Health and Social Care Bill

Viscount Simon Excerpts

Tuesday 11th October 2011 Lords Chamber

[Viscount Simon]

My Lords, there continues to be too much reliance on market forces, pitching primary care against secondary care, damaging both as a consequence, while not recognising the existing strengths of primary care in providing a generalist service and secondary care in providing a specialist service. The Government seem to think that a specialist service can be provided by both. I suggest that this is wrong.

From all of the e-mails and correspondence that we have received, it appears that the continuing merry-go-round of bureaucracy, new legislation and reorganisation is damaging morale within the NHS. Not even senior doctors and managers are able to keep up with the changes. I wonder whether that is the intention of the Government. The Minister said that one of the intentions of the Bill was to depoliticise the NHS. If the Government are concerned about depoliticising the NHS, how come they have appointed police commissioners, which introduces a political element into the police? The two items of course are completely different, but they do not add up.

The words “any qualified provider” have appeared; these include private companies that will be able to provide services in the future, thereby draining resources from both primary and secondary care, cherry-picking the low-risk cases without having to fund the technology or expertise of the more complex cases, or indeed the training and educating of doctors and nurses of the future. A few years ago, I was a member of the Select Committee looking into the provision of allergy services. We visited a number of places. One of them was Addenbrooke’s Hospital in Cambridge. This unit is regarded as the country’s leading allergy unit. I understand that it has been informed by the local commissioners that under the new Bill they are under no obligation to fund allergy services in Cambridge. That will threaten the very survival of this leading unit which treats patients from near and far and trains doctors to become specialised in allergic conditions, which are exceedingly complex. Is this in anticipation of what the commissioners consider the Bill will require? The noble Lord, Lord Kakkar, said that he is concerned with the future training of doctors and nurses and, with the potential closing of this very specialised unit, I agree with him.

Further, a neurosurgeon at Addenbrooke’s recently told me that, due to the financial cuts, eight of his beds had been closed. How will patients with serious problems view this restriction? Could these be regarded as examples of the direction in which the NHS will go under the Bill?

The noble Lord, Lord Clement-Jones, said that the cuts already in place are not understood. In view of what is and might be happening at Addenbrooke’s Hospital—and, I suspect, other hospitals—I am not surprised that patients, let alone health professionals, do not understand what is happening.

Finally, in order to have an example of one of the e-mails that we have all received on the official record, I would like to quote one from Mr Russell, which is short and to the point. He writes:

“Please do all in your power to prevent this awful bill from going through. We didn't vote for this level of change—it really should have been in a manifesto if the NHS is to be less accountable more bureaucratic and effectively partially privatised”.