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Health and Social Care (Community Health and Standards) Bill

Lords amendments considered.

Madam Deputy Speaker (Sylvia Heal): I must draw the attention of the House to the fact that privilege is involved in Lords amendments Nos. 77, 78, 90, 217 and 218, which are to be considered today. If the House agrees to these Lords amendments, I shall ensure that the appropriate entry is made in the Journal.

Clause 1

NHS foundation trusts

Lords amendment: No. 1, leave out clause 1.

2.53 pm

The Secretary of State for Health (Dr. John Reid): I beg to move, That this House disagrees with the Lords in the said amendment.

Madam Deputy Speaker: With this we may take Lords amendments Nos. 2 and 3, Lords amendment No. 4 and the Government motion to disagree thereto and Government amendment (a) to the words restored, Lords amendments Nos. 5 to 55, Lords amendment No. 56 and Government amendment (a) thereto, Lords amendment No. 57 and Government amendment (a) thereto, Lords amendment No. 58, Lords amendment No. 59 and Government amendment (a) thereto, Lords amendments Nos. 60 to 64, Lords amendment No. 161 and the Government motion to disagree thereto and Government amendments (a) to (bb) to the words restored, Lords amendments Nos. 162 to 193 and 227, and the Government motions to disagree to Lords amendments Nos. 5, 26, 28 and 29.

Dr. Reid: Lords amendment No. 1 would leave out clause 1. Let me put it simply: it attempts to wreck the Bill that has been sent from this House.

The Bill represents the next important stage in improving and revitalising our national health service. Let me make it plain right from the start that, to Labour Members, that means a national health service built on the founding principle that everyone in this country should have equal access to health care free at the point of delivery—a principle that will be defended and protected as long as this Government are in power.

Already over the past few years—and, indeed, into the next few years—the Government are making the largest-ever investment and largest-ever injection of finance into the national health service. That is not for one, two or three years, but for five years. Simultaneously, we have improved and will continue to improve and modernise the national health service, reforming the way in which health care is delivered in this country to the benefit of patients. This is already bringing significant results in health care. All the main indicators of waiting times are now lower than they were in 1997, when we inherited an under-invested and impoverished health service from the previous Government.

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For instance, deaths from our two biggest killers are down dramatically. Deaths from cancer are down 10 per cent. in the last few years and death from heart disease are down by no less than 19 per cent.—a dramatic and significant reduction in the scandalous figures that we inherited. In addition, what we have already done can be seen by the additional 55,000 nurses and 14,000 doctors and by the largest building programme in the history of the national health service.

Dr. Ian Gibson (Norwich, North): Does my right hon. Friend agree that the real changes in cancer services have come from the 34 cancer networks that have been involved with patients and right through to doctors, pharmacists and so on? The networks have crossed institutional barriers and they are on their way now. Any interference with that would destroy much of the solidarity that has been built up among many of the work force in the health service.

Dr. Reid: I agree and pay tribute to that. Nothing we are suggesting today would cut across that. My hon. Friend points out the efforts that have been made and the results that the cancer networks have achieved. Without undue immodesty, I think that we are able to claim as a Government that the results are at least partly due to the extra £570 million a year for cancer services and the 30 per cent. increase in the number of consultants since we took office. There are 900 more cancer consultants, so we already bringing about significant benefits to patients. I believe that that is a significant start, but it is not enough. It is not nearly enough to bring the quality of care that those who depend on the national health service should have.

We said in our last manifesto, which we placed before the people of this country, that decentralisation of power to front-line staff is an essential part of the future national health service. It is an integral part of giving patients the power, the information, the quality of service and the degree of choice that they expect from their national health service today and that has hitherto been available only to those rich enough to buy quality, quick access, sensitivity and personal health care outside the national health service.

The Opposition in the other place have completely rejected the principle of handing power in the national health service to front-line staff. In doing so, they have gone far beyond long-established practice. Lords amendment No. 1 and Lords amendment No. 161, which would leave out schedule 1, are not revising amendments; they are wrecking amendments. The Government are proposing to accept the vast majority of the revising amendments agreed in the other place, but the main question before us today is not about sensible scrutiny but about whether the Tories and Liberals, in the main in the upper House, will succeed in overturning the majority will of the House of Commons.

Mr. David Hinchliffe (Wakefield): My right hon. Friend refers to long-established practice. I have been a member of the Labour party for many years and it has been long-established practice to develop policy within the party—at constituency and conference level—but we have not had that with this issue. We have not had Green Papers, White Papers or any consideration at all. There has been no scrutiny at all of this issue in the

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Commons. In view of the way in which this matter has been treated in the Commons, is it not unreasonable to suggest that somehow the Lords have behaved unconstitutionally?

Dr. Reid: I am not sure whether my hon. Friend meant this, but I would not, with due respect to the other place, ever draw comparison between our democratic methods inside the Labour party and the inherited privilege vested in the other place. He will have noticed that I voted—[Interruption.] I am sorry, but I voted for abolition. Those on the Opposition Front Bench have got another thing wrong.

I would not draw such an invidious comparison, but the other place has gone totally against the central element in clause 1. It has not refined or amended it, and that central principle has been the subject of debate and controversy and the Commons has decided on the matter after that debate and controversy. If that principle is rejected, it will go far beyond anything that we have been prepared to tolerate, even from an unelected second Chamber.

3 pm

Mr. David Cameron (Witney): For clarification, will the right hon. Gentleman set out whether there was a specific pledge in the Labour manifesto about foundation hospitals?

Dr. Reid: There was a specific pledge in the Labour party manifesto to decentralise power to the frontline of the national health service. I know that the hon. Gentleman is interested in, and deeply committed to, the process inside the Labour party. We know that the Conservative party has extremely democratic ways of making policy—and choosing leaders, incidentally. The way in which leaders emerge in the Conservative party is paralleled only by the selection of the Chinese leadership.

At least my hon. Friend the Member for Wakefield (Mr. Hinchliffe) has a deep interest in, and commitment to, a democratic discussion of such matters. If he is asking me whether I think, in retrospect, that we could have discussed the process better and more widely, the answer is yes. Therefore, I hope that the fact that our party and Government are about to embark on perhaps the widest consultation that we have ever undertaken is an indication that we have learned some lessons from the process. However, we are judging today not only the process but the merits of the case and the pledge that we made in our manifesto. That is what I am putting to the House today and I hope to receive support from the Government Benches.

Lynne Jones (Birmingham, Selly Oak): What will be the impact on national patient booking systems, electronic patient records and electronic prescribing if foundation trusts are able to opt out of national NHS information technology systems?

Dr. Reid: There is no indication whatsoever that any hospital with or without foundation status would benefit from doing that. It is possible for people to jump off Tower bridge—all things are theoretically possible—but there is not one shred of evidence that there would

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be any incentive to opt out of what will be, by any standards, the biggest ever IT project. Indeed, the introduction of the project will mean that for the first time in history patients inside the NHS will not be referred to a hospital by their doctor and told to go home and wait for instructions on when and where to attend, without any consultation with them. The IT system that we are introducing will, from December 2005, not only allow for consultation with patients so that they have an option of which hospital to attend, but allow them to book online. Such a quality service has previously been commandeered only by the rich of this country, but we shall extend it to people who are dependent on the NHS.

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