National Health Service (Amended Duties and Powers) Bill

Valerie Vaz Excerpts

Friday 21st November 2014 Commons Chamber

[John Healey]

My hon. Friend has been a strong champion of the NHS and followed this issue from day one of this Parliament. To answer directly his question of what could be more succinct and clear, I suspect that when we hear from the new Member for UKIP, the hon. Member for Rochester and Strood (Mark Reckless) or his colleague, the hon. Member for Clacton (Douglas Carswell)—given some of the things that they have argued should be the basis of the NHS in future—they will make the vision of the right hon. Member for South West Surrey look positively UKIP-lite.

This Bill is essential because it starts to correct the three fundamental flaws, brought about by the reorganisation legislation, that are now driving the NHS. We could call them the three Cs—cost, complexity and competition.

On cost, the scale of the reorganisation was simply huge. As the chief executive of the NHS said at the time, it was

“beyond anything that anybody from the public or private sector has witnessed”.

The cost of the waste has been huge. We reckoned beforehand that it was about £2 billion; we now reckon £3 billion. What is clear is that getting on for £1 billion has been paid out in redundancies, much of which was to staff who were paid off and then re-hired by our NHS.

[Valerie Vaz (Walsall South) (Lab)]

Could my right hon. Friend say what steps were taken to publish the risk assessment during the passage of the Health and Social Care Bill?

[John Healey]

I did not want to open up all the old arguments that we fought in 2010-11, though it was extraordinary to see the extreme lengths to which the Government went—seen before only on matters of military information—to stop the disclosure of the risk register about the potential impact and likely consequences of their policy. My hon. Friend was a great supporter of mine in trying to use the Freedom of Information Act to allow the public and this House to see the terms of what the Government knew could happen to the NHS if they passed the legislation.

My second C is complexity. NHS services are now so much harder to plan and so much harder to hold to account because of the changes the Government have made. We saw new national quangos responsible for tens of billions of pounds of spending of public money in each and every one of our local areas in England. The commissioning role, which was previously undertaken by one body, the primary care trust, is now fragmented with at least five different bodies trying to do the same job.

On the third C, competition, the Secretary of State has his foot lightly on the accelerator of privatisation for now, but let us make no mistake, if the Tories win the next election, he will press it hard down to the floor immediately afterwards. Even though they are soft-pedalling on the privatisation that their Act put in place, we have seen in the 18 months since it came into force 131 contracts won by companies such as Care UK, Virgin Care and BUPA. According to the NHS Support Federation, that is already valued at £2.6 billion. At that win rate, the contracts already currently advertised will mean another £6.6 billion in the private sector—getting on for 10% of our NHS run by private companies in private hands.

--- Later in debate ---

[Barbara Keeley]

I thank the hon. Gentleman for that comment, but the point is that Macmillan Cancer Support is using money fundraised by the public in ways that I do not think the public would approve of. That was the key thing we explored. It is not at all clear, if we look at the Macmillan website, how it is using approaching £1 million of the public’s money, donated on that basis.

[Valerie Vaz]

My hon. Friend mentions conflicts of interest. Is she aware that one of the companies bidding for the privatisation of cancer services is UnitedHealth Group, which was advised by the chief executive of NHS England?

[Barbara Keeley]

Indeed. Now that the shortlist for bidding has been announced for end-of-life care, we find that five of the shortlisted bidders are private companies, with only two NHS trusts on the list. For cancer care, there are three private companies and two NHS trusts. Given the seemingly headlong drive for change we found in those commissioning this large and risky contract, a great number of questions were left unanswered. For instance, despite the key role that GPs play in end-of-life care for patients choosing to die at home, the prime provider of end-of-life care will not have control over the actions of the GPs involved in that care unless a specific contract is drawn up and GPs are paid for extra tasks.

The contracts for cancer and end-of-life care are to be placed in early summer 2015, and I invite anybody with an interest in this to review the evidence and, in particular, the unanswered questions in the session the Health Committee held on 14 October. I have yet to find assurances in the evidence I have heard that the profit motive of private providers can be squared with the objective of improving cancer care and end-of-life care for patients.