John Healey
MP for Rawmarsh and Conisbrough · Labour · United Kingdom
“Mr Spock, I think some would say, Mr Speaker! My hon. Friend is right. Despite global conflicts, trade tensions and rising threats in the world, which are pushing up inflation, bearing down on growth and pushing up borrowing costs, the UK economy is demonstrating huge resilience.”
“The Prime Minister and I have been clear that we must cut the costs of welfare. On levels of taxation, we had a period of Conservative Government, with low growth and high debt. They crashed the economy with the mini-Budget, and we had levels of taxation that were putting pressure on business, adding to the cost of living.”
“The hon. Lady is talking to the person who led the work to establish a defence and security partnership with the European Union and bilateral agreements with other countries, on which we now build both our economic strength and our national security strength. On the question of the Budget, I ask the hon.”
“Since day one in the job, the Prime Minister and I have been in lockstep in our determination to meet Britain’s fiscal rules. This is the bedrock on which we build good growth and help give a bit of breathing space to families and businesses.”
“May I start by paying tribute to my predecessor, my right hon. Friend the Member for Leeds West and Pudsey (Rachel Reeves)? I am proud to have been a member of a Government with the first female Chancellor in 700 years.”
“My hon. Friend speaks up very strongly for his local area. He is right about the importance of pubs, social clubs and live venues, and about the importance of the 20% cut that we announced in July. These are the things that make the places where we live the places that we also love.”
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“That allows less than 10 minutes for each amendment that the Government table, and that is before the Opposition table our own amendments and before taking into account the six schedules that are being recommitted.”
“The House cannot do its proper job unless all the areas that the Government say they will change are recommitted. Why are the clauses on the failure and designation regime for hospitals, which the Government say they will change, not covered in the recommittal motion? The House cannot do its proper job, and organisations cannot give proper evidence to the Bill Committee, unless all the amendments are tabled in good time, so why will there be only two full working days between the tabling of amendments and the Committee sitting? The House cannot do its proper job unless the Bill Committee has sufficient time for scrutiny. The 64 clauses in the recommittal motion took 45 hours of debate in Committee last time. The Government are now cutting that time in half. The Minister said that he expects 160 amendments in Committee.”
“In response to a point of order, the Health Minister cited the Planning and Compulsory Purchase Bill of 2003 as a precedent. The Labour Government recommitted that Bill in full and gave Committee members the whole of the summer recess to examine the detailed amendments before the Committee sat again. Why are the Government not acting as they should and as Labour acted in government with that Bill? The NHS, the legislation and the changes to the changes announced last week are all complex, and the House cannot do its proper job unless the Government’s changes to one clause can be considered alongside the consequences for other parts of the Bill and for the health service. How can the promised changes to Monitor’s role be considered without looking at all 29 clauses dealing with its licensing powers?”
“My hon. Friend is right. We know that the Prime Minister is a PR man. We know that he was forced to call the pause and that, when he did, he was looking for a PR solution. The answer that my hon. Friend flushed out of the Government stands that up clearly. To return to the motion before the House and the question whether the Bill requires, as we argue, recommittal in full, parliamentary precedent demands this, proper parliamentary scrutiny demands this and, above all, our responsibility to NHS patients to try to get the legislation right demands this. The parliamentary precedent is clear, as my hon. Friend the Member for Cardiff West (Kevin Brennan) said. The House of Commons Library tells me that the last time a Bill was recommitted in part was 60 years ago.”
“The Minister, his colleagues and the Prime Minister have broken their word so often so far on the NHS that we cannot take at face value what the Minister says. We will wait to see and we will judge what he does when we see the detail of the amendments that he tables.”
“My hon. Friend is right. What the Government are doing is reckless and rushed. The NHS is still intact, but what they are doing will break it up as a national service, as we know it.”
“We will continue to oppose this reckless and needless NHS reorganisation, lead the detailed scrutiny this legislation requires and speak up as patients start to see their NHS services suffer again under the Tories. We will oppose the motion.”
