Andy Burnham
Prime Minister · MP for Makerfield · Labour (Co-op) · United Kingdom
“The right hon. Lady mentions leadership. Let me tell her and the whole House where Britain is showing leadership. There have been Conservative politicians at this Dispatch Box—Labour politicians, too—for decades who have talked about the importance of the two-state solution between Israel and Palestine.”
“I cannot comment today on quasi-judicial decisions, but we will take a pragmatic approach to oil and gas, as I have said before at the Dispatch Box. Let us get to the heart of this question, as the right hon. Lady invites me to do. What is the right way to fund defence and, yes, bring the welfare budget down?”
“I do not think the right hon. Lady is on strong ground when it comes to defence spending. It was 2.5% of GDP when the last Labour Government left office. It was 2.3% of GDP when the Government she was in left office. It is now set to be 2.7% in the next year.”
“This Chancellor, of all Chancellors, will be willing to provide that funding to our armed forces and back our defence investment plan. This Government’s commitment to the defence of this country is absolute. We have taken the strongest possible stance in supporting President Zelensky and Ukraine.”
“I think there are many people watching Prime Minister’s questions across the south of England who would now like Mr Speaker to be demoted in the way that my hon. Friend suggests. [Interruption.] This is very thin ice for a Leigh Leopards supporter to be on.”
“I remember well my visit to Stourbridge; it will not leave me, actually, because of the devastation, and the loss of everything in a moment for so many families. My hon. Friend’s support for them was really visible on the day, and the community is clearly very strong; that was evident.”
The complete record
Every one of 2,246 lines we hold for Andy Burnham, in date order, each linked to its source. Free to read, in full, without an account. Page 29 of 45.
“We have spineless Government MPs who will not come here today to argue for the Act. I congratulate the hon. Member for Rochester and Strood (Mark Reckless) on his victory and on being here today, despite being up all night—I cannot imagine that he managed to get any sleep. His party leader has said that when the hon. Gentleman is tired he says things that he does not mean—I think that he just nodded there. Given that he has been up all night, I can only conclude that he does not actually believe what he said in the speech we just heard. In three days he has gone from being in favour of the repatriation of European citizens to being against the privatisation of the NHS. That is a pretty big political distance to cover in just three days.”
“The hon. Gentleman said that he could not understand Labour’s position, but surely he remembers 2012, when Opposition Members spoke with force against that legislation, which he then voted for in the Lobby. I know that it has been a long night, but he really should try to remember these things, because they are quite important.”
“It is a tiring business being an MP and it is possible to forget things, particularly when one drinks as many pints as UKIP Members do, but they should try to remember. Their party leader once said that he would give the NHS budget to insurance companies; apparently, he does not believe that now. The deputy leader, a Mr Nuttall, said that the right hon. Member for South Cambridgeshire was to be congratulated on bringing a whiff—just a whiff—of privatisation to the NHS, and the hon. Member for Clacton (Douglas Carswell), whom the Minister quoted earlier, described the Lansley reforms as “fairly modest”. He chided his Tory colleagues who were sniping against him at the time and said that the reforms must not be derailed. The party says it is anti-politics in the way things are done. This is sheer opportunism and dishonesty.”
“I appreciate what the hon. Gentleman says—it would be churlish for me to say otherwise—and I am grateful for the way he said it. The things Opposition Members were saying back then have happened, and we can see the effects of the Government’s reorganisation in the NHS. With the new figures that came out this morning, we see that A and E has missed the Government’s target for 70 weeks in a row. The A and E figures are the barometer of the health and care system. They are the best place to look if we want to see whether there are problems in the health and care system. The fact that the target has been missed for 70 weeks in a row tells us that severe storms are building over the NHS.”
“An unnamed senior Cabinet Minister has been quoted in The Times as admitting that it was their single biggest mistake.”
“My hon. Friend is right. The Labour Government inherited a situation where almost three quarters of the NHS estate was built before 1948. We transformed that, as well as bringing those waiting lists down. He is right to remind us. I cannot believe that Government Members have not had the guts to be here today to argue for their own policy on the NHS. Or is it that under the shambolic regime of their new Chief Whip, who is now inflicting the same chaos on the parliamentary Conservative party as he did on England’s schools, the Government did not think they could win the vote today, so they did not dare to bring their troops here to hold it? I do not know what the reason is, but they clearly do not believe in their own legislation and the catastrophic reorganisation that followed.”
