NHS Risk Register

Debate between Steve McCabe and Valerie Vaz

Wednesday 22nd February 2012 Commons Chamber

[Valerie Vaz]

I thank the Minister for making his sedentary intervention.

Obviously, I rise to speak in favour of the motion and I humbly request the Secretary of State for Health to publish the risk register, as recommended by the Information Commissioner. I thank my right hon. Friends the Members for Wentworth and Dearne (John Healey) and for Leigh (Andy Burnham) for taking up this issue. As most people will know from their e-mail inbox and their postbag, and from letters that have gone into various newspapers, the professionals are behind us, as are the public.

I have an image of the Cabinet sitting round the table singing the classic Irving Berlin song, “Anything you can do, I can do better”, as each Secretary of State tries to please the Prime Minister by showing how far they can go beyond what was agreed in the manifesto and the coalition agreement. The Secretary of State for Health, who obviously does not want to hear a good argument, is not so much nudging the NHS—to use his favourite phrase—but giving the NHS a great big shove off the end of the cliff; this is more about the chaos theory than the nudging theory. There is a fundamental flaw at the heart of his reasons not to publish the risk register, which is that it contains the information that the public need to see whether the decision that he has reached in the Bill is without risk to the NHS. The Information Commissioner has deemed this to be in the public interest but the Secretary of State chooses to hide it from the public. The public have a right to know that when a decision is taken in their name the relevant considerations have been taken into account. If this reorganisation goes wrong, as it is doing—the good people in the NHS who are working hard are leaving now—could that possibly amount to misfeasance in public office?

In the Health Committee, we have seen what can be done with co-operation. We visited Torbay and saw public sector leadership at its best. I have absolutely no idea who the staff there voted for—nor do I particularly care—but I know that they saw a system for elderly people that was not working, and they worked hard, not thinking about their pensions or asking for overtime, to devise a system in which there was one point of contact for elderly people. Under the system, the risk is shared, 50% with the NHS and 50% with the local authority. They devised a system with consistency of leadership and long-standing good relations across the system. A care package that might take eight months to deliver elsewhere can now be delivered in two hours. By spending £l million on community care, they saved the hospital £3 million. A seven-step referral is now down to two steps. All of that is at risk, however. The NHS and local authorities could learn from that good practice and evolve in that way.

Some people say that, as a result of the Bill, the people around the table will be the same; they will just have different titles. People need to know that the risk is not just about getting rid of managers. The Secretary of State might say that he is reducing the number of managers by making them redundant, but the NHS still needs some managers—so step forward McKinsey and KPMG to help the GPs who do not have, or might not want, management skills. Members of the public need to know the risk associated with the loss of expertise that has stayed in the public sector for the common good, but which will now be lost by the dismantling of structures.

[Steve McCabe (Birmingham, Selly Oak) (Lab)]

My hon. Friend says that there is a danger that we will end up with the same people sitting around the table. Does she agree that the Government should publish the number of people who have been made redundant and received redundancy payments from PCTs, only to be re-engaged to work for clinical commissioning groups? What has that cost the NHS so far?

[Valerie Vaz]

I absolutely agree with my hon. Friend. I have asked about this in a written question, and I have not had an answer. This is fiscal incompetence.

The public need to know that this is not GP fundholding revisited. They also need to know that, when they visit their GP, as my constituent Inayat did, the decision whether to prescribe antibiotics will be made on the basis of clinical need, not as a result of financial pressures. When Mrs Bennett needs to go to the Manor hospital, she needs to know that she will be next on the list, and that she will not be giving her place to someone who is able to pay, as a result of the cap being raised to 49%.

People need to know that when Nick Black wrote in The Lancet that productivity in the NHS had risen in the past 10 years, he ended his article by saying that he had no conflicts of interest. He was right, and the Secretary of State is wrong. The Secretary of State might not have taken into account relevant considerations when he declared that productivity had fallen. The public need to know of the risk that the Bill will be taking in replacing lines of management. At the moment, we have the Secretary of State, the Department of Health, strategic health authorities and PCTs. We are going to have the Department of Health, the NHS Commissioning Board, clustered SHAs, 50 commissioning support groups, 300-ish clinical commissioning groups, clinical senates, Health Watch—and, I could add, a partridge in a pear tree.

Thanks to the House of Commons Library and the Public Bill Office, I can tell the House that the Bill has had 1,736 amendments: 474 in Committee, 184 on recommittal and 1,078 on Report. The Bill Committee divided 100 times—the first time that that has ever happened. This is a bad piece of legislation. The public need to know the risks to the taxpayer. They need to know that costs have been saved, and not just shifted to another level or outsourced.

We are in this place to serve the people of this country. History does not judge kindly those who do not act in the public interest, and people will not forgive those who save face by continuing with the Bill only for reasons of vanity. The risk register associated with the Health and Social Care Bill should be published. The Information Commissioner has decided that that is in the public interest. The people want it and should have it. I support the motion.

