Parliamentary Debates House of Commons Official Report General Committees

PARLIAMENTARY DEBATES HOUSE OF COMMONS OFFICIAL REPORT GENERAL COMMITTEES Public Bill Committee HEALTH AND SOCIAL CARE (RE-COMMITTED) BILL Eighth Sitting Thursday 7 July 2011 (Afternoon) CONTENTS Clause 55 agreed to. Schedule 8 agreed to. Clauses 56, 58, 59 and 63 agreed to, some with amendments. Adjourned till Tuesday 12 July at half-past Ten o’clock. PUBLISHED BY AUTHORITY OF THE HOUSE OF COMMONS LONDON – THE STATIONERY OFFICE LIMITED £5·00 PBC (Bill 177) 2010 - 2012 Members who wish to have copies of the Official Report of Proceedings in General Committees sent to them are requested to give notice to that effect at the Vote Office. No proofs can be supplied. Corrigenda slips may be published with Bound Volume editions. Corrigenda that Members suggest should be clearly marked in a copy of the report—not telephoned—and must be received in the Editor’s Room, House of Commons, not later than Monday 11 July 2011 STRICT ADHERENCE TO THIS ARRANGEMENT WILL GREATLY FACILITATE THE PROMPT PUBLICATION OF THE BOUND VOLUMES OF PROCEEDINGS IN GENERAL COMMITTEES © Parliamentary Copyright House of Commons 2011 This publication may be reproduced under the terms of the Parliamentary Click-Use Licence, available online through The National Archives website at www.nationalarchives.gov.uk/information-management/our-services/parliamentary-licence-information.htm Enquiries to The National Archives, Kew, Richmond, Surrey TW9 4DU; e-mail: [email protected] 331 Public Bill Committee7 JULY 2011 Health and Social Care 332 (Re-committed) Bill The Committee consisted of the following Members: Chairs: †MR ROGER GALE,MR MIKE HANCOCK,MR JIM HOOD,DR WILLIAM MCCREA † Abrahams, Debbie (Oldham East and Saddleworth) † Morris, Grahame M. (Easington) (Lab) (Lab) † O’Donnell, Fiona (East Lothian) (Lab) † Barron, Mr Kevin (Rother Valley) (Lab) † Poulter, Dr Daniel (Central Suffolk and North † Blenkinsop, Tom (Middlesbrough South and East Ipswich) (Con) Cleveland) (Lab) † Pugh, John (Southport) (LD) † Brine, Mr Steve (Winchester) (Con) Shannon, Jim (Strangford) (DUP) † Burns, Mr Simon (Minister of State, Department of † Smith, Owen (Pontypridd) (Lab) Health) † Soubry, Anna (Broxtowe) (Con) † Burstow, Paul (Minister of State, Department of † Sturdy, Julian (York Outer) (Con) Health) † Thornberry, Emily (Islington South and Finsbury) † Byles, Dan (North Warwickshire) (Con) (Lab) † Crabb, Stephen (Preseli Pembrokeshire) (Con) † Turner, Karl (Kingston upon Hull East) (Lab) † de Bois, Nick (Enfield North) (Con) † Wilson, Phil (Sedgefield) (Lab) † James, Margot (Stourbridge) (Con) † Kendall, Liz (Leicester West) (Lab) Sarah Davies, Mark Etherton, Committee Clerks † Lefroy, Jeremy (Stafford) (Con) † Morgan, Nicky (Loughborough) (Con) † attended the Committee 333 Public Bill CommitteeHOUSE OF COMMONS Health and Social Care 334 (Re-committed) Bill Mr Burns: What I would not do is make the dogmatic Public Bill Committee assertions that the hon. Gentleman made this morning and the argument that he made in general about the 5% figure. It has been contradicted even by the improvement Thursday 7 July 2011 plan published by the Labour Government, and that contradiction has been reinforced by a subsequent Labour (Afternoon) Secretary of State at the Department of Health. I shall move on to another point that the hon. Gentleman mentioned. He was wondering about and questioning [MR ROGER GALE in the Chair] exactly how Monitor’s powers, duties and functions had been changed. It is obvious to Government Members Health and Social Care that they have been changed fundamentally as a result of the listening exercise and the Future Forum’s (Re-committed) Bill recommendations. Although the hon. Gentleman and his right hon. and hon. Friends want to be in denial on 1pm that point, we have had considerable third party The Chair: Good afternoon, ladies and gentlemen. endorsement from organisations that have responded For ease and clarification, I inform hon. Members that to the listening exercise and the Future Forum’s as we have a fairly long sitting this afternoon, I shall, as recommendations; they also seem to think that what we I did last week, suspend the Committee for 15 minutes have accepted from those recommendations significantly at 4 o’clock. I understand that the Minister is winding changes the core functions of Monitor as they were up the debate on clause 55. proposed initially. To help the hon. Member for Pontypridd, may I tell him this? Probably the most important thing is that Clause 55 Monitor’s main duty will be to protect and promote the interests of people who use health care services. It will seek to achieve that not by promoting competition, but MONITOR by promoting the economic, efficient and effective provision Question (this day) again proposed, That the clause of health care services that maintain or improve quality stand part of the Bill. for patients. That