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 42 of 45.
“In a national health service, there are areas where national direction is needed, and when things go wrong, there must be immediate powers of intervention, which, on my arrival in the Department in June 2009, I found I did not have. Foundation trust policy needs to be reviewed and adjusted to mitigate those dangers, including through a reconsideration of the power to de-authorise a failing foundation trust, which was recommended by the first Francis report, but repealed by the Health and Social Care Act 2012. We also need to consider targets and how they are used. Targets helped to deliver the lowest waiting times in history and that must not be forgotten. However, in places, they reinforced negative management practices.”
“Foundation trust status was not a matter for Ministers. It was a job for Monitor, so it has to answer that concern. The hon. Gentleman is right that we had many discussions about a public inquiry. He will remember that in July 2009, two months after I was appointed Secretary of State, I brought in Robert Francis QC to conduct an independent inquiry into what happened. I did not order a full public inquiry and I will explain the reason why later. The difficult thing about the fact that the Mid Staffs board was holding more meetings in private was that we in this House had passed up our powers to intervene to stop it. That is another lesson we must learn: that the FT reform was naive in thinking that local autonomy would lead to improvement in all cases.”
“I would be grateful if the Secretary of State would respond to my offer today.”
“On 6 February, the Prime Minister told this House: “We will study every one of the 290 recommendations in today’s report and we will respond in detail next month”. —[ Official Report , 6 February 2013; Vol. 558, c. 281.] Since then, the Government have commissioned a review of the recommendations, which is due to report in July. Although, like the hon. Member for Bristol North West (Charlotte Leslie), I have great respect for Don Berwick, I am surprised that the response to a long public inquiry is to set up another review. Is it still the Government’s intention to respond in detail this month? Although I welcome this debate, it is narrow in focus, so will the Secretary of State consider having a full day’s debate in Government time? Instead of more delays and reviews, we need action and a timetable for implementation.”
“I will make some progress. The first point is about implementation. I would like to take this opportunity to thank Robert Francis for his work on this inquiry and the previous inquiry, which I commissioned. Robert Francis has taken the best part of three years to consider these matters in detail and has made 290 measured and proportionate recommendations. The people affected by these events should reasonably be able to expect that they will be implemented without delay. I make a genuine offer today to the Secretary of State. If he brings forward proposals, he will have our support in speeding up implementation. I say that because I am becoming concerned about the timetable for the Government’s response.”
“They deserve a safe and sustainable hospital and I hope that the Secretary of State’s response to Monitor’s recommendation will map out a way to achieve that.”
“They will understandably be worried about the recent recommendation from Monitor that the trust should be placed into administration. People will recall, as I said to the hon. Member for Stone (Mr Cash) a moment ago, that I commissioned Robert Francis in July 2009 to conduct an independent inquiry. I know that many people, including the hon. Gentleman, wanted me to go further and order a full public inquiry, but I stopped short because I was concerned about the effect that that would have on the hospital and its viability. All of us in this House now have a responsibility to help this hospital heal. After all that they have been through, it would be highly unfair to the people of Stafford if, at the end of all this, they were to lose their hospital or their A and E.”
“Our attempts to find out new information under FOI requests on providers selected under AQP have hit the brick wall of “commercial confidentiality”. I say to the Secretary of State that that is not good enough. Accountability and transparency must always be paramount, as the motion says. Will the Secretary of State require all providers of NHS services to adhere to FOI principles, and will he ensure that whistleblowers working in organisations that provide NHS services have the legal protections that he has announced today? I draw the attention of the Secretary of State to an early-day motion tabled by my hon. Friend the Member for Easington (Grahame M. Morris) on this subject, which has attracted the support of 109 Members. The fourth area on which the people of Stafford need openness and transparency is the future of their hospital.”
“Despite a promise to rewrite the section 75 regulations that are being made under the 2012 Act, my reading of the rewritten regulations is that regulation 5 will not let doctors decide, but will in effect force clinical commissioning groups to open tender for contracts. That raises the prospect that there will be a significant increase in the coming years in the number of private and voluntary sector organisations providing NHS services. If we believe in transparency and accountability, surely they have to apply across the board and on a level playing field. The problem is that private and voluntary sector organisations are not subject to the same strictures on freedom of information and whistleblowing. If action is not taken, we face the prospect of a serious reduction in transparency and accountability.”
