Future of the NHS

Tony Baldry Excerpts

Monday 9th May 2011 Commons Chamber

[Grahame M. Morris (Easington) (Lab)]

I pay tribute to the thoughtful contribution by the right hon. Member for Charnwood (Mr Dorrell), who chairs the Select Committee on Health.

I come to this debate as, I believe, one of the longest-standing opponents of the Bill, both as a member of the Health Committee and as a member of the Health and Social Care Bill Committee. As such, I have consistently raised serious concerns about not only some of the detail contained in the Bill but the direction of travel charted by these reforms since they have developed from manifesto to coalition agreement to White Paper, and finally morphed into the Bill itself. I have become accustomed to the protestations and rebuttals of Health Ministers on every issue that I have raised, so I am somewhat sceptical about the listening exercise.

Those issues include the pace and scale of reform, the lack of a credible large-scale pilot to assess the impact of the changes, the conflicts of interest inherent throughout the Bill, as identified in the Channel 4 “Dispatches” TV documentary, and the threat of privatisation by stealth. [Interruption.] Despite the protestations and groans of Government Members, there is nothing in the Bill to rule that out. I can cite some examples, not least in relation to the prison health contract that was recently awarded to Care UK to provide health services for eight prisons in the north-east of England, resulting in 120 NHS staff being displaced and made redundant. There is a clear and present danger of privatisation of the service.

Perhaps the strongest advocate of the Bill, as it stands prior to any changes, has been the Minister of State, Department of Health, the hon. Member for Sutton and Cheam (Paul Burstow), who is no longer in his seat, and who was the Lib Dem steward of the Bill in Committee. On 10 March, he said in an interview in The Guardian:

“This is a change that liberals can embrace.”

On 17 November, in the Commons Chamber, he called Labour’s record on the NHS a “failed status quo” and wholeheartedly backed the Tory NHS reforms. This year, we found out that the Department of Health had at that time been trying to suppress an internal Ipsos MORI poll of public satisfaction with the NHS. That is interesting, because the poll shows record levels of public satisfaction. Perhaps even more disturbing are rumours that next year the Department intends to cancel the commissioning of such a survey. Rather than saying that Labour has failed on the NHS, the survey showed the highest ever levels of public satisfaction.

An even bigger supporter of the Bill, until now, has been the Deputy Prime Minister. On 23 January this year, on the “Andrew Marr Show” he was asked by Mr Marr, of the Health and Social Care Bill,

“Was that in the Liberal Democrat manifesto?”

The Deputy Prime Minister responded:

“Actually funnily enough it was. Indeed it was…I agree it’s an ambitious programme of reform—but over time I think it’ll leave patients with the feeling that they are at the centre of it.”

I am slightly perplexed by the hasty posturing and sudden synthetic explosion of anger by senior Liberal Democrats in the coalition, perhaps in the wake of the meltdown following last Thursday’s elections. I take those criticisms with a pinch of salt.

[Tony Baldry (Banbury) (Con)]

The hon. Gentleman is a member of the Health Committee, so one would expect him to be well informed on these matters. I assume that he reads other reports of the House relating to health. I wonder what he would say about the report of the Public Accounts Committee that was recently published, under the chairmanship of one of his right hon. Friends, which says:

“The trend of falling NHS productivity will have to be reversed if the NHS is to deliver, by 2014-15, savings of up to £20 billion each year for reinvestment in healthcare.”

The PAC found that there were serious problems with productivity—

[Madam Deputy Speaker (Dawn Primarolo)]

Order. Interventions, by their nature, must be brief, particularly when so many Members are waiting to speak.

--- Later in debate ---

[Tony Baldry (Banbury) (Con)]

When in government, the Labour party acknowledged that the NHS would have to make considerable efficiency savings over the next few years. My right hon. Friend the Member for Charnwood (Mr Dorrell), the Chairman of the Health Committee, has described that as the Nicholson challenge. The more I listen to speeches from Opposition Members, the more I am convinced that their opposition to the Bill is a cynical exercise. Given the Nicholson challenge, if at any time any hospital gets into difficulty, the Opposition will simply say, “That’s a consequence of the health reforms.”

All of us in the House want to ensure that we get the health reforms right. I suspect that for all Members of Parliament the NHS in their own constituencies is one of the most important political and, indeed, constituency issues, but for me one of the main issues was, for much of the last Parliament—and still is—the need to retain the full range of services at Horton general hospital in Banbury. If there are difficulties in the NHS, it is hospitals such as the Horton that will experience them first. It is therefore imperative, for me, that we get the reforms right, but I have every confidence that the Secretary of State and his ministerial team will get them right.

