Friday Volume 588 21 November 2014 No. 65

HOUSE OF COMMONS OFFICIAL REPORT

PARLIAMENTARY DEBATES ()

Friday 21 November 2014

£5·00 © Parliamentary Copyright House of Commons 2014 This publication may be reproduced under the terms of the Open Parliament licence, which is published at www.parliament.uk/site-information/copyright/. 537 21 NOVEMBER 2014 538

Fovargue, Yvonne McKenzie, Mr Iain House of Commons Francis, Dr Hywel Mearns, Ian Gardiner, Barry Metcalfe, Stephen Gilmore, Sheila Miller, Andrew Friday 21 November 2014 Glindon, Mrs Mary Moon, Mrs Madeleine Goodman, Helen Mordaunt, Penny The House met at half-past Nine o’clock Goodwill, Mr Robert Morden, Jessica Gove, rh Michael Morris, Grahame M. Greatrex, Tom (Easington) PRAYERS Green, Kate Murray, Ian Griffith, Nia Osborne, Sandra Gwynne, Andrew Owen, Albert [MR SPEAKER in the Chair] Gyimah, Mr Sam Penning, rh Mike Hands, rh Greg Perkins, Toby Hanson, rh Mr David Poulter, Dr Daniel NEW MEMBER Heald, Sir Oliver Pugh, John The following Member took and subscribed the Oath Healey, rh John Reed, Mr Jamie required by law: Heath, Mr David Robertson, Angus Mark John Reckless, for Rochester and Strood. Hilling, Julie Robertson, John Hodgson, Mrs Sharon Rotheram, Steve (Eltham) (Lab): beg to move, That the Hollobone, Mr Philip Roy, Mr Frank Hosie, Stewart Rudd, Amber House sit in private. Howarth, rh Mr George Seabeck, Alison Question put forthwith (Standing Order No. 163). Huppert, Dr Julian Sheerman, Mr Barry Irranca-Davies, Huw Shuker, Gavin The House divided: Ayes 1, Noes 125. James, Mrs Siân C. Skinner, Mr Dennis Division No. 88] [9.35 am Jamieson, Cathy Slaughter, Mr Andy Johnson, Diana Spellar, rh Mr John AYES Jones, Andrew Stewart, Bob Nuttall, Mr David Tellers for the Ayes: Jones, Graham Swayne, rh Mr Desmond Jones, Mr Kevan Tami, Mark and Jones, Susan Elan Tredinnick, David Tom Blenkinsop Kane, Mike Twigg, Derek Keeley, Barbara Vaizey, Mr Edward NOES Kendall, Liz Vaz, Valerie Abrahams, Debbie Campbell, Mr Ronnie Khan, rh Sadiq Walley, Joan Alexander, Heidi Chope, Mr Christopher Lavery, Ian Weir, Mr Mike Anderson, Mr David Clark, Katy Lazarowicz, Mark Whiteford, Dr Eilidh Ashworth, Jonathan Clarke, rh Mr Tom Lefroy, Jeremy Williams, Roger Baldry, rh Sir Tony Clwyd, rh Ann Letwin, rh Mr Oliver Williamson, Gavin Baldwin, Harriett Cooper, Rosie Lewell-Buck, Mrs Emma Wilson, Phil Banks, Gordon Cunningham, Mr Jim Long, Naomi Winterton, rh Ms Rosie Mann, John Barron, rh Kevin Dobson, rh Frank Wright, David McCarthy, Kerry Begg, Dame Anne Dunne, Mr Philip Wright, Mr Iain Benn, rh Hilary Durkan, Mark McDonald, Andy Berger, Luciana Eagle, Maria McDonnell, John Tellers for the Noes: Bottomley, Sir Peter Edwards, Jonathan McInnes, Liz Mr David Evennett and Bray, Angie Eustice, George McKechin, Ann Anne Milton Brennan, Kevin Field, Mark Brown, Mr Russell Fitzpatrick, Jim Question accordingly negatived. Burnham, rh Andy Flello, Robert Campbell, rh Mr Alan Flint, rh Caroline 539 21 NOVEMBER 2014 (Amended 540 Duties and Powers) Bill National Health Service (Amended Duties of State about the cost of those lawyers and accountants and Powers) Bill to oversee the tendering process, what was the response? It was, “We do not collect those figures centrally.” I Second Reading wonder why that is.

9.50 am Dr Julian Huppert (Cambridge) (LD) rose— Clive Efford (Eltham) (Lab): I beg to move, That the Bill be now read a Second time. Clive Efford: Ah! The hon. Gentleman is presumably getting to his feet to apologise for supporting the 2012 Today we begin to restore the sovereignty of this Act. House over our national health service. We begin to put patients at the heart of decision making. We will restore Dr Huppert: I have no need to apologise, because I the responsibility of the Secretary of State to promote a voted against it. I was actually about to give the hon. comprehensive national health service. We will tear the Gentleman credit for introducing this Bill, which I look heart out of the hated Health and Social Care Act 2012. forward to supporting, and for his role in opposing We will remove the health service commissioners’obligation some of the things that the Labour Government did. to put services out to tender. We will replace the 49% Does he welcome the fact that the £800 million tender private patient cap, and allow the Secretary of State to for older people’s services in Cambridgeshire stayed set limits. We will prevent competition authorities from within the NHS? Does he also accept the concerns that interfering in mergers that are in the interests of NHS many of us had about the contract at Hinchingbrooke patients. We will stop the sale of assets that are in the that was put out to private tender by the last Labour long-term interests of patients and our national health Government? I am sure he would agree that that was a service. We will restore the powers of the Secretary of problem. State to direct health commissioners. We will create a framework for national health service contracts that Clive Efford: It is just not realistic to compare what will put the interests of patients before competition. We went on under the previous Labour Government with will protect the NHS from the imposition of competition what is going on now. Yes, the contract in Cambridgeshire, rules by the transatlantic trade and investment partnership, at Peterborough, was won by an NHS bidder, but what and give sovereignty to this House. was the cost? How much money was diverted from Through this House, the Secretary of State will be patient care into running that tendering process? That is accountable for promoting a comprehensive national an increasing cost to the NHS that we cannot allow to health service. If any Government dare to impose continue. By the way, I unreservedly withdraw my accusation competition on our national health service in the future, that the hon. Gentleman voted in favour of the 2012 they will have to come before the House and repeal this Act, because that is a calumny I would not use against Bill, if it becomes an Act. We, as Members of the my worst enemy. House, will be accountable to our constituents for how Through the House, the Secretary of State would be we vote in that debate. There will be no hiding place. accountable— Some have expressed the fear that the Bill opens the door to further privatisation. It does not. I accept that Philip Davies (Shipley) (Con): Will the hon. Gentleman the last Labour Government unlocked the door to give way? competition, albeit in a modest and measured way. I voted against the creation of hospital foundation trusts, Clive Efford: Yes, I will, because I have lost my place. which introduced legally binding contracts with NHS commissioners; in retrospect it was a mistake, because it Philip Davies: I am delighted to help the hon. Gentleman brought procurement law into parts of the NHS. out. Helpful as ever! He talks about stopping what he calls privatisation and about putting the Secretary of Sir Oliver Heald (North East Hertfordshire) (Con): I State in charge. At the moment, there is a cap on the congratulate the hon. Gentleman on being so lucky in amount of private income that a hospital trust can gain, the draw. He has referred to competition. Does he not but does he agree that clause 7 of his Bill would remove accept that Labour did much more than he is suggesting? that cap, giving discretion to the Secretary of State? The then Secretary of State, who is now the shadow Does he acknowledge that the amount of private income Secretary of State, privatised an entire hospital in the a hospital could receive could actually go up under east of . That is privatisation. [Interruption.] his Bill?

Clive Efford: It is not possible to compare what went Clive Efford: There are a number of provisions relating on under the last Government with what has been to the Secretary of State which state that everything introduced by the raw market mechanisms of the 2012 Act. that is decided has to put patients first, rather than competition. That is the key difference in this Bill. The Robert Flello (Stoke-on-Trent South) (Lab): I, too, Secretary of State will have to be satisfied that every congratulate my hon. Friend. Is he aware that in north penny raised from private income serves the needs of Staffordshire, cancer and end-of-life care is going into patients. The Secretary of State will set the limit, which the private sector on a 10-year contract worth £1.2 billion? can be variable, but it will have to come down because this House will demand that. Clive Efford: There are numerous examples of contracts that are going out to tender, and the cost to the national Mr Jim Cunningham (Coventry South) (Lab): Is it health service of lawyers and accountants is increasing. not true that, under this Government’s reorganisation, The Government have made so much of the issue of between £3 billion and £5 billion has been wasted as a bureaucracy in the NHS, but when I asked the Secretary result of tendering exercises? 541 National Health Service (Amended 21 NOVEMBER 2014 National Health Service (Amended 542 Duties and Powers) Bill Duties and Powers) Bill Clive Efford: My hon. Friend is absolutely right. Grahame M. Morris (Easington) (Lab): I congratulate There are too many examples of money being wasted my hon. Friend on introducing this Bill. Does he agree on the tendering process. that the Liberal Democrats have got a brass neck in Those who suggest that what the Labour Government making criticisms, given that not only did they sit on did can be compared in any measure with what this their hands during that Bill Committee, but the right coalition has inflicted on our national health service are hon. Member for Sutton and Cheam (Paul Burstow) completely misguided. When the Labour Government was the prime advocate who led the Bill during its were elected in 1997, we spent 5.2% of our GDP on our passage through Parliament? health services. In 2010, we had increased that to 8.6%. We increased the number of doctors by 48,000. We Clive Efford: And then led a campaign to stop his increased the number of GPs by 5,000. We increased local accident and emergency department closing, having the number of training places for doctors, which had done that for the Government. been cut by the previous Tory Government. We increased the number of nurses by 70,000. We had the biggest (Chesterfield) (Lab): I, too, congratulate hospital building programme in the history of the national my hon. Friend on his Bill. He also carries the health service. We rebuilt or refurbished every accident congratulations of 1,924 people from across Chesterfield and emergency department in the country. When Labour who have signed a petition asking me to be here to left office, the NHS had the highest satisfaction ratings support his Bill. He is not just speaking with people from its patients that it had ever had in its history. The behind him here; people right across the country are NHS was in crisis in 1997, and Labour saved it. It is in saying, “Thank you very much for what you are doing.” crisis again now. Clive Efford: I am grateful for my hon. Friend’s kind John Pugh (Southport) (LD): Does the hon. Gentleman words and for the support of all the thousands of accept that Labour also guaranteed the private sector a people, particularly health service staff, who have supported fixed slice of NHS income in a way that the Bill does the Bill. not do? Philip Davies: Will the hon. Gentleman give way? Clive Efford: The hon. Gentleman was on the Bill Committee for the 2012 legislation, and I wonder how Clive Efford: I hope the hon. Gentleman does not many amendments he tabled to put those issues right. mind, but I am going to make some progress. And he has the cheek to come here and ask questions about my Bill, which seeks to put right what he did not Never before have we had market tendering of the attempt to put right when he was on that Committee. health service as we have today, and it is breaking down our NHS. The Bill is not a solution to all the mistakes John Robertson (Glasgow North West) (Lab): I that this Government have made in their top-down congratulate my hon. Friend on getting this Bill to its restructuring of the NHS, but it is an important block Second Reading debate. The Government have been on enforced privatisation. The argument can be simplified throwing all these facts and figures at us about how the into two distinct sides. If people believe the NHS should number of doctors is increasing all the time, but these be a pure market, open to competition regulations, things started under Labour, It takes seven years for a where the interests of competition are put before those doctor to be a decent practitioner, and we are the ones of patients, they belong on the side of the Government. who made a start on this, not the Government. If people believe the NHS is a public service that should be free of competition rules, where the interests of Clive Efford: My hon. Friend is absolutely right: the patients are put first, they should vote for the Bill today. claim that this Government, whose top-down reorganisation We know that No. 10 did not understand what was has caused so much chaos in the national health service, going on in 2012. The Chancellor was asleep at the are responsible for the standards of the NHS now is wheel, and the Liberal Democrats, suffering from some laughable. They claim to have turned the NHS around form of terminal Stockholm syndrome, were led by the in a short space of time, but they are standing on the nose to turn the NHS from a public service into a free shoulders of the achievement of the previous Labour market. My Bill takes a scalpel to cut the heart out of Government. the hated 2012 Act and put right the worst of the Government’s mistakes. It will remove the sections that Mr Dennis Skinner (Bolsover) (Lab): My hon. Friend require the tendering of NHS services for competition is absolutely correct, and another way of putting it is as with the private sector, the result of which has been follows: we dragged the national health service, between millions of pounds being diverted from patient care 1997 and 2010, from the depths of degradation that the into the pockets of lawyers and accountants through Tories left it in and hoisted it back to the pinnacles of the tendering process. NHS bodies are spending millions achievement. I have got a united nations heart bypass to either bidding or managing bidding processes, and that prove it—it was done by a Syrian cardiologist, a Malaysian is all money being diverted from patient care. That must surgeon, a Dutch doctor and a Nigerian registrar, and stop, and this Bill will end it. these two people on the Bench behind me talk about sending them back. If you did that in the hospitals in Nic Dakin () (Lab): I congratulate my London, half of Londoners would be dead in six months. hon. Friend on securing the Bill’s progress today. Does Those are the facts about the he agree with my constituent Julian Corlett, who expresses Independence party. real concern that further privatisation would mean the NHS may be reduced simply to a brand and nothing Clive Efford: My hon. Friend is absolutely right. more? 543 National Health Service (Amended 21 NOVEMBER 2014 National Health Service (Amended 544 Duties and Powers) Bill Duties and Powers) Bill Clive Efford: Absolutely. It is the capacity of the comprehensive national health service. It gives powers NHS to continue to provide services in the future that is of direction to the Secretary of State over NHS England under threat. Eventually and inevitably, with continuing and local commissioners. It also requires the Secretary privatisation of all its services, the NHS will end up as of State to put the needs of patients above those of the just a patchwork of contracted-out services, and that providers, or the market within which providers operate. will put us at the mercy of the private sector. It also provides that all contracts will be deemed to be “NHS contracts”. The significance of that is that they Philip Davies: The hon. Gentleman talks about money will not be subject to competition rules. All complaints being diverted away from patient care and about extended will be dealt with within the framework of the NHS, privatisation, but will he comment on the private finance with the Secretary of State having the final say—not initiatives that the previous Labour Government imposed lawyers or the courts. right across the NHS, bankrupting many of its institutions and taking money away from patient care? Joan Walley (Stoke-on-Trent North) (Lab): I am grateful to my hon. Friend for giving way and for Clive Efford: There are issues about PFI, which securing this private Member’s Bill. One urgent issue we need to sort out. I must say, though, that the that we must address is that of the purchaser/provider hon. Gentleman has picked on the wrong Member of split. Will he assure us that the proposals in this part of Parliament. I have one of the very first PFIs in my local the Bill will mean that health services can be run purely hospital. When was it advertised in the European Journal? on health grounds? In March 1995. It was a Tory PFI and it is one of the most expensive in the national health service; it is Clive Efford: The Bill does not attempt to rid the costing millions of pounds for my local hospital. Both NHS of the purchaser/provider split. That would require Governments have something to answer for when it a new top-down reorganisation of the national health comes to PFI. There are issues that need to be put right, service, which people in the NHS say they do not want. but people must understand that that will not happen What I can say is that this Bill will create a framework in under a Tory Government. which NHS contracts are not open to competition rules. As long as the commissioners of services stay within the Mr David Anderson (Blaydon) (Lab): My hon. Friend confines of the NHS contracts, they will not be open to is making a good case. Is it not the truth that the one competition. They will be compelled to do that by sheer constant over the past quarter of a decade is that both cost, because if they step outside of NHS contracts Governments—they are equally matched in this—did they are then into European competition rules and will not listen to the people who really knew about the have to spend millions on lawyers and accountants to NHS? I am talking about the people who work in the oversee the tendering process. service. To be honest, our Government, to their shame, ignored the working people and those in the NHS who Several hon. Members rose— said do not go into PFI or foundation hospitals. Exactly the same thing happened in 2012 when the Tory party Clive Efford: I shall make some progress before giving ignored the same voices of the people who were saying, way again. “Don’t go ahead with this Act.” We should start listening to the people who know what they are doing—the Part 2 deals with the private patient income. It empowers people we rely on to deliver NHS services. the Secretary of State to set the cap and reduce it from 49%. It also ensures that any income derived from Clive Efford: All Governments have lessons to learn. private care is in the interests of NHS patients. This party is not saying that it has nothing to learn, but Part 3 gets to the core of the issue. It repeals the it wants to end the privatisation of the national health sections of the 2012 Act that require health service service. We must understand one thing: next May is commissioners to put services out to tender, particularly when we have to fight to save our national health the hated section 75. Clause 9 provides that no legally service. If we continue under this Act to keep privatising enforceable procurement obligations shall be imposed our services, we will not have a national health service on NHS commissioners in relation to any arrangement as we understand it. that is proposed to take effect or takes effect by way of an NHS contract. It further provides that commissioners Steve Rotheram (Liverpool, Walton) (Lab): Like me, who place NHS contracts shall not be within the scope is my hon. Friend amazed by the faux indignation of of the Public Contracts Regulations 2006. some of the Government Members? Those Members will be the ones who will benefit from the donations of That provision ensures that article 168(7) of the some of the private sector companies that are winning treaty on the functioning of the European Union is the contracts in our NHS service. given proper effect in UK domestic law. The article states: Clive Efford: We have seen the names—64 of them. “Union action shall respect the responsibility of the Member We will see how they vote today, and then let the public States for the definition of their health policy and for the organisation know what they are doing with our national health and delivery of health services and medical care. The responsibilities service. of the Member States shall include the management of health services and medical care and the allocation of resources assigned Several hon. Members rose— to them.” This provision prevents the market from interfering in Clive Efford: I should like to make some progress. mergers of services and makes it clear that the disposal The Bill is in four parts. Part 1 deals with the powers of assets will require the permission of the Secretary of and duties of the Secretary of State. It reinstates the State. The Secretary of State will exercise his duties in legal duty of the Secretary of State to promote a the interests of patients. 545 National Health Service (Amended 21 NOVEMBER 2014 National Health Service (Amended 546 Duties and Powers) Bill Duties and Powers) Bill Ian Murray (Edinburgh South) (Lab): My hon. Friend Clive Efford: Absolutely essential. The question for is making one of the best speeches we have heard in this the House is whether that policy issue should be decided Parliament about protecting our national health service. by Parliament or the courts. Clause 14 is either unnecessary Does he agree that another way we could prevent private or essential, depending which set of lawyers ends up providers from competing in the national health service being proved correct. We say it should be a decision for would be by persuading this Tory Government to exclude Parliament, not the courts. Clause 14 puts the matter the national health service and other public services beyond doubt. from the transatlantic trade and investment partnership The public must decide whom they trust with the negotiations? NHS. Do they believe the Tories who say they will protect it? After all, the Tories said there would be no Clive Efford: My hon. Friend has guessed the next top-down reorganisation, they said there would be no part of my speech. Part 4 of the Bill deals with TTIP. I closure of A and E departments, they said there would have heard some criticisms that the Bill does not protect be no closure of maternity units except where local the NHS from TTIP. Clause 14 reads: people agreed. “No ratification… of the proposed Transatlantic Trade and Investment Partnership Treaty shall cause any legally enforceable Mr (Hammersmith) (Lab): I am grateful procurement or competition obligations to be imposed on any to my hon. Friend for allowing me to intervene, in NHS body entering into any arrangement for the provision of health services in any part of the health service.” addition to my main function today, which is to provide a cordon sanitaire. [Laughter.] I am very pleased that There are differing legal views on whether the proposed my name appears on the Bill as one of its supporters TTIP will or will not impose legally enforceable procurement because nowhere is it more apparent than in west London or competition obligations on the NHS. However, without what the Tories mean for the NHS. Two A and E this clause the question of which set of highly paid departments closed, and within weeks up to a third of lawyers is right will be decided only after the treaty is patients were not seen within four hours at A and E. signed and will be a decision for the courts, not the Does my hon. Friend agree that unless we get rid of all elected Government. I am sure that is music to the ears this Tory legislation, the NHS will not survive? of Government Members. Clive Efford: My hon. Friend is right. Before the Cathy Jamieson (Kilmarnock and Loudoun) (Lab/Co- election the Tories said that they would seek the agreement op): My hon. Friend is making a tremendous speech. of local people in decision making, but in south-east Will he confirm that clause 14 is absolutely crucial London in 2007 my local health managers published a across the United Kingdom, including Scotland, given document called “A Picture of Health”. It was drawn the potential impact of TTIP? up by doctors, nurses and midwives. They held a conference and reviewed all our services. They came to politicians Clive Efford: My hon. Friend is absolutely right; like me and said, “We want you to behave sensibly. This TTIP is a UK treaty, negotiated by the UK Government, is about improving the quality of care for patients, but and it will affect England, Scotland, Wales and Northern at A and E it is also about saving lives.” Just before a Ireland. general election, it is quite a thing for people to say, “We’re going to close one of your A and Es.” I differed Sheila Gilmore (Edinburgh East) (Lab): My hon. with the health managers over which A and E should Friend may be aware that in response to a question I close, but when clinicians come and say, “We can save asked him this Monday, the Prime Minister indicated lives and improve quality of care,” we have to listen. that he thought the health service would not be affected. That is what the Government said they would He seemed to be suggesting that he did not want it to be do. What happened? The then shadow Secretary of affected. If that is the case, surely his Government State for Health, the right hon. Member for South should be supporting this provision to ensure that does Cambridgeshire (Mr Lansley), came to the A and E not happen. proposed for closure in “A Picture of Health”, marched around the area and told local people, “We’re not going Clive Efford: My hon. Friend is absolutely right. We to close your A and E.” What happened then? The know that the Prime Minister has accepted it was a Tories got into Government and closed the A and E. In mistake, so the Government’s position on the Bill is a London they put nine out of 31 A and E departments bit curious. under threat, then they attempted to force the closure of Lewisham A and E. When they were beaten off by local Albert Owen (Ynys Môn) (Lab): Will my hon. Friend people, they took powers to themselves to close it over give way? the heads of local people. Now, my constituents who get in an ambulance are Clive Efford: I will, but then I will have to make some handed a leaflet that says, “If you come from SE9 or progress. SE3, you can’t go to the local A and E at the Queen Elizabeth.” Where do they have to go? You guessed it: Albert Owen: I congratulate my hon. Friend on securing Lewisham. But Lewisham A and E would not have been this Second Reading debate. He made an important there if the Government had had their way. On top of point about the provisions applying across the United that, the Care Quality Commission has condemned Kingdom: Wales, where the policies are different from A and Es in our area because of lack of resources and those operating across England, would still come under lack of capacity. At the same time the CQC commended the TTIP agreement, so it is important that this clause is the staff for their dedication in keeping the service included. running, yet the Government would have closed Lewisham 547 National Health Service (Amended 21 NOVEMBER 2014 National Health Service (Amended 548 Duties and Powers) Bill Duties and Powers) Bill [Clive Efford] I can just imagine the hon. Gentleman making that speech on a wet Thursday evening during the general A and E. So, what of their pre-election commitment not election campaign in the trades hall somewhere on to do anything over the heads of local people or local Eltham high street. health managers? Do we believe the Tories when they say the NHS is Sir Oliver Heald: Does my right hon. Friend agree safe in their hands? [HON.MEMBERS: “No.”] To defend that it is good to hear an authentic south London voice the NHS, one has to believe in the founding values that speaking up for Labour values rather than the snooty led to its creation. Our NHS treats everyone equally—from lot from north London who manage the party now? each according to their means, to each according to their needs. Are these the values of the party that gave Sir Tony Baldry: Yes, but the first point I want to us the poll tax or the bedroom tax, or the party that make is this. We need to be careful about what we say plunges thousands of disabled people into poverty by about the NHS in the run-up to general elections. The denying them benefits and forcing them through an first general election campaign that I was seriously unending cycle of appeals to get what they are entitled involved in was back in 1966. In every one since then, to? there has been a period when the Labour party has run around saying things along the lines of “24 hours to Throughout history working class people have had to save the NHS.”That is very destabilising, as was evidenced fight to assert the undeniable truth that all men and today in a letter to a national newspaper by Dr Michael women are created equal. From the very first poll tax Dixon, the chairman of the NHS Alliance, and a number rebellions, John Ball asked: of other GPs, in which they say: “When Adam delved and Eve span, who was then the gentleman?” “As NHS doctors, we are deeply concerned about the misguided He educated common people that they were all created and potentially disruptive National Health Service Bill being equal. It is a theme that working class people have been debated today. forced to return to throughout the centuries, whether The Bill’s proponents claim it will remove competition from through Christianity or a political fight for social justice the NHS and guard against ‘privatisation’ by repealing key clauses from the Levellers to the Diggers, from Thomas Paine of the 2012 Health and Social Care Act. and the Chartists to the movement today. We believe this would be a backwards step for patient care, These are the people who fought for the values that reorganising the NHS in a top-down way at a time when it needs created the national health service. There is nothing in to be looking ahead to the huge challenges of the future. These our society today that embodies those values more than were set out in the NHS England Five Year Forward View, and we urge all politicians to support it rather than using the NHS as a our national health service. It is these values that cannot political football. be defended by a party that talks about fairness while it Suggesting that GP commissioners have a ‘privatisation agenda’ justifies the bedroom tax and measures people’s worth. is an ill-informed attack on the clinical leadership which improves That is not what our NHS does. services and helps patients.” This Bill will not solve all the problems in our national I agree. It is disappointing if politicians use the NHS as health service—it will take a Labour Government to a political football. rescue it from a crisis—but it is an essential step in The NHS is an enduring part of the post-war consensus rebuilding our national health service. on the welfare state. That consensus was agreed on by Mr Speaker, I do not beg to move that this Bill be everyone who had gone through the deprivations of the read; I demand it be read, on behalf of NHS patients, second world war, had lived through the blitz, and were on behalf of the staff—the nurses, the doctors, the determined that there would be a better Britain. The support staff, the carers, the volunteers. On behalf of NHS was supported by everyone, including Archbishop everyone who holds our national health service dear, Temple, a brilliant Archbishop of Canterbury, who was I move that this Bill be read a Second time. the person who first coined the phrase “the welfare state”. 10.20 am I have always been interested in the NHS, not least Sir Tony Baldry (Banbury) (Con): I congratulate the because both my parents became part of the NHS on its hon. Member for Eltham (Clive Efford) on introducing very first day. When it came into being in 1948, my his Bill and on the robust candour with which he did so. father was a recently qualified registrar and my mother I am only sorry that he was displaced from his usual was a theatre sister, having served as a theatre nurse perch in the House. However, I am confident that when, during the Coventry blitz. My parents spent the whole after the next general election, the Labour party finds of their working lives in the NHS: my father went on to itself again in opposition on those Benches, Labour become the research secretary of the British Tuberculosis Members will not have to share them with the UK Association and a chest and heart specialist, and my Independence party because we will have won those mother went on to become a sister tutor. seats back. The other reason I have always been extremely interested I can understand why, when there was a coalition in the success of the NHS is that, in the nearly third of a Government at the start of this Parliament, the Liberal century I have been fortunate to be the Member of party wanted, as a condition of the entering into the Parliament for north Oxfordshire, the most important coalition Government, a five-year fixed-term Parliament. issue in my constituency has probably been the position However, one of the difficulties and drawbacks of five-year of Horton general hospital and the retention of its fixed-term Parliaments is that we have some of the services. longest general election campaigns ever, and that makes I have left instructions in my will that my body should it quite difficult to differentiate substantive and serious go to the anatomy department of the university of political points and what is essentially electioneering. Oxford, partly because there is quite a lot of it for them 549 National Health Service (Amended 21 NOVEMBER 2014 National Health Service (Amended 550 Duties and Powers) Bill Duties and Powers) Bill to work on, but also because I feel that the liver of many challenges—we are all conscious that with an anybody who has been an MP for nearly a third of a ageing demography and advances in medical technology, century must be worthy of some anatomical research. I every health care system faces challenges—but we should am also determined that when they open me up, they take pride in being the best. will discover engraved on my heart, “Keep the Horton We also need to be honest about what has gone general.” before. There was an enormous amount of rewriting of What we heard from the hon. Member for Eltham history and revisionism in the speech of the hon. Member was a litany of gloom in the NHS, but Horton general for Eltham. For those of us who have been in the House hospital now has more consultants than at any time in for some time, it may be worth looking back and its and the NHS’s history.The Oxford University Hospitals reminding ourselves about what happened in the not- NHS Trust employs 11,598 staff, including 1,800 doctors too-distant past. and 3,600 nurses. It is important to make clear that, In the introduction to the NHS plan of July 2000, the since 2010, the number of patients seen by the trust, then Secretary of State for Health, , wrote: including at Horton, has increased significantly. There “This NHS Plan sets out the steps we now need to take to has been a 19% increase in elected in-patient admissions, transform the health service so that it is redesigned around the a 9% increase in emergency in-patient admissions, a needs of patients. It means tackling the toughest issues that have 24% increase in day-care admissions and a 12% increase been ducked for too long.” in out-patient attendances. Those are significant increases I do not think anyone would ever disagree with that as a in just over four years, so the NHS continues to treat statement of intent. He went on: more out-patients and in-patients. “For the first time the NHS and the private sector will work Over the past two years, the Oxford University Hospitals more closely together not just to build new hospitals but to NHS Trust has managed completely to eliminate its provide NHS patients with the operations they need.” financial deficit and increase the amount paid to the Bob Stewart (Beckenham) (Con): I am big fan of the Oxfordshire clinical commissioning group, such that NHS. It is my NHS too. I was badly hurt in the Army in the group finished the year with a surplus. Most importantly, 1997, and the NHS sent me to get fixed as a private over the past couple of years the trust has managed to patient, because the NHS could not do it. I am very create 400 new jobs, almost all of them new doctors and grateful to the NHS. That was under a Labour Government, new nursing posts. Sir Jonathan Michael and his team and I hope such a scheme continues. deserve considerable congratulations on managing to balance the finances of the trust and securing a large Sir Tony Baldry: My hon. Friend makes his own number of new medical and nursing posts. point very well in his own way. It is important for all of us to remember that the NHS is our NHS and our Clive Efford: Does the right hon. Gentleman think constituents’ NHS. It does not belong to any particular that all those things would have been achievable had the political party; it is a national heath service. level of funding for the NHS continued at the rate we Alan Milburn concluded that the “major reforms”, inherited in 1997 and had Labour not almost tripled the which included working more closely with the private amount of GDP put into our health services? sector, would “deliver real benefits for NHS patients”. Sir Tony Baldry: Every Government have invested Chapter 11 of the NHS plan of July 2000, on “Changes money in the NHS, and quite rightly so. This Government in the relationship between the NHS and the private have invested real-terms increases in the NHS, as evidenced sector”, said: by the Commonwealth Fund, which compares health systems internationally. It found this year that, although “The NHS is a huge organisation. Using extra capacity and extra investment from voluntary and private sector providers can the United States health care system is the most expensive benefit NHS patients… The time has now come for the NHS to in the world, it underperforms relative to other countries engage more constructively with the private sector”. on most dimensions of performance. The fund studied Under the heading, “The basis for a new relationship”, 11 nations: Australia, Canada, France, Germany, the it went on: Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom and the United States. The United “Ideological boundaries or institutional barriers should not stand in the way of better care for NHS patients…By constructing States ranks last, but who ranks first as the best health the right partnerships the NHS can harness the capacity of care system in the world? The United Kingdom. We private and voluntary providers to treat more NHS patients…Under should all, wherever we sit in this House, be proud that our proposals a patient would remain an NHS patient even if we have the best health care system in the world. they were being treated in the private sector. NHS care will remain free at the point of delivery, whether care is provided by Mr (Christchurch) (Con): The an NHS hospital, a local GP, a private sector hospital or by a picture is not quite as rosy as my right hon. Friend voluntary organisation.” paints it, is it? Even newspaper reported John Pugh: The right hon. Gentleman is outlining a that the Commonwealth Fund survey showed that the thread of continuity very well. Is it not strange that the “only serious black mark against the NHS was its poor record on principal adviser to Alan Milburn has now been appointed keeping people alive.” by this Government as the head of NHS England? Does that not show that there has been continuity from Sir Tony Baldry: I am not entirely sure what point my one Government to another with the same policies? hon. Friend is trying to make. The fact is that the Commonwealth Fund found that the NHS is the best Sir Tony Baldry: I would hope, with an organisation health care system in the world. I hope that he and like the NHS, that it would not become a political everyone in the House takes pride in that. The NHS has football—that there would be considerable continuity. 551 National Health Service (Amended 21 NOVEMBER 2014 National Health Service (Amended 552 Duties and Powers) Bill Duties and Powers) Bill [Sir Tony Baldry] the last Labour Government— “has entered into this concordat with Healthcare The fact that the person now in post worked with a Association to set out the parameters for a partnership between Labour Government on NHS proposals when they the NHS and private and voluntary health care providers. It were in government is a strong point rather than a weak describes a partnership approach that enables NHS patients in one. England to be treated free in the private and voluntary health care sector. Mr Brian H. Donohoe (Central Ayrshire) (Lab): I am The key tests for any relationship between the NHS and wondering whether the right hon. Gentleman supports private and voluntary health care providers is that it must represent or opposes the Bill, because he has been speaking for good value for money for the tax payer and assure high standards some time and has not made that clear. of care for the patient. The involvement of private and voluntary health care providers in the planning of local health care services Sir Tony Baldry: The point I am making, which I at an early stage will enable the NHS to use a wider range of shall develop, is that the Bill is completely unnecessary. health facilities within their locality.To achieve this Health Authorities I also want to make the point that all Opposition in their strategic leadership role will be expected to ensure that local private and voluntary health care providers are involved in Members seem to wish to deny that there has been any the processes designed to develop the local Health Improvement involvement of the NHS with the private sector. It is Programme as appropriate.” important to remind the House of the fact that it was the Labour party, and a Labour Government, who And it carries on. The document is headed, by the last introduced the private sector into the NHS, and the Labour Government, “Socialist Health Association…A 2012 legislation in no way significantly changed that Concordat with the Private and Voluntary Health relationship. Care…Sector”. Indeed, the last Labour Secretary of State for Health signed a concordat with the Independent Philip Davies: Does my right hon. Friend agree that Healthcare Association on 31 October 2000. those people who support the Bill would be supporting The decision to make greater use of private sector the removal of the cap on the amount of private income facilities for NHS patients did not require new legislation that hospitals can receive? Does he think that, when and it was possible to undertake it within the existing 38 Degrees was encouraging people to write in about legislation on the NHS, but for the avoidance of doubt the Bill, it made that clear to the people who signed its let me quote the Labour party manifesto from 2001. In petition? the chapter on NHS reform, Labour promised to Sir Tony Baldry: My hon. Friend makes a good “work with the private sector to use spare capacity, where it point. I think the Labour party will regret signing up to makes sense, for NHS patients” every 38 Degrees campaign, because if 38 Degrees and to starts drafting the Labour party manifesto rather than “create a new type of hospital—specially built surgical units, the Labour party, the Labour party will never sort out managed by the NHS or the private sector—to guarantee shorter whether it is , old Labour or any other sort waiting times”. of Labour, which is why it did so incredibly badly In my constituency, we have an independent orthopaedic yesterday in the Rochester by-election. treatment centre run by the private sector and introduced (Leigh) (Lab): The right hon. Gentleman under the Labour Government. We have a Darzi walk-in has just made a comment that cannot go unchallenged. centre run by private GPs, which was also introduced He claims that the relationship that this Government during the time of the Labour Government. have with the private sector is the same as that of the previous Government. That is absolute rubbish. When Mr Anderson: I thank the right hon. Gentleman for his Government’s legislation went through, he said that giving way in his long diatribe. He quotes the 2001 doctors would decide. Doctors throughout the country Labour manifesto, but it also said that any relationship are now saying that they are mandated to put services with the private sector would not be at the expense of out to the open market under section 75 of the Health the terms and conditions of the staff working in the and Social Care Act 2012—his Government’s legislation. private sector who were transferred out. Today, Care UK That was not the case under the previous Government. people who work in are facing a 40% cut in If this Government are just doing the same as the their take-home pay. Does he not see that that is one previous Government, why did they need a 300-page of the consequences of the Health and Social Care Bill to rewrite the legal basis of the national health Act 2012? service? Sir Tony Baldry: May I remind the right hon. Gentleman Sir Tony Baldry: With respect, I think the hon. Gentleman of a document published on 31 October 2000, under the is seeking to avoid the point, which is that the 2012 Act last Labour Government? The printout that I have is did not fundamentally change the situation in the NHS entitled, “A Concordat with the Private and Voluntary between the public and private sectors. I draw the Health Care Provider Sector”. It is headed, “Socialist House’s attention to a debate that took place in Westminster Health Association—Promoting health and well-being Hall in 2002 on the subject of the private sector in the through the application of socialist principles”. It was a NHS that was initiated by the then Chair of the Select concordat introduced by the previous Government with Committee on Health, the then Member for , the private and voluntary health care sector. It says: David Hinchliffe. The Minister, John Hutton, made a “Introduction. There should be no organisational or ideological speech in response that could easily have been made in barriers to the delivery of high quality healthcare free at the point identical terms by the Under-Secretary of State for of delivery to those who need it, when they need it. The Health, my hon. Friend the Member for Central Suffolk Government”— and North Ipswich (Dr Poulter). John Hutton said: 553 National Health Service (Amended 21 NOVEMBER 2014 National Health Service (Amended 554 Duties and Powers) Bill Duties and Powers) Bill “I do not want to repeat arguments that have already been history of the NHS, the Act gave a role to the competition made about the future of our relationship with the private sector, authorities, under the Enterprise Act 2002, in taking but I shall deal with some more specific points. My hon. Friend precisely the kind of action that my hon. Friend referred the Member for Wakefield was concerned about whether reference to. I am very surprised the right hon. Gentleman does costs provide a sufficient measure of value for money in the NHS. We accept that they do not, and we have tried to set out in our not know that; may I suggest that he does not know report several ways in which we can strengthen reference cost what he is talking about? data.” He went on to say: Sir Tony Baldry: We heard that argument during the “My hon. Friend also referred to the evidence that my right passage of the Act, and it is simply wrong. It is wrong to hon. Friend the Secretary of State gave to the Committee. He set suggest that somehow the Act opened the door to out four essential tests that we apply to each prospective partnership competition. in the NHS and private sector. Is it in the interests of patients? Is it consistent with the local and national strategies of the NHS? Is it value for money? Is it consistent with public sector values, Sir Oliver Heald: I wonder if my right hon. Friend including that treatment is determined by clinical need and staff shares my consternation at the shadow Secretary of are treated fairly? Those are the yardsticks by which we will judge State’s remarks, given that throughout the 2000s, all we and develop our relationship with the private sector. Provided that heard from Labour, John Hutton and the other Ministers those tests are satisfied, we should use the private and voluntary he has mentioned was the importance of value for sector where it has a track record of achievement or where it can money and tendering for things. They are going back to offer clear potential gains.”—[Official Report, 11 July 2002; Vol. 388, the days of the right hon. Member for Holborn and c. 354WH.] St Pancras () being in charge. I have absolutely no doubt that those are views that my hon. Friend the Minister would endorse today. It is an Sir Tony Baldry: My hon. and learned Friend makes entirely sensible approach to how the NHS and the a very good point. There is confusion about whether we private and independent sector should work. The National have got new Labour or old Labour. The Labour party Health Service Bill passed during the Session of 2005-06 has to set out how it would undo the market it created further enshrined the relationship between the national without further top-down reorganisation. It could not health service and the private sector in statute. do it simply by removing the health rules that manage The Bill promoted by the hon. Member for Eltham it. There has been no change on when to tender misses the point. The Health and Social Care Act did competitively; the rules on procurement are the same as not and does not introduce competition into the NHS, those used by the previous Government. The Act makes it does not change the rules on when to tender competitively it clear that the Secretary of State remains politically and there is no requirement to tender all services. What accountable to the NHS. The changes in the Bill would it does do is manage the competition that has been restrict the greater autonomy given to the NHS and introduced. inhibit staff from making the innovative changes needed to secure sustainable, high-quality care for patients. In Clive Efford: If the Act did not introduce competition particular, it would tie the hands of clinical leaders on to the NHS, will the right hon. Gentleman explain the CCGs, which the NHS England five-year forward view following? Bristol hospital wanted to restructure its says should have more powers, not fewer. head and neck cancer surgery service. Monitor considered the proposal and concluded that it was likely to improve Grahame M. Morris: The right hon. Gentleman is the quality of service to patients, butthat engaging in a lengthy filibuster, in my opinion. I served “the merger removes important competitive constraints for elective on the Committee for the 2012 Act, and a plethora of head and neck, ENT, OMF, urology and symptomatic breast care organisations pointed out during the passage of that services in the absence of other competitors”. Bill the folly of what the Government were doing. They In effect, it said that the restructuring could have improved introduced a lengthy Bill; we spent 40 sittings in Committee; the quality of care, but that because it would have they tabled more than 1,000 amendments to their own removed competition, it could not go ahead. Bill; it had 20 different sections; part 3 introduced Monitor. To suggest to the House that that Act introduced Sir Tony Baldry: The hon. Gentleman misunderstands no change to the system operated under Labour is—well, my point. The Act did not introduce competition into it is not disingenuous, but it is not correct. I am not sure the NHS because that competition had already been what term is best to use. introduced by the previous Labour Government, who introduced greater private sector involvement in the Sir Tony Baldry: During the passage of that Bill, the NHS. Labour made binding rules to manage the Labour party and certain organisations, including some competition, and the Act continued that approach with trade unions, sought to rewrite history. Interestingly, an expert health sector regulator working in the best when Labour introduced things such as the independent interests of patients. Removing Monitor as the health treatment centres, the Darzi centres and the 2002 concordat, sector regulator would merely leave commissioners facing the trade unions that rallied to support the hon. Gentleman actions through the courts under Labour’s own 2006 in Committee were totally silent. I do not think it lies in procurement regulations, which I do not think would be the mouth of those organisations, which did not complain in the best interests of patients. when the Labour party introduced a partnership and a concordat with the independent and voluntary sector Andy Burnham: I am afraid that the right hon. Gentleman when it was in government, now to complain, simply has undermined his entire speech with the ignorance he because it is the Conservative party in a coalition has displayed in response to my hon. Friend the Member Government, that we are somehow “privatising” the for Eltham (Clive Efford). For the first time in the NHS. It is simply not true. 555 National Health Service (Amended 21 NOVEMBER 2014 National Health Service (Amended 556 Duties and Powers) Bill Duties and Powers) Bill Mr Anderson: Will the right hon. Gentleman give So why no Tory apology to NHS staff, patients and way? the public? Why no Tory apology to NHS staff for forcing through the largest internal reorganisation in Sir Tony Baldry: I have given way to the hon. Gentleman 65 years of NHS history and for forcing them to cope once, and as the hon. Member for Easington (Grahame with increasing confusion, complex bureaucracy and M. Morris) accused me, ungallantly and unfairly, of wasted cost? Why no Tory apology to the public for an filibustering—even though everything I have said is NHS that they now see has longer waiting lists and relevant and to the point—I would like now to make a service cuts? Why no Tory apology to the public for little more progress and come to my final point, or breaking election promises and the terms of the coalition almost my final point. agreement to stop top-down reorganisations of the NHS, which have often got in the way of patient care? Madam Deputy Speaker (Mrs Eleanor Laing): Order. Finally, while we are at it, why no apology to this House It is not possible for the right hon. Gentleman to for the way we were misled about the reorganisation filibuster, because if he was not in order, I would not and the legislation in 2010 and 2011, which became the allow him to continue speaking. 457-page Health and Social Care Act 2012?