“This week, the Care Quality Commission reported that one in 10 hospitals in England and, worse, one in five learning disability and mental health services do not have adequate staffing levels. Surely that should ring alarm bells in the Department as it suggests that parts of the NHS are already forgetting the lessons of the recent past. The third area on which we need a clear statement from the Government today is the accountability and transparency of all organisations providing NHS services. Under “any qualified provider”, the Government are persisting with their assumption that all NHS contracts should be open to full competitive tender.”
“No, I am making some progress. The second area where more transparency and accountability is urgently needed is on staffing levels. If the Government are not yet able to commit to all the recommendations, I ask them to expedite their response to Robert Francis’s important recommendation on patient-staff ratios. The board of Mid Staffs embarked on a dangerous programme of staff cuts, and yet public and staff representatives had no outside guidance to challenge it. The chief nursing officer said yesterday that staffing should be a local decision. Surely the lesson of Mid Staffs is that there is a need for much clearer national standards and guidelines, as suggested by the Francis report?”
“No, that is not what I am saying. I commissioned a second-stage— [ Interruption. ] The hon. Member for Cannock Chase should listen to the answer. I commissioned a second-stage review before the general election after Robert Francis delivered his first-stage review to me. I simply said that I took that judgment because I was worried that if there was ongoing uncertainty about the hospital for a long period, it may affect its viability. I have seen the statements from Monitor that there is a concern about the future viability of the hospital. I am making an appeal, on a cross-party basis, to say that all of us owe the people of Stafford a safe and sustainable hospital. I hope that the hon. Gentleman would agree with that sentiment. My fifth and final point concerns staff morale.”
“They are working flat out, with some coping better than others with the pressure that they are under. Politicians need to do more than just point out the failings of hospitals and NHS staff. We all need to support them with proper staffing levels on the wards. We all need to support them to speak out, wherever they work. We all need to stop the reorganisations that distract them from patient care. Those are the lessons of Stafford. Today, let us all resolve to face up to them.”
“No, I will not. This is a difficult time in the NHS. The chief executive of the NHS has described it as a period of “maximum risk” as it struggles with the simultaneous challenges of efficiency and reorganisation. Morale in the NHS is low and one thing is clear: patient care will not improve if it stays like that. The Secretary of State is right to speak out for patients when the NHS falls short, and he should always do that. However, statements should be fair and should recognise the good that the vast majority of staff do, day in, day out, and the pressure that they are under, which is not of their own making. That balance has been missing from recent Government statements. I say to the Secretary of State that hospitals and NHS staff are not coasting—far from it.”
“I am listening carefully to the Secretary of State but it is not fair to people in the NHS for him to say that Stafford equals everywhere in the NHS, and that we can take one failing—a terrible failing, as I said in my speech—in a locality and apply it to the whole NHS. He must acknowledge that NHS staff did an incredible job to end the situation when people were spending months and years on waiting lists, and even dying on them.”
“Surely, as a clinician, the hon. Gentleman would resent the idea of politicians’ interfering in the independent clinical regulation of hospitals. I did not do nothing. Within days I had asked the Care Quality Commission to investigate the outliers that Brian Jarman had given me. I will not sit here and accept the hon. Gentleman’s suggestion that I complacently did nothing. That is not true, and he should not repeat it in the House.”
“I am listening carefully to what the hon. Gentleman is saying. It is not strictly true to say that that was a Government inquiry. I brought in Robert Francis—will he acknowledge that?—in July 2009 to conduct an independent inquiry. As my right hon. Friend the Member for Kingston upon Hull West and Hessle (Alan Johnson) said, in presenting his findings Robert Francis said that he felt that more people had come forward because of the nature of that inquiry.”
“May I just correct the hon. Gentleman? I was not a Minister in the Department of Health on 1 February 2008. Furthermore, the awarding of foundation trust status was the responsibility of Monitor, not Ministers in the Department.”