The Secretary of State, the Minister of State, Department of Health, my right hon. Friend the Member for Chelmsford (Mr Burns), and pretty well every other health Minister has been to Banbury to visit the Horton. As the Secretary of State made clear to GPs in Banbury not so long ago, GP commissioning enables GPs to put their confidence in their local hospitals by commissioning services for them. In my county we will be replacing an Oxfordshire-wide PCT with an Oxfordshire-wide GP-led commissioning body, with GPs in the county working collaboratively.

In the brief time I have to speak, I want to make two points to Ministers. While I am sure it is right for us to pause and listen, we should also recall that GPs are keen to get on with this task. I have had public meetings in my constituency that have been open to every GP on my patch, and the message that I have received from them is that they want to be catalysts for change: they want to be able to shape health services in Oxfordshire.

GPs throughout the county recently elected Dr Stephen Richards to lead the development of the Oxfordshire GP consortium. His first comment was this:

“GP practices are the bedrock of the NHS. Now, the whole GP community, from partners and sessional doctors through to GP trainees are in a unique position to reshape health care for the population of Oxfordshire.

The new Consortium Lead and the Locality Leads in OGPC”—

the Oxfordshire GP consortium—

“will have much greater influence over the improvement of patient care. These GPs will be accountable to their GP colleagues”

and

“to the public... I aspire to Oxfordshire leading the way in developing ‘Evidence Based Commissioning’. A new form of commissioning that offers contracts based on incentives and agreed improved patient outcomes.”

[Andrew George]

Will my hon. Friend give way?

[Tony Baldry]

No, I am not going to give way as I am conscious that many Members wish to speak, and Madam Deputy Speaker has already told me off this afternoon for taking too long.

[Madam Deputy Speaker (Dawn Primarolo)]

Order. I was not telling the hon. Gentleman off; rather, I was reminding him of the convention.

[Tony Baldry]

I can recognise a chastisement when I see it!

GPs want to get on with things, and while it is important that we should pause and have a listening exercise, we also need to give GPs the confidence so that they continue to plan for GP-led commissioning.

The more I listen to the contributions in the debate, the clearer it becomes that each Member has their own agenda of changes that they wish to be made. Much has been made of the 98% vote against my right hon. Friend the Secretary of State by the Royal College of Nursing, but I listened to Peter Carter, chief executive and general secretary of the RCN, on “The World at One”, and I was so struck by what he said that I took down a transcript. Martha Kearney put it to him—

[Madam Deputy Speaker (Dawn Primarolo)]

Order.

[Tony Baldry]

Am I out of time, Madam Deputy Speaker?

[Madam Deputy Speaker]

Yes. Thank you.

--- Later in debate ---

[Emily Thornberry (Islington South and Finsbury) (Lab)]

This has been an interesting and important debate at an important time for our health service.

[Tony Baldry]

Where are they?

[Emily Thornberry]

I am being heckled already. I do not intend to make a habit of this—the hon. Member for Banbury (Tony Baldry) can heckle as much as he likes—but I will answer on this occasion. There is another draw this afternoon. My right hon. Friend the Member for Doncaster North (Edward Miliband) is speaking, but I understand that my hon. Friends will be coming in a moment.

We have heard a number of interesting and important speeches from Members who have shown great expertise and have been serving the community and the public through their work on Select Committees, including the Health Committee. We heard from my hon. Friends the Members for Easington (Grahame M. Morris), for Walsall South (Valerie Vaz), for Oldham East and Saddleworth (Debbie Abrahams) and for Pontypridd (Owen Smith), and from the hon. Members for Central Suffolk and North Ipswich (Dr Poulter) and for Stafford (Jeremy Lefroy). Listening to their contributions, we have had a taste of the quality of debate that took place in the Health and Social Care Public Bill Committee. It is a shame that the Government did not give an inch as a result of those debates.

We have heard from the Liberal Democrat representatives, including the hon. Member for Southport (John Pugh), who talked about the Jekyll and Hyde drafting of the Bill, and the hon. Member for St Ives (Andrew George), who said that he is likely to vote against it on Third Reading. We heard a characteristically passionate, robust and articulate speech from my right hon. Friend the Member for Holborn and St Pancras (Frank Dobson). My hon. Friend the Member for Eltham (Clive Efford) asked a very simple question that I will repeat in the hope of getting an answer: what changes will be made as a result of the pause?

I hope that the Secretary of State was listening to my hon. Friend the Member for Stockton North (Alex Cunningham) because he brought a dose of reality to the debate by explaining the effect the reorganisation will have on his poor constituency and the redundancies it is suffering.