Sir Tony Baldry: I know that; you know that, Madam Mr (Bury North) (Con): I will tell the Deputy Speaker; I just wanted to make quite sure that right hon. Gentleman why there has been no apology: the hon. Gentlemen below the Gangway knew that I because there is nothing to apologise for. That is the was speaking relevantly. simple reason. We have a better health service now than I want to say something about the transatlantic trade we had before; that is why there has been no apology. and investment partnership. This is another of those things that people run around saying will be the end of : Patients say exactly the opposite of civilisation as we know it. The transatlantic trade and what the hon. Gentleman has just argued. However, I investment partnership will not change the fact that it is understand that he feels he has nothing to apologise for. up to the UK Government alone to decide how UK If he fundamentally believes that the NHS should be a public services, including the NHS, are run. Any assertion system based on full-blown competition, delivered by that TTIP will undermine the NHS is a complete red the private sector, then of course he would want to herring. The position has been confirmed by both the legislate in that way. European and the US negotiators, and indeed the chair of the all-party group on European Union-United States Philip Davies: While the right hon. Gentleman is trade and investment. Excluding health from the agreement going back to fighting some 1980s ideological warfare, I would prevent our pharmaceutical and medical devices think most constituents are bothered about what happens sectors from benefitting from TTIP. in practice. Is he really asking me to apologise to my As we approach the next general election, I hope the constituents for the fact that there are now 9% more Labour party will not treat the NHS as a political professionally qualified clinical staff at teaching football. I hope we will not see, as we have at every hospital and 42% fewer senior managers, or that there general election since I have been an adult, the Labour are 7% more professionally qualified clinical staff at party running around saying that it has 24 hours to save Airedale NHS Foundation Trust and 14% fewer managers, the NHS or that the Conservative party is seeking to or, I might add, for the brand spanking new, state-of-the-art privatise it, which is completely and utterly untrue. We A and E department at Airedale hospital? Does he all have a collective interest in ensuring that our NHS really think that is something to apologise for? continues to be the best health care service in the world. There are huge challenges ahead for health care in this John Healey: The hon. Gentleman normally finds a country, with an ageing population and ever-increasing common touch in the way he makes his points. I have to improvements in medical technology. We should be tell him that if he tries to trot out those sorts of figures facing up to those changes in an adult and responsible on the doorstep in the next five months, he will find that way. The Labour party should not be reneging on the they cut no ice with the public, because they know what clear commitments it made in both legislation and is happening to their NHS day to day, and we will make policy when it was in government. This Bill is totally sure they understand why it is happening. unnecessary and it should not pass. Sir Oliver Heald rose— 10.52 am John Healey (Wentworth and Dearne) (Lab): It is a John Healey: I will give way to the hon. and learned pleasure to follow the right hon. Member for Banbury Gentleman and then make some progress. (Sir Tony Baldry). He made an attempt to make a serious speech, but his 30 minutes were based on one Sir Oliver Heald: Why should I apologise for the argument that is fundamentally wrong, which is that £150 million of investment in Lister hospital in Stevenage this Government have made no changes to the basis of or the £98 million in Addenbrooke’s hospital in the NHS in this country. These 457 pages of his Cambridge—fantastic, world-beating facilities? Government’s legislation show that that is wrong. If he looks at sections 72, 73 and 80 of the Health and Social John Healey: We on the Labour Benches cannot wait Care Act 2012, he will see that the Competition Act for the debate on the NHS to be put right at the heart of 1998, the Enterprise Act 2002 and the Office of Fair the next five months of policy and political debate, and Trading are brought into play for the first time in my right hon. Friend the shadow Secretary of State will our NHS. make sure that happens. 557 National Health Service (Amended 21 NOVEMBER 2014 National Health Service (Amended 558 Duties and Powers) Bill Duties and Powers) Bill Let me return to my point about the way that we in has been paid out in redundancies, much of which was this House were misled about the reorganisation and to staff who were paid off and then re-hired by our the legislation. I am disappointed to see that the man NHS. who led it, the right hon. Member for South Cambridgeshire (Mr Lansley), is not in the Chamber today to explain (Walsall South) (Lab): Could my right himself. He argued—it was completely wrong, but he hon. Friend say what steps were taken to publish the argued it—in the debate on Second Reading in January risk assessment during the passage of the Health and 2011: Social Care Bill? “It is about gearing the entire system towards supporting the relationship between doctor and patient”.—[Official Report, John Healey: I did not want to open up all the old 31 January 2011; Vol. 522, c. 617.] arguments that we fought in 2010-2011, though it was Of course, it was not and it is not. As I argued, at the extraordinary to see the extreme lengths to which the time from the Opposition Front Bench: Government went—seen before only on matters of military “The reorganisation and legislation is designed to break up the information—to stop the disclosure of the risk register NHS, to open up all areas of the NHS to private health companies, about the potential impact and likely consequences to remove requirements for proper openness, scrutiny and of their policy. My hon. Friend was a great supporter of accountability to the public and to Parliament, and make the NHS subject to both UK and European competition law.”—[Official mine in trying to get the Freedom of Information Act Report, 16 March 2011; Vol. 525, c. 378.] to allow the public and this House to see the terms of what the Government knew could happen to the NHS if The Government were and are driving free market they passed the legislation. political ideology through the heart of our NHS. The arguments that those of us on the Opposition My second C is complexity. NHS services are now so Benches made then are those that we make now, and much harder to plan and so much harder to hold to that my right hon. Friend the Member for Leigh (Andy account because of the changes the Government have Burnham) makes especially strongly from our Front made. We saw new national quangos responsible for Bench. That is why the Bill that my hon. Friend the tens of billions of pounds of spending of public money Member for Eltham (Clive Efford) has introduced is so in each and every one of our local areas in England. essential and why I am so pleased and proud to be one The commissioning role, which was previously undertaken of his sponsors. by one body, the primary care trust, is now fragmented with at least five different bodies trying to do the same job. Grahame M. Morris: My right hon. Friend made some powerful points when the Health and Social Care On the third C, competition, the Secretary of State Act 2012 was going through Parliament, when Tory has his foot lightly on the accelerator of privatisation Members were denying the purpose of the legislation. for now, but let us make no mistake, if the Tories win He quoted the last Health Secretary, but the current the next election, he will press it hard down to the floor Health Secretary, the right hon. Member for South immediately afterwards. Even though they are soft-pedalling West Surrey (Mr Hunt), said in a book: on the privatisation that their Act put in place, we have “Our ambition should be to break down the barriers between seen in the 18 months since it came into force 131 contracts private and public health provision, in effect denationalising the won by companies such as Care UK, Virgin Care and provision of healthcare in Britain”. BUPA. According to the NHS Support Federation, that What could be a more succinct and clear expression of is already valued at £2.6 billion. At that win rate, the their intentions? contracts already currently advertised will mean another £6.6 billion in the private sector—getting on for 10% of our NHS run by private companies in private hands. John Healey: My hon. Friend has been a strong champion of the NHS and followed this issue from day one of this Parliament. To answer directly his question Andy McDonald (Middlesbrough) (Lab): Has it come of what could be more succinct and clear, I suspect that as any surprise and is it just a coincidence that the very when we hear from the new Member for UKIP, the hon. companies securing these major contracts are six-figure Member for Rochester and Strood (Mark Reckless) or donors to the Tory party? his colleague, the hon. Member for Clacton (Douglas Carswell)—given some of the things that they have John Healey: It comes as no surprise, and I am argued should be the basis of the NHS in future—they grateful to my hon. Friend for underlining that point. I will make the vision of the right hon. Member for was not planning to make that point, but I am glad that South West Surrey look positively UKIP-lite. it has been made so clearly. This Bill is essential because it starts to correct the three My argument is with the Prime Minister. So much for fundamental flaws, brought about by the reorganisation what he said, and so much for his word when he said legislation, that are now driving the NHS. We could call back in 2011 that them the three Cs—cost, complexity and competition. “we will not be selling off the NHS”. On cost, the scale of the reorganisation was simply Perhaps the most serious consequence of this fragmentation, huge. As the chief executive of the NHS said at the this privatisation and this contractualisation is the fact time, it was that the most important and fundamental value at the “beyond anything that anybody from the public or private sector heart of the NHS—an imperative at its heart—is the has witnessed”. ability properly to plan, co-ordinate and deliver services. The cost of the waste has been huge. We reckoned That is being made much harder, as the Health Select beforehand that it was about £2 billion; we now reckon Committee has said, and sometimes impossible by the £3 billion. What is clear is that getting on for £1 billion operation of the Health and Social Care Act and 559 National Health Service (Amended 21 NOVEMBER 2014 National Health Service (Amended 560 Duties and Powers) Bill Duties and Powers) Bill [John Healey] Jonathan Edwards: I am grateful to the right hon. Gentleman for making a very important point about competition law. If anybody doubts it, they should look TTIP. I know that the Scottish Government want the at the case of the two NHS trusts—the Royal Bournemouth Scottish health service excluded and I would hope that and the Poole NHS Trusts—whose merger made great the Welsh Government would have the same position. sense to patients, but was prevented by this Government’s Is there not an onus on the UK Government to make legislation. those representations on behalf of the devolved Let me say a few words about the transatlantic trade Governments? and investment partnership. I have chaired the all-party group that has followed these negotiations for the last John Healey: Indeed. There is an onus, a responsibility 18 months in order to try to encourage a better and and, I would argue, a duty on British Ministers to make more balanced public and parliamentary understanding those representations and to secure those protections in and debate, as well as to put the Government on the any deal for the whole of the UK. spot and hold them to account for what they are doing. Finally, the Prime Minister made his most personal We are trying to ensure that if we get a deal, it will bring pledges before the last election to protect the NHS and real benefits not just to British business, but to British to stop top-down reorganisations. He has broken those workers and British consumers. pledges to the British people, and the damage that he Two things have become clear. First, the NHS can be and his Tory Ministers have inflicted through this NHS fully protected in TTIP. I am convinced of this, not just reorganisation and legislation has been unwanted, wasteful because other EU trade agreements have protected public and wrong. It will fall to a Labour Government, after services, but because if the Government want them, May, to put right this damage and to rescue the NHS, as there are specific member state reservations to cover my hon. Friend the Member for Eltham said in his public services and because we have heard the confirmation, opening speech, just as we did in 1997. This Bill—it is directly from the chief negotiator whom I have met why I am pleased and proud to support it—is an essential twice about this, that even with ISDS—investor-state step towards doing that, but the election of a Labour dispute settlement—provisions, which I do not support, Government must follow if we are to do the job properly. nothing could prevent a future Labour Government from bringing parts of the NHS now in private hands 11.9 am back into public hands. John Pugh (Southport) (LD): It is a pleasure to The second thing that has become clear is that these follow the right hon. Member for Wentworth and Dearne commitments have been secured despite, not because of, (John Healey), and I agree with most of what he said, Government Ministers. It is clear that Ministers have but probably not the conclusion. done next to nothing to try to influence the negotiations It gives me pleasure that we are having this debate. I and secure the full exclusion and protection we require think we all accept that the Bill will not go right the way for our NHS and wider public services. Indeed, rather through Parliament and end up on the statute book by as the right hon. Member for Banbury (Sir Tony Baldry) 2015. We know what will happen: private Members’ observed, the Minister for Trade and Investment, Lord Bills are lining up behind one another, and most of Livingston, who is responsible in government for leading them will hit the buffers. However, the Bill moves the the British position, has said that he would welcome NHS debate up a notch. the inclusion of health services in any deal. When the It is fashionable at the moment to regard the Health Minister gets up to speak, perhaps he will—formally, in and Social Care Act 2012 as a disastrous mistake. In this House—make the Government’s position clear. fact, I believe that view is now shared in the Treasury. I What is clear is that if we are properly to protect our did not support the Act, and not for the usual reasons—that NHS in any future TTIP, we must have a strong British it was not in the manifesto or the coalition agreement voice in Brussels, which we do not have at the moment. and was sprung upon Parliament. Those were good reasons, but they were not my main reason, nor was it Sheila Gilmore: I gave the Prime Minister an opportunity because I am awkward or I thought it was a good career on Monday to say that he would take specific action to move. It was not because I did not see some of the ensure that the NHS would be protected if TTIP were upside, which I am sure the Minister will rehearse successfully negotiated. He did not do so, but does my later—the emphasis on public health, clinical involvement, right hon. Friend feel that this debate provides an health inequality and mental health, and a smidgen of opportunity for that to be done in his name? democratic accountability. John Healey: I would expect these trade negotiations My main reason for opposing the Lansley Bill was to stretch into at least the end of next year, so I hope that I saw it as the logical conclusion of a trend that and expect that the responsibility for making sure that began under Mrs Thatcher, was carried on by Blair and this deal is good for Britain will become that of a survives to this day. That trend, fundamentally, is an Labour, not a Tory, Government and of Labour Ministers, attempt to run the NHS as a market—not a real market, not Tory Ministers. of course, but an internal market; a funny sort of Alice in Wonderland market with none of the advantages of a Jonathan Edwards (Carmarthen East and Dinefwr) real market and most of the downside. It is one where (PC) rose— everything is free, but prices, wages and policies are set by the Government; where NHS bodies compete not John Healey: I will give way to the hon. Gentleman just against the private sector but against one another; before finishing on the issue of the Prime Minister, where, as others have said, integration and real efficiency which my hon. Friend the Member for Edinburgh East often go out of the window; where strategic leadership (Sheila Gilmore) has just raised. just does not seem to exist, as the right hon. Member for 561 National Health Service (Amended 21 NOVEMBER 2014 National Health Service (Amended 562 Duties and Powers) Bill Duties and Powers) Bill Wentworth and Dearne said; where we struggle to deliver party in desperate straits that knows exactly what it is not products, as in ordinary markets, but entitlements; doing in using the word “privatisation”? It knows that and where half the NHS, which we call commissioners, people out in the country associate it with having to buy is billing the other half, which we call producers—that private health care, but actually nobody is proposing to point has already been made—and bean-counters proliferate change the fundamental ethos of the NHS, which is that on either side and lock horns over bills. treatment is free at the point of need. The Labour party In my view, the Health and Social Care Act was not is conflating the two as a desperate political tactic. so much about privatisation, or private industry helping to deliver NHS services—that was already happening John Pugh: The hon. Gentleman is not altogether under Labour—but primarily about marketisation. Some wrong, but if we are to continue to deliver, in stressed of course, see that as a conspiracy—marketisation as circumstances, a service that is free at the point of need, the prelude to total privatisation—but I have to tell we cannot run the NHS as an internal market for ever. hon. Members that marketisation as a faith is still very In fact, the NHS is already trying to morph into something much around, including on the Front Benches of most different. We now have health and wellbeing boards, political parties, and is supported by practically every which mean that commissioners and providers get together health think-tank we talk to. to try to agree a local plan. They are struggling in every way to behave like a health board, but they do not have The market, external or internal, tweak it as we may, the executive powers to do so. There has been the move simply cannot deliver entitlements and the moral objectives away from tariffs, which have been used to try to adjust of the NHS in anything like an efficient manner. It the market, and we are now talking about whole-treatment cannot deliver to people the care that they need regardless costs. There is also talk about integration. of their means. Worse still, it solves none of the current problems of the NHS, which were largely parked in What is clearly entirely disruptive, though, is the 2010—the financial pressures on the acute sector, which intrusion of competition where it is not needed—where have come back to haunt us recently; the poor integration it is simply dogma; where it is seen as a panacea for of services, which we have still not got right; and the producing good results, whether or not there is a good separation of health and social care, which is unfinished case for saying that; where it derails sustainable services; business. or where it becomes a central operating principle of the NHS. None of those things is particularly helpful. If I have a proposal to put to the House, it is that I would like to see the commissioner-provider split ended. I do not want to comment on TTIP, because I do not That has been mentioned already.We moved an amendment think it is well understood at the moment, but we will at the Liberal Democrat conference to try to see whether certainly need to look at how it plays into the competition and how that could be permitted. I would like to see the agenda. creation of local health boards, charged with integrating services and running them efficiently. John Healey: If the hon. Gentleman or any other Members want to know a little bit more about TTIP, Dr Huppert: The amendment my hon. Friend is talking particularly the potential impact on the NHS and public about was proposed by Cambridge Liberal Democrats, services, we have a meeting of the all-party group on and I pay particular tribute to Councillor Kilian Bourke, European Union-United States trade and investment at who chairs the health committee in Cambridgeshire. It 2 o’clock on Monday, at which the EU chief negotiator suggested allowing NHS commissioners and providers will be on the panel alongside Dave Prentis, general in a local area to form an integrated health organisation secretary of Unison. The hon. Gentleman might like to if that was what they wanted to do. Does my hon. come along. Friend agree that that would achieve the benefits that he and I seek without the need to force through a massive John Pugh: If the right hon. Gentleman reminds me, top-down reorganisation? Would he urge the hon. Member I will endeavour to do so. What I am really hoping for, for Eltham (Clive Efford) to accept such an amendment though, is a change in the conversation about the NHS if the Bill made progress? so that we stop talking about the internal market—Labour Front Benchers have in a sense reneged on their involvement John Pugh: If the hon. Member for Eltham wished to in that—and instead talk about how we should organise talk about that, we could happily move away from the NHS services that will efficiently deliver the moral internal market where local circumstances required and entitlements that people expect. demanded it. That would be an entirely sensible policy. I see no reason, though, why health boards should not Jeremy Lefroy (Stafford) (Con): I am grateful to my procure goods and services based on simple best-value hon. Friend for giving way and to the hon. Member for principles without all the competition legislation that Eltham (Clive Efford) for introducing this opportune has been vilified in the debate. They should be funded—as Bill. most services are—by capitation and according to local Does my hon. Friend agree that one problem with an need, and they should be in some way democratically internal market is the sheer complexity of tendering, accountable, and I think we can get a genuine public which means that smaller organisations such as some in service element back into the NHS. However, not every my constituency are simply not capable of matching up political party is advocating that at the moment, and with the organisations that decide to tender for some of some are steering in quite the opposite direction. the contracts that are available?

Philip Davies: The hon. Gentleman is making a John Pugh: My hon. Friend makes a good point. For thoughtful speech, as is typical of him. Does he agree those who are unsure about the benefits of the internal that what we are dealing with today is an Opposition market, there is a way of addressing the problem, which 563 National Health Service (Amended 21 NOVEMBER 2014 National Health Service (Amended 564 Duties and Powers) Bill Duties and Powers) Bill [John Pugh] Andy McDonald: Perhaps the hon. Gentleman would like to clarify, for the benefit of the House, whether his is to allow individual health economies, in whatever party is in favour of a private insurance-backed approach area—Eltham or wherever—to opt out of the internal to health care or whether it actually believes in the market if they can prove that there is a case for doing so. NHS. That could be put into legislation in a permissive form, so it would not be a top-down reorganisation, and it Mark Reckless: My party believes in the NHS as a would allow people objectively and sensibly to test the service that is free at the point of delivery. My father is a benefits of the internal market against a more normal doctor, and my mother is a nurse. That belief is core to model of public service delivery, which I support, as I my values, and to the values of my party. [Interruption.] hope the hon. Member for Eltham does. That is our policy. Our policy is determined by our party, and it is to support an NHS that is free at the 11.18 am point of delivery. Mark Reckless (Rochester and Strood) (UKIP): It is Mr Anderson: When did the hon. Gentleman come to a pleasure to speak on this Bill. that conclusion?

Mr (Blyth Valley) (Lab): On this Mark Reckless: I think that the hon. Gentleman may side of the House. be referring to the answer to a question that was asked Mark Reckless: And indeed on this side of the House. two years ago, which is now being taken out of context. Our party is not quite like the Liberal Democrats with It is a particular pleasure to speak on a Bill introduced their federal policy executive, but we have formal measures by the hon. Member for Eltham (Clive Efford), because for the making of policy, and UKIP has decided— I have spent time in the past few weeks defending myself following allegations from the Conservative party that I Mr Anderson: Will the hon. Gentleman give way? grew up in his constituency, in SE9. Mark Reckless: I will continue, if I may. Clive Efford: You should be proud. Dr Huppert rose— Mark Reckless: Indeed, I am proud, and many people in my constituency have moved down from Eltham and Mark Reckless: I will give way to the hon. Gentleman. the surrounding areas, and I am delighted that they returned me to the House in the early hours of this Dr Huppert: Although I do not agree with the hon. morning. Gentleman on many things, I welcome him back to the I found the hon. Gentleman’s speech compelling. At House. He has talked about the history and the evidence. half-past 4 this morning or thereabouts, I was extolling He might be interested to know that, according to the the virtues of the Levellers and the Chartists. I can only House of Commons Library, the amount spent by NHS think that I had a premonition of the speech that the England on buying health care from outside the NHS hon. Gentleman was to make in the House this morning. rose from £1.1 billion in 1997-98 to £7.5 billion in The other reason for my presence here is that, in the 2009-10. Those are the facts, according to the Library. by-election I have just fought, we had in Naushabah Khan a Labour candidate who made—quite eloquently, I thought Mark Reckless: The hon. Gentleman is correct. There —the case against fragmentation and privatisation of was a great deal of privatisation and, indeed, fragmentation the NHS, and she and others in Medway Labour of the NHS under Labour, and I do not deny that there commended the Bill to me. has been more of it under the current Government. I think that it is a problem that has afflicted both main Grahame M. Morris: I was not in Rochester last parties. night. I joined a vigil outside Parliament by groups who are campaigning to save our NHS, and I had a conversation Mr Anderson rose— with a consultant oncologist on that very issue of fragmentation. He said that the only competition we Mr Donohoe rose— should have in the NHS is the competition to defeat disease. Does the hon. Gentleman agree with that? Mark Reckless: I will continue for a bit, if I may. Let me explain how I view the issue from a local Mark Reckless: That sounds a good statement. I perspective. As far as I can see, Darent Valley hospital, myself feel a certain degree of scepticism, as the hon. which is in my constituency, was privatised under Labour Member for Southport (John Pugh) said, about internal in one of the most disastrous private finance initiatives markets in the NHS and other public services. Much experienced by the NHS. Medway NHS Foundation depends on the circumstances of the service provided, Trust became a foundation trust on the basis of what and an ideological predisposition either against or in was largely a box-ticking exercise, which focused on favour of internal markets is probably not wise. finances and appeared to ignore the fact that by that The Labour candidate in the by-election opposed stage the hospital’s standardised mortality rate was fragmentation and privatisation of the NHS, and the some 10% above the norm: one in 10 more patients were Bill appears to do so as well. I have discovered that this dying that should have been expected. is now the Labour party’s position. I had assumed that the Labour party was in favour of fragmentation Mr Donohoe: I know that the hon. Gentleman had a and privatisation in the NHS, because that was my late night, but can he tell us what is his party’s view of understanding of what the record had been. the health service in Scotland? 565 National Health Service (Amended 21 NOVEMBER 2014 National Health Service (Amended 566 Duties and Powers) Bill Duties and Powers) Bill Mark Reckless: I will clarify the view of my party on deals with the allocation of time for legislation. We have the NHS in general, but I am afraid that I am not yet in a Committee of Selection, but it is run by the usual a position to give details of its policy on the NHS in channels—the Whips on either side of the House—and Scotland. I should be happy to seek to assist the hon. people with expertise such as the hon. Member for Gentleman on another occasion. Totnes (Dr Wollaston), who might actually have improved What happened in Medway was fragmentation. The the Bill, were excluded from it. hospital was cut loose by the Department of Health, and is now essentially run by an independent board. Dr Poulter: I feel I should quote further from what When there are problems and it is in special measures, was said by the hon. Member for Clacton, when much there is now a potential for greater intervention, but we of the Committee stage of the Health and Social have in Monitor what appears to be a backstop regulator, Care Bill had been completed. He went on to say—on rather than a regulator that is able to come in and run 11 February 2012, on his TalkCarswell.com website— the hospital and turn it around. It can get rid of the “If these proposals were defeated, it would be a setback for all chair and the chief executive, but it cannot make those of us who would like to see public service reform. We need constructive improvements. to keep our nerve.” That rather contradicts what the hon. Gentleman has Mr Anderson: Will the hon. Gentleman give way? just said, does it not? Mark Reckless: I will continue, if I may. Mark Reckless: That is an excellent website, which I The independence of such hospitals, the inability of recommend to all Members. The Minister has said that the House or the Secretary of State to drive improvements, my hon. Friend made those observations when most of and the decision to allow a hospital to become a foundation the Committee stage of the Bill had been completed. trust although one in 10 more people were dying than Was that during the “pause” that had been invented as a should have been the case, constitute an indictment of new mechanism for Parliament? My hon. Friend is not the last Government’s policy. I was delighted to hear here at the moment, but I think he would agree with me from the Labour candidate whom I have faced in recent that the 2012 Act is not as it was billed to us by those on weeks that Labour is now against fragmentation and the Government Front Bench. It has led to an extraordinary privatisation of the NHS. I welcome the Bill, and I am degree of additional complexity in the NHS, and the pleased to be able to support it. introduction of competition bodies—and, in particular, European competition law—into the NHS is not welcome. Clive Efford: I welcome support for my Bill from all quarters, but why should anyone believe what the hon. Philip Davies: Will the hon. Gentleman give way? Gentleman says about the NHS? Does he accept that the Government were elected with no mandate to introduce the 2012 Act, and that he voted for it? Mark Reckless: No, I will continue for a bit, if I may. I do not think that the extent of the difficulties that Mark Reckless: I think that that is probably correct. I doctors and others would encounter as a result of may be guilty of having believed the undertakings I was section 75 of the Act and the bureaucratic, market- given by those on the Government Front Bench. based—or quasi-market-based—commissioning rules that it requires was any more apparent to my hon. Friend The Parliamentary Under-Secretary of State for Health the Member for Clacton than it was to other Members, (Dr Daniel Poulter): It might be helpful for the hon. although some Opposition Members may have had Gentleman to bear in mind the words of his colleague, premonitions of it. I thought that the Bill was intended the hon. Member for Clacton (Douglas Carswell), who to allow the various local bodies to get on with running said: the NHS in their areas. Some would run it better than “Never one to slavishly support the party line, I would be quite others; there would be local decision-making and discretion, prepared to oppose these reforms” and people would learn from each other. Now, however, —the 2012 Act— there are centrally determined rules that force everyone “if I felt they were a step back. But I won’t. These changes are into, in particular, commissioning or contracting behaviour, necessary—and contrary to much of the mainstream media coverage, but do not make sense in the context of the service that in my experience they are quietly supported by many doctors is being delivered. too.” Does the hon. Gentleman support what his colleague Philip Davies: I congratulate the hon. Gentleman on said, or does he not? his victory in last night’s by-election. It was an excellent result for him and it would be churlish not to point Mark Reckless: I think that my hon. Friend the that out. I know that he is a long-standing believer in Member for Clacton was right in saying that some localism. Is he not worried by the British Medical doctors supported the Bill that became the 2012 Act. Association’s concerns that the Bill would give much During the early stages of that Bill, a number of wider powers to the Secretary of State, thereby centralising representative bodies supported it, or were presented as powers and taking the day-to-day running of the NHS doing so. As the Bill proceeded, however, some of what away from clinical staff and putting it in the Secretary had been claimed to be support from organisations of State’s hands? As a champion of localism, is he not such as the British Medical Association seemed to fall worried by that? away. I believe that the Bill ran to 460 pages. The problem was the way in which legislation is made Mark Reckless: I am grateful to the hon. Gentleman in the House. The coalition agreement promised us for his congratulations; that is very decent of him. I am a House Business Committee, but no such Committee not a fan of quasi-autonomous bodies, of great amounts 567 National Health Service (Amended 21 NOVEMBER 2014 National Health Service (Amended 568 Duties and Powers) Bill Duties and Powers) Bill [Mark Reckless] 11.34 am of regulators or of overlapping layers of bureaucracy; David Tredinnick (Bosworth) (Con): I am grateful to they rarely work. Given the degree of complexity that be called to speak in the debate, Madam Deputy Speaker, has now been brought into the NHS, I think it is and I apologise to my Front-Bench colleagues that I possible—although I am not certain—that the centralisation might not be here for the wind-ups because I have to be of power in a single Secretary of State who is at least in Hinckley for the switching on of the Christmas lights, accountable to the House might be better than the which is something I always look forward to. current diffusion and fragmentation of powers, which I should like to follow a long tradition in the House does not seem to be working effectively. My party in which the speaker who follows a Member making would like to replace the alphabet soup of regulators their maiden speech—even though I am told that, and the overlapping layers of bureaucracy with a single, technically, it was not one—says something nice about elected health board for each county area. That would them. I congratulate the hon. Member for Rochester give a degree of clarity to the oversight and management and Strood (Mark Reckless) on winning his by-election of the NHS. last night, and I further congratulate him on getting to Mr Donohoe: Why does the hon. Gentleman not the House this morning. I imagine that he has been up think that health boards should be taken back into local all night. I simply offer him this warning. I was thinking authority control, where a democratic ticket is already of Dave Nellist, a former Member for Coventry, who involved, rather than creating a separate vote for stand-alone defected to another party and then disappeared. I have health boards? to warn the hon. Gentleman—my former hon. Friend—that the history of those who defect in this place shows that Mark Reckless: There is an argument for doing that, they do not remain here for very long after they come and a judgment has to be made. It might be possible, back. We expect to regain his seat at the next general depending on the different areas of the countries— election, but well done to him in the meantime. particularly in the devolved Administrations—that the I should also like to congratulate the hon. Member solution to that question might be different. My general for Eltham (Clive Efford) on introducing his Bill. I once view is that it is much better to have democratic had the honour to stand for the Greater London council accountability than not to have it, and in many areas I in the constituency adjacent to his. It was then known would prefer that to be local. My party wants to see as Woolwich East, so I know his area and his hospitals a health boards elected on a county basis. little. He has certainly done well to get his Bill to the My party also wants European competition law to be House, and I note from the Division this morning that taken out of the NHS, and the Bill is exemplary in that he has 100 additional Members here today, so he is no regard. I strongly support that provision. doubt hoping for a closure motion at some point. If his I have signed a pledge on TTIP, along with most Bill progresses, I would be happy to serve on its Committee. other candidates in the by-election, except for the I have a long-standing interest in health matters and I Conservative—[Interruption.] No, not the Liberal one— have been a member of the Health Select Committee that was not a good one to sign—although I did vote since it was set up in this Parliament, as well as of the against tuition fees, along with most Opposition Members. Science and Technology Committee in this Parliament. I would like to see the NHS excluded from TTIP. There I am also the chair of the all-party parliamentary group are arguments as to whether it will be or not, but those on integrated health care. arguments should be settled in the House as per this Bill, rather than being left to the unpredictability of This is a wide-ranging Bill. I hope to address some of future legal actions. the things that are not in it, although I will not talk about all the things that are in it as time is short and I Philip Davies: Will the hon. Gentleman give way? do not want to occupy the stage for too long. I want to look at three areas. The first is the hon. Gentleman’s Mark Reckless: I am just reaching my conclusion, if I proposal to change the arrangements that allow trusts may. to generate half their income from private sources. The hon. Member for Eltham made a mistake in Secondly, I want to look at whether mergers should be talking about the UK negotiating on TTIP. That is an dealt with by Monitor or whether that area should be area of exclusive competence for the European Community, reclaimed. I want to focus on mergers and integration, and it is therefore the EU Commission that will negotiate because the integration of services in the NHS is of with the United States on that matter. When I first fundamental importance. He might be able to improve heard about TTIP, it sounded as though it would be all his Bill in that respect. Thirdly, if time allows, I want to about free trade and I thought that it would be broadly talk about the proposal to exempt the NHS from the a good thing. The more I looked into it, however, the transatlantic trade and investment partnership. more it seemed to be not about free trade but about the I have just been speaking to the right hon. Member creation of a single set of transnational regulations for Wentworth and Dearne (John Healey), and I believe between the US and the European Union, and that it that Labour’s whole strategy is based on something that would be illegal for anyone not complying with them to is fundamentally untrue. It is based on trying to persuade sell goods and services. I am therefore very sceptical the electorate that we are setting out to privatise the about TTIP and I am not sure it is something that I health service and thereby reduce the health care available. would want to support. I certainly do not want to see It is regrettable that Labour is taking the Goebbels-esque the NHS included in it. approach of saying something that is fundamentally I congratulate the hon. Member for Eltham on his Bill, untrue and then repeating it and repeating it in the hope and I look forward to supporting him in the Lobby. that the electorate will buy into it. I put it to Labour 569 National Health Service (Amended 21 NOVEMBER 2014 National Health Service (Amended 570 Duties and Powers) Bill Duties and Powers) Bill Members that that might be a populist approach, but it risk of privatisation, but what is actually happening as a could be hard for them to defend as we get nearer the result of the 2012 Act process is that there is more election. money in our NHS, rather than less.