“It is one of the biggest scandals of recent times that people in this House who have links to private health, and many more in the other place, put through legislation that did not have a mandate from the British people and from which they would benefit financially. The story of that will one day be told in full. The reorganisation has dragged the NHS down and left it on the brink. A reorganisation that was meant to put GPs at the heart of the NHS has left patients waiting days or even weeks to get a GP appointment. This week, there was news that the NHS has missed its cancer standard for the third quarter, leaving thousands of cancer patients waiting more than two months for treatment to start. It is a reorganisation that has systematically run down the NHS and opened the door for it to be sold off.”
“The example that my hon. Friend quotes is the best example of the fact that the Government see no limit at all on the scale or extent of privatisation in the NHS, both in terms of the monetary value— £1 billion—and the fact that they are prepared to put cancer services out on the open market.”
“The Bill before us deals comprehensively with that threat from any proposed TTIP treaty. I am glad to see the hon. Gentleman in his place today.”
“Importantly, it stops hospitals devoting half their beds and half their facilities to the treatment of private patients.”
“Because Ministers have refused to exempt the NHS from the TTIP treaty, we could soon have private US health care providers ringing up CCGs to challenge them on their commissioning decisions. This Bill legislates to remove that threat. It repeals section 75 and it really does let doctors and local commissioners decide. It restores the role of the Secretary of State and brings much needed ministerial accountability back to this House. No longer will Ministers be told to write to NHS England when they have concerns. Instead, there will be answers from the Government Dispatch Box about the service that matters most to their constituents. It removes the role of the competition authorities that the Government’s Act introduced. It stops the ludicrous situation where hospitals such as Bournemouth and Poole are not allowed to collaborate.”
“That was the specific inspiration for his reorganisation. He sold his Bill on the basis that doctors would decide, but doctors tell us that they have no choice but to put services out to the market. Section 75 says that commissioners may not run a tender if there is only one available provider. That is never the case, which is why CCG lawyers conclude that they have no choice but to put services out to tender. That is why we see, according to figures from the NHS Support Federation, that 865 contracts for NHS services, worth £18.3 billion, have been offered to the market. Some 67% of the contracts awarded so far have gone outside the NHS. It is this decision to mandate the tendering of services which places the NHS in the full glare of EU procurement and competition law.”
“Those examples will alarm people. In Greater Manchester, a bus company has been running ambulance services. We had news this week that an arms manufacturer is bidding for a GP contract. These are the things that are beginning to happen to the NHS. Nobody’s constituents have ever given their permission for any of this to happen. We heard speeches from the hon. Member for Bosworth (David Tredinnick) and the right hon. Member for Banbury (Sir Tony Baldry), who said that nothing had changed and what was happening in the NHS now was just a continuation of what the previous Government were doing. No, it is not. The right hon. Member for South Cambridgeshire said in a speech on 9 July 2005: “The time has come for pro-competitive reforms in…health” and he help up the example of utilities and rail.”
“The party that created the NHS is proud to support it, and I urge all Members to vote for it.”
“If the Government stop this Bill receiving Royal Assent, it will form the basis of the repeal Bill that the next Labour Government will lay before the House in May next year. But it will do more than that: it will remove the competition role to allow the full integration of health and care to build and lay the foundations for a 21st-century NHS. One final thing needs to be said. Before we vote, there is a simple truth that all Members in all parts of the House must confront: nobody here has permission from their constituents to put the NHS up for sale. Today is their last chance to put that right before they face their constituents in six months’ time. The people of this country value and trust a public NHS that puts people before profits. This Bill restores that.”
“What is happening in west London should send a shiver down the spine of every community in the country. The NHS is being torn apart, which is damaging patient care and leading to the consequences that my hon. Friend outlines. This is how the character of the NHS is changing under this Government and before our eyes. With every year that the Health and Social Care Act stays on the statute book, the private sector will be more embedded in the NHS and the public NHS weakened as a result. The Government have undermined the “N” in NHS. They are letting our hospitals become part-privatised and they must be stopped. If the Government continue on their current course, in the next Parliament the NHS will be overwhelmed by a toxic mix of cuts and privatisation.”