“Both the supposed benefits and the stated costs have changed, yet the Government tell us that the new impact assessment will not be published until the Bill reaches the Lords. How much will this reorganisation now cost? How much can the Government now claim this will save? What are the risks? Why has the Health Secretary being blocking my freedom of information requests to release the official risk register since November? Why will the Government not welcome and allow full scrutiny of the Bill in view of the significant policy changes they say they are making? Why are they preventing this elected House from doing its proper job of fully scrutinising the legislation? If the programme motion is passed, more will need to be done on Report in this House and during the Bill’s passage through the other place.”
“The hon. Gentleman served on the Public Bill Committee. I hope he will continue to serve when the Bill is recommitted. He is right. The public and NHS patients expect us to do our best to get the legislation right. To do that, we require the detail, we require the time, and we require the whole Bill to be recommitted. The House cannot do its proper job without an impact assessment. The current assessment says that “the full benefits of these changes will not be realised unless there is a change to regulation to promote competition”. The Government now say that this policy will be altered. There will also be greater bureaucracy, longer time scales and more bodies with more complex accountabilities.”
“At its heart, the Bill will still be the Tory long-term plan to see the NHS set up as a full-scale market, and the NHS broken up as a national public service, so that patients increasingly see the services on which they depend subject to the lottery of where they live. The public have rumbled the Prime Minister. They know that they cannot trust him with the NHS. Fewer than one in four now trusts him to keep his NHS promises, and more than half believe that the Conservative party’s plans for the NHS are just a way to privatise the health service. Today, the Government have recycled their plans for the NHS when they should have been scrapped. People are right to conclude that they cannot trust the Tories with our NHS.”
“Will he admit that this reorganisation creates five new national quangos, set to spend tens of billions of pounds? Will he admit that this reorganisation replaces one local body—the primary care trust—with at least five others, all of which will play a part in commissioning? Will he admit that the plans still cut hospitals loose from the NHS, with no limits on treating private patients while NHS patients wait longer, and no support from the NHS if they run into financial trouble? Will he admit that hospitals will no longer have the protection as a public service from the full force of competition law? What was a very bad Bill will still be a bad Bill. This House should be allowed to do its proper democratic job, as the only elected House, and scrutinise in full in Committee the whole Bill.”
“Why is he ploughing on with the Health and Social Care Bill when what he announced today could largely be done without legislation, and certainly without the risk and cost of the biggest reorganisation in NHS history? This is a political fix, not a proper plan for improving care for patients, or for a better or more efficient NHS that can meet the big challenges that it must face for the future. Make no mistake, today’s plans will mean that the NHS is mired in more complex bureaucracy, more confusion and more wasted cost in the years to come. In the battle of spin, with all parts of the divided Government claiming a win, the big losers will be NHS patients. The Opposition and the public will judge the Government on what they do, not on what they say. I lost track of the bureaucracy that the Health Secretary announced in his statement.”
“Why no apology for patients, who are already beginning to see the NHS go backwards again because of this reorganisation? More than one in 10 people now waits 18 weeks for operations, three times the number of patients wait more than six weeks for tests, and casualty waits are at a six-year high. This is the first Prime Minister who has been forced to ask 45 experts for a report on how to protect the NHS from his own Government’s policies. Now he is reorganising his reorganisation. The Future Forum report yesterday was a demolition job on the Government’s misjudgments and mishandling of the health service. Why is he wasting £800 million on redundancy payments when some of the same people will be re-hired to do the same job? Why is he holding back £2 billion promised for patient care when it could fund 55,000 nurses?”
“I thank the Secretary of State for an advance copy of his statement, although I learned more from the Prime Minister’s press conference than from the statement. Humiliating! The Health Secretary has had health policy taken out of his hands. He spent the last nine months telling anyone who criticised the Government’s health plans that they were wrong, and that they did not understand. Today, he admits that he is wrong. How can he argue for this latest blueprint for the biggest reorganisation in NHS history with any credibility or integrity? The man who messed up so badly last year is telling us how he will mess up next year too. Why no apology to NHS patients and staff for the wasted year of chaos, confusion and incompetence? Why no apology for breaking the coalition agreement to stop top-down reorganisations?”