Seema Malhotra (Feltham and Heston) (Lab/Co-op): David Tredinnick: The Act is complicated. It is a big The hon. Gentleman says that he does not believe Act and it landed with a thump when the right hon. creeping privatisation is taking place as a result of the Member for Wentworth and Dearne (John Healey) changes that the Government have introduced, but does dropped it on the Opposition Benches. I think he did so he not see it as an inevitable consequence, even if it is intentionally; and it was very theatrical and effective. It not the Government’s stated intention? is true that there is more money there, and it is clear that the Government pledged at the last election to maintain David Tredinnick: I thank the hon. Lady for her the funding of the health service and have done so. We intervention. The Government have made it possible for also have in place the Nicholson challenge, a phrase trusts to generate half their income from private sources, coined by my right hon. Friend the Member for Charnwood but it is not true to make out that we are in some way (Mr Dorrell)—formerly the Member for Loughborough— privatising the health service in a way that is detrimental when he was Chair of the Health Committee, and we to patients. We have made it possible for trusts to now face even greater challenges. generate more income. In an ideal world, it would be Let me set out to the hon. Member for Eltham what wonderful if we could pay for all health care through he could include in his Bill if it goes forward. He could general taxation. However, the Health Committee has examine the next stage of bringing together health and examined the Nicholson challenge and seen the tremendous social care. On Tuesday, the Health Committee heard demand on resources. We have managed to maintain a from Dame Kate Barker, the chair of the Commission flat-line budget in this Parliament, but demand is such on the Future of Health and Social Care in England. that it is difficult to pay for everything through general We were examining the transitional costs of bringing taxation. One way to do it is by getting the private health and social care together, and looking ahead at sector to contribute to the health service. The original the savings that can be made. The hon. Gentleman arrangements were increased to this figure of nearly might apply his mind to the complications arising from half. The thing to remember is that all the money the different streams of funding represented in health generated from these sources is reinvested in patient and social care, whereby health is funded by general care. taxation and some private support, which I have already I had some freedom of information requests made, discussed, whereas social care is the subject of means and wish to refer to the effect of these arrangements on tests and other constraints. We are therefore talking four NHS foundation trusts in the midlands. They are about completely different funding stream. I do not not from Leicestershire, because those figures did not know how the Health Committee will report this, but I come through, but I do represent a midlands constituency. was struck by Dame Kate Barker’s determination that The Dudley Group NHS Foundation Trust received there should be one person running health and social £68,000 in 2010-11, £50,000 in 2011-12 and another care. That is essential if we are going to bring those two £80,000 in 2012-13 in funds that can go directly into things together. patient care. The figures for the Heart of England NHS The other point the hon. Gentleman should take on Foundation Trust are £559,000 in 2009-10, another half board as we look at the Bill is the high profile that a million in 2010-11, a bit more in 2011-12 and nearly the Secretary of State and his predecessor, my right £532,000 in 2012-13, and there has been an increase to hon. Friend the Member for South Cambridgeshire £628,000 in 2013-14. (Mr Lansley), have given to patient choice. The Government My FOI request to the Shrewsbury and Telford Hospital have said time and again that patient choice is at the NHS Trust elicited the following response—it is a short heart of the health service, and we have already seen the paragraph, so if I may, I will read it out: benefits. The personal budgets now available for people “The Shrewsbury and Telford Hospital NHS Trust gains substantial who are seriously ill have had three benefits. First, they income from Apley Ward and Clinic. Where private patient work enable the patient to choose whatever treatment they is carried out in an NHS hospital, it is carried out in addition to want, be it tai chi, yoga or piano therapy—I believe that and not in place of regular NHS treatment. Profits from this there have even been cases where tickets to a football private facility make a considerable contribution to the running match have been given. This is not something regulated costs of the hospital for the benefit of all patients and staff.” by double-blind placebo controlled trials, as some of The hon. Member for Eltham made a passionate speech, the other access arrangements for health care are. Secondly, but this point goes to the heart of the issue: privatisation the personal budgets enable the carers to go out into the is not about reducing resources, but increasing them. I world and get jobs, so freeing them up. Thirdly, when gave notice to the hon. Member for Walsall South the personal budget money is given, it is spent responsibly (Valerie Vaz) that I was going to mention the other by the patients. We have a whole new paradigm of figures I received, which are from the Walsall Healthcare health through personal budgets, and that should be NHS Trust and which show that over the past four examined through this Bill. years it has gained between £14,000 and £50,000 a year. I have always felt that the 2012 Act and the reforms The figures illustrate clearly that this approach is helping, that were made produced something that put in place and that is very welcome. two legs on the stool, not three. The third leg comprises the vast and diverse multiplicity of support services that Mr Nuttall: The point my hon. Friend has just made are not used in great depth in the health service now. is key in showing the dangers of this Bill. People have Using them would considerably reduce costs and increase been writing to say that they are concerned about the choice. The choice of these other support services will 571 National Health Service (Amended 21 NOVEMBER 2014 National Health Service (Amended 572 Duties and Powers) Bill Duties and Powers) Bill [David Tredinnick] Madam Deputy Speaker (Mrs Eleanor Laing): Order. The hon. Gentleman is aware that I am watching very inevitably come to the fore as patients demand what carefully the matters that he is addressing in the House they want, and we really have to bring this into the right now. He must speak to the Bill. We are discussing health service. whether the Bill should have a Second Reading and go I have had many conversations about these things into Committee. with the Under-Secretary of State for Health, my hon. David Tredinnick: Madam Deputy Speaker, you are Friend the Member for Central Suffolk and North kind to draw that to my attention. I simply say this: Ipswich (Dr Poulter)—the Minister on the Front-Bench there are different regulatory bodies—not just Monitor— today. He has entrusted me with being vice-chair of the that we should consider. We should be taking on board herbal working group, which is trying to sort out herbal the fact that osteopaths, chiropractors, homeopaths medicine regulation. When we examine the support and doctors are regulated by an Act of Parliament, yet services that are not now part of mainstream health the Health and Care Professions Council regulates clinical care, we see that we have a fundamental problem relating scientists, paramedics, physiotherapists. The Professional to the insistence that we rely on evidence-based medicine. Standards Authority, which is another regulatory body, I do not know where that phrase came from—it has not provides oversight of nine statutory bodies. Then there been around for a long time. Various bodies protect the is the umbrella body, the Complementary and Natural public, and all new drugs are carefully scrutinised, by Healthcare Council. I will leave it at that, as I do not the pharmacists and the Herbal Medicines Advisory wish to stray. On the safety aspects of those bodies, I Committee, which has put together a list of what are, in understand from Balens, which has been insuring support effect, poisons and bans the use of some herbs. The services for 10 years, that there has not been a claim public are protected in that way, but it is very difficult to against a herbalist for more than 10 years. use normal measurements to assess the effectiveness of, The Bill partly addresses the issue of the transatlantic for example, acupuncture, which the National Institute trade and investment partnership. Across the world, for Health and Care Excellence has approved for treating there is whole mass of new thinking that could be lower back pain. A lot of evidence shows that acupuncture incorporated in our health service. I am nervous that if can reduce the effects of lower back pain and save the we take out TTIP—if an exemption for the NHS is NHS a lot of cost. With homeopathic medicine, which I proposed—it will not be in our interests. In America have long supported and advocated, it is impossible to there are a lot of integrated practices, in which a range run trials on every dilution: some are so dilute that they of different health disciplines are brought together to do not show up. reduce costs. Dr Huppert: Will the hon. Gentleman give way? Angie Bray (Ealing Central and Acton) (Con): Does my hon. Friend agree that the Government and the David Tredinnick: I am always glad to give way to the European Commission have made it clear that decisions hon. Gentleman—I am sure he will agree with my every on the provision of public services will continue to be word. made by the Government here in Westminster? David Tredinnick: We are agreed on that. It is a case Dr Huppert: My hon. Friend will be well aware that of the extent to which we derogate the powers of the there have been many trials of homeopathic medicines, Secretary of State. We have a whole lot of new bodies, and the fact is that none of them has shown that they including clinical commissioning groups, which have work better than a placebo. He is right that they are been a great success. very dilute; that is why they do not work. I congratulate the hon. Member for Eltham on securing this slot today. I wonder whether he still has 100 troops David Tredinnick: The hon. Gentleman makes my in the Tea Room waiting to come in for a closure point. I remember when some of his friends went to motion, if Madam Deputy Speaker is gracious enough Boots in Kensington high street and consumed the to grant it. I am happy to serve with him in the future entire stock of homeopathic medicine. They saw that as on his Bill. a huge triumph, as they felt it illustrated the fact that homeopathic medicine was not effective. Of course it 11.54 am did nothing of the sort; it proved that it was absolutely Andy Burnham (Leigh) (Lab): Tuesday 20 March 2012 safe to take these preparations under any circumstances, was a black day for the NHS and for this Parliament. A and that the only time they work is if they are in the Bill with no mandate from the British people was allowed right preparation and are taken in the right amount, as to pass through this House and to place market forces prescribed by a professional. at the heart of our health service. It allowed this democratic I say to the Minister—I hope he will tune in to what I House to be bypassed when it comes to decisions affecting am saying—that we must move away from this insistence the country’s most valued institution. In other words, it on evidence-based medicine and look at evidence-based was a crime against democracy and the national health practitioners. This is an area that has been overlooked service. Ever since that dark day, the damage has been for a very long time. There is much evidence that mounting: NHS services worth billions of pounds— practitioners are well regulated, and we do not need to including blue light 999 ambulance services and cancer insist on checking every single preparation that people services—forced out to open tender; millions of pounds consume. Five areas of regulation already exist. The thrown at competition lawyers and consultants to run hon. Member for Eltham might want to think about those tenders; and NHS hospitals, freed to earn up to that, as it is a matter that could be put into the Bill if it 49% of their income from treating private patients, goes to Committee. doing just that and letting NHS waiting lists get longer. 573 National Health Service (Amended 21 NOVEMBER 2014 National Health Service (Amended 574 Duties and Powers) Bill Duties and Powers) Bill (Wansbeck) (Lab): Is my right hon. Friend That is why my hon. Friend the Member for Eltham aware of the unique deal between Northumbria Healthcare gave a stirring speech of the kind this House needs to NHS Trust and the Labour-led Northumberland county hear more, full of conviction and passion, standing up council in which the council bought out the PFI deal, for the national health service that he believes in. He has which means a better deal for the taxpayers in brought before the House a Bill that reaffirms the words Northumberland and a much better deal for the NHS of Nye Bevan’s original National Health Service Act trust and the patients? 1946 on the democratic accountability of the NHS to the Secretary of State and, by extension, to this House. Andy Burnham: Yes, I am aware of the deal, and it is a The Bill abolishes the compulsory tendering of NHS great example of how a Labour council, working with services and removes market forces. It reduces the private the NHS, can take steps to improve funding for front-line patient income cap back down to single figures. Once patient care. It happened because of the deal that was and for all, it fully exempts the NHS from EU procurement struck in the latter stages of the previous Labour and competition law, as is our right under the Lisbon Government. treaty. It sends the Government an uncompromising As a result of the Health and Social Care Act 2012, message that the NHS will never be touched by any NHS hospitals can earn more money from treating TTIP treaty. private patients, while NHS waiting lists get longer. In particular, I commend my hon. Friend for saying Those same hospitals have now been told by competition that it is about time this House regained full sovereignty authorities that they cannot collaborate any more because over the national health service. They gave it away—the it is “anti-competitive.” How did it come to this? That is Eurosceptics sitting there on the Government Back not the health service that we have known for 66 years. Benches—when they mandated open tendering of services. Every day that this illegitimate legislation remains in By doing that, they placed the NHS in the full glare of force is a day closer to the demise of the national health European competition law. [Interruption.] They do not service. like to hear it, but that is what they did.

Jonathan Edwards: In response to an FOI request, I Sir Oliver Heald: Is the right hon. Gentleman the was told by my local health board that between December same man who used to talk about an end to the polarising last year and July this year, 373 ophthalmology patients, debate on private and public sector provision? Is he the 90 pain management patients, 165 neurology patients same man who, when Secretary of State, privatised the and 264 orthopaedic patients were transferred to private services for an entire hospital at Hinchingbrooke? What sector providers at a cost of nearly £600,000. What is is he doing today? It is buff and blow party politics. the right hon. Gentleman’s message to his Labour colleague, the Health Minister for Wales? Andy Burnham: I told the hon. and learned Gentleman earlier that that was incorrect and that he should withdraw Andy Burnham: I will give the hon. Gentleman my the suggestion, because I did not do that. The contract message now: the Labour Government in England and for Hinchingbrooke was awarded under his Government. in Wales have taken steps to bring down NHS waiting I will tell him who this man is. This is the man who, lists. When we left office, they were at the lowest ever when Secretary of State, introduced the concept of NHS level. I make no apology to him for those improvements. preferred provider, because I believe in the public The 2012 Act has put the NHS in danger, which is NHS and what it represents, unlike him. I believe in an why it has to go. Back on that March day in 2012, I NHS that puts people before profit, unlike him. That is pledged that the party that created the NHS would the man he is talking to, and that is what I will always repeal that Bill at the first opportunity, and today we stand up for. honour that promise. The Bill before us, presented by my hon. Friend the Member for Eltham (Clive Efford), Dr Huppert: The right hon. Gentleman correctly says restores the right values at the heart of the NHS: that the contract for Hinchingbrooke was let under this collaboration over competition; integration over Government, but does he not accept that it was he who, fragmentation; people before profits. when Health Secretary, reduced the list of bidders to five, none of which were NHS bidders, and then to Angie Bray: Will the right hon. Gentleman care to three, all of which were private companies? Does he comment on the letter in today, accept that he could have left NHS bidders in the signed by a number of doctors and led by the chairman process, rather than only private bidders? Then he complains of NHS Alliance, asking people not to support this Bill when one of the providers that he shortlisted got the today, as it would be a backward step for patients? contract.

Andy Burnham: I am sure that Tory central office has been ringing around for a few days trying to find some Andy Burnham: I am afraid that the hon. Gentleman doctors who are still in favour of the legislation, and has to get his facts right, because they are wrong. When they found 11. Well, I think that is probably about the I was Health Secretary and Hinchingbrooke needed to limit for the number of people prepared to put their find a new operator, I asked local NHS trusts in his area name to it. I can tell the hon. Lady that thousands of to come forward, and at the time none of them wanted doctors lined up with the Opposition and pleaded with to do that, so we had to find an operator— her party to call off its reorganisation, and that included the British Medical Association and the royal colleges, Sir Oliver Heald: On a point of order, Madam Deputy but it would not listen. The Government ploughed on Speaker. I may have inadvertently said that the contract regardless, and the NHS has gone downhill ever since. was let, but I do not believe that I did. The true position 575 National Health Service (Amended 21 NOVEMBER 2014 National Health Service (Amended 576 Duties and Powers) Bill Duties and Powers) Bill [Sir Oliver Heald] Government are doing. It will not have escaped their notice that scores of Government MPs have failed to is that it was the right hon. Gentleman who took the turn up today to defend what was one of their flagship decision to privatise the services in that hospital, and it Bills. What a shower! There are people who kept a vigil is wrong for him to seek to deny it. [Interruption.] outside the House last night, in cold temperatures, imploring Members to be here to pass this Bill because Madam Deputy Speaker (Mrs Eleanor Laing): Order. the issues it raises matter so much to them. Then we I appreciate that the hon. and learned Gentleman wishes have the spineless MPs of a disintegrating Government, to ensure that the record is set straight. He has attempted some loaded up to the eyeballs with links to private so to do, but it is not a point of order for me to deal health care, who do not have the guts to come here with. today to argue for what they have done. Is it any wonder that people are losing faith in this place? Andy Burnham: “Attempted” is the operative word, Madam Deputy Speaker. The hon. and learned Gentleman Dr Huppert: On a point of order, Madam Deputy says that it was my decision, but it was the decision of Speaker. The right hon. Gentleman claimed earlier that his right hon. Friend the Member for South Cambridgeshire one of the bidders at Hinchingbrooke was an NHS (Mr Lansley). He did it when their Government came provider, but according to the National Audit Office in, and the hon. and learned Gentleman should have there was Circle, Serco and Ramsay. Can he now either the good grace to withdraw what he said. correct the record for the House, or let us know which I was in the middle of answering the intervention of those three he believes is an NHS provider? from the hon. Member for Cambridge (Dr Huppert)—the hon. and learned Gentleman should listen to this, because Madam Deputy Speaker (Mrs Eleanor Laing): The he will get his answer. I said that the process should go hon. Gentleman makes a perfectly good point of debate, forward under the NHS preferred provider principle, but it is not a point of order. which I introduced—he seems not to understand that. To correct him, when the previous Government left Andy Burnham: We have spineless Government MPs office there were three bidders, one of which was an who will not come here today to argue for the Act. NHS provider, so he really needs to get his facts straight— I congratulate the hon. Member for Rochester and Strood (Mark Reckless) on his victory and on being Dr Huppert: Will the right hon. Gentleman give way? here today, despite being up all night—I cannot imagine that he managed to get any sleep. His party leader has Andy Burnham: No. The hon. Gentleman needs to said that when the hon. Gentleman is tired he says get his facts straight before he tries to shout the odds in things that he does not mean—I think that he just my direction. nodded there. Given that he has been up all night, I can only conclude that he does not actually believe what he The Bill gives back to this House sovereignty over the said in the speech we just heard. In three days he has national health service, which millions of people will gone from being in favour of the repatriation of European welcome. The Bill means so much to so many people citizens to being against the privatisation of the NHS. who are concerned about what is happening to the NHS That is a pretty big political distance to cover in just right now under this Government. three days.

Barry Gardiner (Brent North) (Lab): My right hon. Mark Reckless: I have only ever argued for European Friend says that the Bill will mean so much to so many citizens to be able to stay; any other words came from people. He will recall that in 1997 the waiting lists at others, not me. It is the right hon. Gentleman’s party Northwick Park hospital were the highest in the country, that has reversed its position, having previously privatised with people having to wait for 21 hours on trolleys. He the Darent Valley hospital and fragmented the Medway will also know that the people in Brent and Harrow who Foundation Trust, but it now seems to have a better rely on that hospital today are now enduring the highest policy, which I am happy to support. waiting lists in the country again. Waiting lists came down on his watch, but they are back up again. What Andy Burnham: The hon. Gentleman said that he message does that send to the people of Brent and could not understand Labour’s position, but surely he Harrow? remembers 2012, when Opposition Members spoke with force against that legislation, which he then voted for in Andy Burnham: My hon. Friend is right to remind the the Lobby. I know that it has been a long night, but he House that in 1997 people were spending years on NHS really should try to remember these things, because they waiting lists, and even dying while still on them. As my are quite important. hon. Friend the Member for Bolsover (Mr Skinner) said, we brought those waiting lists down, and by the Mr Anderson: Is it not also true that the hon. Gentleman time we left government in 2010 this country had the went through the Lobby not once, but 18 times, despite lowest ever NHS waiting lists and the highest ever level being told time and again that what has now happened of public satisfaction in the NHS. That is Labour’s would happen? The people who had their finger on the record, and we will not let the Government forget it. pulse were telling us what would happen, but he ignored What is happening now? NHS waiting lists are back them. at a six-year high. That is the result of the reorganisation that the Government ploughed through, which nobody Andy Burnham: It is a tiring business being an MP wanted. The country did not want it. There are millions and it is possible to forget things, particularly when one of people out there who are concerned about what the drinks as many pints as UKIP Members do, but they 577 National Health Service (Amended 21 NOVEMBER 2014 National Health Service (Amended 578 Duties and Powers) Bill Duties and Powers) Bill should try to remember. Their party leader once said Andy Burnham: It is one of the biggest scandals of that he would give the NHS budget to insurance companies; recent times that people in this House who have links to apparently, he does not believe that now. The deputy private health, and many more in the other place, put leader, a Mr Nuttall, said that the right hon. Member through legislation that did not have a mandate from for South Cambridgeshire was to be congratulated on the British people and from which they would benefit bringing a whiff—just a whiff—of privatisation to the financially. The story of that will one day be told in full. NHS, and the hon. Member for Clacton (Douglas The reorganisation has dragged the NHS down and Carswell), whom the Minister quoted earlier, described left it on the brink. A reorganisation that was meant to the Lansley reforms as “fairly modest”. He chided his put GPs at the heart of the NHS has left patients Tory colleagues who were sniping against him at the waiting days or even weeks to get a GP appointment. time and said that the reforms must not be derailed. The This week, there was news that the NHS has missed its party says it is anti-politics in the way things are done. cancer standard for the third quarter, leaving thousands This is sheer opportunism and dishonesty. of cancer patients waiting more than two months for treatment to start. It is a reorganisation that has Mark Reckless: I recall much of what the right hon. systematically run down the NHS and opened the door Gentleman said from the Dispatch Box in 2012, and I for it to be sold off. would like to credit him because a lot of it has come to pass. He was perspicacious in much of what he said and Paul Farrelly (Newcastle-under-Lyme) (Lab): The many of the assurances that I was given from the reorganisation was unnecessary. My right hon. Friend Government Front Bench have been found wanting. is no doubt aware that in Staffordshire a £1 billion cancer contract has been put out to tender. The newly Andy Burnham: I appreciate what the hon. Gentleman rebuilt local hospital is concerned that that will destabilise says—it would be churlish for me to say otherwise—and its finances. Does he agree that we should be very I am grateful for the way he said it. The things Opposition careful about going down that route without proper Members were saying back then have happened, and we consideration? can see the effects of the Government’s reorganisation in the NHS. With the new figures that came out this Andy Burnham: The example that my hon. Friend morning, we see that A and E has missed the Government’s quotes is the best example of the fact that the Government target for 70 weeks in a row. The A and E figures are the see no limit at all on the scale or extent of privatisation barometer of the health and care system. They are the in the NHS, both in terms of the monetary value— best place to look if we want to see whether there are £1 billion—and the fact that they are prepared to put problems in the health and care system. The fact that cancer services out on the open market. the target has been missed for 70 weeks in a row tells us that severe storms are building over the NHS. Mark Durkan (Foyle) (SDLP): Does my right hon. Friend recall that some of us supported his opposition to the Health and Social Care Bill, which purported to Mr Jim Cunningham: I am glad my right hon. Friend be England-only legislation? By its marketisation and raised that. It takes us back to pre-1997, when people altering of the public service ethic for the health service, who could not get beds were lying on trolleys. I am sure it was going to be predictive legislation with severe he remembers that. I can remember a hospital in Coventry implications for devolved services. For similar reasons that was falling down. As a result of the Labour we support the Bill today, because it offers a bulwark Government, we got a new hospital. against TTIP hazards for devolved health services.

Andy Burnham: My hon. Friend is right. The Labour Andy Burnham: The Bill before us deals comprehensively Government inherited a situation where almost three with that threat from any proposed TTIP treaty. I am quarters of the NHS estate was built before 1948. We glad to see the hon. Gentleman in his place today. transformed that, as well as bringing those waiting lists down. He is right to remind us. Robert Flello: Is my right hon. Friend aware that the I cannot believe that Government Members have not companies on the list of preferred bidders to provide had the guts to be here today to argue for their own cancer care in north Staffordshire include CSC computer policy on the NHS. Or is it that under the shambolic services, which was responsible for the £10 billion IT regime of their new Chief Whip, who is now inflicting failure, the Lorenzo system, and Interserve Investments, the same chaos on the parliamentary Conservative party which was fined £11 million by the Office of Fair as he did on England’s schools, the Government did not Trading for anti-competitive bid rigging? These are the think they could win the vote today, so they did not sort of firms that our cancer services might go to. dare to bring their troops here to hold it? I do not know what the reason is, but they clearly do not believe in Andy Burnham: Those examples will alarm people. In their own legislation and the catastrophic reorganisation Greater , a bus company has been running that followed. An unnamed senior Cabinet Minister has ambulance services. We had news this week that an been quoted in as admitting that it was their arms manufacturer is bidding for a GP contract. These single biggest mistake. are the things that are beginning to happen to the NHS. Nobody’s constituents have ever given their permission Mr Ronnie Campbell: Will my right hon. Friend for any of this to happen. touch on the fact that 71 coalition Members of Parliament We heard speeches from the hon. Member for Bosworth are being paid by private companies involved with the (David Tredinnick) and the right hon. Member for national health service? Banbury (Sir Tony Baldry), who said that nothing had 579 National Health Service (Amended 21 NOVEMBER 2014 National Health Service (Amended 580 Duties and Powers) Bill Duties and Powers) Bill [Andy Burnham] If the Government stop this Bill receiving Royal Assent, it will form the basis of the repeal Bill that the changed and what was happening in the NHS now was next Labour Government will lay before the House in just a continuation of what the previous Government May next year. But it will do more than that: it will were doing. No, it is not. The right hon. Member for remove the competition role to allow the full integration South Cambridgeshire said in a speech on 9 July 2005: of health and care to build and lay the foundations for a “The time has come for pro-competitive reforms in…health” 21st-century NHS. and he help up the example of utilities and rail. That One final thing needs to be said. Before we vote, there was the specific inspiration for his reorganisation. He is a simple truth that all Members in all parts of the sold his Bill on the basis that doctors would decide, but House must confront: nobody here has permission from doctors tell us that they have no choice but to put their constituents to put the NHS up for sale. Today is services out to the market. Section 75 says that their last chance to put that right before they face their commissioners may not run a tender only if there is one constituents in six months’ time. The people of this available provider. That is never the case, which is why country value and trust a public NHS that puts people CCG lawyers conclude that they have no choice but to before profits. This Bill restores that. The party that put services out to tender. created the NHS is proud to support it, and I urge all That is why we see, according to figures from the Members to vote for it. NHS Support Federation, that 865 contracts for NHS services, worth £18.3 billion, have been offered to the 12.21 pm market. Some 67% of the contracts awarded so far have The Parliamentary Under-Secretary of State for Health gone outside the NHS. It is this decision to mandate the (Dr Daniel Poulter): I shall begin by returning to the tendering of services which places the NHS in the full founding moment of our NHS, when a national health glare of EU procurement and competition law. Because service was created which remains to this day a world-class Ministers have refused to exempt the NHS from the health service where care is available to all, irrespective TTIP treaty, we could soon have private US health care of ability to pay and free for all at the point of delivery. providers ringing up CCGs to challenge them on their These fundamental principles of our NHS have been commissioning decisions. cherished and protected by each and every Government This Bill legislates to remove that threat. It repeals throughout its proud history, and were in 2012, for the section 75 and it really does let doctors and local first time, put on to statutory footing by this Government commissioners decide. It restores the role of the Secretary through the Health and Social Care Act. of State and brings much needed ministerial accountability back to this House. No longer will Ministers be told to Angie Bray: Will my hon. Friend give way? write to NHS England when they have concerns. Instead, there will be answers from the Government Dispatch Dr Poulter: If my hon. Friend will bear with me, I am Box about the service that matters most to their constituents. going to make a little more progress and then give way It removes the role of the competition authorities that later on. the Government’s Act introduced. It stops the ludicrous Those who believe that our NHS has always been run situation where hospitals such as Bournemouth and solely through public providers are of course very wrong. Poole are not allowed to collaborate. Importantly, it From its very inception, the NHS that Nye Bevan stops hospitals devoting half their beds and half their created has comprised providers in the public and the facilities to the treatment of private patients. non-public sectors. In 1948, independent GPs, community pharmacists and dental practitioners contracted with Mr Slaughter: Since Hammersmith and Central our health service to provide primary medical services Middlesex A and E departments closed two months to patients, and they continue to do so to this day as ago, we have had people waiting in ambulances and part of the public-private partnership. It is worth reflecting waiting rooms with every seat taken. We have even had on the fact that ’s former political secretary, people waiting on floors. The Government’s answer to John McTiernan, said only this August that that is to close two more A and E departments, those at “an NHS without private providers is unimaginable. For one Charing Cross and Ealing in west London. Is that not thing, no one—even on Labour’s extreme left—is arguing that we just preparing the NHS for failure and for privatisation? should nationalise general practice. But GPs are private providers, acceptable to opponents of the ‘private sector’ because most Andy Burnham: What is happening in west London encounters with the NHS are visits to your local doctor. should send a shiver down the spine of every community We also take for granted the key role played by charities in the country. The NHS is being torn apart, which is and the voluntary sector in providing NHS care to damaging patient care and leading to the consequences patients across the country, notably Macmillan Cancer that my hon. Friend outlines. Support and Marie Curie Cancer Care. This is how the character of the NHS is changing In opening my contribution to this debate, I reaffirm under this Government and before our eyes. With every this Government’s commitment to the founding principles year that the Health and Social Care Act stays on the of our NHS, a health service free at the point of statute book, the private sector will be more embedded delivery, and recognise that since its creation by Nye in the NHS and the public NHS weakened as a result. Bevan in 1948 our NHS has always been a public-private The Government have undermined the “N” in NHS. partnership. For public services to be equitable and free They are letting our hospitals become part-privatised at the point of use, they did not all need to be provided and they must be stopped. If the Government continue on a monopoly basis within the public sector, controlled on their current course, in the next Parliament the NHS in a rigid way by local bureaucracies often deeply resistant will be overwhelmed by a toxic mix of cuts and privatisation. to innovation and genuine local autonomy. 581 National Health Service (Amended 21 NOVEMBER 2014 National Health Service (Amended 582 Duties and Powers) Bill Duties and Powers) Bill “The aim should be to change fundamentally the way the NHS Dr Poulter: I think that the hon. Gentleman’s remarks was run: to break up the monolith; to introduce a new relationship are very clearly on the record, and I am sure that NHS with the private sector; to import concepts of choice and competition”. staff, many of whom come from very diverse, multicultural Those are not my words, but those of Labour Prime backgrounds, will be very aware of them. In this Minister Tony Blair about the reforms to the NHS that Conservative-led Government, we are very proud of the he introduced under the previous Labour Government. contribution that people from all over the world make to our NHS, and I believe that that needs to continue in Angie Bray: Does my hon. Friend agree that the most the future. As we have seen from the hon. Gentleman’s damaging thing for the NHS—patients and staff alike—is leader, his party makes it up as it goes along on things a lot of misleading scaremongering? I am afraid that we to do with the NHS. It is in favour of privatisation and have heard more of that in the Chamber today. Will he does not value the contribution—[Interruption.] correct the record to make sure that it is very clear that the pledge made by the Secretary of State for Health Sir Tony Baldry: On a point of order, Madam Deputy that the A and Es at Ealing and Charing Cross hospitals Speaker. There is so much noise coming from the will both remain open for the long term still stands, and Opposition Bench below the Gangway that it is impossible that they will allow themselves to be directed by Bruce even for someone who is as near to the Minister as me Keogh’s report such that whatever recommendations he to hear what he is saying. Given that Labour Members makes on A and E, they will make sure that they meet appear to support this Bill, it would be a courtesy for those requirements? them at least to listen to the Minister with some attention.