BBC (Proposed Cuts)

Debate between Steve McCabe and Valerie Vaz

Thursday 1st December 2011 Commons Chamber

[Valerie Vaz (Walsall South) (Lab)]

I begin by thanking my hon. Friend the Member for Great Grimsby (Austin Mitchell) for introducing this timely debate. It is always a pleasure to follow the hon. Member for Cleethorpes (Martin Vickers).

The motion says it all. I call on the BBC to reconsider some of its short-term responses to the problem of relieving pressure on its budget, and I hope to set out why. So many times in the Chamber recently I have had to express my concern about our national institutions, which are the envy of the world. The BBC is a well loved service, and one that is respected for factual output, drama and music. It is now leading the debate on science and bringing its beauty and wonder to the masses.

I shall focus on the national position, what is happening locally in the west midlands and what will happen in future. As my hon. Friend the Member for Great Grimsby said, for just £12 a month, the nation can enjoy new drama, science and current affairs programmes. In my view, the BBC is hamstrung, because although the licence fee settlement is guaranteed until 2017, the licence fee is frozen. As he said, the BBC will also have new funding responsibilities for, among other things, the World Service and S4C, and must make savings of 20%.

The whole point of a public broadcaster is that it need not have an eye to the shareholder, so it can commission new and innovative programmes. The BBC is accountable to viewers, who will always tell it what they like and do not like, but people must have space and time to hone their craft. Creativity cannot be measured as a unit of expenditure.

[Steve McCabe]

Is it fair that viewers in the west midlands should have to pay the same licence fee as viewers in Cardiff, Bristol or Salford when the former get such a limited return for their investment compared with the latter?

[Valerie Vaz]

I thank my hon. Friend for that intervention, but I shall come to what is happening to BBC West Midlands.

A drama can have a greater impact and provide greater understanding of a topic; one has only to watch “Later…with Jools Holland” to see this country’s tremendous musical creativity; and in both television and radio, exploring the boundaries of our world and helping us to make sense of it is one of the cornerstones of what the BBC does.

What concerns me most as a west midlands MP is the proposed decimation of BBC West Midlands, which has a unique 90-year history of both factual and drama programme making. It is home to some of the most excellent programmes, such as “Countryfile”, “Coast” and “Gardeners’ World”. A long time ago, I made a programme that came from Pebble Mill—“Network East”—and I remember the expertise of the staff. They edited a piece on the Chelsea flower show at 7.50 pm for transmission at 8.00 pm. One can find such professionalism and dedication to the job across the whole of the BBC. As many hon. Members from the west midlands will know, when we go on the “Politics Show”, a remarkable woman—is there not always a remarkable woman?—does our make-up, acts as floor manager and provides the hospitality at the end of the programme. I am not sure what else she can include in her job. Perhaps the BBC will expect her to be a camera operator as well. That is the nature of her commitment and the commitment of the other people who work there.

The £15 million that is spent on the region is worth £28 million to the local economy, not to mention that Birmingham is the country’s second city and the geographical heart of England. That as well as skilled jobs such as journalists, researchers, engineers and producers could be lost. The pitch is that 150 skilled jobs in the area could be lost.

--- Later in debate ---

[Valerie Vaz]

Oh dear. I thought that the hon. Gentleman was listening. I was voicing not official party policy, but my concerns. I tend to look at the future and worry about things. The hon. Gentleman should be aware that such a move is a possibility. It is not one with which I agree. People have actually starved to secure the channel S4C, and it should remain in Wales, which is the most wonderful country. Let me press on now.

Each generation has seen the BBC achieving new successes. Programmes such as “Doctor Who” have been reworked and old legends such as “Merlin” have been broadcast. Savings can be found by curbing the excessive salaries of the so-called stars.

[Steve McCabe]

Jeremy Clarkson.

[Valerie Vaz]

Yes, Jeremy Clarkson. As I mentioned earlier, all this output costs £12 a month. If we match some of the savings with a slight increase in the licence fee—7p a day would mean a £2 increase a month—which my hon. Friend the Member for Great Grimsby mentioned, we could stop all these cuts. We cannot have a situation in which we buy in other people’s words and pictures rather than have news reporting on the ground. I have written about this matter to Mark Thompson and the chairman, Chris Patten. The reply, which I received today, does not reassure me that any of these cuts are necessary. I urge the BBC to think again. Operating a camera, directing and editing are different skills. Mistakes are made when there is no time for research and facts are not checked. The BBC is not a throwaway institution, but an institution that nurtures new talent while celebrating the wisdom of the long-standing people who work there. The world is getting more complex; the BBC needs to expand and not contract. The message from this House must be that it has to think again.