“That is a very important point that goes to the heart of this debate and that really needs to be cleared up for those listening and watching. The Minister said that the Act did not introduce competition. Will he confirm that it gave, for the first time, a role to the competition authorities under the Enterprise Act 2002 and that since then they have intervened, for the first time ever in the history of the NHS, in Bournemouth and Poole?”
“(Urgent Question) : To ask the Secretary of State for Health if he will make a statement on the “Five Year Forward View” for the national health service.”
“The big question people are asking is: where on earth is his?”
“It will not have escaped people’s notice that the report does not give one mention to competition—that is because it creates fragmentation, when the future demands integration. So will the Secretary of State commit to reviewing his competition rules and vote with Labour in four weeks’ time to repeal them? Finally, on funding, the report could not be clearer: simply protecting the NHS budget in the next Parliament, as the Conservatives propose, will not prevent it from tipping into a full-blown crisis. As the hon. Member for Totnes (Dr Wollaston), the Chair of the Health Committee, has said, current Tory funding plans raise the spectre of rationing, longer waits and charges. Will he now drop them and match Labour’s plans for more money for the NHS? Labour has set out its plan, and today the NHS endorses that plan.”
“Will he accept its recommendation to stop his cuts to the GP budget, stabilise funding and match Labour’s plans to recruit 8,000 more GPs? Secondly, on cancer, the report makes it clear that “faster diagnosis” is needed—we agree. So why did the Prime Minister yesterday dismiss Labour’s proposals for one-week cancer tests? On integration, the report endorses Labour’s vision for new models of care, including hospitals evolving into integrated care organisations with more salaried GPs. Can the Secretary of State tell the House why he has spent the last few weeks attacking that plan, and is he now prepared to drop his opposition? On public health, is the report not right that the time has come for radical action on obesity, and will he now concede that his voluntary responsibility deal is simply not working?”
“A five-year forward view for the NHS, involving more than £550 billion of public spending, briefed to the media but not to Parliament—what clearer illustration could there be of the serious loss of public accountability arising from the Government’s reorganisation? The Secretary of State is in his place today only because he was dragged here by us. I do not know who runs the NHS these days, but I do know that it is certainly not him. We know why he wants to distance himself from this report: because it endorses key planks of Labour’s plan and leaves him with big questions to answer. First, on GP services, does the Secretary of State agree with the report that primary care has been under-resourced and that people are struggling to get appointments?”
“At their conference, the Tory party promised flat funding for the NHS in the next Parliament, but experts say that the service is at breaking point now and that the funding promised is not enough. Now, the Secretary of State’s own side are saying the same thing. The Chair of the Health Committee said last night: “The Chancellor is going to have to write a bigger cheque” or we will “see reductions in services or waiting times increase” and “go down the route of top-ups and charges”. Does the Secretary of State agree with her, and will he concede that a flat budget for the NHS in the next Parliament will not stop it tipping into a full-blown crisis?”
“The House will have noticed that the Secretary of State did not answer my question. There is a very simple reason why the Secretary of State cannot answer my question: his party has prioritised unfunded tax cuts for higher earners, leaving a large black hole in the public finances. There will be nothing left for the NHS if the Tories are re-elected. We on the Labour Benches, in contrast, have promised £2.5 billion over and above what they are committed to. Does that not make the choice on the NHS now clear: under Labour, more money for the NHS; under the Tories, tax cuts for some but an NHS crisis for all?”
“So where, after four and a half years of the coalition Government, does the NHS stand in 2014? It is at “breaking point”— [ Interruption. ] Hon. Members laugh, but those are not my words but those of the seven medical royal colleges and trusted organisations, including the Royal National Institute of Blind People, the Multiple Sclerosis Society, Anthony Nolan and the Alzheimer’s Society, which wrote an open letter last week to all the political parties. They said that “staff feel undervalued and demoralised…things cannot go on like this.””