“The Secretary of State spoke in glowing terms of the last year, but the last year has been a catalogue of confusion, incompetence and broken promises. So will he now accept that the Government’s massive mishandled NHS reorganisation is piling extra pressure on NHS services, with nearly £2 billion promised for patient care being wasted on the internal changes? Will he admit that it is patients who will suffer as front-line NHS staff lose their jobs, treatments are cut back and waiting times start to rise again under the Tories?”
“Is that not why MORI shows public concern about the NHS rising rapidly and why people are right to conclude that they cannot trust the Tories on the NHS?”
“The Secretary of State mentioned a lot of things, but I notice that he did not mention the Prime Minister’s five new guarantees. [ Interruption. ] The Secretary of State shakes his head as if they do not matter, but perhaps he was not consulted on them. People have seen the Prime Minister make and then break promises on the NHS before, but this time he is breaking his pledges as he is making them. The King’s Fund says that waiting times are going up and the Nuffield Trust says that health funding is being cut in real terms. Privatisation, the break-up of integrated care and the removal of national standards at the heart of the health service are exactly what his health Bill is designed to do.”
“He and the Prime Minister co-signed the foreword to the White Paper last summer, and he signed off the NHS legislation in Cabinet before Christmas. He and his Lib Dem MPs have backed the Bill at every stage in Parliament. In Committee, his Lib Dem Health Minister led the rejection of Labour’s amendments—the amendments that he now says he wants to make. Now that the Lib Dems are making many of the arguments that Labour has been making since early autumn, people may ask what the Deputy Prime Minister has been doing for the past year, when he changed his mind and why. People may suspect that the deal he is stitching together has more to do with saving his party than safeguarding the NHS.”
“He was forced to do so because of the growing criticism, confusion and crisis of confidence over the Government’s NHS reorganisation. It was unprecedented because he told his Health Secretary to stop what he was doing while 45 others on the NHS Future Forum work out what he should be doing. It looks as though the Prime Minister is listening to anybody and everybody on the NHS except the Health Secretary. We have called this debate after the Deputy Prime Minister’s flagship policy was sunk in the AV referendum last week. He is now trying to find a replacement, and claims that changes to the Health and Social Care Bill are his new No. 1 priority. The Deputy Prime Minister and his party are up to their necks in the Tory NHS plans.”
“I beg to move, That this House notes the growing concerns over the Government’s handling of the NHS and the effect its policies are having on hospitals and patient care; and calls on the Government to uphold the Coalition Agreement promise to stop the top-down reorganisations of the NHS which have got in the way of patient care, to use the present pause in the progress of the Health and Social Care Bill to make fundamental changes, including dropping the damaging and unjustified market-based approach, and to concentrate efforts instead on achieving sound efficiencies, better clinical quality and improved integration of services. We have called this debate after the Prime Minister was forced to order an unprecedented pause in his health legislation last month.”
“There is nothing wrong with the general aims of the changes, but what the Government are doing is different from what they are saying. In one third of the legislation, they are not setting up GP consortia or reducing bureaucracy in the NHS, but setting up the NHS as a full-blown market. That is the wrong prescription for our NHS, and it is patients who will suffer.”
“In principle, that is a good move. The Opposition, including those of us on the Front Bench, have said that it makes sense in principle to give local authorities a lead responsibility on public health; after all, they are responsible for things that affect public health such as housing, employment and a good environment. The Government’s failure is that local authorities are not getting the powers or resources to do the job properly. The provisions in the Bill will fragment the NHS and make it harder, not easier, for them to do that job.”
“My hon. Friend has been pressing that point with his local hospital, because it is quite clear that the hospital’s managers were forced to look at privatising it and having its management run by a private company. I fear that under the provisions of the Health and Social Care Bill, more hospitals will be driven to the brink and will have to face the prospect of insolvency or a takeover by the private sector companies that are lining up to make the most of the Government’s plans for the NHS.”
“My hon. Friend gives good service on the Health Committee and follows the details of the matter more closely than most in the House. He has an important point, because the quality of health services for patients is inevitably affected by the deep and fast cuts in other areas. People in local authorities are experiencing difficulty in continuing to provide good social care, which is causing problems for the people who depend on that care and for the NHS.”