Dr Poulter: I am happy to confirm and to put on the Madam Deputy Speaker (Mrs Eleanor Laing): The record the points that my hon. Friend has made. It is right hon. Gentleman knows very well that all Members important that the NHS is not used as a political exercise their right to speak loudly, quietly, in stage football, and that services are always designed and whispers and in other ways in this Chamber. I am delivered in the right way for patients. There is often too listening very carefully to the level of noise, and if it much scaremongering in these debates. I reiterate that reaches much higher than it already has, I will ask what she said about the local A and Es is absolutely Members to be more courteous to the Minister. However, correct. I am quite sure that the Members present will wish to be courteous to the Minister and to hear what he has to say. Mr Slaughter: Will the Minister give way on that point? Dr Poulter: Thank you, Madam Deputy Speaker. I am sure that Members in all parts of the House—although Dr Poulter: I have just dealt with it, and I am going to perhaps not the hon. Member for Rochester and Strood— make a little progress. would like to reaffirm their commitment to and the I want to deal with the contribution made by the hon. value they place on all NHS staff, no matter what Member for Rochester and Strood (Mark Reckless). He background or culture they come from. We want those failed to address the issues that I had raised earlier staff to continue to practise in and work for our NHS to about the support that the hon. Member for Clacton the benefit of patients. (Douglas Carswell), his party colleague, gave to the Health and Social Bill—now the Health and Social Mark Reckless rose— Care Act. In fact, as the right hon. Member for Leigh (Andy Burnham) said, the hon. Member for Clacton Dr Poulter: I think that the hon. Gentleman has said thought that the reforms did not go far enough. Indeed, quite enough already, and I need to make some progress. the leader of his party is on record as talking about the need, in effect, to privatise our NHS. I would like to Let me move on to the second, substantive, point in reconfirm the commitment that that will absolutely this debate, on which I hope there will be a large never happen under this Government or any Conservative amount of agreement. It was articulated— Government. Mark Reckless rose— Another important point needs to be made. Earlier this week, the hon. Member for Rochester and Strood expressed frankly unacceptable and distasteful views on Madam Deputy Speaker: Order. The Minister is not repatriation. We must of course bear in mind that 40% giving way. of staff in our NHS come from very diverse, multicultural backgrounds. We very much value the contribution that Dr Poulter: Thank you, Madam Deputy Speaker. doctors, nurses and health care staff from all over the The point was articulated very well by my right hon. world make to our NHS. I do not want to see those Friend the Member for Banbury (Sir Tony Baldry) in people repatriated; I want to see them continuing to one of the best and most accurate speeches of this deliver high-quality care for patients in our NHS— Parliament in an NHS debate. something that UKIP clearly opposes. Mark Reckless: On a point of order, Madam Deputy Mark Reckless: I have made absolutely no such remarks; Speaker. The Minister has made a false allegation to I have said only that we wanted such people to be able which he has not given me the right of reply. Of course I to stay. The disgraceful remarks were actually made by welcome all those immigrants in the NHS. They are the Conservative candidate, who juxtaposed the issues very welcome and we want them to stay as much of unlimited immigration and fear of crime. as he does. 583 National Health Service (Amended 21 NOVEMBER 2014 National Health Service (Amended 584 Duties and Powers) Bill Duties and Powers) Bill Madam Deputy Speaker: There has been much discussion Mr Mike Weir (Angus) (SNP): There is an interesting this morning about who has said what about what. argument taking place between the two Front Benchers My concern in the Chair is that the Bill should be about who is responsible for bringing competition into discussed. That is the matter before the House, and we the health service, but the fact is that, no matter who is will discuss it. responsible, the health service could now come under the transatlantic trade and investment partnership. Why will the Government not specifically exclude health Dr Poulter: Thank you, Madam Deputy Speaker. I services from TTIP before it is negotiated? think the tone of that point of order made my point for me better than I could have done. Dr Poulter: I will come on to TTIP later, and I hope I As my right hon. Friend the Member for Banbury will be able to reassure the hon. Gentleman. said in what was one of the best speeches on the NHS I The previous Labour Government attempted to make have heard in this Parliament, the Health and Social commissioners compliant with the law by publishing Care Act 2012 did not introduce competition into our the “Principles and rules for cooperation and competition” NHS. To say that it did is factually incorrect, in 2007 and establishing the competition and co-operation scaremongering and distracts the NHS from addressing panel in 2009, to oversee Labour’s NHS marketplace. the key issues it faces. It was the creation of a mixed Let us be clear: it was the previous Labour Government health economy, implemented by the previous Labour who chose to introduce private providers into our NHS Government, that exposed our NHS to competition and it was the previous Labour Government who set up law, not the introduction of the Health and Social the legal framework to support private providers in the Care Act. health service. It has been said that Andy Burnham: That is a very important point that “the private sector puts its capacity into the NHS for the benefit goes to the heart of this debate and that really needs to of NHS patients, which I think most people in this country would be cleared up for those listening and watching. The celebrate.”—[Official Report, 15 May 2007; Vol. 460, c. 251WH.] Minister said that the Act did not introduce competition. Once again, those are not my words, but those of the Will he confirm that it gave, for the first time, a role to right hon. Member for Leigh when he was a Minister in the competition authorities under the Enterprise Act the previous Government. That is a fitting memory of 2002 and that since then they have intervened, for the the previous Labour Government’s expansion of private first time ever in the history of the NHS, in Bournemouth providers in the NHS. Let us remind ourselves of the and Poole? right hon. Gentleman’s words again: he said that most people in this country would celebrate the private sector Dr Poulter: What I will confirm is that it is factually in the NHS. correct, as my right hon. Friend the Member for Banbury made clear, to say that it was the previous Labour Mr Ronnie Campbell: The Minister talks about Labour Government—Tony Blair’s Government—who introduced privatisation, but why is it that so many Conservative competition into our NHS. At the end of Labour’s time Members are being paid by private companies? What in office, I believe that £6 billion a year was going to are you getting money off them for? What are you NHS providers. The right hon. Member for Leigh was doing? quite happy to pay private sector providers 11% more than NHS providers for providing the same service. Dr Poulter: I am just a doctor who still works in the That was Labour’s commitment to the private sector, health service and I practise medicine for free. Of course, which we have cleared up and put right in the 2012 Act. we could go into the fact that I am the only Front Let us remember what the Labour party said in its Bencher present who has front-line experience of looking last general election manifesto. I am sure Labour Members after patients. Professional politicians on the Opposition will remember it well—the right hon. Gentleman may Benches are outlining a case that is incoherent with well have written it. It said: their record in government. We could also talk about the huge union funding that goes towards many Labour “All hospitals will become Foundation Trusts…Foundation policies, but time would forbid us from doing so and I Trusts will be given the freedom to expand their provision…and am sure that the Deputy Speaker would not want me to community care, and to increase their private services”. digress from the subject of this debate. That is from the manifesto that every Labour Member Let us come on to what the Health and Social Care stood on at the last election. The facts are clear: competition Act actually did. First, it stripped out an entire layer of in our NHS was introduced well before this Parliament management from what was at the time an overly and well before this Government came into power. It bureaucratic NHS. This is an important point that hon. was introduced by policies made by Members who now Members would do well to listen to. The reforms will sit on the Opposition Benches—the policies of the save our NHS £5.5 billion in this Parliament alone, and previous Labour Government. £1.5 billion every following year. That money is being As my right hon. Friend the Member for Banbury put back into front-line patient care. In addition, as I reminded us, it was Labour that introduced the use of notified the House in an answer to a recent written independent treatment centres in 2003, the “any willing question, spending on administration as a proportion provider” policy and the advent of patient choice in of the total NHS budget has fallen under this Government 2006, and it was Labour’s policies when in government from 4.3% in 2010-11 to 2.9% in 2013. More money is that brought NHS commissioning under the scope of going into front-line patient care because we have stripped European competition law through the Public Contract out bureaucracy and administration and freed up that Regulations 2006. money to look after patients. 585 National Health Service (Amended 21 NOVEMBER 2014 National Health Service (Amended 586 Duties and Powers) Bill Duties and Powers) Bill Between 2010 and July 2014, the number of infrastructure Dr Poulter: The chief executive makes exactly the and administration support staff in the NHS has reduced point. It was of course the Labour Government who by 10.3%, which is about 21,000. That includes a 17.7% introduced competition into the NHS. If the hon. decrease in managers and senior managers combined. Gentleman has a problem, he should take it up with his Savings from reducing bureaucracy in this manner are colleagues further along the Front Bench who they being ploughed back into front-line patient care. For introduced competition into the NHS. Monitor, as the instance, we now employ 8,000 more doctors and 5,600 sector regulator, must now have regard to having better more nurses on our wards than in May 2010, and our integrated services, reducing fragmentation and putting NHS can do nearly 1 million more operations every more emphasis on the best interests of patients. year. The fourth effect of the Health and Social Care Act has been to provide clarity about existing NHS practices Clive Efford: The hon. Gentleman is taking us through on patient choice and competition that were introduced a very detailed list of bureaucratic costs. Obviously, the by the previous Government. Under the Act, nothing Government are paying close attention to that, but why changed from the rules laid down under Labour on how is it that when I asked them about the cost of overseeing commissioners should behave when they procure services. the tendering process—the cost of lawyers, accountants That has been borne out, despite the myths and scare and other advisers—they said that they do not collect stories surrounding the Act. , a former that information? Labour under Tony Blair and now head of NHS England, said to the Health Committee that Dr Poulter: I will come on later to the costs that the “if the claim was that CCGs have to start putting all of their hon. Gentleman’s Bill would directly create. The point health service purchases out to public procurement, that is clearly is that we should be proud—the Labour party should not true and it isn’t happening”. be supporting the Government—that we are reducing administration and bureaucratic costs, because that money That was the current head of the NHS making it clear is now being spent on patients. Why cannot Labour for and putting the record straight on the Opposition’s once accept that a good thing has happened and that scaremongering. The NHS agrees: the NHS Confederation more money is now going into front-line patient care? stated in its briefing on the Bill: The second effect of the 2012 Act is that it empowered “The current rules are clear that no-one can pursue competition local doctors and nurses, as those closest to and most in the NHS if it is not in the interests of patients.” able to determine the needs of their patients, to design Our NHS finances bear that out. In the last financial and lead the delivery of services around the needs of year, spending on independent health care provision by those patients. Thirdly, the Act placed great importance commissioners was shown to be about 6%, compared on and sought to drive increased integration across our with 5% under Labour in 2010. That is hardly evidence NHS, a point clearly articulated by my hon. Friend the of the sweeping privatisation of NHS services, but it is Member for Bosworth (David Tredinnick). Commissioners evidence of clinical commissioners making informed, had duties placed on them by the Act to consider how clinically led choices for the benefit of patients. services could be provided in a more integrated way, and we have since built on the Act by supporting a Dr Steve Kell, chair of the NHS Clinical Commissioners, number of integration pioneer sites, which will trail-blaze has made it clear that there is not a clinical commissioning new ideas to bring care closer together, particularly for group in the land that has any kind of “privatisation frail elderly people and people with complex care needs. agenda”. What CCGs all share is clinical expertise and They will be leaders of change—a change we have to see an unflinching desire to improve local health services in the health system, if we want to offer the very best for their patients. This Government will not stand in quality of care to patients. their way or play party politics with the judgments of doctors and nurses who are making the right choices in We are also supporting the health and care system the best interests of their patients. Indeed, Dr Michael through the £5.3 billion better care fund, with Dixon, chair of the NHS Alliance, and others wrote in commissioners working in partnership with local authorities The Daily Telegraph this morning: to deliver more integrated person-centred care. Offering seven-day services and delivering care that is centred on “As NHS doctors, we are deeply concerned about the misguided patients’ needs will encourage organisations to act earlier and potentially disruptive National Health Service Bill being debated today.” to prevent people from reaching crisis point. That is the sort of clinical leadership that the Act has fostered. It Working with other key health care organisations, will refocus the point of care towards more proactive NHS England—I hope that Labour Members will agree community-based care, for the benefit of so many patients. with this uncontroversial point—has set out how the health system must change over the next five years, Grahame M. Morris: The Minister is defending looking at new models of care delivery and taking a fragmentation, but may I, as a former member of the more integrated approach to the delivery of health and Health Committee, remind him that Sir David Nicholson, care. Earlier in the year, the head of NHS England, the former chief exec of the NHS, summed up the Simon Stevens, made it clear that if the procurement, situation last year by saying: patient choice and competition rules stood in the way of delivering the required changes, he would say so. Clearly, “You’ve got competition lawyers all over the place, causing enormous difficulty. We are getting, in my view, bogged down in a he has not done so. morass of competition law which is causing significant cost in the Let me be absolutely clear: the NHS England “Five system”. Year Forward View” did not call for further legislative Is the Minister saying that the chief exec is wrong in his change—that is what the Bill proposes—or for structural assessment? upheaval or a return to Whitehall control of our NHS. 587 National Health Service (Amended 21 NOVEMBER 2014 National Health Service (Amended 588 Duties and Powers) Bill Duties and Powers) Bill [Dr Poulter] It would not be permissible because of regulations introduced by the previous Labour Government. That I am sure that we can all agree that NHS England’s is another reminder that Labour introduced competition “Five Year Forward View” was an important piece of into the NHS. work that deserves to have broad cross-party consensus. As I explained earlier, under changes introduced by Politicians now need to leave the NHS to get on with the previous Labour Government, health commissioners the job: let the doctors and nurses run the NHS as we were subject to EU competition law for several years have freed them up to do. We can support leaders in the prior to the Act, and they would continue to be subject system, and help to free more money for front-line care to it even if the Act was repealed. through improved NHS procurement, better estate management and reduced spending on temporary staff. Dr Whiteford: The points the Minister is making However, making top-down legislative change to the about competition take us back to the transatlantic system, as the hon. Member for Eltham proposes, would trade and investment partnership. He must be aware be disastrous at a time when we should focus on supporting that the NHS across these islands is developing in very our NHS to deliver better care for patients. different directions, and competition has not been at the It is important to look at what the Bill would do. It is heart of what has happened in other parts of the UK. I quite simply wrong to believe that removing the parts of want him to give us cast-iron guarantees today that the 2012 Act that relate to the competition will stop there will be no obligation on the NHS in Scotland to competition law applying to our NHS. open up because of that trade agreement, even if the UK decides in its favour. What opportunities are there, if the treaty exposes the Scottish Government to— Mr Anderson: Is the Minister happy that, because of competition, groups such as Care UK have cut professional health workers’ pay by between 35% and 40%? How Mr Deputy Speaker (Mr Lindsay Hoyle): Order. The does he expect those people to feel motivated to go to hon. Lady must sit down. work every day when they cannot afford to pay their mortgage or to look after their kids properly? Is that Dr Poulter: I will come to TTIP shortly, and I think really what we should expect in this day and age? that I will be able to reassure the hon. Lady and the hon. Member for Angus (Mr Weir). Dr Poulter: The hon. Gentleman will be aware that The Health and Social Care Act put in place an Care UK provides a lot of the care in the social care alternative route to the courts, through Monitor, to sphere. I understand that much of the social care address abuses of the rules around procurement. The commissioned by local authorities is already provided Bill would remove that alternative route, meaning that by the private sector. The big idea of the right hon. future complaints under the law would result in hugely Member for Leigh is about driving further integration. costly legal processes for health care commissioners, Under the integration plans that he has outlined, more and complaints would be considered by the courts, power would of course be given to companies such as rather than by Monitor, a health expert regulator. That Care UK. We support integration, but it must be done cannot be good for patients. The Bill would result in in a way that always meets the best needs of local more money for the lawyers, and much less money for patients, and it must be evolutionary change rather than our NHS and the patients that it looks after. revolutionary change, working with front-line professionals Another important point is that by favouring NHS to do the best for their patients. over non-NHS providers, the Bill would be a move against the voluntary and charity sector providers, such Several hon. Members rose— as Macmillan and Marie Curie, who have done so much to help care for patients for many years. Dr Poulter: Let me make a little progress on the damage that the Bill might do. As I have said, the belief Jeremy Lefroy: I am glad that my hon. Friend has that removing the parts of the 2012 Act that relate to mentioned Macmillan. At the moment, Macmillan is in the competition will stop competition law applying the middle of tendering for end-of-life and cancer care to our NHS is simply wrong. That important point goes in Staffordshire, which hon. Members have mentioned. to the heart of what the right hon. Member for Leigh Although the integration that the tender requires is has said. absolutely vital—I think that it is supported by all Members, including the hon. Member for Stoke-on-Trent Central () in a recent article—one of the Dr Eilidh Whiteford (Banff and Buchan) (SNP): rose— real problems involves the mechanism. The fact is that the integration seems to require the tender to be for the Dr Poulter: If the hon. Lady will let me make some entire service, rather than for just a small contract, say, progress, I will come to her shortly. to help with integration. Will he comment on that, The fact that such a belief is wrong was recently because this is one of the problems at the heart of the made clear in correspondence from Simon Stevens to matter? We do not want large private companies to run the right hon. Gentleman—from one former Labour our cancer and end-of-life services. special adviser to another—which stated: Dr Poulter: In a moment I will address in a little more “We are, as appropriate, required to observe European procurement regulations, originally introduced in 2006, and related UK law. In detail a couple of the points that were raised. I reassure everything we do we are also required to exercise our functions my hon. Friend that the section 75 regulations that effectively, efficiently and economically. As a result we are advised underpin the Bill, which are almost identical to regulations that a blanket contracting ban would not be permissible.” that the previous Government were involved with, outline 589 National Health Service (Amended 21 NOVEMBER 2014 National Health Service (Amended 590 Duties and Powers) Bill Duties and Powers) Bill very clearly, under regulation 10, that integrated service, clear. I note the comments of Ignacio Garcia Bercero, or encouraging co-operation between providers in the EU chief negotiator, on the record at the end of round 7 interests of patients should not be seen as anti-competitive. negotiations— Regulation 15 makes it clear that Monitor cannot direct a commissioner to hold a competitive tender. There is Dr Whiteford rose— strong support throughout those regulations, as there is throughout the 2012 Act, for integrated service delivery Dr Poulter: I am addressing the hon. Lady’s point, so in the best interests of patients, where that is appropriate. I hope she will let me do so. Ignacio Garcia Bercero said: Joan Walley: Will the Minister give way? “I wish…to stress that our approach to services negotiations excludes any commitment on public services, and the governments Dr Poulter: I am going to make some progress—I remain at any time free to decide that certain services should be hope the hon. Lady will forgive me—because Mr Deputy provided by the public sector.” Speaker is looking at me. That is a very clear reassurance, and I hope it will be accepted by all hon. Members. I will give way just once Mr Deputy Speaker (Mr Lindsay Hoyle): Yes,Iam more, because I do not want to test Mr Deputy Speaker’s looking at you. patience as I come to a conclusion.

Dr Poulter: Points were made about the voluntary Dr Whiteford: I am grateful to the Minister, but my and charitable sector supporting innovative new models understanding is that the Commission has said that if of care. Through the Newquay pathfinder project Age one part of the UK market is opened up through UK has provided volunteer support to vulnerable older privatisation—perfectly democratically, as it could be—then people considered at risk. Under the home scheme the all parts will be opened up. I want his assurances that British Red Cross provides volunteer support to patients Scotland will not be forced, by the back door, to privatise in their homes, which is aimed at preventing admission its NHS on the coattails of this House. to, or facilitating discharge from, hospital. The charity has care in the home contracts with more than 30 NHS Dr Poulter: I believe I have given the hon. Lady those trusts and social services departments, and the scheme reassurances. enables reduced admissions, increased convenience to patients, and many other associated benefits. Clive Efford rose— My hon. Friend the Member for Stafford (Jeremy Lefroy) mentioned Macmillan. I like to talk about Dr Poulter: The Government’s health care reforms Macmillan, which has long provided vital support to ensured that, as under the last Labour Government, patients right across the UK. It is collaborating with day-to-day decisions of care delivery became the doctors in Staffordshire to transform cancer care and responsibility of clinically led NHS commissioners. It is end-of-life care, and together they aim to commission for the local NHS to decide which providers, whether care right across the patient journey. In cancer, that from the public, private or voluntary sectors, can best means commissioning prevention and health promotion, meet the needs of their patients and deliver high quality ensuring early diagnosis and prompt treatment through care. survivorship and improving end-of-life care. In reality, the only route proposed in the Bill for Clive Efford rose— recourse against unfair treatment by commissioners is to take us back to the previous Labour Government’s Dr Poulter: I will give way one more time in a moment, competition laws in 2006 and open up legal challenge and then that really will, I am afraid, be the lot, because through the courts. Only private providers with enough I know that Mr Deputy Speaker would like me to come resource behind them are likely to be able to afford to to a conclusion. exist in that court-based system, to pay high legal fees, and to invest in providing NHS care to patients, and smaller providers, especially charities, will lose out. Mr (Huddersfield) (Lab/Co-op): On Surely we do not want to see that in our NHS—an NHS a point of order, Mr Deputy Speaker. I do not know in which, I hope we all agree, charitable and small local what is going on with this speech. I know that the health care organisations have something important to Minister is a distinguished medical person, but he is contribute for the benefit of patients. presenting the speech with so much jargon and such technical terms that very few people out there will Before I conclude, I must briefly address some of the understand the main thrust of it. The only thing many misleading commentary that has surrounded TTIP, which people have understood in the last few minutes is the is serving only to distract from the real debate about our back-door privatisation. NHS. First, may I state that there is absolutely no agenda whatsoever to privatise our NHS through the back door? TTIP cannot force the privatisation of public Mr Deputy Speaker (Mr Lindsay Hoyle): That is services by EU member states. This position has been absolutely not a point of order, but we will hear from made explicitly clear by us and by the relevant negotiating some other speakers if we can get to the end of this parties. To suggest otherwise would be disingenuous speech. We might then hear some other parts of the and, frankly, wrong. I encourage Members to look at debate. the recent negotiating mandate published by the European Commission, where this position is made absolutely Dr Poulter: Thank you, Mr Deputy Speaker. 591 National Health Service (Amended 21 NOVEMBER 2014 National Health Service (Amended 592 Duties and Powers) Bill Duties and Powers) Bill [Dr Poulter] made I have further reassured the House about the protection that this Government have made for the I have mentioned the benefit to patients many times NHS in TTIP. in my speech, because that is, after all, what I care about I am immensely proud of the way our NHS has as a doctor and what I care about as a Health Minister, already responded to the challenges of a growing and and what I hope all hon. Members care about; I know ageing population, meeting increased demand through that the hon. Member for Huddersfield (Mr Sheerman) a purpose and drive to improve the quality of patient does so. care. That is why our NHS was recently ranked No. 1 in Additionally, and contrary to claims made by some, the Commonwealth Fund’s assessment of 11 global TTIP will not prevent any future Government from health care systems. This is at a time of unprecedented changing the legal framework for the provision of NHS challenge to public finances across the globe, and testifies services. Neither will it prevent the termination of the to the incredibly hard work of NHS staff and a very private provision of such a service in accordance with tough choice by this Government to protect our NHS the law or contracts entered into, as is already the case budget and increase it by £12.7 billion between 2010 today. The reassurances that we and the European and 2015—a decision that the right hon. Member for Commission offered were sufficient for the right hon. Leigh called irresponsible but one of which we are very Member for Wentworth and Dearne (John Healey), a proud. previous shadow Health Secretary, when he stated: I remind the House of the words of the right hon. “On the NHS....my direct discussions with the EU’s chief Member for Leigh when he was a Health Minister negotiator have helped produce an EU promise to fully protect defending Labour’s record on introducing private providers our health service including, as the chief negotiator says in a letter into our NHS: to me, so that: ‘any ISDS provisions in TTIP could have no impact on the UK’s sovereign right to make changes to the “I think the NHS can finally move beyond the polarising debates NHS.” of the last decade over private or public sector provision”. If it was good enough for the right hon. Gentleman— I agree: it is definitely time to move on. Our NHS focus needs to be on delivering for patients, so let us put distractions aside and let our hard-working doctors, Clive Efford rose— nurses and health professionals get on with the job.

John Healey rose— 12.58 pm Dr Poulter: I will give way to the hon. Member for (Worsley and Eccles South) (Lab): I Eltham and then I will conclude. congratulate my hon. Friend the Member for Eltham (Clive Efford) on his excellent opening speech—I think Clive Efford: That really will not wash. The Minister it was one of the best speeches I have heard in the is saying that we must trust the Government and that House—and on introducing his Bill so that we can they will not allow TTIP to apply to the national health review and reform some of the more pernicious effects service. The Bill says that this House will be sovereign; of the Health and Social Care Act 2012. One of the this House will decide whether TTIP applies to our worst was to force market tendering of services, meaning national health service. Does he support that? that millions of pounds are wasted on the process, money that should be spent on improving front-line patient care. Dr Poulter: I was simply quoting the reassurances that his right hon. Friend had given to all hon. Members, As a member of the Health Committee, I am very which was that concerned about the increasing role that private companies are paying in providing NHS services. We recently looked “any ISDS provisions in TTIP could have no impact on the UK’s at what is happening in Stoke and Staffordshire. There sovereign right to make changes to the NHS”. have been a few references to that in this debate and I If TTIP is good enough for the right hon. Member for will talk some more about it, but we looked at it under Wentworth and Dearne , it should be good enough for the label of the integrated care pioneers pilot. I want to everyone in the Labour party. talk more about that development as an example of just what can happen under this Government’s market John Healey: Would the Minister be good enough to framework—[Interruption.] concede that that has absolutely nothing to do with what the Government have been arguing; that is to do Mr Deputy Speaker (Mr Lindsay Hoyle): Order. There with the EU and their negotiation. The Trade Minister are a lot of conversations and I am struggling to hear in charge has said that he does not want the NHS to be the hon. Lady. If we need to have the conversations, can excluded in the way that we want. we turn them down a little?

