All 2 Debates between Tanmanjeet Singh Dhesi and Justin Madders

Mon 12th Jun 2023
Retained EU Law (Revocation and Reform) Bill
Commons Chamber

Consideration of Lords messageConsideration of Lords Message
Tue 23rd Nov 2021
Health and Care Bill
Commons Chamber

Report stageReport Stage day 2

Retained EU Law (Revocation and Reform) Bill

Debate between Tanmanjeet Singh Dhesi and Justin Madders
Justin Madders Portrait Justin Madders
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I am grateful for that intervention. I note that, again, the Secretary of State for Business and Trade is not here to defend the Bill in its current form. We have consistently been told by businesses throughout the Bill’s passage that it is so chaotic that nobody can possibly plan ahead. How can any business prepare for the future if it cannot understand what the rules will be six months hence, never mind 12 or 18 months into the future.

Tanmanjeet Singh Dhesi Portrait Mr Tanmanjeet Singh Dhesi (Slough) (Lab)
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Many of my Slough constituents are concerned, because they feel that non-regression, upholding international treaties and consulting experts should be wholly uncontroversial. Does my hon. Friend feel that, with the Government’s approach, we will merely have more watering down of our high environmental standards, and that such watering down must be blocked at every opportunity?

Justin Madders Portrait Justin Madders
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I thank my hon. Friend for that intervention, as he sets out what this amendment is attempting to secure, which is a bit of security.

I shall make some progress, as I am aware that a number of people wish to speak. As we have heard, Lords amendment 15B seeks to introduce conditions on some of the powers in sections 12, 13,15 and 16 relating to the environment. As my hon. Friend says, it stipulates that any regulations made may not

“reduce the level of environmental protections”

or

“conflict with any…international environmental agreements to which the United Kingdom is party”.

It also sets requirements on consultation. Given that the Government are supposedly committed to maintaining the highest environmental standards, one might think that those conditions are uncontroversial; they are the actions I would expect any Government committed to maintaining high standards would want to undertake. That view is shared by a range of experts, including, but certainly not limited to, the Government’s own watchdog, the Office for Environmental Protection. Its written evidence submission endorsed all three of those suggested conditions, with its chair, Glenys Stacey, remarking:

“Worryingly, the Bill does not offer any safety net, there is no requirement to maintain existing levels of environmental protection.”

The Government are not listening to their own watchdog and have instead chosen to refer to those conditions as “burdensome” and “unnecessary”. I have yet to hear any rational explanation as to how the conditions in the Lords amendment can be both of those things at the same time; if these steps are, as the Government tell us, things that they would be doing in any event, how can they possibly be an additional burden as well? When we are met with illogical and unconvincing arguments such as that, we are right to be concerned. I note the assurances given at the Dispatch Box on this and previous occasions, but, as we have seen with this Bill in particular, Ministers come and go, and if we were to rely on everything said at the Dispatch Box as having the same weight as actual legislation, Acts of Parliament might be half the length that they are. There is a reason we do not do that.

Of course, we can all imagine what might be said by the public if the worst was to happen and environmental standards were to slip as a result of this Bill. We would say to our constituents, “But we were promised this wouldn’t happen” and our constituents could point to the 40 hospitals not having been built, Northern Powerhouse Rail not having been started, the ditching of the Animal Welfare (Kept Animals) Bill or any number of other broken promises, and they would call us naive at best. So we are right to insist that these protections stay in the Bill.

Lords amendment 42B tackles one of the most controversial clauses, the one that the Hansard Society referred to in its written evidence as the “do anything we want” powers for Ministers. The Hansard Society is not prone to exaggeration and its comments have merit. As we know, clause 15 empowers Ministers to revoke regulations and not replace them; replace them with another measure which they consider appropriate

“to achieve the same or similar objectives”;

or

“make such alternative provision as the…national authority considers appropriate”.

In the face of such untrammelled concentrations of power in the Executive, Lords amendment 42B seeks to put a democratic check on the use of those powers. Actually requiring a Minister who wishes to use these powers to set out their proposals before each House is entry-level transparency that should have been part of the procedure to start with. Allowing a Committee of this House to consider them seems a fairly uncontroversial suggestion, even if some people now think that Committees cannot act in a bipartisan way. Of course, giving a Committee the power to request a debate on the Floor of the House will be reliant on its making the judgment that such a debate is necessary, but this does secure a degree of scrutiny over ministerial decisions. It also hands at least some power back to Parliament, which was, of course, for some, what Brexit was all about.

