern Ireland to suggest a model such as that being proposed tonight, they would get a very dusty answer—it might not be replied to with sword or pen alone, but it would certainly be responded to.

The NHS is not something that we choose to buy into or out of. It is something that we all subscribe to. For many people—I should think everyone in this Chamber except me—it is a part of their birthright. People have been born under the NHS, have lived with the NHS, have funded the NHS and have supported it, and their voices must be heard. What we have tonight does not represent a valid mechanism for people to engage with the NHS. That is the key point. It is simply not good enough to set up a sub-committee of a quango and imagine that it has any force. We must realise that, yes, people may have different political opinions and there might be different priorities, but we do not have differential rates of national insurance. We pay national insurance because it is our national health service, and we have a right to have our voices heard.

[Fiona O'Donnell]

Does my hon. Friend agree that part of the problem is that such a complex measure is before the House? The Government’s thinking was not developed in the early stages, and the Conservatives’ coalition partners have contributed nothing throughout our scrutiny in Committee. That is why, at this late stage, the Opposition are still left trying to amend and improve the Bill.

--- Later in debate ---

[Stephen Pound]

As ever, my hon. Friend makes an important point. In responding to it, I would like to ask the House to cast its mind back to the contribution of my right hon. Friend the Member for Wentworth and Dearne (John Healey). He rightly said that this is not an issue of party politics. The fact that we see party politics in its worst form—its most loathsome shape—forming before our very eyes, clouded in some foul, mephitic, stygian Hades, is to be deplored. We should all listen to my right hon. Friend and actually try to admit to ourselves that we do not know everything—that the people’s voice does deserve to be heard and that the national health service is just that: a national health service, for all people. Everybody has that right to have their voice heard.

[Lilian Greenwood (Nottingham South) (Lab)]

Does my hon. Friend agree that one of the deepest problems with this Bill is that the people’s voice has not been heard? These proposals were never put before the people in party manifestos. That is exactly why they feel so very angry.

[Stephen Pound]

I am grateful to my hon. Friend for her question. It is a great sadness and reflects ill on my personal life that I spend many a night browsing through Liberal Democrat and Conservative manifestos. I have searched; I have examined; I have deconstructed; I have applied the principles of Jacques Derrida to those manifestos. Have I found in there any smidgen, any suggestion, any hint or any implication that the NHS was to be fragmented, privatised and ultimately destroyed, and the connection between the people and the NHS to be ripped up, torn into shreds like the integrity of the Liberal Democrats, hurled from the window to flutter in the breeze of history, never, ever to be seen again? Had I found that, I would almost certainly have voted Labour—but as I did so anyway, that is neither here nor there. But the point that my hon. Friend makes is absolutely right. How can the people, who fund the NHS, who are born in the NHS, who live in the NHS and who will ultimately quit this mortal bourn in the NHS—when they depart this vale of tears, it will be with the comforting arm of the NHS about their shoulders—feel that they are best served by this organisation if their voice is not heard?

[Fiona O'Donnell]

If it is difficult for those people to imagine how they can rely on the NHS, surely they should take a lead from the Lib Dems at their spring conference and show Liberal Democrat Members that they need to listen to their members and vote with us this evening.

[Stephen Pound]

My hon. Friend tempts me down a partisan path. I hope she will forgive me if on this occasion I will not follow so closely behind her. All I will say is that Gateshead—that wonderful, glorious city—has been demeaned by the presence of those who spin endlessly before our eyes, desperately trying to justify their own appalling behaviour.

What we have this evening is a Bill that is inchoate in its extremities. There are so many different clauses. I challenge any individual to respond to a question on the total number of amendments that we have had to face before tonight. But above all, leaving aside all the numbers, the clauses, the subsections, there is at the heart of all this one basic irrefragable—