Dr Poulter: No; I am simply quoting what the right Barbara Keeley: Thank you, Mr Deputy Speaker. hon. Gentleman has already put on the record about The clinical commissioning groups involved plan to reassurances that he has received from the EU about an tender by summer 2015 a £1.2 billion contract to deliver EU trade settlement. Surely, if the reassurances were cancer services and end-of-life care for 876,000 people good enough for him when he wanted to communicate across the area. The witnesses we heard from made it them more broadly to his colleagues, and more broadly clear that commissioning on a disease-specific basis like to members of the public, they are good enough now. It this is risky. There are only a few small-scale examples is very difficult to climb down from those reassurances, of that being done anywhere, and nothing on the scale which he has previously given, and in the remarks I have of this project. Despite the risk, we heard some worrying 593 National Health Service (Amended 21 NOVEMBER 2014 National Health Service (Amended 594 Duties and Powers) Bill Duties and Powers) Bill things about local people or local MPs not being listened The contracts for cancer and end-of-life care are to be to and about a lack of consultation with or involvement placed in early summer 2015, and I invite anybody with of hospital-based clinicians. The Minister has just referred an interest in this to review the evidence and, in particular, a number of times to letting doctors get on with running the unanswered questions in the session the Health the NHS, but the CCGs involved in driving this pilot Committee held on 14 October. I have yet to find are not even involving or listening to local clinicians. I assurances in the evidence I have heard that the profit and other colleagues on the Committee found that motive of private providers can be squared with the bodies such as Healthwatch England and Macmillan objective of improving cancer care and end-of-life care Cancer Support were cheerleaders for—and in Macmillan’s for patients. case, a funder of—development work on a project that could end up privatising cancer and end-of-life care for Chris Ruane (Vale of Clwyd) (Lab): Cancer care for almost a million people. I for one found that disturbing. north Wales is provided by bodies in the north-west of I felt, and I know that some of my colleagues did too, England. MPs on the Government Benches are saying that there was a conflict of interest. Healthwatch England that I, as a Welsh MP, should not have a vote on this was meant to be the consumer champion of health and matter. What does my hon. Friend think about that? care. Should I be concerned about standards of care and the By contrast with what Government Members have privatisation of the English health service? My constituents said, there was also a fair amount of concern among will suffer if it is hollowed out and privatised by the Committee members about the role of Macmillan Cancer Government. Support in funding the development work when many believe that the money they give to Macmillan goes Barbara Keeley: My hon. Friend absolutely should be directly to cancer care. Indeed, the example I saw on the concerned and I know that he is. Macmillan website yesterday was that a donation would One of the elements of cancer and end-of-life care pay for a Macmillan nurse for a period to help people given to us as an example of where improvement is living with cancer and their families receive essential needed in Staffordshire and Stoke was patient transport. medical, practical and emotional support. It does not However, we know in the north-west that going to new appear to be a selling point for that charity that funds private providers does not tend to help. We have already would be used on a project to privatise end-of-life and had a negative experience since patient transport was cancer care in Staffordshire and Stoke. contracted out to the bus company Arriva. A number of my constituents have had problems Jeremy Lefroy: As I have already said, I have major with Arriva’s patient transport. One contacted me following concerns about the form of the contract. The hon. a wait of more than three hours for ambulance transport Member for Stoke-on-Trent Central (Tristram Hunt) to be arranged for her husband. He has terminal cancer wrote, and I say this in defence of Macmillan: and needed to be transported back to Salford Royal “This is the context for our new cancer contract and we should after oncology treatment at the Christie hospital. That not pass knee-jerk judgments upon new ideas which aim for was the second time in three weeks that this terminally better outcomes and efficiency.” ill patient had to wait two or three hours for transport. That is what Macmillan is after. Staff at the Christie hospital told my constituent that such long waits were common, despite the fact that Barbara Keeley: I thank the hon. Gentleman for that many oncology patients are very sick. comment, but the point is that Macmillan Cancer Support is using money fundraised by the public in ways that I Mr Slaughter: I am very grateful to my hon. Friend do not think the public would approve of. That was the for giving way, particularly because the Minister did not key thing we explored. It is not at all clear, if we look at in the course of his very long speech. Of course, that the Macmillan website, how it is using approaching might have been because the main emergency hospital £1 million of the public’s money, donated on that basis. in my constituency, Charing Cross, is being demolished, losing all but 24 of its 360 beds, losing the best stroke Valerie Vaz: My hon. Friend mentions conflicts of unit in the country and losing its A and E, which, interest. Is she aware that one of the companies bidding according to board papers, is moving from the site. bid for the privatisation of cancer services is UnitedHealth There will be no emergency consultancy services at all. Group, which was advised by the chief executive of Is not what is happening on the ground very different NHS England? from the jargon-filled rubbish we heard from the Minister today? Barbara Keeley: Indeed. Now that the shortlist for bidding has been announced for end-of-life care, we Barbara Keeley: Absolutely, and I am saying what is find that five of the shortlisted bidders are private happening on the ground to a terminally ill cancer companies, with only two NHS trusts on the list. For patient. cancer care, there are three private companies and two NHS trusts. Given the seemingly headlong drive for In her letter to Arriva, my constituent told the company: change we found in those commissioning this large and “Your company should not have this contract if it displays risky contract, a great number of questions were left such a lack of concern for very ill patients causing distress to both unanswered. For instance, despite the key role that GPs them and their relatives”. play in end-of-life care for patients choosing to die at Not only was the delay unacceptable to a terminally ill home, the prime provider of end-of-life care will not patient, but the reply to my constituent’s complaint was have control over the actions of the GPs involved in one of the worst I have ever seen, as we are talking that care unless a specific contract is drawn up and GPs about gobbledegook. For instance, the explanation for are paid for extra tasks. the long wait included the following sentence: 595 National Health Service (Amended 21 NOVEMBER 2014 National Health Service (Amended 596 Duties and Powers) Bill Duties and Powers) Bill [Barbara Keeley] element is dominant in the Act, but that is not true. The procurement policy is set out to secure the needs of “When an outpatient booking is made, the expected outbound patients and improve quality and efficiency. I want to blocking is automatically populated, using the throughput give an example from my constituency of how the assumption.” reforms are working. Royston is part of the Peterborough The jargon that starts at the top permeates down even and Cambridge CCG. Before that was so, we had a to the complaint handling. It took a lot more letters to proposal for the redevelopment of Royston hospital. A get an apology for such appalling service and such a Royston hospital action group was formed, while the poor reply. friends of Royston hospital were concerned about the Another constituent has told me of unsuitable transport proposals, which were top down. However, Tom Dutton, and untrained staff—we have heard about this happening the CCG strategic lead, has worked tirelessly with the across the country—sent to the home of a patient who NHS and the local community, as has the local chairman, needed to use a wheelchair. That meant that the patient Dr John Hedges, a GP in Royston, and they understand missed their appointment and an important investigation local needs, so we are now getting tailored provision of their health was delayed by a number of weeks. I that suits the needs of my constituents. trust that the commissioners driving the privatisation of I meet the CCG, councillors, local groups and other cancer services in Staffordshire and Stoke are aware of stakeholders every six weeks, and I believe that we are just how wrong transport services can go with a private now getting a service for Royston and a proposal that transport provider. meet local needs. The £1 billion tender for older people’s This Government’s measures have put competition services was in our CCG area. The hon. Member for and privatisation above the needs of NHS patients. The Eltham (Clive Efford) criticised the cost, but we had a Health and Social Care Act has put pressure on regulators consultation meeting in Royston that 150 local people to make clinical commissioning groups and NHS trusts attended, while 250 local people filled out the questionnaire. adopt tendering processes that are not in the best interest The proposal and consultation will have cost money, of patients. That means wasted money, resources and yes, but the end result was that the tender process was time. This Bill would remove these damaging reforms, won by the Uniting Care partnership, an NHS partnership and patient care would be prioritised instead of unnecessary involving Addenbrooke’s hospital and the Cambridge competition. The Bill would not prevent competition and Peterborough NHS trust, and it is now delivering within the NHS, but it would prevent competition at the more joined-up care. expense of patient care. Our national health service is different from other Dr Huppert: I was delighted with that outcome. One sectors and needs a different approach. Integration to of the successes I hope the hon. and learned Gentleman improve patient care needs collaboration rather than will mention is the better joint working between acute competition. It is a great pleasure to be in the Chamber care, mental health care and community services to today to speak and vote in support of the Bill. avoid delays in the transfer of care. This could be a very good outcome for the NHS and patients. 1.8 pm Sir Oliver Heald: That is exactly the point I was going Sir Oliver Heald (North East Hertfordshire) (Con): I to make. The process, which involved local people, has am grateful to have the opportunity to make a few short resulted in a reform that gives us the sort of joined-up remarks. The hon. Member for Worsley and Eccles care the hon. Gentleman mentions. South (Barbara Keeley) is right to be concerned about any problem that occurs in the NHS, but I am sure she To conclude, the Bill seeks to prevent privatisation would accept that it is an enormous organisation and that is not happening on the ground, while some of the that the key point is that when things go wrong, the changes we have made are bringing positive benefits for lessons are learned and things are put right. Most of the people in my constituency. life of the NHS has been under Conservative Governments, and we on the Government Benches are as proud of the 1.13 pm NHS as Labour Members are. I congratulate the hon. Member for Eltham (Clive Mrs Emma Lewell-Buck (South Shields) (Lab): I would Efford) on being a strong voice for Labour principles, like to offer my support for the Bill and congratulate my but I am concerned that the effect of his Bill will be to hon. Friend the Member for Eltham (Clive Efford) on undermine the operational independence of the NHS, bringing it to the House. cause disruption and introduce unnecessary bureaucracy. Members will be pleased that I intend to keep my Putting powers back with the Secretary of State through comments brief. Our NHS is a monumental achievement the re-establishment of powers of direction is going in and one that my party remains deeply proud of. There the wrong direction. Preventing illness, diagnosing and are many people alive today who remember what life treating patients are not political activities. They should was like before the NHS and who would never go back be in the hands of professionals and the operational to a time when the poor could not afford treatment for independence of the NHS means that clinical considerations preventable illnesses. That is the generation that truly are paramount. When I was a Health spokesperson, I understands what the NHS means and why we must went to look at health systems in Europe, and the key protect it. point I took away was that the best systems were those That is not to say that people today take the NHS with a lot of clinical input in management. for granted. In fact my inbox, like those of other It is not necessary to rewrite the Act. Instead, the hon. Members, has been overflowing with e-mails from changes we have made need to work their way through. constituents worried about the future of our health The shadow Secretary of State said that the competition service. They want the principle of free and equal access 597 National Health Service (Amended 21 NOVEMBER 2014 National Health Service (Amended 598 Duties and Powers) Bill Duties and Powers) Bill protected and the needs of patients put before profit, as I welcome clause 1. During the trust special administrator they should be. I and those people are afraid of the process that we had to go through, the inability of direction the NHS is heading in under this Government. providers and commissioners to speak to one another—in We see the Tories wedging open the door for private some cases because of so-called commercial confidentiality companies to come in and deliver services, and we see —was ridiculous and without doubt delayed the process. hospitals encouraged to take on ever more private patients. At certain points, the whole process cried out for someone, People do not believe the Government’s spin: they if necessary the Secretary of State, to put everyone in a know that the changes are part of the creeping privatisation room for a day with instructions not to leave until being encouraged by the Tories and that the reorganisation everything had been sorted out. However, everybody in the 2012 Act was all about Tory ideology, not patient was walking on eggshells in case they did something care. The reorganisation wasted £3 billion and has seen that might result in a judicial review and a reversion to millions more spent on tendering exercises and competition square one. That was not in the interests of patients. lawyers which could have been spent on treatment for That is not to be critical of those involved: for the most those who genuinely needed it. They also know that part they tried very hard and we got a better result than they cannot trust a Health Secretary who has previously at some points we feared. backed calls to dismantle the NHS or a party that I want to make a serious point about clause 1 and the brought the NHS to the brink of collapse the last time it desire for the Bill to place the running of the NHS was in power. Back then, it took a Labour Government firmly in the hands of the Secretary of State. It is vital to save the NHS, and now history is repeating itself. that there should not be too much hands-on running of The constituents who have written to me, the people I the NHS by the Secretary of State—the British Medical was proud to join on the NHS march earlier this year Association, which has some very positive comments and those I joined last night for a vigil outside Parliament about the Bill, says that as well. understand what is at stake. The NHS is more than just I am short of time, so let me conclude by talking a service; it is a principle of fairness. Illness and accidents about cancer and end-of-life services, which have been strike us all at some point, often without warning and raised today. The problem is the way in which the NHS leaving us little time to plan, and before the NHS, this is funded and the fact that the tender is for all services kind of misfortune could destroy lives and condemn involved in those pathways. It would have been much families to extreme poverty. Now we have a service that more sensible for the tender to help the work of integration, says nobody, whether rich or poor, should have their life which would have involved a much smaller amount, ruined by misfortune. That is the principle that my hon. rather than the full amount of services. Friends and I are standing up for today. Clive Efford claimed to move the closure (Standing 1.15 pm Order No. 36). Jeremy Lefroy (Stafford) (Con): I welcome the Bill Question put forthwith, That the Question be now and congratulate the hon. Member for Eltham (Clive put. Efford) on introducing it; I shall be supporting its The House proceeded to a Division. Second Reading today. My support derives mainly from my and my constituents’ Mr Deputy Speaker (Mr Lindsay Hoyle): I ask the experiences over several years of some of the workings Serjeant at Arms to investigate the delay in the No of the Health Act 2006, introduced by the previous Lobby. Government, and the 2012 Act, introduced by the this The House having divided: Ayes 239, Noes 20. Government. In particular, two matters have been, and continue to be, of great significance: first, the two Division No. 89] [1.19 pm Francis inquiries into cases of dreadful care in my constituency, and secondly, the reports that have had AYES such a major influence on the entire NHS. Just yesterday, Abbott, Ms Diane Brown, Lyn my wife was giving a lecture to medical students on Abrahams, Debbie Brown, rh Mr Nicholas aspects of the Francis reports. It is vital that these Ainsworth, rh Mr Bob Brown, Mr Russell lessons, particularly on patient safety and zero avoidable Alexander, rh Mr Douglas Buck, Ms Karen harm, are not forgotten, which is why I introduced a Bill Alexander, Heidi Burden, Richard Ali, Rushanara Burnham, rh Andy on the subject two weeks ago. Allen, Mr Graham Byrne, rh Mr Liam The second concerns a more recent matter referred to Anderson, Mr David Campbell, rh Mr Alan already today: the review, supported by Macmillan, of Ashworth, Jonathan Campbell, Mr Ronnie cancer and end-of-life services in north Staffordshire, Austin, Ian Carswell, Douglas Stoke-on-Trent, Stafford and Cannock, which has resulted Bain, Mr William Caton, Martin in a tender of all these services to be managed through Balls, rh Ed Champion, Sarah an integrator. Just to correct the record, it is not just Banks, Gordon Chapman, Jenny private companies on the tender—NHS organisations Barron, rh Kevin Clark, Katy are also on it—but I still have major concerns. I am Beckett, rh Margaret Clarke, rh Mr Tom Begg, Dame Anne Clwyd, rh Ann looking at this through the eyes of patients everywhere. Benn, rh Hilary Coaker, Vernon The NHS must not be about structures or be in thrall to Berger, Luciana Connarty, Michael political dogma of any kind; it must be about safety and Blackman-Woods, Roberta Cooper, Rosie quality of care for all patients. I hope the Government Blears, rh Hazel Cooper, rh Yvette might see the Bill in that way and use it as an opportunity Blomfield, Paul Corbyn, Jeremy to make improvements to both the 2006 Act and the Blunkett, rh Mr David Creagh, Mary 2012 Act. Brennan, Kevin Creasy, Stella 599 National Health Service (Amended 21 NOVEMBER 2014 National Health Service (Amended 600 Duties and Powers) Bill Duties and Powers) Bill Cryer, John Jarvis, Dan Reynolds, Emma Thomas, Mr Gareth Cunningham, Alex Johnson, Diana Reynolds, Jonathan Thornberry, Emily Cunningham, Mr Jim Jones, Graham Riordan, Mrs Linda Timms, rh Stephen Cunningham, Sir Tony Jones, Mr Kevan Robertson, Angus Trickett, Jon Curran, Margaret Jones, Susan Elan Robertson, John Turner, Karl Darling, rh Mr Alistair Jowell, rh Dame Tessa Robinson, Mr Geoffrey Twigg, Derek David, Wayne Kane, Mike Rotheram, Steve Twigg, Stephen Davidson, Mr Ian Kaufman, rh Sir Gerald Roy, Mr Frank Umunna, Mr Chuka Davies, Geraint Keeley, Barbara Ruane, Chris Vaz, Valerie De Piero, Gloria Kendall, Liz Ruddock, rh Dame Joan Walley, Joan Denham, rh Mr John Khan, rh Sadiq Sarwar, Anas Watson, Mr Tom Dobson, rh Frank Lammy, rh Mr David Sawford, Andy Watts, Mr Dave Docherty, Thomas Lavery, Ian Seabeck, Alison Weir, Mr Mike Donohoe, Mr Brian H. Lazarowicz, Mark Sharma, Mr Virendra Whiteford, Dr Eilidh Doughty, Stephen Lefroy, Jeremy Sheerman, Mr Barry Whitehead, Dr Alan Dowd, Jim Leslie, Chris Sheridan, Jim Williams, Hywel Doyle, Gemma Lewell-Buck, Mrs Emma Shuker, Gavin Williamson, Chris Dromey, Jack Lewis, Mr Ivan Skinner, Mr Dennis Wilson, Phil Dugher, Michael Long, Naomi Slaughter, Mr Andy Winterton, rh Ms Rosie Durkan, Mark Love, Mr Andrew Smith, Angela Wishart, Pete Eagle, Ms Angela Lucas, Caroline Smith, Nick Woodcock, John Eagle, Maria Lucas, Ian Smith, Owen Wright, David Edwards, Jonathan MacNeil, Mr Angus Brendan Spellar, rh Mr John Wright, Mr Iain Efford, Clive Mactaggart, Fiona Straw, rh Mr Jack Elliott, Julie Mahmood, Shabana Stringer, Graham Tellers for the Ayes: Ellman, Mrs Louise Malhotra, Seema Stuart, Ms Gisela Nic Dakin and Engel, Natascha Mann, John Tami, Mark Tom Blenkinsop Esterson, Bill Marsden, Mr Gordon Evans, Chris McCann, Mr Michael NOES Farrelly, Paul McCarthy, Kerry Fitzpatrick, Jim McDonagh, Siobhain Baldry, rh Sir Tony Metcalfe, Stephen Flello, Robert McDonald, Andy Baldwin, Harriett Mordaunt, Penny Flint, rh Caroline McDonnell, John Bray, Angie Nuttall, Mr David Flynn, Paul McFadden, rh Mr Pat Chope, Mr Christopher Patel, Priti Fovargue, Yvonne McGovern, Alison Davies, Philip Penning, rh Mike Francis, Dr Hywel McGuire, rh Mrs Anne Eustice, George Poulter, Dr Daniel Galloway, George McInnes, Liz Goodwill, Mr Robert Swayne, rh Mr Desmond Gapes, Mike McKechin, Ann Gyimah, Mr Sam Vaizey, Mr Edward Gardiner, Barry McKenzie, Mr Iain Hands, rh Greg George, Andrew McKinnell, Catherine Heald, Sir Oliver Tellers for the Noes: Gilmore, Sheila Meacher, rh Mr Michael Hollobone, Mr Philip Anne Milton and Glass, Pat Meale, Sir Alan Letwin, rh Mr Oliver Mr David Evennett Glindon, Mrs Mary Mearns, Ian Godsiff, Mr Roger Miliband, rh Edward Question accordingly agreed to. Goodman, Helen Miller, Andrew Greatrex, Tom Mitchell, Austin Question put accordingly, That the Bill be now read a Green, Kate Moon, Mrs Madeleine Second time. Greenwood, Lilian Morden, Jessica The House proceeded to a Division. Griffith, Nia Morrice, Graeme (Livingston) Gwynne, Andrew Morris, Grahame M. Mr Deputy Speaker (Mr Lindsay Hoyle): I ask the Hamilton, Mr David (Easington) Serjeant at Arms to investigate the delay in the No Hamilton, Fabian Mulholland, Greg Hanson, rh Mr David Murphy, rh Mr Jim Lobby. Harman, rh Ms Harriet Murphy, rh Paul The House having divided: Ayes 241, Noes 18. Harris, Mr Tom Murray, Ian Havard, Mr Dai Nandy, Lisa Division No. 90] [1.34 pm Healey, rh John Nash, Pamela Heath, Mr David O’Donnell, Fiona AYES Hendrick, Mark Onwurah, Chi Abbott, Ms Diane Beckett, rh Margaret Heyes, David Osborne, Sandra Abrahams, Debbie Begg, Dame Anne Hillier, Meg Owen, Albert Ainsworth, rh Mr Bob Benn, rh Hilary Hilling, Julie Pearce, Teresa Alexander, rh Mr Douglas Berger, Luciana Hodgson, Mrs Sharon Perkins, Toby Alexander, Heidi Blackman-Woods, Roberta Hoey, Kate Phillipson, Bridget Ali, Rushanara Blears, rh Hazel Hosie, Stewart Pound, Stephen Allen, Mr Graham Blomfield, Paul Howarth, rh Mr George Pugh, John Anderson, Mr , rh Mr David Hunt, Tristram Qureshi, Yasmin Ashworth, Jonathan Brennan, Kevin Huppert, Dr Julian Raynsford, rh Mr Nick Austin, Ian Brown, Lyn Irranca-Davies, Huw Reckless, Mark Bain, Mr William Brown, rh Mr Nicholas Jackson, Glenda Reed, Mr Jamie Balls, rh Ed Brown, Mr Russell James, Mrs Siân C. Reeves, Rachel Banks, Gordon Buck, Ms Karen Jamieson, Cathy Reid, Mr Alan Barron, rh Kevin Burden, Richard 601 National Health Service (Amended 21 NOVEMBER 2014 National Health Service (Amended 602 Duties and Powers) Bill Duties and Powers) Bill Burnham, rh Andy Hanson, rh Mr David Morris, Grahame M. Sheridan, Jim Byrne, rh Mr Liam Harman, rh Ms Harriet (Easington) Shuker, Gavin Campbell, rh Mr Alan Harris, Mr Tom Mulholland, Greg Skinner, Mr Dennis Campbell, Mr Ronnie Havard, Mr Dai Murphy, rh Mr Jim Slaughter, Mr Andy Carswell, Douglas Healey, rh John Murphy, rh Paul Smith, Angela Caton, Martin Heath, Mr David Murray, Ian Smith, Nick Champion, Sarah Hendrick, Mark Nandy, Lisa Smith, Owen Chapman, Jenny Heyes, David Nash, Pamela Spellar, rh Mr John Clark, Katy Hillier, Meg O’Donnell, Fiona Straw, rh Mr Jack Clarke, rh Mr Tom Hilling, Julie Onwurah, Chi Stringer, Graham Clwyd, rh Ann Hodgson, Mrs Sharon Osborne, Sandra Stuart, Ms Gisela Coaker, Vernon Hoey, Kate Owen, Albert Tami, Mark Connarty, Michael Hollobone, Mr Philip Pearce, Teresa Thomas, Mr Gareth Cooper, Rosie Hosie, Stewart Perkins, Toby Thornberry, Emily Cooper, rh Yvette Howarth, rh Mr George Phillipson, Bridget Timms, rh Stephen Corbyn, , Tristram Pound, Stephen Trickett, Jon Creagh, Mary Huppert, Dr Julian Pugh, John Turner, Karl Creasy, Stella Irranca-Davies, Huw Qureshi, Yasmin Twigg, Derek Cryer, John Jackson, Glenda Raynsford, rh Mr Nick Twigg, Stephen Cunningham, Alex James, Mrs Siân C. Reckless, Mark Umunna, Mr Chuka Cunningham, Mr Jim Jamieson, Cathy Reed, Mr Jamie Vaz, Valerie Cunningham, Sir Tony Jarvis, Dan Reeves, Rachel Walley, Joan Curran, Margaret Johnson, Diana Reid, Mr Alan Watson, Mr Tom Darling, rh Mr Alistair Jones, Graham Reynolds, Emma Watts, Mr Dave David, Wayne Jones, Mr Kevan Reynolds, Jonathan Weir, Mr Mike Davidson, Mr Ian Jones, Susan Elan Riordan, Mrs Linda Whiteford, Dr Eilidh Davies, Geraint Jowell, rh Dame Tessa Robertson, Angus Whitehead, Dr Alan De Piero, Gloria Kane, Mike Robertson, John Williams, Hywel Denham, rh Mr John Kaufman, rh Sir Gerald Robinson, Mr Geoffrey Williamson, Chris Dobson, rh Frank Keeley, Barbara Rotheram, Steve Wilson, Phil Docherty, Thomas Kendall, Liz Roy, Mr Frank Winterton, rh Ms Rosie Donohoe, Mr Brian H. Khan, rh Sadiq Ruane, Chris Wishart, Pete Doughty, Stephen Lammy, rh Mr David Ruddock, rh Dame Joan Woodcock, John Dowd, Jim Lavery, Ian Russell, Sir Bob Wright, David Doyle, Gemma Lazarowicz, Mark Sarwar, Anas Wright, Mr Iain Dromey, Jack Lefroy, Jeremy Sawford, Andy Dugher, Michael Leslie, Chris Seabeck, Alison Tellers for the Ayes: Durkan, Mark Lewell-Buck, Mrs Emma Sharma, Mr Virendra Nic Dakin and Eagle, Ms Angela Lewis, Mr Ivan Sheerman, Mr Barry Tom Blenkinsop Eagle, Maria Long, Naomi Edwards, Jonathan Love, Mr Andrew NOES Efford, Clive Lucas, Caroline Elliott, Julie Lucas, Ian Baldry, rh Sir Tony Letwin, rh Mr Oliver Ellman, Mrs Louise MacNeil, Mr Angus Brendan Baldwin, Harriett Nuttall, Mr David Engel, Natascha Mactaggart, Fiona Bray, Angie Patel, Priti Esterson, Bill Mahmood, Shabana Chope, Mr Christopher Penning, rh Mike Evans, Chris Malhotra, Seema Davies, Philip Poulter, Dr Daniel Farrelly, Paul Mann, John Dunne, Mr Philip Swayne, rh Mr Desmond Fitzpatrick, Jim Marsden, Mr Gordon Eustice, George Vaizey, Mr Edward Flello, Robert McCann, Mr Michael Goodwill, Mr Robert Flint, rh Caroline McCarthy, Kerry Gyimah, Mr Sam Tellers for the Noes: Flynn, Paul McDonagh, Siobhain Hands, rh Greg Anne Milton and Fovargue, Yvonne McDonald, Andy Heald, Sir Oliver Mr David Evennett Francis, Dr Hywel McDonnell, John Galloway, George McFadden, rh Mr Pat Question accordingly agreed to. Gapes, Mike McGovern, Alison Bill accordingly read a Second time; to stand committed Gardiner, Barry McGuire, rh Mrs Anne to a Public Bill Committee (Standing Order No. 63.) George, Andrew McInnes, Liz Gilmore, Sheila McKechin, Ann Clive Efford: On a point of order, Mr Deputy Speaker. Glass, Pat McKenzie, Mr Iain I understand that, in order to go into Committee, this Glindon, Mrs Mary McKinnell, Catherine Bill requires a resolution from the Government. Given Godsiff, Mr Roger Meacher, rh Mr Michael the overwhelming numbers of people who turned up on Goodman, Helen Meale, Sir Alan a Friday to support it, would it not be churlish of the Greatrex, Tom Mearns, Ian Government not to pass that resolution and make sure Green, Kate Miliband, rh Edward Greenwood, Lilian Miller, Andrew that this Bill goes into Committee forthwith? Griffith, Nia Mitchell, Austin Mr Deputy Speaker (Mr Lindsay Hoyle): As you Gwynne, Andrew Moon, Mrs Madeleine pointed out, it is something for the Government, but Hamilton, Mr David Morden, Jessica not me, to take on board. Hamilton, Fabian Morrice, Graeme (Livingston) 603 21 NOVEMBER 2014 Zero Hours Contracts Bill 604