“The independent sector treatment centres played a part in clearing the backlog and improving waiting lists. They introduced the extra capacity that allowed the Labour Government, through a combination of investment and reform, to achieve the highest levels of patient satisfaction with the NHS ever and the lowest waiting times ever.”
“My hon. Friend is absolutely right, and he makes the point that I have begun to make to the House. The Liberal Democrats have been up to their necks in this for the past year, and welcome though their late conversion is, the House is entitled to ask exactly why the Deputy Prime Minister now believes that radical changes to the Health and Social Care Bill are required.”
“I am going to carry on and make a little progress. If the Deputy Prime Minister is not going to sell out the principles of the NHS like he has the principles of his party, he must toughen the tests for the Bill and help stop the market free-for-all in the Government’s plans. If he and his party mean what they say, they can start today by backing us and backing the motion. It calls on the Government to drop “the damaging and unjustified market-based approach”, exactly as the Liberal Democrat spring conference did, and to “uphold the Coalition Agreement promise to stop the top-down reorganisations of the NHS which have got in the way of patient care”. There is no mandate for this, the biggest reorganisation in NHS history, either from the general election or from the coalition agreement.”
“The Prime Minister’s broken promise on NHS reorganisation is part of the reason for the growing doubt and distrust about whether he is making the right decisions for the right reasons on the NHS. He promised to give the NHS a real rise in funding, but the Budget this year confirmed a £1 billion shortfall in England. He promised to protect front-line services, but nursing posts are already going, and the Royal College of Nursing expects 40,000 NHS jobs to go in the next four years. The Prime Minister promised a moratorium on hospital A and E, and maternity service closures, but some are now going ahead, and more will follow—without public consultation—under the Health and Social Care Bill plans.”
“Some of the reorganisations in the 13 years of our Government played an important part in the reform and the great gains that patients saw in the NHS. However, it is also the case—and we learn from this—that reorganisations often take longer, save less, cost more and have less impact on improving care for patients than envisaged at the outset. We learned that lesson towards the end of our 13 years, which is why we had a period of important stability in the NHS, but it is a lesson that the Conservatives have failed to learn—extraordinarily so, as we all thought that they had learned it, because NHS reorganisation is exactly what the Prime Minister promised not to do before the election.”
“Let me help the hon. Lady. For the first time, all parts of the NHS, including the commissioning job, will be opened up to private companies and subject to competition. As I have said, independent sector treatment centres played a part in our being able to clear long waiting lists and restore the quality of service to the NHS, as well as in supplementing the mainstream NHS, not substituting for it, which is what will happen under her party’s Bill.”
“The right hon. Gentleman will know from his current position that the premium that we paid in the first wave of treatment centres was stopped in the second wave. He will also know that by the end of our period in government we had stopped the independent treatment centres programme; and he ought to know that built into his Bill’s impact assessment is what it calculates to be a 14% premium, paid to providers under his proposals.”
“No. What I am referring to is the provision in the Bill to allow the job of commissioning to be outsourced to private companies. That has never been done before. It is there in the Bill and it is a big risk for the future. The Prime Minister made the NHS his most personal pledge before the election.”
“The point about the Health Secretary’s legislation is that it allows consortia to outsource in whole the job of, not the responsibility for, commissioning. He made the point that the consortia are public bodies, but they meet none of the standards of public governance. They can meet in private. As the right hon. Member for Charnwood (Mr Dorrell) has said, that serious job should be done by properly constituted and governed public authorities, but that is a loophole in the Bill.”
“Just one week after the announcement, and in fact on the day that the Health Secretary received that historic vote of no confidence at the Royal College of Nursing, the NHS chief executive wrote to NHS managers to tell them that “we need to continue to take reasonable steps to prepare for implementation and maintain momentum on the ground”. The House is used to pre-legislative scrutiny, but not pre-legislative implementation.”