“Back in 1997, people were waiting months and years, and even dying, on NHS waiting lists. The last Labour Government brought that scandal to an end. Following the Wanless report we increased investment in the NHS, although that was opposed at the time by the Tories. Slowly, over the course of the past decade, the NHS rose up the international league table to the point where, in June 2010, it was judged by the Commonwealth Fund to be one of the best—if not the best—health services in the world. Of course it was not perfect, and there were terrible failings at Mid-Staffs, but the legacy inherited by this Government included the lowest ever waiting lists and the highest ever public satisfaction. That was Labour’s record: a massive turnaround in the fortunes of the NHS from the crumbling service that we inherited.”
“I beg to move, That this House notes comments from leading experts that the NHS and social care services are at breaking point; believes that this is linked to the Government’s decision to reorganise the NHS; further notes that one senior Cabinet minister has said that reorganising the NHS was the Government’s biggest mistake; further believes that the NHS reorganisation has wasted money which could have been spent on frontline care; further believes that access to NHS services is now deteriorating and that staff numbers are not keeping pace with demand; notes the report by the Nuffield Trust, entitled Cause for Concern: Quality Watch annual statement 2014, published in October 2014, which found that it is now becoming harder to access care in many settings, with some people facing extreme waits; calls on the Government to act swiftly to reverse the deterioration in accident and emergency, cancer and referral to treatment waiting times; further calls on the Government to publish its independent evidence on the costs of reorganising the NHS; and further calls on the Government to match the Labour Party’s plans to raise an extra £2.5 billion to invest in building the NHS workforce of the future.”
“It is happening because the GP budget has been repeatedly cut under this Government, because Labour’s 48-hour appointment guarantee has been axed and because the Government—in the words of their own GP taskforce—have presided over a “GP workforce crisis”. The number of GPs per 100,000 population increased from 54 in 1995 to 62 in 2009. However, the figure has now gone back down to 59.5. At Prime Minister’s questions today, the Prime Minister tried to claim that there were 1,000 more GPs in the NHS than under the last Government. This is simply not true. I wonder what we can do about it, Madam Deputy Speaker. We have a Prime Minister who regularly abuses statistics at that Dispatch Box, and even when he has been found out, as he has on many occasions—”
“I want to make some progress. The letter identifies six areas of major concern, and I shall focus on three of them today. The first is GP services. The letter states: “A shortage of GPs means that patients are struggling to get an appointment to see their doctor.” Paul Turner-Mitchell got in touch with me today to say that getting a GP appointment is now like trying to get sought-after concert tickets with the phone stuck on redial. I am sure that a lot of people watching this debate today will know exactly what he means. It is becoming the norm for people to ring the surgery early in the morning only to be told that there is nothing available for days. This year, 13 million people have either waited a week or more for a GP appointment or could not get one at all. That figure has gone up by 2.5 million since 2011. Why is this happening?”
“A and E performance over the past six weeks has been worse than it was last winter. Loud alarm bells should be ringing in the Department about this coming winter, but instead of having a plan it seems that Ministers have given up on ever meeting their own target again. The annual winter A and E crisis is now a permanent spring, summer and autumn crisis, too.”
“The letter states: “Major accident and emergency departments in England have failed to meet their waiting times targets for an entire year.” An entire year! What have Ministers been doing? In fact, it is longer than a year, as the target has been missed for 63 weeks running. We must remember that we are talking about this Government’s own, lowered A and E target. Before the Secretary of State says that that is not the figure for the whole NHS because it excludes minor injury units and walk-in centres, I can tell the House that the NHS as a whole has missed the A and E waiting time target for five out of the past six weeks. Almost 95,000 people waited longer than four hours in A and E in September 2014, which compares with 70,000 in September 2013. So there has been a dramatic deterioration.”
“I will rephrase it, Madam Deputy Speaker, but we have had rulings from the Office for National Statistics in respect of these things. I shall say that the Prime Minister has misused statistics at that Dispatch Box and there is plentiful evidence that that is the case. Statistics have been misused, and I wish to give this example from today. Figures from the 2009-10 census—this was the final year of the previous Government —show that there were 32,426 GPs then. The most recent figures report 32,201 GPs, which is 226 fewer. So let us get some facts on the record. The second area highlighted by the letter is accident and emergency, the classic barometer of the whole health and care system.”
“Ambulances cannot hand patients over to A and E so they end up queuing outside, meaning that ambulance response times get worse. That is the knock-on effect of the Government’s policies across the NHS, and the deteriorations she is seeing for her constituents are mirrored right across the country.”
“Many questions are raised by that decision. Areas of the country where services were being run well would say that they did not get money and instead the money was given to areas where things were not working properly. The situation my hon. Friend describes is what is happening across the NHS in England. The Government have cut the GP budget, the mental health budget and the social care budget, and all that has led to increased pressure on hospitals. There are too many people in hospitals right now in England. The wards are full and people cannot be sent back home because the social care is not there. So the wards do not become free, and A and E cannot admit people to the wards because no beds are available. A and E therefore becomes blocked.”
“All the evidence from around the world tells us that more market-based health systems cost more than systems such as the NHS, and are more complex and fragmented. The clear conclusion I draw is that the market is not the answer to 21st-century health and care. The Government believe it is, which is why they must be defeated if we are to protect our national health service.”
“We brought in other providers in a supporting role to add capacity to bring down NHS waiting lists to the lowest ever level. That is what the previous Government did. By contrast, this Government are doing something different. It is mandating tendering on GP commissioners, requiring people to compete, wasting money on running tenders and privatising the national health service, which is why they must be stopped.”
“May I remind the hon. Gentleman, for whom I have a lot of respect, that I, as Health Secretary in 2009, introduced to the national health service a policy of NHS preferred provider? That is because I am not neutral about the NHS. I believe in the public NHS and what it represents, which is people before profits. Any policy that I develop will always be based on that principle. I was attacked at the time by the Conservative party for introducing such a policy, but I make no apology for it. We used the private sector in a supporting role, but the Government want to use it in a replacement role, and there is a very big difference between the two things. If they were continuing what we had done, why did they need a 300-page Bill to rewrite the whole legal basis of the national health service?”
“I am interested to see this new friendship that my hon. Friend has struck up with the hon. Member for Clacton (Douglas Carswell) on the Front Bench. My hon. Friend is absolutely right. The promise was that there would be no top-down reorganisation. We told the Government that it would be a major mistake to break that promise. They broke that promise and now they are admitting it in private to newspapers. I will come to that point a bit later.”
“I am glad that my hon. Friend raised that point, as again it highlights the major difference between us and the Government. They were saying that we brought in private providers. Yes, that is true, but that was to bring down waiting lists for planned operations, such as hip and knee operations. As she has just rightly said, the Government are putting out to tender cancer services. That is a very different thing. The Government are presiding over a major increase in private ambulances providing blue light 999 services. That is a massively different policy from the one they inherited, which is why the points they have made simply do not hold water.”
“He should get to the negotiating table tomorrow and start treating the staff of our national health service with the respect they deserve.”
“That is why the agency bill is out of control, and it is happening on his watch. In 2013-14 the NHS spent £2.6 billion on agency staff. For foundation trusts that is a staggering 162% over what was planned. That helps to explain why trust deficits are mounting. Does not this mismanagement of the staffing budget explain why the Government are now reneging on their promise to pay nurses a meagre 1% pay rise? Is not that the real reason? I wonder how the Secretary of State thinks those nurses will feel when they read this week that senior mangers’ pay has increased by 13.8% on this Government’s watch, while their pay has gone up by only 5%. I am told that he has refused to meet the unions even to discuss it. It is not good enough.”
“The NHS has been recruiting more staff in the wake of the Francis report, but this is where the damage done by the reorganisation is hitting NHS trusts. They are being forced to recruit overseas or to turn to agency staff because there are simply not enough nurses coming through the training system. I have been contacted by a whistleblower from a trust in Liverpool who says that it is now common for staff to receive text messages from agencies such as Pulse offering huge fees—up to £1,000—to work weekends in London or the north-east, with all travel and accommodation costs paid. That is now the norm, and it is happening on this Secretary of State’s watch. Some nurses are literally taking off one uniform on a Friday night and putting on another for the weekend.”
“If this private apology now is designed to bring people back on board, it will not work. Doctors and nurses lined up to plead with the Government to call the reorganisation off, but they ploughed on. In the words of Mark Porter, chairman of the British Medical Association: “The damage done to the NHS has been profound and intense”. Let me focus on just one example of that damage, staffing costs, as the Secretary of State was talking about them this week. The staff census shows very clearly that in the early years of this Parliament, when spending on back-office restructuring was at its peak, front-line nursing posts were cut by about 7,000. At the same time, the reorganisation threw nurse training into chaos. Training places were cut and have never recovered, down from 21,000 a year to 18,000 today.”
“It is an embarrassing situation for the Secretary of State to deal with, but at least we have from the very top of this arrogant Government the first admission that their reorganisation was a major mistake. The article goes on to quote an ally of the Chancellor, who says: “George kicks himself for not having spotted it and stopped it.” Not having spotted it? This was famously the reorganisation so big we could see it from space. Not spotted it? What planet was the Chancellor living on? The truth is that the Government could have and should have stopped the reorganisation for the simple reason that they were elected on a promise of no top-down reorganisation and did not have the permission of a single person in this land to carry it out. That is why Thursday 7 May 2015 will be their day of reckoning on the national health service.”
“The rest are minor.” The Secretary of State is conveniently looking down and avoiding my eye at this point, but I am sure he has found out who that was. I am sure he knows. I know that he is avoiding looking at me, but is he prepared to tell us who it was or is he going to carry on with his head buried and avoiding— [ Interruption. ] He is blushing. I see that he has the good grace to do that, at least. It is an embarrassing comment, it really is, from a senior Cabinet Minister, but what use is it to people now, when people such as the hon. Member for St Ives (Andrew George) and I were pleading with the Government to stop the process, to admit that it was all a mistake?”
“That is why the NHS has missed the cancer treatment target for two quarters running, the first time that it has ever done that. The evidence is indisputable. The NHS has gone downhill on this Government’s watch and the question follows of what they are doing to bring GP, A and E and cancer services back up to national standards. That is what our motion and, more importantly, patients demand to know from the Secretary of State today, but they will also want to know why the NHS has gone from being a successful service four years ago to being at breaking point today. The front page of The T imes on Monday offered us an answer. It quoted a senior Cabinet Minister who said: “We’ve made three mistakes that I regret, the first being restructuring the NHS.”
“It said: “Thousands of patients are facing longer and even unacceptable waits to find out whether or not they have cancer, because services are under extreme pressure and referral targets are being missed.” In 2014, 10,000 people in England had to wait longer than the recommended 62 days to start their cancer treatment. The number of patients waiting longer than six weeks for diagnostic tests has doubled in the past year—doubled, for cancer tests. That is simply not acceptable. We need to hear today what the Secretary of State is going to do about it and may I suggest that the very first thing he should do is stop the cuts to cancer care? A parliamentary question shows that expenditure on cancer services has fallen by £800 million in real terms since 2009-10; the information comes from his Department and I will send it to him.”
“I do get emotional about the NHS, because I believe in it, unlike the hon. Gentleman. That is fine, I do not mind—it does animate me. Let us have a look at Wales and, as I am about to come on to cancer care. In England, only 84% of patients receive treatment within 62 days. That is not good enough, and Wales has better figures on cancer care. The analysis of the four home nations’ health care systems found that there is good and bad in all of them and this Tory attack on the national health service in Wales has to stop. I will move on to cancer and I will go back to the letter that I was quoting.”
“Either he publishes the independent analysis that he claims supports his figure of £1 billion, or he stops making a claim that is simply not credible.”
“I will not. The Secretary of State now claims that his reorganisation is saving £1 billion a year, but the truth is that that is a fantasy figure. The reorganisation, which cost £3 billion and counting, turned the 163 NHS organisations into 440 separate administrations with their own running costs. It introduced a new competition regime that is eating up tens of millions of pounds of NHS money. Perhaps that is why Kieran Walshe, professor of health policy at Manchester business school, said: “I haven’t found anybody who thinks that this reorganisation has made the NHS more efficient and more productive… and I don’t think you find many people who think that the new system costs any less to run.” The Secretary of State needs to clear this up today.”