Health and Care Bill

Debate between Tanmanjeet Singh Dhesi and Justin Madders
Tanmanjeet Singh Dhesi Portrait Mr Tanmanjeet Singh Dhesi (Slough) (Lab)
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Many of my constituents find it increasingly difficult to book an appointment with an NHS GP or dentist, forcing them either to go private or to suffer without treatment. Does the shadow Minister agree that, after a decade of failure and misguided policies, the Government must take urgent remedial action? However, the term “waiting time”, to which he has just referred, is not mentioned once in the Bill.

Justin Madders Portrait Justin Madders
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My hon. Friend is right that one of the criticisms we have levelled against the Bill is that it does not address the issues and challenges facing the NHS. I will take no further interventions, because I am conscious that many Members have contributions to make.

I will move swiftly on to our two amendments dealing with inequality and to new clause 64 in the name of my hon. Friend the Member for Oldham East and Saddleworth (Debbie Abrahams). To show that this is an NHS and social care Bill, not just an NHS Bill, local authorities need to be more involved and more emphasis must be placed on wellbeing and better outcomes. We support the NHS triple aim—improving health, quality of care and cost control are, of course, important functions. Nevertheless, we live in a country where significant inequalities remain, and narrowing those gaps should be a national priority.

Research from the IPPR last month highlighted the 10-year gap in life expectancy between a person living in the poorest community and a person in the best off. That gap doubles when we talk about healthy life expectancy. Tackling that disparity must be a priority in the Bill. The Secretary of State for Health and Social Care said in his first speech that said he wanted to tackle the “disease of disparity”, so why is that missing?

Turning to clause 39—one of my favourites—why it remains in the Bill is a mystery given that the previous Secretary of State, the right hon. Member for West Suffolk (Matt Hancock), who requested these powers, is no longer in the role. Perhaps he will give us his insight into that later on. It is the absolute antithesis of the Lansley view that politicians should be distanced from NHS operational issues and makes a mockery of the overall thrust of this Bill, which is about encouraging local decision making. It is no exaggeration to say that, taken literally, clause 39 and its accompanying schedule 6 require the Secretary of State to be told if there are, or even if there might be, proposals to vary service—even moving a clinic from one location to another nearby.

As has been pointed out by wise heads, the power is not one that many Secretaries of State should want to get involved in. A Secretary of State who used it could be accused of favouring certain areas or decisions for political purposes. The well-articulated fear is that it will be used to block necessary but unpopular changes and that expediency will rule. Such decisions should be left to the clinicians or maybe the health economists but not politicians. Labour opposes this new power and would gently say to the Minister, “Be careful what you wish for.”

Finally, the issues around discharge to assess are complex. As we worked our way through in Committee, we heard evidence from many stakeholders, and it is fair to say that views on the matter were polarised. We are led to believe, and have some confirmation, that this development is working well for some acute settings, helping ease the perennial and disruptive issues around delayed transfers of care, but in other places we hear voices calling for much greater caution and for tougher safeguards or even, as amendment 60 requests, to stop it altogether. While we have sympathy with amendment 60, it would only pose more problems for the NHS if it was passed, so we have opted in our amendment 73 just to tighten up on safeguards.

Of course the real solutions are far more complex and would require higher investment both in the NHS and in social care. It should be mandatory that all aspects of ongoing care have been properly discussed and agreed with the patient and carers prior to discharge. An assessment should include carers with special attention if a child carer is involved, and there is a concern that unpaid carers will not be identified and consulted at the point of discharge.

The system for step-down care outside acute hospitals must be adequate, and there must be sufficient high-quality and funded places in care settings of all kinds. We are literally a whole generation away from having that kind of system, even if the funding started to become available today. On a related point, new clause 63 from the hon. Member for St Albans (Daisy Cooper) also deserves support.

I will leave my comments there, as I know many hon. Members want to speak.