is the crucial issue—improving quality for patients and enhancing and improving outcomes. The Minister of State, Department of Health (Mr Simon That is ultimately the most important thing. Burns): Indeed I am winding up the debate, Mr Gale, and I do not intend to detain the Committee too long. I Liz Kendall (Leicester West) (Lab): Will the Minister have just one or two points and will seek to keep my give way? remarks relevant to clause 55. One point that we debated this morning—the hon. Mr Burns: I am between comments on the functions Member for Pontypridd made a big deal about it—was of Monitor. The hon. Lady may wish to wait. [Interruption.] about the private sector being involved in providing No? Then I shall give way now. 5% of the health care in the NHS under the previous Government. The hon. Gentleman might like to know Liz Kendall: I hope that it is in order, Mr Gale, to that the 2004 NHS improvement plan stated that intervene between comments; I wish to double check on “by 2008, independent sector providers will provide up to 15%”— the procedure. I think that that is three times 5%, if my mathematics is What are commissioners doing if not promoting right— equality and efficiency for patients? Why do we need “of procedures on behalf of the NHS.” Monitor to do that? That rather undermines the argument that the hon. Gentleman made this morning. Mr Burns: Commissioners are part of the jigsaw and the equation. They will obviously have a crucial role in This, too, might be of interest, particularly to the improving the quality of care, promoting equality of hon. Member for Leicester West, because she may well care and improving and enhancing outcomes, but they have written it. In 2006, Patricia Hewitt said: will not be doing it on their own; many other aspects of “I am not going to lay down from Richmond House how many the NHS will be working to that end. The core principle hospitals, how many beds, how many staff of each grade and each of these modernisation plans is to put patients at the qualification, what kind or how many different providers there should be.” centre of care, to involve them, give them choice and drive up improvements in quality of care, with the That suggests that Patricia Hewitt, too, was not fixated knock-on effect of improving and enhancing outcomes. by the figure. Monitor’s competition role will be clearly limited to addressing anti-competitive behaviour. The hon. Owen Smith (Pontypridd) (Lab): The Minister refers Member for Pontypridd made what I consider to be the to something that I said this morning. I take it that he bizarre point—from their reaction, my hon. Friends would not contest the fact that, whatever the projections— seemed totally baffled—that there was no difference whatever was written on a piece of paper somewhere—the between promoting competition and anti-competitive reality, as David Bennett, whom I quoted this morning, responsibilities, as if they were one and the same thing. stated, is that private sector involvement accounts for I have to tell him that they are fundamentally different. only about 5% of NHS spend at the moment, in 2011. In a moment, I shall explain why. 335 Public Bill Committee7 JULY 2011 Health and Social Care 336 (Re-committed) Bill Monitor will now have new duties to enable the to the Bill to give the Co-operation and Competition integration of health care across health care services Panel and the Principles and Rules for Co-operation and between health care and other services, including and Competition more bite. The CCP will no longer social care services—something that we debated at report to the Department of Health, which can choose considerable length on Tuesday. There will be a new whether to accept the panel’s recommendations. The duty on Monitor to involve those who use health care fact that the rules will in future be set and enforced by services and other members of the public in its work, an independent body will in itself put them on to a and to ensure that it takes appropriate clinical advice in stronger footing. carrying out its functions—another matter that we have We would expect the rules and principles to be embedded discussed at length on previous amendments. It will be in the system by way of regulations, guidance and explicit on Monitor that it should not exercise functions licence conditions under the Bill. The current rules in order to increase or decrease the market share of any would apply, including principle 7, which the right hon. type of provider, whether public or private. Monitor Gentleman referred to. The aim is to provide as much will not, as originally proposed, have the power to allow continuity to the NHS as possible. We will ensure that one provider access to another provider’s facilities. the status of principle 7 is clarified when the principles We have already debated most of these matters, and I are next updated.

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