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Mr. Yeo : I draw attention to my entry in the Register of Members' Interests. I am delighted to have this early opportunity to debate such an important aspect of the Government's health policy so soon after taking on my new responsibilities. As it is the first time that I have debated with the Secretary of State, I should like to be as charitable as I can, although he has taken up well over a third of the time available for debate and left unanswered almost as many questions as there were before he stood up 45 minutes ago.
The key to what the Secretary of State thinks about the issue was revealed in the last minute or two, when it was plain to anyone in the Chamber that his concern about how the vote goes this afternoon is not about what that vote will do to patients or the national health service, but about what the vote will do to the Government and his position in it.
The Secretary of State raised a great many issues in his speech, some of which were somewhat tenuously related to the subject of the debate. I shall deal with those on another occasion. He frequently resorted to ludicrous allegations about the intentions of the Conservativesintentions that we have never had, will never have and do not have now. Let me place on record the fact that I and the whole Conservative party are totally and unequivocally committed to the founding principle of the national health servicethat care should be available to all free at the point of delivery, based on patient need and not on ability to pay.
Mr. Jon Owen Jones: Will the hon. Gentleman give way?
I regret that the Secretary of State does not have and never will have the advantage that I and other hon. Members representing English constituencies have. We can see at first hand the results of his Government's policies on our constituents. We can learn from our constituents who are patients worried about their treatment, and from our constituents who are doctors and nurses and who speak to us of their frustrations as a result of the constant interference that they suffer from the Government. It is particularly unfortunate that as a Scottish Member of Parliament, the Secretary of State is trying to impose on England arrangements for hospitals that will not apply in Scotland.
The Secretary of State faces the debate this afternoon because he has failed to convince not just Conservatives and Liberal Democrats, but many in his own party and many people of no party about the merits of the Government's policy.
Andy Burnham (Leigh): The hon. Gentleman is making a point about members of his party. Does he agree with his Front-Bench colleague, the hon. Member for South Cambridgeshire (Mr. Lansley), who stated last week:
The Secretary of State's failure to persuade people of the merits of the Government's policy has cost his right hon. Friend the Minister for Sport and Tourism a chance to support England's splendid rugger team in Saturday's world cup final in Sydney. [Interruption.] I hope that he is back. For the sake of the taxpayer, I hope that yanking Ministers back from Australia in an attempt to save the Government's bacon in the House of Commons does not become a habit.
Dr. John Reid: First, will the hon. Gentleman confirm that the Conservative party has brought the hon. Member for Bournemouth, East (Mr. Atkinson) back from China? Obviously, he is unaware of that; I am slightly ahead of him. Secondly, will he explain why I cannot be objective about people in the health service, although I visit them constantly and am on their side, whereas he can apparently be objective about old folks and residents in care homes despite the fact that he is a director of care homes?
Mr. Yeo: That is a very obscure intervention. I have not been discussing with my Whips the whereabouts of my hon. Friends, which is not a matter of concern to me. I have been considering the merits of the case that is before us this afternoon, which the Secretary of State seems singularly reluctant to address. The point that I want to make about his position as a Scottish Member of Parliament is that however disastrous the effects of the policies that he may be following are on the national health service, his constituents will not have to face those consequences.
Tony Baldry (Banbury): Does my hon. Friend accept that I gladly flew through the night from Sierra Leone to vote against the Government today because this is a totally iniquitous proposal? Poor star-rated trusts such as Oxford Radcliffe will never get foundation hospital status. The Bill ensures that unto those who have shall be given, while from those who have not shall be taken away even that which they have. That is the policy on the NHS under this Government.
Mr. Yeo: My hon. Friend eloquently anticipates the point that I was about to make. I am delighted to have his support. I say clearly that the Conservative party is opposed to this group of proposals on grounds of principle. In their present form, their effect will be to damage the national health service, not improve it.
Mr. Weir : The hon. Gentleman said that the policy had no impact in Scotland, but it has an impact in Scotland and Wales as their health service spending is determined by the Barnett formula, which depends on public spending in England. The Bill means that there will effectively be private health spending in England, which will affect Scotland and Wales. That is why we are voting against it.
Mr. Yeo: I think that I shall let the hon. Gentleman pursue that point in his own time.
As the hon. Member for Wakefield (Mr. Hinchliffe) pointed outI was going to call him my hon. Friend, as he was my shadow counterpart about 10 years ago and we had many happy debates in the Chamber and outsidethe proposal has emerged with a minimum of consultation. There was no sign of a White Paper and no mention in an election manifesto. Indeed, when the policy was finally debated at the Secretary of State's party conference this year, it was defeated.
Opposition Members would very much like to be able to support the Bill. In this House and the other place, we have made strenuous efforts to improve the measures that it contains. We have often done so with the co-operation of the Liberal Democrats and other minority parties, and in the House of Lords we did so with the co-operation of many Cross Benchers. During that process, the Government have conceded a number of points, but despite those concessions the House of Lords did not feel able to support clause 1. The fact that it reached that conclusion is not really so surprising because many other people and organisations have expressed their concern. The hon. Member for Halifax (Mrs. Mahon) referred to some of those organisations, which include the King's Fund, the British Medical Association, the Trades Union Congress, the Royal College of Nursing, Unison, the Society of Radiographers, the Transport and General Workers Union, the GMB and many others that the Secretary of State attempted to tarnish by saying that they had all apparently opposed the creation of the NHS 54 years ago.
Hugh Bayley (City of York): Will the hon. Gentleman give way?
Mr. Yeo: In a moment. The next point concerns the Secretary of State's remarks about his own Back Benchers. On this morning's "Today" programme, he sounded as if he was almost attacking his colleagues for contemplating voting against the Government. The truth is, as he should know, that those Members who are courageously thinking of opposing this clause are standing shoulder to shoulder with their constituents because they can see the damage that the Bill will do to them in its current form. Those who put the interests of their constituents first will enjoy the respect of this House, and of those whom they represent here.
We oppose the amendmentsreluctantly, as I have saidfor two reasons. First, they will harm those hospitals that do not receive foundation trust status. To begin with, that means the vast majority of the hospitals that our constituents use every day. Secondly, the foundation trusts established by the Bill will themselves be heavily burdened by a management structure that is muddled, confusing and expensive; by a star-rating system that distracts doctors and nurses, and sometimes prevents them from treating the patients most in need of their care; and by a regulator that, far from being independent, will be little more than a creature of the Secretary of State, with sweeping powers to direct foundation trusts' activities.
Mr. Stephen McCabe (Birmingham, Hall Green): Can the hon. Gentleman estimate how many NHS hospitals would be damaged by his policy of siphoning off money and giving it to private practice?
Mr. Yeo: I regret giving way to the hon. Gentleman. Such a tired old allegation is completely irrelevant to the important matters that the House has a limited amount of time to consider this afternoon.
There is no doubt that the clause will create a two-tier health service. The chairman of the British Medical Association council said: