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14 Nov 2002 : Column 189—continued
Glenda Jackson: The hon. Gentleman has already told the House that the Conservatives welcome the idea of foundation hospitals because of the freedom that it would afford them, but, with respect and given his previous contributions, the freedom to do precisely what? He has already argued that money is not achieving any improvements in the NHS, that there are insufficient nurses and doctors and that there is far too much red tape. Given that that is his position, what will the foundation hospitals afford his party the freedom to do?
Dr. Fox: Making a mistake once is understandable, but making it twice—giving way again—is plain stupid. The hon. Lady must ask those questions primarily of the Secretary of State, as it is Government policy to introduce foundation hospitals. I have told her that I agree with the principle.
We studied foundation hospitals overseas and I asked what their most useful freedom was. They said that it was the freedom to borrow externally, because they can make quick decisions about investment, most notably in diagnostics, where patient treatment bottlenecks tend to occur. Such hospitals can also set their own pay and conditions to deal with recruitment and retention problems in their locality, and they can determine information technology strategies in line with their local health community.
There are three freedoms, for a start, that I would have thought most hon. Members agree with. The Government are right to move down that route and we shall support them, but we shall not support their proposals on the problem of delayed discharge, or bed blocking as it is known. The Secretary of State is quite right—he intends to fine local authorities. The Government say that they got that example from Sweden, but they could not have spent much time examining it, as they would have discovered that there are huge differences between the model employed in Sweden and that being used in the UK.
The Government would have found that Swedish local authorities are responsible for social care as well as hospital care, so they can affect the patient flows that result in bed blocking and delayed discharge. The problem in Britain is that the PCTs are responsible for patient throughput and patient flows, but local government is to be made financially liable for delayed discharging. In other words, local government will be punished for something over which it has absolutely no control. The proposal is preposterous. Have the Government thought about what it will mean on the ground? It will result in the worst perverse incentives in general practice.
Imagine a hard-pressed GP trying to get an elderly patient into a care home on a Friday afternoon—it is difficult to get a place. Under the Government's proposal, patients in an acute hospital will necessarily get first call on any care home beds that become available, so there will be an incentive for doctors to
admit patients to acute hospitals as they will get first call and be most likely to get a care home bed as a result. That is a crazy policy, and its effect will be exactly the opposite of what the Government expect. If anything, it may worsen delayed discharges in the health system.The Government have proposals on mental health. The Secretary of State told us on this morning's XToday" programme, as he has just told the House, that the Bill will return during this Session after the consultation has been considered. He said that the number of consultations is one reason for the delay, but it cannot be that hard to understand the point that nobody supports the Bill. All the consultations are hostile, and the Royal College of Psychiatrists, Mind, SANE, the BMA, the Royal College of Nursing, the Conservative party, the Liberal Democrat party, many Labour MPs and most Labour peers are all totally against what is proposed. The Bill is not a mental health Bill, but a personality disorder Bill dressed up to look like a mental health Bill.
If the Government bring the Bill back in its current form, they are as stupid as they are arrogant. It is stigmatising, regressive and an affront to our civil liberties, and we shall join forces inside and outside Parliament to stop it, as it must not become the law of this country.
Where the Government's programme will improve health care and coincides with our views, we will support it, even if the Government cannot muster support on their own Benches, but we will continue to expose the distortions of the truth, the propaganda and the spin that is this Government. Some things are for sure: they will tax more and more, they will spend more and more but they will disappoint and fail to deliver. The real losers, sadly, will not be the politicians but the patients.
Mr. Deputy Speaker (Sir Alan Haselhurst): Order. I remind the House that a 12-minute limit on Back-Bench speeches will apply.
3 pm
Mr. Stephen Byers (Tyneside, North): This is my first contribution in the House from the Back Benches for more than eight years. I no longer have the convenience and comfort of resting on the Dispatch Box, sometimes using it as a means of physical protection, or the tumbler of water always ready. I have to admit that there have been times when I have addressed the House in the past 12 months when something stronger than water might have been helpful.
On the Back Benches, I have the time and opportunity to reflect on the direction of the Government and the way in which they should respond to meet people's needs and aspirations. I have the opportunity to challenge the Government if they slow the pace of reform and modernisation that will be vital if we are to introduce policies for the common good of the people of our country.
The Queen's Speech and the Budget are perhaps the two timetabled items in the parliamentary calendar that say everything about the Government of the day. They identify priorities and reorder the programme of the
Government. They should underpin the values and principles of the political party that has been elected to office at that time.In government, it is often a race against time. It is worth reflecting on the fact that when the period of the Queen's Speech is over and the programme is put into place by the autumn of next year, half the lifetime of this Government will be over. In the autumn of 2003, we will probably be less than two and a half years from the next general election, so it is a race against time for the Government, with people's expectations rightly raised.
