What is happening now? NHS waiting lists are back at a six-year high. That is the result of the reorganisation that the Government ploughed through, which nobody wanted. The country did not want it. There are millions of people out there who are concerned about what the
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Government are doing. It will not have escaped their notice that scores of Government MPs have failed to turn up today to defend what was one of their flagship Bills. What a shower! There are people who kept a vigil outside the House last night, in cold temperatures, imploring Members to be here to pass this Bill because the issues it raises matter so much to them. Then we have the spineless MPs of a disintegrating Government, some loaded up to the eyeballs with links to private health care, who do not have the guts to come here today to argue for what they have done. Is it any wonder that people are losing faith in this place?
Dr Huppert: On a point of order, Madam Deputy Speaker. The right hon. Gentleman claimed earlier that one of the bidders at Hinchingbrooke was an NHS provider, but according to the National Audit Office there was Circle, Serco and Ramsay. Can he now either correct the record for the House, or let us know which of those three he believes is an NHS provider?
Madam Deputy Speaker (Mrs Eleanor Laing): The hon. Gentleman makes a perfectly good point of debate, but it is not a point of order.
Andy Burnham: We have spineless Government MPs who will not come here today to argue for the Act.
I congratulate the hon. Member for Rochester and Strood (Mark Reckless) on his victory and on being here today, despite being up all night—I cannot imagine that he managed to get any sleep. His party leader has said that when the hon. Gentleman is tired he says things that he does not mean—I think that he just nodded there. Given that he has been up all night, I can only conclude that he does not actually believe what he said in the speech we just heard. In three days he has gone from being in favour of the repatriation of European citizens to being against the privatisation of the NHS. That is a pretty big political distance to cover in just three days.
Mark Reckless: I have only ever argued for European citizens to be able to stay; any other words came from others, not me. It is the right hon. Gentleman’s party that has reversed its position, having previously privatised the Darent Valley hospital and fragmented the Medway Foundation Trust, but it now seems to have a better policy, which I am happy to support.
Andy Burnham: The hon. Gentleman said that he could not understand Labour’s position, but surely he remembers 2012, when Opposition Members spoke with force against that legislation, which he then voted for in the Lobby. I know that it has been a long night, but he really should try to remember these things, because they are quite important.
Mr Anderson: Is it not also true that the hon. Gentleman went through the Lobby not once, but 18 times, despite being told time and again that what has now happened would happen? The people who had their finger on the pulse were telling us what would happen, but he ignored them.
Andy Burnham:
It is a tiring business being an MP and it is possible to forget things, particularly when one drinks as many pints as UKIP Members do, but they
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should try to remember. Their party leader once said that he would give the NHS budget to insurance companies; apparently, he does not believe that now. The deputy leader, a Mr Nuttall, said that the right hon. Member for South Cambridgeshire was to be congratulated on bringing a whiff—just a whiff—of privatisation to the NHS, and the hon. Member for Clacton (Douglas Carswell), whom the Minister quoted earlier, described the Lansley reforms as “fairly modest”. He chided his Tory colleagues who were sniping against him at the time and said that the reforms must not be derailed. The party says it is anti-politics in the way things are done. This is sheer opportunism and dishonesty.
Mark Reckless: I recall much of what the right hon. Gentleman said from the Dispatch Box in 2012, and I would like to credit him because a lot of it has come to pass. He was perspicacious in much of what he said and many of the assurances that I was given from the Government Front Bench have been found wanting.
Andy Burnham: I appreciate what the hon. Gentleman says—it would be churlish for me to say otherwise—and I am grateful for the way he said it. The things Opposition Members were saying back then have happened, and we can see the effects of the Government’s reorganisation in the NHS. With the new figures that came out this morning, we see that A and E has missed the Government’s target for 70 weeks in a row. The A and E figures are the barometer of the health and care system. They are the best place to look if we want to see whether there are problems in the health and care system. The fact that the target has been missed for 70 weeks in a row tells us that severe storms are building over the NHS.