“Will the hon. Gentleman acknowledge that I asked Robert Francis to conduct two independent inquiries into what happened? It is not the case that I was not doing anything. I made that judgment because I wanted to get to the truth of what happened while not overburdening the hospital with the job of getting better. I tried to strike that balance, and that is why I reached the judgment that I did.”
“(Urgent Question): To ask the Secretary of State for Health if he will make a statement on comments by the deputy medical director of the NHS Commissioning Board on the regulations on procurement, patient choice and competition under section 75 of the Health and Social Care Act 2012.”
“Will they also respond today to the research of the Nuffield Trust, which shows that more competition in the NHS has resulted in falling productivity? A quarter of a million people who signed the 38 Degrees petition have forced the Government into yet another humiliating U-turn, but there will be lingering distrust at the fact that they had the audacity even to attempt this. The simple truth is this: the British public have never given them permission to put the NHS up for sale. Until they acknowledge that, we will never tire of reminding them.”
“Will he give a categorical assurance that there will now be a fundamental rewrite to reflect to the letter commitments given to the House and to the professions? More broadly, we now need urgent clarification, in a full and detailed statement, of what Government policy on competition actually is. Will the Minister today send the clearest message to clinicians that they will control whether or not to use competitive tenders, and will he fulfil the pledge by his leader to protect the NHS from the full glare of EU competition law? If the Government still want to argue for more private providers in the NHS, is he confident that this will not restrict whistleblowing as it has in other outsourced public services?”
“We notice that the Secretary of State is not here today, but perhaps the Minister will remind him of the statement his predecessor made to GPs: “I know many of you may have read that you will be forced to fragment services, or to put services out to tender. This is absolutely not the case.” I am tempted to ask: if the aim is to revert to the position we held, why on earth bring forward a 300 page Bill to rewrite the entire legal basis of the national health service? The truth is that they have been found out trying to sneak through the back door privatisation proposals that the Minister’s predecessors were forced to rule out to save their discredited Bill. In that light, does the Minister accept that it will not be good enough to bring these proposals back with a few cosmetic changes?”
“In less than four weeks’ time, new GP commissioners take control, yet today there is complete confusion about the job they are being asked to do. Following comments by the deputy medical director of the NHS Commissioning Board and the statement we have just heard, coalition policy on competition in the NHS is in utter chaos. It beggars belief that almost three years after the White Paper introduced by the right hon. Member for South Cambridgeshire (Mr Lansley) and after all the upheaval he inflicted on the NHS, there is still no clarity on policy today. They are in this mess because the “doctors will decide” mantra was always a fig leaf for their true ideological purpose of driving competition and privatisation into the heart of the NHS.”
“I am sure that, like me, the Secretary of State has spent recent weeks absorbing the Francis report and its recommendations; there are lessons for everyone at every level, particularly on staffing. New analysis to be published later today will show that the NHS is set to lose 12,000 nurses over the course of this Parliament, raising doubts about its ability to respond to Robert Francis’s recommendations on staffing. Will the Government say today whether they accept those recommendations and the principle of a minimum staff-to-patient ratio?”
“I have read both Francis reports, and I think it is essential that everybody learns the lessons—that is what I said—including Labour Members. It is also important that we do not repeat the mistakes, and the first Francis report said that the problems were caused because the trust cut staff to dangerously low levels. The most worrying thing from the analysis that will be published today is that four in 10 of the jobs being lost come directly from services linked to the care of older people. Does the Secretary of State therefore agree that there is a danger that the NHS is already failing to learn the lessons of the recent past? Will he join me in sending a message to the NHS that care of older people should be a priority for improvement, not an easy target for cuts?”
“Finally, the proposal fails to meet the scale of the challenge of the ageing society. It will not lead to more integration of care. Instead, it will entrench the separation between two separate systems: a free-at-the-point-of-use NHS and charged-for social care. Would it not have made more sense, rather than developing these piecemeal plans in isolation, to have set them out as part of a single vision for a sustainable health and care system in the 21st century? The Secretary of State has made progress, but he has missed an opportunity to produce a long-term plan that is fair to everyone and built on cross-party consensus. He has settled for a timid solution when what older people needed was a far bigger and bolder response.”
“The third problem is that this package disguises yet another coalition U-turn, this time on inheritance tax— [ Interruption. ] It is ironic, I must say. In 2007, a flagship pledge was made to increase the inheritance tax threshold to £1 million. Just eight weeks ago, the Chancellor said that he would increase the threshold in two years’ time. What has happened in the past two months to make him change his mind? Is not this the quickest coalition U-turn yet? The irony will not be lost on people that the Government are now increasing death taxes to pay for their plan. The Secretary of State has also said the rest will be made up from national insurance. Does he think it is fair to ask the working age population to pay for something else, rather than older people?”
“If he fails to face up to the current crisis in council funding, is it not the case that, with care charges rising, today’s announcement will feel like a con? It is true that the Government have raised the capital threshold, and I have said that we welcome that, but can the Secretary of State give the House any confidence that the extra support that people receive through a more generous means test will not be more than offset by increasing care charges caused by collapsing council budgets? What people might not know is that the cap reflects not what people actually pay for care but a local authority average, and that it does not include accommodation costs. That was not mentioned in the Secretary of State’s statement. Will not people feel conned if the Government do not make that clearer?”
“Will the Secretary of State confirm that this was against the advice of Andrew Dilnot to the cross-party talks? In practice, it will mean that vulnerable people will continue to face rising charges, as councils put up fees to cope with the growing shortfall in their budgets, making it more likely that those people will, in time, have to pay right up to the new £75,000 cap. To many people, that will not feel like progress. More than £1.3 billion has been cut from local council budgets for older people’s care since the coalition came to power. Care charges are rising above inflation, and councils are warning that, by 2024, they will be overwhelmed by the costs of care. Does the Secretary of State accept that forecast, and if he does, how will the plans he has announced today help to address it?”
“Is this not a plan for the few and not the many, and further proof that we are not all in it together? The Secretary of State claims that insurance companies will step in with new products to help more people to protect their assets, but in evidence to the Health Committee, the Association of British Insurers said that it did not believe that the capped cost model would result in a market for pre-funded care insurance. So what further confidence can the Secretary of State give the House today that such a market will in fact emerge? Secondly, the plan is at best a partial solution. With this decision, the Government have prioritised the funding of a cap on care costs with new money, over and above addressing the crisis in council care budgets.”
“First, it fails the fairness test. We will only have a durable solution if it can answer this question: will it help every person and every couple to protect what they have worked for, whatever their wealth and savings? I am afraid that the answer is no. According to Demos, a £35,000 cap would benefit about 3.2 million pensioners. A per-person cap of £75,000 will benefit just 1.4 million. For the average couple, the cap is £150,000. That might be enough to protect detached houses, but it will not protect the average semi-detached home in large parts of England. As Andrew Dilnot said today, the cap “is higher than we would have wanted —£11,000 higher than the top end of our range—and I regret that”. Will the Secretary of State confirm that people with modest to average homes and savings are not protected under his plan?”
“Yesterday, on The Andrew Marr Show, the Secretary of State said: “I've been hauled before the Speaker before and I wouldn’t want that to happen again and so I don’t want to go into the details.” Now that we have heard the details, perhaps the Secretary of State could explain on which part of his statement the media had not been pre-briefed. It is disappointing that the media rather than the House were briefed first on a statement that was of such importance to so many people. It is also disappointing that the Government have abandoned any effort to build a cross-party consensus before rushing to announce its proposals, and that they have chosen to rewrite the Dilnot report with figures of its own, breaking its careful logic. More specifically, there are four problems with what has been announced today, and I will address each in turn.”
“The House has been presented with a flawed prospectus today. Vulnerable people will still face rising care charges and homes will still be lost, notwithstanding valiant attempts to put the best possible spin on things in the weekend media. Yesterday the Deputy Prime Minister made the big claim that the Government were going to “crack” the care “conundrum”. Today, when we are faced with this meek package, that sounds suspiciously like overselling. Stephen Burke, the director of United for All Ages, has described the cap as “the dampest of damp squibs”.”
“I thank the Secretary of State for his statement, and for early sight of it. I agree with him that our current social care system in England is the worst of all possible worlds: a cruel lottery whereby people go into later life with everything for which they have worked on the roulette table, and the most vulnerable are always the biggest losers. That needs to change. The Secretary of State has tabled a modest plan that will make the system fairer than it is today, and we congratulate him on that. We welcome elements of what he has announced today. A cap of £75,000 will protect people from the catastrophic costs of care, and raising the means-test threshold will help more people on lower incomes to obtain some help with care charges. This is a step forward, but it is a faltering one.”
“If that is the case, are they not justified in continuing the fight to stop this Government riding roughshod over the people of Lewisham and south London? What we have seen here today is the first glimpse of the new market-driven NHS that the Government have created, where the moneymen and not the medics are calling the shots. We have seen another chapter in the unfolding omnishambles that is this Government—this one, sadly, could be entitled the Lewishambles. We have seen a scandalous waste of money on a solution that will not be acceptable to people in Lewisham—and it is not acceptable to people anywhere. The Secretary of State is asking this House to accept the unacceptable. We will not do that for Lewisham and we will not do it for anywhere else.”
“This community have rallied together to defend their local hospital, led by the fantastic efforts of the local MPs, but more than that, they have fought valiantly for every community worried about this Government’s cavalier approach to our country’s most valued institution. This community have stood up to an out-of-touch Government who think they can treat some of more deprived parts of our country with utter disdain. This community have achieved something today, but I am certain that they will continue the fight—and let me say that they will have our support. Will the Secretary of State confirm that what he has just announced takes away their right of appeal to the Independent Reconfiguration Panel?”
“Will the Secretary of State confirm, learning from this debacle, that in future no proposal to downgrade or close A and E and maternity services will ever get out of the starting blocks if it does not have a proper clinical case to support it? Will the Secretary of State today issue an apology to the people of Lewisham? How on earth are they expected to have confidence in the figures he has announced from a clinical review thrown together—cobbled together —in his Department in a matter of days? He has caused huge distress to them but he has also failed to listen to them. Thousands of people have put their lives on hold to fundraise, to lobby, to campaign: 52,000 names on a petition; 25,000 people on a march.”
“We warned him that he was going beyond the powers in the Health Act 2009. He said that he would commission fresh legal advice. Will he publish it today so that there can be a proper debate on the legal position? He mentioned PFI, but is it not the case that the schemes he mentioned were initiated and negotiated under the Major Government? He said that he had consulted South London Healthcare NHS Trust, but is it not a fact that it found out about this process from the media? This decision will damage fragile trust in the way that the NHS manages changes to hospitals. The Government need to get back to first principles.”
“Let me quote to him the chair of the Lewisham clinical commissioning group, Dr Helen Tattersfield, who has said: “If the TSA proceeds as currently planned it is my belief that not only will this result in a reduction of quality and provision of health services for Lewisham residents with huge risks to health outcomes but also the effective end of clinical commissioning in Lewisham.” It is clearly the case that the proposals that the Secretary of State has announced today will lead, in Dr Tattersfield’s words, to a reduction of quality and provision in Lewisham. These changes are opposed by the doctors he promised to put in charge of the NHS, and therefore clearly fail the fourth test that he has set out. Furthermore, is the Secretary of State confident that what he has announced today is legal?”
“They have set up a financially driven process and thrown together a clinical justification that is not independent but drawn up in his own Department, leaving the Secretary of State’s so-called four tests in tatters. Let me remind him that the fourth test is that any proposal for change must have “demonstrable support from commissioners”.”
“There is now utter confusion about the Government’s policy on hospital reconfiguration. In three years, they have gone from moratorium to pandemonium. Across the country, half-baked cost-driven proposals to close A and Es and maternity units are being foisted on local communities without evidence of how that can be done safely and without putting lives at risk, yet at the same time, A and Es everywhere are under severe pressure. Thousands more patients are waiting for more than four hours to be seen and there are queues of ambulances lined up outside. In that context, it is simply not tenable to downgrade any A and E department without first establishing a clear clinical case for how it can be done without compromising patient safety, but that is what the Government are doing here.”