“My hon. Friend puts the position and the challenge, especially to the Lib Dems, very clearly. The challenge to Conservative Members is this: they must recognise that the Prime Minister made the NHS his most personal pledge before the election. People wanted to believe him, but in just one year the NHS has become his biggest broken promise. My hon. Friend mentions the pause. In our Opposition motion in March, we urged the Government to “pause the progress of the legislation in order to re-think their plans”. —[ Official Report , 16 March 2011; Vol. 525, c. 374.] The Health Secretary dismissed that, but he has now been told to do so by the Prime Minister. However, many of the signs point to the Prime Minister’s “pause to listen” being a sham.”
“My right hon. Friend is absolutely right, and he draws on his experience as a former Health Minister. While implementation continues apace, there is a so-called pause in the legislation. His point is exactly the one made by the all-party, Tory-led Health Committee in a recent report. If the Prime Minister wants to prove to NHS patients and staff that his pause is not just spin, he must shelve the Bill and make radical changes to his NHS reorganisation plans.”
“The hon. Gentleman has great expertise in, and commitment to, cancer care. He is right that our survival rates continue to lag behind those of parts of Europe, but I am sure he is aware that the rate of fall in deaths from cancer has accelerated in the past decade. On that basis, and with continued investment and reform, we have a chance of catching up to European levels. However, the reforms proposed in the Bill, as many cancer charities and those who represent patients testify, raise the concern that the great gains made by the cancer networks in integrating and co-ordinating services for cancer patients and sufferers will be put at risk.”
“In future, the power to decide what health services will be provided free at the point of need—as now—and what further services will be charged for will rest with the new commissioning consortia. That was the basis of the concern expressed today by the Royal College of General Practitioners. These consortia will be able to meet and take decisions in private, and to outsource commissioning to private companies; but they will not even need to have a GP on their board—in fact, they will not need to have a board at all.”
“The Government’s first act was to remove national waiting time standards—the patients’ guarantee that they would be seen and treated quickly—which the Health Secretary described as “clinically unjustified targets”, but the patients do not see it that way, and nor do the surgeons. The president of the British Orthopaedic Association described the delays now being faced by patients as “devastating and cruel”. The NHS Bill takes the break-up of our NHS still further. National Institute for Health and Clinical Excellence decisions on what drugs or treatments patients should have on the NHS become optional for commissioning consortia, and for the first time since 1948 the Secretary of State will not be responsible for delivering a national health service or for defining its scope.”
“This is not just a problem with the timing or pace of change, however, and nor is it a problem of presentation. In fact, the closer people look at the plans, the more concerned they become, which is why there is growing criticism of the Tory plans for the NHS from doctors, nurses, patients’ groups, NHS experts, the Health Select Committee, peers in all parts of the House of Lords and now even the Lib Dem leader. The closer people look, the more fundamental and far-reaching they see these changes to be. Today, the Royal College of General Practitioners warned the Prime Minister that his health Bill undermines our comprehensive health care system and will cause “irreparable damage” to the core values of the NHS. So far Ministers have branded such criticisms as scaremongering, but people in the NHS are already starting to see this happen.”
“I was in Wigan this morning, where the chief executive of the hospital trust told me that the hospital must make £14 million in cost savings this year and similar amounts the following year. He described that as an almost impossible task. More importantly, however, it puts at risk the strategy for better services and better value for money, and the strategy for more integration of hospital and community services. He said of the Government’s plans that the sheer distraction of reorganisation and insistence on competition will scupper our chance of doing that. The pressures of this high-risk reorganisation are one the reasons that, just one year into this Government, patients are starting to see the NHS go backwards again under the Tories, with waiting times rising, operations delayed, services cut back and front-line jobs lost.”
“I am going to make progress now. The NHS chief executive described the NHS reorganisation as “enormous—beyond anything anybody from the public or private sector has witnessed”. He is right. At this time of tight finances, the Government are piling on extra pressure and putting the NHS at risk with this reorganisation. The Health Committee warned in January that the NHS efficiency challenge was “already a high-risk strategy and the White Paper increased the level of risk considerably”. Now nearly £2 billion that was promised for patient care is being held back to cover the cost of reorganisation, and hospitals are being forced to cut back on costs by one third over the next five years, as all are forced into foundation status by 2014.”