Zero Hours Contracts Bill Ian Mearns: If the hon. Gentleman had been listening, he would have heard me point out that Ministers in his Second Reading own Government were admitting to 200,000 such contracts only three years ago, but there are now 1.4 million of 1.50 pm them, which is a massive burgeoning in the use and exploitation of workers through the abuse of zero-hours Ian Mearns (Gateshead) (Lab): I beg to move, That contracts. the Bill be now read a Second time. In politics, it is said that there are no final victories Ian Murray (Edinburgh South) (Lab): My hon. Friend and no final defeats; that each generation must fight is making a powerful speech on the use of zero-hours many of the same battles that the generation before contracts, but is not the proof of the pudding always have, and that the generation after may have to fight as in the eating? Although unemployment has gone down well. Today, I am fighting for the same thing that people in this country, the tax-take to the Treasury from income of every generation have fought for: the right to decent tax has stayed flat, despite the Treasury predicting a and secure conditions and terms of employment. huge increase. That shows that we have under-employment It is not a great ask. A well-paid and steady job and a massive explosion in zero-hours contracts. is the bedrock on which people build their lives. It is the starting point for planning for the future, and the Ian Mearns: I am grateful to my hon. Friend for platform of stability needed to pay the bills, meet the making that point. Government Members celebrate the rent, pay the mortgage and start a family. Those are not fact that 3 million workers have been taken out of tax extravagances, but the minimum that should be available completely, but they are also celebrating the fact that to any person who is prepared to work to pay their way 2 million of them are earning £200 or less a week. I do in a wealthy nation such as ours. Yet that stability and not think that is anything to celebrate in this day and security is denied to millions of workers in this country. age. Increasingly, people are finding themselves plagued by Given the variety of employers now using zero-hours job insecurity, not knowing from one day to the next contracts, from Sports Direct to Buckingham palace whether they will be working or earning. even, it is clear that they are not just filling a niche; they In recent years, the rise in the number of those feeling are also being exploited by unscrupulous employers insecure at work has been startling. In 2011, 6.5 million looking to dodge their responsibilities to their staff. people surveyed said that they felt insecure in their work. By this year, that number had almost doubled to Philip Davies (Shipley) (Con): The hon. Gentleman 12 million people. talks about employers exploiting their workers by giving them zero-hours contracts. I presume that within that Mr David Nuttall (Bury North) (Con) rose— group he includes all the Labour councils that employ people that way. Has he done any investigations into Ian Mearns: Let me make some progress. What we why so many Labour councils employ so many people have witnessed is not so much an economic recovery as on zero-hours contracts? an economic transformation. Almost daily, the Government boast about job creation in the private sector, but the Ian Mearns: As a matter of fact, I have. I would ask truth is that the jobs that were lost due to the global colleagues engaged in public service provision up and economic crash and the Government cuts have been down the country to think very deeply about their largely replaced by low-skilled, low-waged and, sadly, employment practices. I do not condone it, but I know insecure jobs. It is leaving large swathes of the work that for some workers zero-hours contracts are a handy force living on, or just above, the breadline. way of gaining part-time employment, but only part-time employment. Many find it very difficult to sustain an As they are so keen to remind us, the Conservatives ordinary family life on a zero-hours contract. have a long-term economic plan, but it is not one for the working person. Nowhere is that clearer than in the Ian Lavery (Wansbeck) (Lab): Is not the fact of the explosion in the use of zero-hours contracts. As recently matter that the Bill, if we manage to pass it, would as last year, the coalition was claiming that slightly prevent anyone, whether a Labour council, a Tory council more than 200,000 people were employed on zero-hours or even a Tory MP, employing people on zero-hours contracts. The true figure, as revealed by the Office for contracts? They would be abolished entirely. National Statistics, was in fact seven times higher than Government Ministers admitted—a staggering 1.4 million Ian Mearns: I am grateful to my hon. Friend for that people engaged in zero-hours employment contracts. intervention. The Bill seeks to curtail the use of zero-hours Zero-hours contracts—if they are used at all—are contracts severely. supposed to be used for short-term or seasonal work, occupying a niche in the labour market, but the reality Mr (Knowsley) (Lab): My hon. is that they have become the norm across many sectors. Friend is being generous in giving way. He is making a powerful case for how morally repugnant that kind of Mr Nuttall: The hon. Gentleman makes reference to employment is, but does he also agree that more enlightened the number of zero-hours contracts that exist at the employers say that it is actually a lazy form of employing moment. Back in 2000, the ONS estimated that there people and that, with more thought, those employees were 225,000 people on zero-hours contracts. Why is it could have proper contracts and proper hours? all right for people to be on a zero-hours contract under a Labour Government, but not under a Conservative- Ian Mearns: I will be developing that point in due led one? course. 605 Zero Hours Contracts Bill21 NOVEMBER 2014 Zero Hours Contracts Bill 606

The gross weekly average wage for a zero-hours contract and then it turned out that the employer was not even worker is £236, which is a full £246 less than the average paying him the . It is just not good wage for those in regular, full-time employment. We enough. really need to think about the fact that in a nation such as ours, and in this day and age, so many people are Ian Mearns: My hon. Friend’s example exemplifies employed on irregular hours and earn a mere £236 a the exploitative practices and abuse by some employers. week. Workplaces that utilise zero-hours contracts have For Government Members to deny that this is happening a higher proportion of staff on low pay, and those is unbelievable. employed on zero-hours contracts also work fewer hours— These are employment practices from another era, they work an average of 21 hours a week—than those in which is where they should remain. Zero-hours contracts other part-time jobs who are not on zero-hours contracts, are a new manifestation of the casualisation of the who work an average of 31 hours a week. labour market, a race to the bottom in wages and terms Zero-hours contracts are an employer’s paradise. In and conditions, and a return to the bad old days of fact, they are a one-way street, because they demand workers queuing at the factory gates, the shipyard or total flexibility and commitment from individual employees the pit and hoping to be picked to be employed for the but offer very little in return from the employer. day. John Cryer (Leyton and Wanstead) (Lab): The growth Mrs Sharon Hodgson (Washington and Sunderland of zero-hours contracts, together with other practices West) (Lab): My hon. Friend is making a powerful such as the appearance of payroll companies and umbrella speech. Does he accept that while those employers want companies, and the growth of bogus self-employment, it all their own way, they often penalise young people, in means that in certain sectors we are seeing the virtual particular? For instance, when people cannot agree to abolition of permanent and full-time work. work an extra shift, they find that they are offered no shifts the following week. Ian Mearns: I could not agree more. As was pointed out earlier, it is about sloppy planning on the part of Ian Mearns: Absolutely. It is that sort of intermittent employers. If they looked at the way they employ people, work pattern that is often exploited, because sadly in they could rationalise the way in which their production many parts of the country there is a surplus of labour, and output work, and it would be better for the company with many people either unemployed or underemployed. if they did so. Employees must agree to make themselves available Dockers—I meet old dockers, and sons and daughters for work but receive no guarantee of work in return. of dockers—remember queuing for work every day, and Workers find themselves being called into work at the being told to “sling their hook” when there was none. drop of a hat or having their shifts cancelled with only a When sufficient men had been selected for work on a couple of hours’ notice or, in some cases, after they have particular day, the rest were told to go home. The same already incurred the expense of travelling to work or practice has acquired a modern veneer. Rather than arranging child care. They turn up at their place of queuing at their place of work, people simply receive a work, only to be told, “We’ve nothing for you today.” text a couple of hours before a shift starts saying, “No work today.”This creates a desperate and easily exploitable Andy McDonald (Middlesbrough) (Lab): Does my work force. hon. Friend agree that putting people in that position I am sure every Member is aware of the horror limits their ability to be economically engaged, because stories we have heard concerning adult social care, they cannot plan or apply for mortgages and all the rest where 307,000 workers are employed on zero-hours of it? That might be to the benefit of the exploitative contracts. Employers frequently use such contracts to employer, but it does nothing to help the economy or circumvent their obligation to pay the national minimum people by giving them security of employment. wage.

Ian Mearns: I could not agree more. I do not see the Jim Sheridan (Paisley and Renfrewshire North) (Lab): benefit to a local economy of having so many people on Fast-food companies such as McDonald’s spend thousands low pay. A low pay, low disposable income economy is and thousands of pounds in this place, providing hospitality not good for other small businesses in the area that are to right hon. and hon. Members at receptions. Will my trying to sell their goods and services in the local hon. Friend join me in asking colleagues who feel it market, which is deprived of disposable income. necessary to go along and sup the wine of people who are profiteering from zero-hour contracts for young Employees are expected to perform all the roles of a people either to refuse to go to such a reception or, if regular employee but have no entitlement to sick leave, they do go, to ask how many workers are employed by holiday pay, overtime payments or many of the hard-won the company on zero-hours contracts? rights and protections that have been gained by work forces over the years. Ian Mearns: My hon. Friend makes a valid point. In our community leadership role, as Members of Parliament Fiona O’Donnell (East Lothian) (Lab): My hon. Friend representing constituencies throughout the country, we is very generous in giving way; I realise that he is should be giving the lead on this by not giving succour struggling to maintain the flow of his speech. Will he to companies which, as he says, are engaged in these join me in celebrating the work of our citizens advice exploitative practices. bureaux? Mine in Musselburgh highlighted in its annual report the case of a man who had gone from five days a Mr George Howarth: My hon. Friend mentioned the week on a zero-hours contract to two days. His employer old dock employment practices, which were known in would not pay him statutory sick pay or paternity pay, Liverpool as the “pen system”, for all the obvious 607 Zero Hours Contracts Bill21 NOVEMBER 2014 Zero Hours Contracts Bill 608

[Mr George Howarth] Grahame M. Morris (Easington) (Lab): My hon. Friend is making a terrific speech, and I am proud to reasons. Is it not instructive that it was a Labour support his private Member’s Bill. I completely agree Government, when Harold Wilson was Prime Minister, with his points about the hospitality sector. May I also who abolished that system? Who abolished that in its draw his attention to very profitable companies where turn? The Thatcher Government. there is no real excuse for the employer to switch from existing contracts of employment to zero hours? I am Ian Mearns: That comes as no surprise. The deregulation thinking of JD Sports, for example, where 90% of the of workplace practices is the stock in trade of Members work force were switched from standard contracts to on the Government Benches. zero hours. It is sheer exploitation so that the workers Anyone who has had any experience of the hospitality cannot be paid pensions and other benefits. sector will be familiar with workers being too frightened to turn down shifts or to make a complaint at work Ian Mearns: My hon. Friend makes a pertinent and because of the fear that they will be “zeroed out” and powerful point. employed for zero hours per week—in other words, no Given that there is an inextricable link between job work this week and no work next week. Since the security and consumer confidence, do we really think recession, there have been countless stories of employers that workers with little or no job security, living in a who have fired their staff only to rehire them on zero-hours climate of fear, are the foundation of a successful contracts, meaning that their workers are no longer Britain in a globalised world? In the previous two entitled to sick leave, holiday pay, and other rights and centuries, tremendous and hard-fought-for progress was protections. made on workers’ rights and conditions of service, and it is madness to spend the 21st century going into Catherine McKinnell (Newcastle upon Tyne North) reverse. (Lab): My hon. Friend is making a very powerful speech. He mentioned adult social care workers. A The principle enshrined in the Bill is simple: if someone constituent who came to see me highlighted just how works regular hours they should have a regular fixed-hours little economic sense zero-hours contracts make for the contract, along with all the rights and protections afforded taxpayer as well. From one week to the next, he may or to regular workers. It is unacceptable that a person who may not be able to pay his rent and may need housing works as a full-time employee, sometimes for many benefit support. That creates a total mess for the support months, or even years, remains on a zero-hours contract. systems that have to provide support to these people on very insecure work contracts. The cost to the taxpayer Pat Glass (North West Durham) (Lab): Does my of sorting out that mess is adding to the problem. hon. Friend accept that this system does not work for Employers need to step up to the mark. the people who receive these services? Many constituents have said to me that they have people, particularly in the Ian Mearns: My hon. Friend makes a powerful point. social care sector, coming into their homes and carrying With regard to people working in the adult social out very personal tasks for them, and that they need care sector, it is right that we want the very best quality consistency. They want to know that the same person is of care for the most vulnerable people in society—the coming in and that they can trust that person, and that elderly, the frail, the disabled and so on—who rely on does not happen with zero-hours contracts. these social care contracts, yet we expect people who are being paid next to nothing to conduct that high-quality Ian Mearns: I could not agree more with my hon. care. I find that bizarre. Friend. I repeat that if we really want to care for the most vulnerable in our society, we should have people in Ian Lavery: Is my hon. Friend aware of the situation professional positions doing so on a regular basis. The at HMP Northumberland, where Sodexo, a French familiarity of seeing the same person time and again is catering company, has privatised the prison and sacked the bedrock of a care system. or made redundant more than a third of the work force? It does not have enough people to make the prison safe, Paul Flynn (Newport West) (Lab): Is my hon. Friend but it is bringing in people on banked-hours and zero-hours aware of the Social Action, Responsibility and Heroism contracts. That is an outrage. Bill, which is going through the other place at the moment? It has been described as “utter tosh” by Ian Mearns: I could not agree more. the right hon. and learned Member for Beaconsfield I was talking about the hospitality sector. Whether (Mr Grieve), the previous Attorney-General, and is we allow this exploitation and abuse to continue is a designed to increase the number of volunteers. The big question not just of whether these contracts are fair on society seems to be an idea whose time has gone. The the employee but of what type of society we want to live Bill is designed to push people not into zero-hours in and what type of economy we want to work in. Do contracts, but into zero-pay contracts. we really expect our sick and elderly to get the care they deserve when those we trust to care for them live in fear Ian Mearns: I am grateful to my hon. Friend for and trepidation, not knowing whether they will earn making that point. I have the greatest admiration for enough to keep the heating on or buy the weekly shop? many people up and down the country who devote their Do we really think that we will reduce the benefits time freely to volunteering for a whole range of charitable bill—the frequently stated intention of the Government— and local causes. At the same time, however, I detest the when only state subsidies for employers paying poverty fact that those volunteers are replacing full-time, paid wages are keeping our work force’s heads above water? jobs, because that is not good for the local economy. 609 Zero Hours Contracts Bill21 NOVEMBER 2014 Zero Hours Contracts Bill 610

My Bill states that if someone has been in a job for appears that some of the worst offenders are not only 12 weeks, they will become a regular employee entitled Labour councils, but Labour MPs. I do not know to a fixed and regular-hours contract with all the conditions whether any of those in the Chamber want to fess up of service that go with it. We will not prosper as a today, but perhaps those who skulked out quietly at the society or grow the type of economy we need as long as start of this debate are the guilty parties. I read more than 1 million workers go to sleep at night not somewhere—so it must be true—that 62 Labour MPs, knowing whether they will have the much-needed earnings which I reckon is about a quarter of them, actually from the next morning’s shift. The Bill would allow employ their staff on zero-hours contracts, which I workers to escape from the financial limbo in which cannot believe. many of them find themselves. The Bill states that if someone’s employer requests or Andy McDonald: That was a very nice attempt at a requires them to work without giving reasonable notice smear. Will the hon. Gentleman say where that was of three days, they should be paid time and a half for a published and where the information is, and how about shift ordered within those three days. It also states that naming some names? He cannot just cast that out on to if their employer cancels their shift at the last minute, the water as if it were true. they should not be plunged into financial instability but paid in full for the period in question. Philip Davies: The hon. Gentleman’s problem and That will take a measure of improved work force and mine is that the unnamed Labour MPs do not, for some production planning by employers, but that is not bad reason, admit to it. They do not come out and say that thing in itself; it is actually good for companies to they use zero-hours contracts. rationalise the way in which they engage people. The Bill would return a degree of mutuality and fairness to (Bolton South East) (Lab) Will the the employment arrangements with which many of the hon. Gentleman give way? poorest and most vulnerable people in our society find themselves. Philip Davies: I will in a second. We can all understand why they do not want to draw attention to the fact. I am delighted that Labour Front Benchers have pledged to stamp out the abuse of zero-hours contracts when they are elected to government in 2015, but I do Mr Deputy Speaker (Mr Lindsay Hoyle): Order. The not believe that underpaid, insecure, zero-hours contract hon. Gentleman will give way when he is ready. The workers—our constituents—should have to wait until hon. Member for Bolton South East (Yasmin Qureshi) then. does not have to remain standing. I do not want her knees to give way while she is waiting, because it could People outside this place see zero-hours contracts for be a long time. what they are: Victorian-era employment practices that have no place in a modern, 21st-century economy. Those Philip Davies: I would be perfectly happy for us to employed on them know only too well what a zero-hours have some way of admitting whether we employ our contract means: low pay, insecure work and zero rights staff on zero-hours contracts. I do not, and I have no in the workplace. If the Government will not support intention of doing so, but perhaps there might be our plans, it will yet again fall to a Labour Government something that we all sign. to protect the interests of ordinary working people doing a decent day’s work in workplaces up and down Yasmin Qureshi: The issue is not about which councils this nation. or which MPs use zero-hours contracts. If the hon. Gentleman and the Government supported our Bill, 2.13 pm everyone would be banned from using them. Surely the Philip Davies (Shipley) (Con): I congratulate the hon. issue is about stopping the use of zero-hours contracts. Member for Gateshead (Ian Mearns) on promoting his Bill and on his speech. I very much enjoyed the time I Philip Davies: I understand that point, and it was spent working with him on the Backbench Business made in an intervention by the hon. Member for Wansbeck Committee and I would like to think that everybody (Ian Lavery) during the opening speech of the hon. would agree that he is one of the nicest people in this Member for Gateshead. I do not want to embarrass the House. I wish him well personally, even though I cannot hon. Member for Wansbeck, but I am a big fan of his as particularly guarantee that I will support his Bill. I hope well. He is also a good guy, and he stands up for what he he will realise that that is not meant personally in any believes in. way, because he is a good guy and I certainly do not doubt his sincerity in promoting the Bill. Anyone could Jim Sheridan rose— tell from his speech that he clearly feels very strongly about it, and I am all for people who stand up for things Philip Davies: I will give way to the hon. Gentleman they believe in. The hon. Gentleman believes in this Bill in a second. and more power to his elbow for that. [HON.MEMBERS: My problem with such an argument is that no law “But?”] There is a “but” and it would be quite a lengthy currently makes it compulsory to employ somebody on one if I had the time. a zero-hours contract. Nothing forces any Labour council To be perfectly honest, I must say, and we need to get to employ somebody on a zero-hours contract; it is their this on the record before the clock counts us out, that it choice. My point is that if the Labour party genuinely is a bit rich for the Labour party to come here en masse wanted to end zero-hours contract, the best thing to do to pretend that they are massively opposed to zero-hours would be to start by smartening up their act and to contracts, when if one believes what one reads in the make sure that no Labour MPs or councils employ press—I am one of those who does, rightly or wrongly—it people on such contracts. 611 Zero Hours Contracts Bill21 NOVEMBER 2014 Zero Hours Contracts Bill 612

Grahame M. Morris: rose— Philip Davies: Go on—admit it!

Philip Davies: There is not much time left, but I will Grahame M. Morris: I am not admitting it; I absolutely do my best to squeeze in the hon. Gentleman. do not use zero-hours contracts. I think part of the It is not just any old Labour councils that go for problem is that many local authorities do not have tight zero-hours contracts. I know that Bury council, the enough procedures with subcontractors; I would encourage council of my hon. Friend the Member for Bury North them so to do. The point I wanted to make is this: is not (Mr Nuttall), is one of the worst offenders, but so is the what we are all concerned about in-work poverty and council in Doncaster, my home town. People in Doncaster the 59% increase in such in-work poverty? have the honour, the privilege or the misfortune—I do not know which, but we can all choose an appropriate Philip Davies: I am grateful. We have had a second adjective—not just to have the Leader of the Opposition Labour view. I think, if I heard correctly, the hon. as one of their MPs, but to have their three local MPs in Gentleman said that he does not employ anybody on a the shadow Cabinet. They are blessed with highly talented zero-hours contract. That is two down—plenty more to people, including the Leader of the Opposition, as their go. local MPs. If the abolition of zero-hours contracts was so important for the Labour party, one would think Ian Mearns: I am aware that colleagues from all that its leader, who is the Leader of the Opposition, parties occasionally employ people on a task-and-finish might just have enough clout in Doncaster, with an basis—a fixed fee for doing a particular task, using the elected Labour mayor and a majority Labour council, Independent Parliamentary Standards Authority payments to encourage it to get rid of zero-hours contract. There system. That may have been interpreted by the Daily are two things at play. Either the Labour party really Mail as employing people on zero-hours contracts. has no intention of getting rid of zero-hours contracts and does not really care about them, or the Leader of the Opposition has so little clout within his party, and Philip Davies: We are getting nearer. I fear that if we so few persuasive skills, that he cannot even persuade a go much further, we will get a full confession at some Labour council and an elected Labour mayor to do it. point.

Jim Sheridan rose— Ian Lavery: This is a really serious debate, but we seem to be trivialising it, suggesting that the problem is Philip Davies: I am going to call the hon. Member for perhaps the fault of my right hon. Friend the Leader Paisley and Renfrewshire North (Jim Sheridan) my of the Opposition. The hon. Member for Bury North hon. Friend, because he is a great man, a fellow member (Mr Nuttall) hit the nail on the head. I think it was in of the Select Committee. I know that has probably 2000 that only 200,000 people in this country were on finished off his career for good, but he is a great man. I zero-hours contracts. As we sit in the Chamber today, give way to him, because he has been waiting patiently. there are 1.4 million people on zero-hours contracts. Jim Sheridan: I am sorry I stood up. First, I plead not That is the real problem. I stand for the total abolition guilty to employing people on zero-hours contracts—not of zero-hours contracts for every single person, regardless guilty, your honour. I would also quite like to exonerate of where they work. my local authority from engaging people on zero-hours contracts. Not only does it not engage people on zero-hours Philip Davies: I am grateful to the hon. Gentleman contracts, but it pays them the . for his intervention. There is a certain amount of dispute over the actual number of people who are on zero-hours Philip Davies: I very much welcome that intervention. contracts. The labour force survey, which collects data To be honest, I would never have thought that the hon. on individual workers, not on the number of contracts, Gentleman was one of the people who used zero-hours and asks employees and not workers for the information, contracts. He is a good man and he does not only stand has an estimate for the fourth quarter of 2013 of 583,000 up for what he believes in; he practises what he preaches. people on zero-hours contracts. There is clearly a dispute I take my hat off to him for that. over the figures. I am not necessarily saying that the We have a good process of elimination going on here. hon. Gentleman and his hon. Friends are wrong in their If we could just get every single Labour MP before us, figures; they have obviously sourced those figures from we could go through them one by one and find out somewhere. Those who compile the labour force survey which have been using zero-hours contracts. have different figures. I genuinely do not understand the hon. Gentleman’s Grahame M. Morris rose— logic. He seems to be saying that it is absolutely fine for Ian Lavery rose— 200,000 people to be on zero-hours contracts, but that it is an absolute scandal for 1.4 million people to be on Philip Davies: I will give way in a second. those contracts. Either zero-hours contracts are a good However, I think what we have safely also found out thing or they are a bad thing. Surely it cannot be a today is that the hon. Member for Paisley and Renfrewshire question of, “Because there were only 200,000 people North has much better powers of persuasion than the on zero-hours contracts when Labour was in office, that leader of his party. If only he were leader of his party was fine; that was a reason to do absolutely nothing the party might not be in the dire straits that it is in at about it and bury our heads in the sand, but now there the moment. are a few more of them, it is a massive scandal and we need to do something about it.”Either zero-hours contracts Grahame M. Morris: I do not want to indulge this are right or they are wrong. The number of people who atmosphere of— are on them cannot be the determining factor. 613 Zero Hours Contracts Bill 21 NOVEMBER 2014 614

Graeme Morrice (Livingston) (Lab) rose— The Minister for Culture and the Digital Economy (Mr Edward Vaizey): Does my hon. Friend agree that one Sheila Gilmore (Edinburgh East) (Lab) rose— can always make improvements to zero-hours contracts? This is the first Government to have consulted on zero- hours contracts, we have got rid of the exclusivity Philip Davies: I give way to the hon. Lady first. clauses and we are bringing in transparency to ensure that people know they are on zero-hours contracts. Sheila Gilmore: The public might be interested to know whether the hon. Gentleman favours or opposes Philip Davies: I have no doubt that the Government zero-hours contracts. Throughout everything he has are moving towards the Labour party on this issue; they said, he has not made that clear. Since he is attempting tend to move towards the Labour party on most issues. to criticise certain councils, that might mean that he is The Minister’s confirmation of that fact comes as no against zero-hours contracts. Perhaps he would like to surprise to me and I do not think it will come as much support the Bill promoted by my hon. Friend the Member of a surprise to anybody. for Gateshead (Ian Mearns) today? Mr Vaizey: Does my hon. Friend agree that it is always dangerous to try to get him on side and that it Philip Davies: If Labour Members were not so can often backfire on a Minister? enthusiastic in standing up to admit whether they employ anyone on a zero-hours contract or otherwise, I might Philip Davies: That is probably true. get around to starting my speech. If I were able to do so, we might get into the nitty-gritty of the debate, but I am Toby Perkins (Chesterfield) (Lab): The hon. Gentleman afraid that all of my time thus far has been taken up in was complaining about the direction in which his party dealing with excitable Labour Members which means is moving, so I wondered in which party’s direction he that we cannot have the debate that the hon. Lady was moving. wants. Philip Davies: I am not moving in any direction. As I have for the past 10 years, I am staying where I am in Graeme Morrice: I just want to follow up on the point every possible regard. I do not move my views and raised by my hon. Friend the Member for Edinburgh policies based on what the latest opinion poll says or East (Sheila Gilmore). I appreciate that we only have what the other parties might say. If there is one thing about five minutes left and I know that the hon. Gentleman the people might be able to agree about it is that I stick has said that he has yet to start his speech, but perhaps to what I believe in, no matter how popular or unpopular to save a bit of time he could tell us whether he is in it is or whatever the passing trend or fad. I stick up for favour of zero-hours contracts or not. If he is not, will what I believe in, which is something I have in common he give me an indication of whether he will support the with the hon. Member for Gateshead (Ian Mearns). He Bill promoted by my hon. Friend the Member for does much the same. Gateshead (Ian Mearns)? In the limited time left, I want to pick up on one more point. It was unfortunate, as I do not think the hon. Philip Davies: I would like to think that I made it Gentleman intended to say this, but he seemed to indicate clear at the start of my speech that I do not support the that zero-hours contracts were linked to quality of care. Bill. For many workers, particularly students, zero-hours contracts are a good thing. They suit their patterns, Ian Mearns indicated assent. they help them and they are a good way into the employment market. It suits their lifestyle to have zero-hours Philip Davies: He is nodding in agreement. I think contracts. Some people have zero-hours contracts through that is unfair on those people who work in the care choice; they are not all awful. I do not want to ban sector on zero-hours contracts. There is no evidence something that many people have by choice. So no, I do that they give any worse care than other people— not agree with the Bill. 2.30 pm The debate stood adjourned (Standing Order No. 11(2)). Mr Christopher Chope (Christchurch) (Con): My hon. Friend is making a brilliant speech. When is he going to Ordered, That the debate be resumed on Friday get on to that part of the Bill that makes it clear that 28 November. those proposing it are not against zero-hours contracts completely and do not wish to outlaw them? They just Business without Debate wish to limit them, yet all their rhetoric has been about outlawing zero-hours contracts. LOCAL GOVERNMENT (RELIGIOUS ETC. OBSERVANCES) BILL Philip Davies: My hon. Friend makes a good point Bill read a Second time; to stand committed to a Public and I would have liked to have humoured him by going Bill Committee (Standing Order No. 63). through all this in as much detail as he would want, but it appears that time is against us. He is right to draw PUBLIC SERVICES (OWNERSHIP AND USER attention to the fact that once again—the situation is INVOLVEMENT) BILL very similar to the previous debate—the Labour party Motion made, That the Bill be now read a Second is trying to give an impression to its voters, perhaps time. running scared of UKIP in its constituencies, that its Members believe in something. Yet the Bill proposed is Hon. Members: Object. nothing like the rhetoric that accompanies it. Bill to be read a Second time on Friday 27 February. 615 Business without Debate 21 NOVEMBER 2014 616

CARERS BEDROOM ENTITLEMENT (SOCIAL A1(M) (Hertfordshire) HOUSING SECTOR) BILL Motion made, and Question proposed, That this House Motion made, That the Bill be now read a Second do now adjourn.—(Harriett Baldwin.) time.