“But the Secretary of State has accepted the principle that a successful local hospital can have its services downgraded to pay for the failures of another trust. That takes the NHS into new territory. The Secretary of State has just crossed a line and set dangerous precedents—namely, that in his new market-driven NHS, finance takes precedence and any hospital, no matter how successful, is vulnerable to changes through backdoor reconfiguration, that success can be punished and failure rewarded, and that a community can see its A and E and maternity services downgraded without proper consultation and without clinical justification. There will be no cheers for the statement in Lewisham and it will send a chill wind through any community worried about its hospital services.”
“Just when we thought this Government’s mismanagement of the national health service could not get any worse, it just has. Let us be clear about what the Secretary of State has announced today. He has at last accepted recommendations that were agreed by the previous Government but then delayed by his predecessor’s moratorium, thereby deepening the financial problems of South London Healthcare NHS Trust. And he has rejected an outrageous proposal that Lewisham hospital should lose its accident and emergency department—a proposal that never should have been made in the first place, but which has cost more than £5 million of precious NHS cash on accountants in the process, enough to give some of the 5,000 nurses who were sacked their jobs back.”
“As winter bites, the NHS faces its toughest time of year, but there is mounting evidence that the Secretary of State has left it unprepared. For 105 of his 133 days in office, the Government have missed their own A and E target for major A and Es. Last week, for the first time, the figure fell below 90%. Right now in A and Es up and down England, ambulances are stuck in queues outside, patients are on trolleys in corridors, and people are waiting to be seen for hours on end. Does the Minister accept that there is a growing crisis in our A and Es, and if he does, what is he doing about it?”
“I suggest to the Minister that he needs to get out on the ground in the NHS a bit more. The figures I gave him were for major A and Es. If he got out more, he would realise that his complacency, which we have just seen at the Dispatch Box, is not justified. Let us look at Milton Keynes, which was identified by the Care Quality Commission as one of the 17 understaffed hospitals, and where last week just 72% of patients were seen within four hours. Milton Keynes is one of 15 trusts in England where A and E performance plummeted below 80%. These are the kind of figures that we have not seen in the NHS since the bad old days of the mid-1990s. Ministers like to blame nurses, but it is time they started accepting some responsibility. Will the Minister today ensure that all A and Es in England have enough staff to get safely through the winter?”
“This process is attempting to rewrite the rules on making changes to hospital services, bypassing the intention of the House. It will send a shiver through any communities without a foundation trust, as it raises the prospect that their hospital will be able to be used as a pawn to solve problems in another. People in Lewisham feel a huge sense of unfairness and I am sure that that will be shared by people across the House. The onus is on the Secretary of State to justify the changes and ensure that rules governing hospital changes are fair and respect the essential rights of all communities to be fully consulted and involved in any decision affecting their services.”
“As this is a financially driven process, the people of Lewisham have justifiable concerns about whether it is safe to close their A and E and downgrade the maternity services. Is the Secretary of State satisfied that a clinical case has been established behind these major changes? Given that all A and E departments in south London are currently overstretched and operating at full capacity, people will need to be convinced that these changes will not put lives at risk. Finally, will the Secretary of State give a guarantee today to the people of Lewisham that, if he accepts the TSA’s recommendations, they will have the full consultation rights that come with any hospital reconfiguration, including the ability to challenge the clinical case and, if necessary, to refer it to the Independent Reconfiguration Panel?”
“The Health Act 2009, which I took through this House, states that “the administrator must provide to the Secretary of State and publish a draft report stating the action which the administrator recommends the Secretary of State should take in relation to the trust.” In making recommendations that have a major impact on another trust, is the Secretary of State not going beyond the powers this House has given to him? He has acknowledged that he needs to commission fresh legal advice, which suggests to me that the legality of the process is in doubt. Will he publish all the legal advice he has been given so far and give a commitment that any new legal advice he commissions will be made available?”
“I apologise for missing the start of proceedings on this urgent question. It has long been accepted that difficult decisions are needed to secure the sustainability of health services in south-east London. That is why recommendations from the review, “A Picture of Health”, were agreed under the previous Government. The trust special administrator has adopted many of those proposals, which we welcome. However, the review presented today goes way beyond that and takes the NHS into new territory. It uses powers passed by the previous Government in a way that was never intended and, in so doing, sets a worrying precedent whereby normal processes of public consultation are short-circuited and back-door reconfigurations of hospital services are pushed through.”