“That means that, in the long term, we will see clinical planning in the NHS being replaced by market competition, service integration being replaced by corporate cherry-picking, public accountability being replaced by commercial confidentiality and the public ethos at the very heart of our NHS being replaced by the profit motive. I agree with the Deputy Prime Minister that no Bill is better than a bad one, but I say to him that this is a bad Bill. That is why we have opposed it from the outset, and that is why we say that it must be shelved in its current form and that radical changes must be made. For us, for the NHS and for NHS patients, this is the test of the Prime Minister’s promise to protect the NHS. I commend the motion to the House. [ Interruption. ]”
“It is the 85 clauses that set up the NHS as a full-scale market, and it is part 3 of the Bill, which opens up all areas of the NHS to private health companies; removes requirements for proper openness, scrutiny and accountability to the public and to Parliament; allows NHS hospitals to go bust and face a commercial insolvency scheme; places the judgment of the new competition regulator—just like those for gas and electricity—at the heart of decisions about the future of the NHS; and, for the first time, makes the NHS subject to the full force of UK and European competition law.”
“When the hon. Gentleman reads his next edition of Pulse , he will see my correction of that report, and note that the first five paragraphs were all reported and contained no quotes from me. He ought to know that after a survey by the British Medical Association found that more than half of doctors believed that they would spend less time with their patients as a result of these changes, the chairman of the BMA council, Dr Hamish Meldrum, said: “This survey shows that the government can no longer claim widespread support among doctors as justification for these flawed policies.” It is not the five clauses that set up the GP consortia that cause the most concern.”
“After 20 minutes of the Health Secretary’s speech, the hon. Member for St Ives (Andrew George) finally brought him to his own plans and he was clearly very uncomfortable. What does he say when the Prime Minister wonders how he got the Government into such a mess over his plans? What does he think of the chair of Monitor’s observation that the approach being taken is a combination of “previously unannounced policies, a complete failure to build the necessary political and professional consensus and an apparent disdain for the detailed planning of implementation”? That was said by one of the Government’s allies.”
“How does the Health Secretary square the Prime Minister’s promise to pause in his changes to the NHS with the NHS chief executive saying a week later: “I want to stress very firmly that we need…to maintain momentum on the ground.” With the Government’s health Bill, are we not seeing both rushed pre-legislative implementation and confused post-legislative policy making? If the Prime Minister really gets cold feet about his NHS changes, let me ask the Health Secretary for a fourth time whether the Government will guarantee the extra time needed for this House to examine the changes fully?”
“The Health Secretary ducked for the fourth time this afternoon the question of whether he will do right by this House in allowing sufficient time for proper scrutiny of any changes to the Bill that come forward. While he is listening, will he consider the risks he is running with the NHS? The Prime Minister promised a real rise in NHS funding, yet this year more than nine out of 10 hospitals are faced with cutting costs by more than 4%; one in seven by more than 8%; while nearly £2 billion for patient care is being held back to cover the costs of the internal NHS reorganisation. Will he admit that this reorganisation is now piling extra pressure on NHS funding and services so that patients are seeing waiting times rise, operations cancelled and front-line staff jobs cut as the NHS starts to go backwards again under the Tories?”
“On a point of order, Mr Speaker. This afternoon in Health questions, the Health Secretary told the House that waiting times were stable in the NHS. In fact, for the first time in three years more than one in 10 in-patients are waiting more than 18 weeks for their hospital treatment; the proportion of people waiting more than four hours for emergency treatment is the highest for six years; and the number of people waiting for diagnostic tests for more than six weeks has doubled. Those are the Government’s figures, confirmed recently by the independent King’s Fund. Can the House, through you, Mr Speaker, ensure that the Health Secretary sets the record straight and, in future, gives a full and accurate account of the changes in waiting times that we have seen over the past year?”
“Will he delete the one third of the Bill that breaks up the NHS and makes it into a full-blown market ruled by the forces of market regulation and EU competition law? Will this be just a public relations exercise or will real changes be made in the NHS plans—or has the Prime Minister not yet told the Health Secretary? This is no way to run a Bill; this is no way to run a Government; this is no way to run the NHS.”