This Queen's Speech gets it broadly right. Stressing the need for a strong society based on rights and responsibilities is what people want. We need to push forward with our reform of public services, so that they are more responsive, meet the high standards that people want and give them choice.
This stage of a Parliament is often the most challenging for a Government. Vested interests regroup, voices call for consolidation and some even argue for a change and reconsideration of our objectives and direction, but this is not the time to stand still, cling to the comfort blanket of the status quo and opt for a quiet life by leaving things as they are.
We live in a world whose chief characteristic is change. Force of change outside our country is driving the need for change within it. Our people have new ambitions, different priorities and raised expectations. If the Government or indeed any political party fail to reflect that reality, they will quickly become redundant and their ideas will become dogma.
That is why the Labour party has changed. That has been reflected in the Queen's Speech. We have made changes, not to betray our principles as the Labour party but to fulfil them by being in office, not to lose our identity as a political party but to keep our relevance to the people of our country. I appreciate that for many in the Labour party that has been a difficult and sometimes painful process but in this modern world—I think that the Conservative party may be learning this—to fail to embrace change is to condemn oneself to almost permanent Opposition.
It is vital that, in government, we continue to make the changes necessary to ensure that we keep in touch and reflect the needs and aspirations of the British people. To achieve that in office will require as much fresh thinking, new ideas and courage as was necessary during the 1990s to make the Labour party electable again. That is why I congratulate my right hon. Friend the Secretary of State for Health, who, in making the proposals for foundation hospitals, has shown how fresh, new thinking to identify and meet the needs of the present day can be embedded in the values and principles of the Labour party that was founded over 100 years ago.
We need to change the political landscape so that it reflects our values and principles. We need to seek a new political consensus to sustain us in office. That consensus must recognise that social justice and economic efficiency are two sides of the same coin—they are not in conflict with each other; one feeds off the other. Opportunities should be extended to our people so that everyone can achieve their full potential with their talents. Rights must be coupled with responsibilities. It should be recognised that an
individual does best in a strong community and a society of others, and that greater investment is needed to improve public services, which must be reformed and modernised to meet the demands of the 21st century. That is the consensus around which we can unite as a country and that is reflected in the Queen's Speech.We like as a Government to say that we are for the many and not the few. We must show that that is more than just a political slogan or a convenient soundbite and put real substance on it. That is a challenge for the Government.
There are a number of ways to meet that challenge. It is important because it identifies a key political division, a divide between political parties. The Conservative party, although it may say otherwise, will always be the party that wants to pander to an elite. That runs deep in its history and I do not believe that it is ever going to change. We, however, based on our history as a political party, recognise that there is too much wasted talent, too much inequality, and that people with potential are being wasted.
It is a challenge for the Government to change that, to ensure that we can deliver for all our people and to liberate those individuals. We do it for them and for our country because we all benefit. We will not have a strong and robust economy if we have a weak and divided society. That is why all people have a part to play.
The Government need to deal with the difficult issue about inequality of assets and wealth. We have done a lot to tackle the inequality of income. We have introduced the national minimum wage, the working families tax credit and the child tax credit. All that will make a difference. It will take many people out of the daily grind of poverty, but we now need to turn our attention to a far more difficult issue: inequality of assets. By that, I mean people who have no savings, who do not own their own home and who do not have investments in shares and so on.
That is important because an increasing number of people in Britain are without assets and the position is getting worse. The new divisions that we have to tackle are between the asset-excluded, the asset-poor and the asset-rich. In 1996, according to the Institute for Public Policy Research, 10 per cent. of the UK population had no assets. Now 20 per cent. of those aged between 20 and 34 have no assets. Figures given to me just this week by the House of Commons Library show that in 2001, more than 50 per cent. of the population had savings of less than #1,500. We have to find ways of ensuring that all people can have assets that they can call their own.
The Labour party manifesto in 2001 contained two proposals that could make a real difference. The first was the introduction of equity shares for tenants in social housing and the second was the creation of a child trust fund through an endowment paid by the Government. That is sometimes referred to as a baby bond. The lump sum would not be means-tested. It would be paid into an account on birth and drawn down at the age of 18. Every person from whatever background would have access to their own opportunity fund at the age of 18. The cost would be significant as an endowment fund of #1,000 would cost some #700 million in benefit, but I consider that it should be a priority. Equity shares should also be pursued.
As I said earlier, the Queen's Speech gets it broadly right. It addresses the need to reform our public services and rebalance our criminal justice system so that people recognise their rights and responsibilities. It meets the challenges of the day. The public want it and it is now the Government's responsibility to deliver. I am confident that they will discharge that responsibility.
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