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19 Mar 2003 : Column 1035—continued
Mr. Waterson: I am extremely puzzled by the attitude of the Minister and the Government to these perfectly sensible and appropriate amendments. Lords amendment No. 24 would specify bodies that will monitor the impact of the measure at regular intervals and Lords amendment No. 25 provides for an annual
report to Parliament. As my right hon. Friend the Member for East Yorkshire (Mr. Knight) pointed out, such a report might give the Government the chance to trumpet the success of the legislation. I seem to recall that the Government used to issue an annual report to trumpet their achievements, but that practice seemed to fall into disuse two or three years ago—presumably because there was not much to trumpet.I urge the Minister to think again about the amendment. I appreciate why she might be feeling defensive about the measure; as we have already established, the Bill does not have a friend in the world. Even some of the Government's Back Benchers, including the Chairman of the Select Committee on Health, are not willing to support it. It has caused a storm of protest throughout the country, expressed through the Local Government Association, the Association of Directors of Social Services and so on.
The Minister seems to think that the amendment will wreak a huge sea change in the position. Indeed, her thesis, which seems to go further away from reality, is that the mere threat of the Bill has enormously improved the bed-blocking position and that it will make a vast difference and improve the lives of many hundreds of thousands of patients throughout the country. She may be right. If she is, fine, but I do not think that she is. Equally, the Opposition and various bodies may well be right, and the law of unintended consequences will kick in and set at odds with one another some of the agencies that, certainly in my constituency, are now working in much closer partnership than they ever did before.
I pay tribute to East Sussex county council for its work in the past year or two, since it has been run by the Conservatives, who have got to grips with the issue and worked closely with the health organisations. Although there are occasional blips, the result is a steady decline in the number of beds blocked or delayed discharges.
I concede that the truth may turn out to be somewhere between those two views. However, on any assessment, this is a brand new regime with some pretty draconian powers, and it could all go horribly wrong or, at the very least, not produce the results that the Minister wants, so I fail to understand why she does not think that monitoring its progress is a good idea. There may be some scope for discussing whether that duty should arise only in the initial stages of its implementation. I can understand the Minister's argument that that should not happen every year, for ever, if the legislation has settled down or, even more likely, the problem has gone away of its own accord.
In the debate in the other place, Baroness Noakes said that, under the current arrangements, the bodies involved would be the Audit Commission, the Commission for Health Improvement and the social services inspectorate, and she put it extremely well. Of course we have heard that, yet again, some of those bodies are in a state of flux, and we will end up with something called the Commission for Health Care Audit and Inspection. Whatever label is attached to those bodies, if legitimate concerns are felt not just by the official Opposition or the Liberal Democrats, but by lots of people at the coalface throughout the country who deal with such problems daily, it is surely important that we should get an idea early on whether the
provisions are having the effect that the Minister thinks that they should. Surely, she, more than anyone else, would wish to know whether that was the case.If I may give the Minister a bit of friendly advice, I do not think that she should associate herself too closely with the Bill or she may turn into another Minister who never was, like Lord Hunt who used to deal with such matters in the other place.
The Bill's effects will need careful examination in the real world. We have heard about some of the problems. Baroness Noakes referred to some of them in the other place, and my hon. Friend the Member for West Chelmsford (Mr. Burns) has dealt with the problem of readmission, so I need not do so. It is possible that people will be discharged home without adequate support services, and there is a whole series of possible knock-on effects, simply because of this ill-thought-out, hurried Bill.
It is worth quoting what the Right Rev. Bishop of Hereford said in the other place. He referred to what he called
- "the widespread feeling that patients are treated . . . as commodities."—[Official Report, House of Lords, 17 February 2003; Vol. 644, c. 975.]
There will be some serious, hard cases in the real world, affecting our constituents, as well as those of the Minister and other hon. Members, so why on earth does not the Minister want to reassure people? Of course she takes the view that the rest of the world is out of step and that she is the only one in step, but if she is so utterly convinced of her rectitude, why not put it to the test? As my right hon. Friend the Member for East Yorkshire has already said, if there is good news to tell, let her blazon it in the House with an annual report and let it be reported on and authenticated by those audit bodies.
I could not agree more with the comment that Baroness Noakes made in last month's debate:
- "the Bill . . . tends to marginalise the individuals who are at the heart of the processes."—[Official Report, House of Lords, 18 February 2003; Vol. 644, c. 1029.]
I hope that the House will support the Lords in their amendments and maintain them in the Bill.
Mr. Greg Knight: We have just heard three very powerful speeches explaining why the Minister is wrong on the issue with which the amendments deal but not one voice raised in support from the Labour Benches.
The Minister's opening remarks sounded rather half-hearted and certainly showed a paucity of reason. We are disappointed by her attitude to the amendments because we had a debate yesterday in which the Opposition were prepared to take a non-partisan approach on a very important issue and say that, where we thought that the Government and the Prime Minister in particular were right, they had our support. All that we are asking her to do is listen to our arguments and reflect on what she will say in advising the House about how to treat the proposed additions to the Bill. What are we seeking to do? We are seeking to say that proposals that are moderate, modest and reasonable should remain in the Bill.
- "The Secretary of State shall specify to the bodies charged with inspection of health and social services that they should monitor".
I cannot understand why the Minister is not willing to accept Lords amendment No. 25. As you will be well aware, Mr. Deputy Speaker, it used to be said in the days of the previous Conservative Government that there was terrible pressure on parliamentary time and that it was not possible always to accommodate debates on every single issue that hon. Members felt was important. However, there has been a change in our procedures since that time—the addition of Westminster Hall. Although the former Leader of the House, who has just resigned his position, and his predecessor both gave an undertaking to the official Opposition that Westminster Hall would not be used for introducing legislation, there is consensus in all parts of the House that it could and should be used for debates on annual reports such as the one in question. In the light of the fact that we now have that other Chamber a stone's throw away from this place, I am at a loss to understand why the Minister will not accept the amendment.
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