Hon. Members: Object. 2.32 pm Bill to be read a Second time on Friday 9 January. Sir Oliver Heald (North East Hertfordshire) (Con): I am glad to have the opportunity to raise the issue of ARMED FORCES (PREVENTION OF Hertfordshire’s roads and the widening of the A1(M), DISCRIMINATION) (NO. 2) BILL which is an important concern for my constituents, Motion made, That the Bill be now read a Second Hertfordshire and the UK economy. time. Each morning and evening on the A1(M), between Hon. Members: Object. Welwyn Garden City and Stevenage, there are long tailbacks, and this bottleneck is affecting several Bill to be read a Second time on Friday 5 December. constituencies and our national infrastructure. I am grateful to the , Department for Transport, ROAD TRAFFIC REGULATION (TEMPORARY the right hon. Member for South Holland and The CLOSURE FOR FILMING) BILL Deepings (Mr Hayes), the trunk roads Minister, for Resumption of adjourned debate on Question agreeing to meet me, along with my right hon. Friends (7 November), That the Bill be now read a Second time. the Members for Welwyn Hatfield () and for Hitchin and Harpenden (Mr Lilley) and my hon. Hon. Members: Object. Friend the Member for Stevenage (Stephen McPartland), to discuss in more detail what improvements might be Bill to be read a Second time on Friday 28 November. possible. Given that the Minister agreed to this meeting, it ILLEGAL IMMIGRANTS (CRIMINAL might be helpful if I set out some of the main concerns. SANCTIONS) BILL Hertfordshire is one of the most productive of revenue- Resumption of adjourned debate on Question raising counties in the country. Its geographical location (24 October), That the Bill be now read a Second time. and the nature of its economy make it suited to sustainable business growth. It has world-beating industry, such as Hon. Members: Object. Johnson Matthey in Royston, and major companies, Bill to be read a Second time on Friday 28 November. such as MBDA and GlaxoSmithKline in Stevenage. Watford is a business success and the county is a centre for the cultural industries: it is home to Elstree studios, (MAXIMUM MEMBERSHIP) and many film and television programmes are shot on BILL location in the county. Letchworth garden city, in my Motion made, That the Bill be now read a Second constituency, has an innovative Da Vinci school specialising time. in training young people, from 14 to 19, in cultural industry skills. Hon. Members: Object. The Hertfordshire local enterprise partnership makes Bill to be read a Second time on Friday 28 November. it clear that congestion is a key issue for businesses and residents and that addressing the issue will be instrumental EU MEMBERSHIP (AUDIT OF COSTS AND in accommodating further growth in the county. The BENEFITS) BILL LEP believes that increased capacity on the A1(M) is the No. 1 priority for the county’s road network between Motion made, That the Bill be now read a Second 2015 and 2020. Our strong local science base has huge time. potential for further growth. Some 861 hectares of employment land are accessed from the A1(M), and the Hon. Members: Object. area employs 200,000 people, with 60,000 commuting Bill to be read a Second time on Friday 28 November. in. Many homes are due to be built in the corridor over the next 20 years. By 2017, that section of the A1(M) WILD ANIMALS IN CIRCUSES BILL will be under even greater stress and will struggle to accommodate any growth in the corridor without additional Motion made, That the Bill be now read a Second capacity. time. Hertfordshire can be accessed easily from London Hon. Members: Object. and the midlands. It is convenient for the east coast ports and it has five railways and main roads—the Bill to be read a Second time on Friday 28 November. A1(M), the A5, the A6, the A41, the M1, the M11 and the M25—that provide access to the rest of the country. We also have two airports, at Luton and Stansted, on the borders of the county, which open it up to the rest of Europe. This successful part of the country needs a well-functioning and well-funded transport infrastructure. Although much of our infrastructure is good, there are 617 A1(M) (Hertfordshire)21 NOVEMBER 2014 A1(M) (Hertfordshire) 618 instances where we are let down. I would like to elaborate are extremely important in that, and recent announcements on three of them and consider the widening of the by my right hon. Friend the Chancellor about the A1(M) a little later. creation of a northern hub will make the A1 even more I held an Adjournment debate on the subject of significant. The section between Welwyn and Huntingdon roads of Hertfordshire in 1998, in which I called for needs further improvement. The road is not as good as three bypasses in my constituency: one for Baldock, one it should be. The section of the A1(M) between Stevenage for Wadesmill to Puckeridge, and one around Royston. and Welwyn is important, but it is composed of only I can report that two have been built, which is a substantial two lanes in each carriageway. Every morning and investment, but not the one for Royston. There has long evening, the road is congested and tailbacks are long, as been a bypass to the north of the town, diverting the the road narrows for that section. east-west A505 around it. However, the north-south I recently received a letter from a constituent in A10 still goes right through the town centre. In the Letchworth, explaining that these problems had lasted 17 years since I first called for a bypass on the A10, for 25 years. He said: the situation has, if anything, worsened. The joint “During that time I have travelled up and down the AIM success of London, Hertfordshire, the midlands and between Letchworth gate and the clock roundabout at Welwyn Cambridgeshire, and a natural growth in the town’s and ended up going into work before 7 and coming home after population has put even more pressure on our road 7 in the evening to miss the jams on the AIM. Even when I was networks. Royston’s problems are becoming more serious, travelling 25 years ago the bottleneck of the dual carriageway with heavy traffic streams through the town on a daily motorway from the Corey’s Mill roundabout at the Hitchin Junction and the clock roundabout is a crawl that adds considerably basis, tailbacks and road congestion clogging up Melbourn to travel time, pollution and frustration…Even today when I road, which affects children attending the main schools travel to Heathrow or Gatwick airport you either have to travel at located on the other side of the A10. 5 in the morning or the day before and the cost of a hotel because Both the town council and local county councillors of the bottleneck. Successive governments have failed…on upgrading are united behind a plan to improve the situation with a the road to 3 lanes in each direction.” bypass. In 1994, the Highways Agency announced that Junction 7 at Stevenage connects one of the biggest it supported the construction of an A10 bypass at industrial areas in Hertfordshire with the rest of the Royston and the then Minister pledged to keep the case UK, but drivers see regular queues on the motorway under review. I think you would agree, Mr Deputy and some members of the Herts chamber of commerce Speaker, that it is a long review. Royston remains the suggest that continued non-remedied access to Stevenage only town on the A10 between London and King’s could prompt them to relocate. We cannot let this Lynn without a bypass. In my view the case is a strong happen. At the other end of the two-lane section, one. I wonder whether the Minister would write to me Welwyn Garden City junction 6 is dead-centre of the about how best to make progress on that. so-called golden triangle of Oxford, Cambridge and We have been fortunate locally in recently gaining London. The problems here are a blight on one of the funding from Government for a bypass on the A120 powerhouses of the UK economy. around Little Hadham and improvements to the A602, Some changes to the slip road at junction 6 have been both in my constituency. The county council is consulting suggested, but there is confusion locally about the on the detail of those schemes, but given the strategic announced managed motorway solution. At first, it importance of the link between the A10 and the A120 spoke of use of the hard shoulder to add capacity, but in relation to Stansted airport and travel on the A120 that was then rejected by the Department for Transport. east of Bishop’s Stortford, I would be grateful if the One of the best and simplest things that could be done Department started to consider how best to improve is the widening of this section of the A1(M) to three the route further. I would argue that a Standon bypass lanes on each carriageway. This would allow for a is needed to complement the works that have already greater stream of traffic, it would ease congestion and been agreed. enable an important national connection to flow more I should like now to turn to issues surrounding the freely. Businesses would be helped, things would be widening of the A1(M). I have described the huge value made easier for commuters, less time would be spent in of Hertfordshire in terms of its businesses and local traffic jams and it would reduce pollution. enterprise. From our multinational corporations to our Hertfordshire is a strong contributor to the UK and small and medium-sized enterprises, at all levels of the to public spending across the country. Hertfordshire supply chain our businesses are successful. UK Trade & contributes £12 billion in tax revenues each year and Investment says that inward investment to Hertfordshire receives £8 billion in public expenditure—meaning that shows a 61% increase in the last year. Members of the county’s net contribution is £4 billion a year. My Hertfordshire chamber of commerce tell us that the constituents feel that some of these public funds should pool of skills comes not just from local residents. Major be used in Hertfordshire to sort out the problems I have companies such GSK and Airbus, although based in outlined. north Hertfordshire, cast a wide net for employment. I look forward to meeting the trunks Minister with Those commuters must be catered for on our roads. The my colleagues. I hope that the Minister responding road network is not as strong as it should be, so some of today will be able at least to acknowledge the importance Hertfordshire’s potential is not being realised. of the Hertfordshire economy and the need for a good One of the most important of those roads is the strong infrastructure to support it. A1(M). Starting in London, it moves into Hertfordshire, servicing Hatfield, Welwyn, Stevenage and Letchworth in my constituency, and then goes on to Peterborough, 2.42 pm Doncaster, and finally Edinburgh. The road is The Parliamentary Under-Secretary of State for Transport important in getting workers to work and also products (Mr ): I congratulate my hon. and learned out to the UK market and beyond. London and Edinburgh Friend the Member for North East Hertshire (Sir Oliver 619 A1(M) (Hertfordshire)21 NOVEMBER 2014 A1(M) (Hertfordshire) 620

[Mr Robert Goodwill] On current investment in the strategic road network in Hertfordshire, smart motorway systems are now in Heald) on securing this debate on future strategic operation between junctions 23 and 27 of the M25. improvements to the A1(M). The great north road is a Smart motorways help to relieve congestion by using very important trunk road for this country, and coming technology to vary speed limits, and they also allow the from the great north myself I understand its importance. hard shoulder to be allowed as a running lane to create Indeed, much has already been done on the A1, as additional capacity. They deliver those benefits at a many sections have been upgraded to motorway standard, significantly lower cost than conventional motorway and we look forward to further investment in this very widening, and with less impact on the environment important route in the future. during construction. The project is already relieving congestion and smoothing the flow of traffic, which is I know that my hon. and learned Friend has been improving safety and journey times. Those benefits are supporting his constituents, local businesses and the also supporting economic development in the region. local economy by pursuing improvements to the A1(M) to unlock potential growth in Hertfordshire throughout The pinch point programme forms part of the UK the year. I applaud his engagement with the A1(M) Government’s growth initiative, which was outlined in consortium and would hold up this cross-organisational the autumn statement in November 2011. That was body as a good example of a constructive approach to followed up with the allocation of further funding in stimulating debate and developing consensus on the the 2012 autumn statement. The Highways Agency has way forward for Hertfordshire. designed the programme to deliver smaller-scale improvements to the strategic road network that will Before I passed over responsibility for strategic roads help to stimulate growth in the local economy, relieve to the Minister of State, Department for Transport, my congestion and improve safety. right hon. Friend the Member for South Holland and More than £2 million of funding has been allocated The Deepings (Mr Hayes), I took a particular interest to improving junction 6 of the A1(M) at Welwyn. The in the issue of the A1(M) in Hertfordshire, meeting key features of the scheme include amending the current both my right hon. Friend the Member for Welwyn road layout to provide a lane drop at junction 6 and Hatfield (Grant Shapps) and the editor of the Welwyn extending and amending the existing layout of the Hatfield Times to discuss future improvements to this junction 6 entry slip road. That will improve traffic flow road. At those meetings, I made it clear that my Department on the A1(M) northbound carriageway, with the amended would give serious consideration to this issue, together entry slip road layout providing additional distance for with taking early action to address pinch points. traffic joining the A1(M) to merge safely with the main I also know that my hon. and learned Friend expects line of traffic. Work on the scheme will start in December to bring a number of MPs from across Hertfordshire to and is due to be completed in April 2015. a meeting with my right hon. Friend the Minister of In addition, £5.6 million has been committed to the State who is responsible for strategic roads in order to A1 Black Cat roundabout improvements at Chawston. set out the case for widening the A1(M) from the M25 Although that is in Bedfordshire, that scheme will have to Letchworth before the autumn statement. a positive impact on the effectiveness of the A1(M) in Before I respond to the points raised by my hon. and Hertfordshire. It will reduce congestion by widening the learned Friend, it is perhaps worth taking the opportunity roundabout and the A1 approach roads, and by providing to set out this Government’s position on investment in 24-hour signals at the points at which the A1 meets the the strategic road network and the history of proposals roundabout. It is predicted that the proposed scheme for major improvements to the A1(M), as well as setting will reduce congestion, improve journey time reliability, out how my Department will consider options for future improve safety and reduce carbon emissions. Work began major investments. in June and is due to be completed in early 2015. In July, the Government announced a series of growth The strategic road network is the Government’s largest deals with businesses and local authorities across England single asset, currently valued at about £100 billion and through the local growth fund. The Hertfordshire local comprising approximately 4,350 miles of motorways enterprise partnership has secured £199.2 million from and all-purpose trunk roads. The Government recognise the fund to support strategic development, relieve congestion the importance of transport infrastructure to support and reduce journey times across the Hertfordshire area. the economy, and we have already announced increased As my hon. and learned Friend the Member for North Government funding to deliver improvements targeted East Hertfordshire mentioned, the Hertfordshire local at supporting economic growth. My right hon. Friend enterprise partnership has been successful in securing a the Chancellor made clear our commitment to deliver a substantial amount of funding through its local growth step change in investment in transport infrastructure in deal—in the region of £48 million—for the M11/A10 his statement on 26 June 2013, when he announced the transport package, which includes Little Hadham bypass, conclusions of the Government’s spending review of upgrades to the network to improve the resilience of the that year. A10 and improvements on the A602 around Stevenage. The Treasury’s Command Paper “Investing in Britain’s Further priorities for improvements to the local transport future” said that the Government would invest more network will be for the Hertfordshire local enterprise than £28 billion in enhancements to, and maintenance partnership to identify for future rounds of the local of, national and local roads, and confirmed that we growth fund. would provide funding for the building of a number of As my hon. and learned Friend will know, the Highways Agency major road projects to tackle the Hertfordshire growth deal reflects the importance of most congested parts of the network, subject to value the A1(M) for local growth ambitions, with £3.8 million for money and deliverability. being invested in transport improvements through the 621 A1(M) (Hertfordshire)21 NOVEMBER 2014 A1(M) (Hertfordshire) 622

A1(M) transport package, and £16 million being invested that, as we heard from my hon. and learned Friend, in the A1(M) growth area forum to help facilitate there is planned development and growth in the surrounding developments around Stevenage. The package also includes area. The Highways Agency and the Department used a number of sustainable transport measures to provide the evidence to identify priority locations for possible more realistic alternatives for local trips, including the future investment in the strategic road network, and A1 sustainable transport package, the A602 local congestion have started a programme of studies at those locations. measures and Buslink 2016. The M11/A10 transport Proposals emerging from those preliminary studies will package attracted £48.4 million of local growth fund be considered by my Department in the lead-up to the money, for a package of schemes including station autumn statement—which, confusingly, will be presented access improvements, upgrades to the network to improve in December this year—and will help to inform the resilience, the Little Hadham bypass, A602 improvements Department’s road investment strategy, which we aim and A10 network resilience. to complete before the end of the year. The route The M1/M25 transport package has £15 million of strategy work is due to be completed by the end of local growth fund finance for a package of transport March 2015. schemes including A414 junction improvements, Hemel I note that the A1 corridor consortium is already Hempstead station forecourt enhancements, and Watford working with the Highways Agency and other parties to business park pedestrian and cycle access enhancements. develop a strategy to address congestion and future Hertfordshire county council’s BigHertsBigIdeas project capacity issues on the A1(M), and I encourage the is a package of measures designed to address congestion consortium to continue to work with the agency as the and regeneration needs in Watford, Hemel Hempstead route strategy process develops. and St Albans. That includes cycling provision, public I congratulate my hon. and learned Friend on his transport improvements and electric vehicle charging. tenacity in campaigning for investment in transport The county council has secured a total of £11.69 million infrastructure in Hertfordshire over a number of years. from the Department for the project through the local I fully recognise the importance of the A1(M) to him sustainable transport fund. and his constituents. I have made it clear that the Hertfordshire county council continues to receive Government are committed to, and have set out, plans high levels of maintenance and integrated transport for large-scale investments to improve our national block funding. It was also allocated an additional strategic road network in the relatively short term. We £3.621 million from the March 2014 weather repair are also committed to maintaining a pipeline of future fund, and £2.191 million from the June 2014 pothole longer-term investments. Indeed, we are tripling the funding allocation to help to deal with all the potholes budget that was delivered by the last Government—if that appeared during the bad weather. I suspect that “delivered” is a word that can be used to describe that some of the potholes were there before the bad weather paltry investment. started, but they still need to be dealt with. In considering the choices to be made in relation to As for the Government’s future investment planning future investments in the strategic road network, my processes, my hon. and learned Friend will know that Department and I, and the Highways Agency, will work the Highways Agency is currently conducting its route closely with local stakeholders through the route strategy strategy process, and that the Government recently process, to ensure that not just future transport problems concluded the growth deal process with all local enterprise but the range of possible solutions are considered. As I partnerships. Earlier in the year, John Gourd, the chair have said, it is important that proposals for future of Hertfordshire local enterprise partnership, met officials investment are clearly supported by local stakeholders, from the Department and the Highways Agency to and that there is a clear consensus on what is required. discuss the Department’s future investment planning Ultimately, any proposals for future investment need to processes, including the route strategy process. The be able to demonstrate a strong business, and the delivery strategies that are being developed by the Highways of both transport and wider economic benefits. Agency will establish outline operational and investment We are also committed to working with local partners, priorities for all routes on the strategic road network— including local authorities and local enterprise partnerships, including the London to Leeds (East) route strategy, on considering proposals for improvements that are which encompasses the A1(M)—for the period up to affordable and clearly supported by local and regional March 2021, and will give an indication of the priorities stakeholders. In that way, we can place ourselves in a beyond that. strong position to make the best use of the available Last autumn local enterprise partnerships, local funds and to establish a sound base for the development authorities and other interested groups were invited to of a transport system that can contribute to a low-carbon contribute to discussions about the current and future economy and to our long-term economic plan. performance of the strategic road network to help to Question put and agreed to. identify local priorities, and the evidence report has subsequently been published. It acknowledges the issues 2.55 pm that exist on the A1 (M) in Hertfordshire and the fact House adjourned.

17WS Written Statements21 NOVEMBER 2014 Written Statements 18WS

If it is agreed that the functions of each should Written Statement continue to be delivered by NDPBs, the second stage will review the organisational control and governance Friday 21 November 2014 arrangements in place to ensure that they are compliant with the recognised principles of good corporate governance and delivering good value for money. CULTURE, MEDIA AND SPORT The structure, efficiency and effectiveness of the two UK Sport and Sport England(Triennial Review) bodies will be considered as part of both stages. This will include an assessment of how well the two bodies work together, their progress against the conditions set The Parliamentary Under-Secretary of State for Culture, in January 2013 on deciding not to merge them and the Media and Sport (Mrs Helen Grant): I am today announcing scope for further savings. the start of the Triennial Review of UK Sport and Sport England. As executive non-Departmental Public The findings at both stages of the review will be Bodies (NDPB), UK Sport and Sport England are examined by a challenge group. required to undergo a Triennial Review. The joint UK Further details of the review and a survey seeking Sport/Sport England review will have two principal evidence about UK Sport and Sport England can be aims, represented by two stages. found on the DCMS website at https://www.gov.uk/ The first stage will provide a robust challenge for the government/news/triennial-review-of-uk-sport-and- continuing need for the functions performed by both sport-England UK Sport and Sport England, and, if there is, whether some or all of these functions should be delivered by I will inform the House of the outcome of the review alternative delivery models or continued delivery by a when it is completed and copies of the report of the Non- Departmental Public Body (NDPB). review will be placed in the Libraries of both Houses.

9P Petitions21 NOVEMBER 2014 Petitions 10P

Responsibility for the introduction of traffic management Petition and the control of parking falls to individual traffic authorities. They are free to make their own decisions Friday 21 November 2014 about the design of the streets under their care, provided they take account of the relevant legislation. This includes the provision of traffic management measures such as OBSERVATIONS traffic calming. Rule 240 in the Highways Code lists places where it is illegal to park at the roadside and rule 243 lists places where parking could be dangerous. It is for the police to deal with instances of illegal parking TRANSPORT and obstruction. county council can ban parking at locations with this is deemed necessary and, Traffic Calming Measures on Glentworth Road East in because they also have Civil Parking Enforcement (CPE) Westgate powers they can take any necessary action against those The Petition of members of the community in Morecambe, who infringe parking restrictions. If the council wants to restrict or prohibit parking in Westgate they can Declares that the Petitioners believe that there should do so. be traffic calming measures introduced on Glentworth The Department for Transport has published guidance Road East and also parking restrictions imposed. on the design of traffic calming measures in local Transport The Petitioners therefore request that the House of Note (LTN) 1/07 Traffic Calming which is available on Commons urges the Government to encourage Lancashire the DFT website at: County Council to take steps to support the residents in https://www.gov.uk/government/publications/local- Morecambe and to ensure that measures are introduced transport-notes to stop speeding and dangerous parking in Westgate. We have also published guidance for local authorities And the Petitioners remain, etc.—[Presented by David on the operation of CPE areas at:- Morris, Official Report, 21 October 2014; Vol. 586, c. 869.] https://www.gov.uk/government/publications/ operational-guidance-to-local-authorities-parking- [P001390] policy-and-enforcement Observations from the Secretary of State for Transport: In line with the coalition Government’s commitment I recognise the concerns about speeding and dangerous to localism, Ministers and officials have no remit to parking and how the introduction of traffic calming intervene in the day-to-day affairs of local authorities measures and parking restrictions might help. except where specific provision has been made in legislation.

WRITTEN STATEMENT

Friday 21 November 2014

Col. No. CULTURE, MEDIA AND SPORT ...... 17WS UK Sport and Sport England(Triennial Review) ... 17WS PETITION

Friday 21 November 2014

Col. No. TRANSPORT ...... 9P Traffic Calming Measures on Glentworth Road East in Westgate ...... 9P Members who wish to have the Daily Report of the Debates forwarded to them should give notice at the Vote Office. No proofs of the Daily Reports can be supplied. Corrections which Members suggest for the Bound Volume should be clearly marked in the Daily Report, but not telephoned, and the copy containing the Corrections must be received at the Editor’s Room, House of Commons,

not later than Friday 28 November 2014

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CONTENTS

Friday 21 November 2014

New Member [Col. 537]

National Health Service (Amended Duties and Powers) Bill [Col. 539] Motion for Second Reading—(Clive Efford)—on a Division, agreed to

Zero Hours Contracts Bill [Col. 603] Motion for Second Reading—(Ian Mearns)

A1(M) (Hertfordshire) [Col. 616] Debate on motion for Adjournment

Written Statement [Col. 17WS]

Petition [Col. 9P] Observations

Written Answers to Questions [The written answers can now be found at http://www.parliament.uk/writtenanswers]