Mr Jim Cunningham: I am glad my right hon. Friend raised that. It takes us back to pre-1997, when people who could not get beds were lying on trolleys. I am sure he remembers that. I can remember a hospital in Coventry that was falling down. As a result of the Labour Government, we got a new hospital.
Andy Burnham: My hon. Friend is right. The Labour Government inherited a situation where almost three quarters of the NHS estate was built before 1948. We transformed that, as well as bringing those waiting lists down. He is right to remind us.
I cannot believe that Government Members have not had the guts to be here today to argue for their own policy on the NHS. Or is it that under the shambolic regime of their new Chief Whip, who is now inflicting the same chaos on the parliamentary Conservative party as he did on England’s schools, the Government did not think they could win the vote today, so they did not dare to bring their troops here to hold it? I do not know what the reason is, but they clearly do not believe in their own legislation and the catastrophic reorganisation that followed. An unnamed senior Cabinet Minister has been quoted in The Times as admitting that it was their single biggest mistake.
Mr Ronnie Campbell: Will my right hon. Friend touch on the fact that 71 coalition Members of Parliament are being paid by private companies involved with the national health service?
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Andy Burnham: It is one of the biggest scandals of recent times that people in this House who have links to private health, and many more in the other place, put through legislation that did not have a mandate from the British people and from which they would benefit financially. The story of that will one day be told in full.
The reorganisation has dragged the NHS down and left it on the brink. A reorganisation that was meant to put GPs at the heart of the NHS has left patients waiting days or even weeks to get a GP appointment. This week, there was news that the NHS has missed its cancer standard for the third quarter, leaving thousands of cancer patients waiting more than two months for treatment to start. It is a reorganisation that has systematically run down the NHS and opened the door for it to be sold off.
Paul Farrelly (Newcastle-under-Lyme) (Lab): The reorganisation was unnecessary. My right hon. Friend is no doubt aware that in Staffordshire a £1 billion cancer contract has been put out to tender. The newly rebuilt local hospital is concerned that that will destabilise its finances. Does he agree that we should be very careful about going down that route without proper consideration?
Andy Burnham: The example that my hon. Friend quotes is the best example of the fact that the Government see no limit at all on the scale or extent of privatisation in the NHS, both in terms of the monetary value— £1 billion—and the fact that they are prepared to put cancer services out on the open market.
Mark Durkan (Foyle) (SDLP): Does my right hon. Friend recall that some of us supported his opposition to the Health and Social Care Bill, which purported to be England-only legislation? By its marketisation and altering of the public service ethic for the health service, it was going to be predictive legislation with severe implications for devolved services. For similar reasons we support the Bill today, because it offers a bulwark against TTIP hazards for devolved health services.
Andy Burnham: The Bill before us deals comprehensively with that threat from any proposed TTIP treaty. I am glad to see the hon. Gentleman in his place today.
Robert Flello: Is my right hon. Friend aware that the companies on the list of preferred bidders to provide cancer care in north Staffordshire include CSC computer services, which was responsible for the £10 billion IT failure, the Lorenzo system, and Interserve Investments, which was fined £11 million by the Office of Fair Trading for anti-competitive bid rigging? These are the sort of firms that our cancer services might go to.
Andy Burnham: Those examples will alarm people. In Greater Manchester, a bus company has been running ambulance services. We had news this week that an arms manufacturer is bidding for a GP contract. These are the things that are beginning to happen to the NHS. Nobody’s constituents have ever given their permission for any of this to happen.
We heard speeches from the hon. Member for Bosworth (David Tredinnick) and the right hon. Member for Banbury (Sir Tony Baldry), who said that nothing had
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changed and what was happening in the NHS now was just a continuation of what the previous Government were doing. No, it is not. The right hon. Member for South Cambridgeshire said in a speech on 9 July 2005:
“The time has come for pro-competitive reforms in…health”
and he help up the example of utilities and rail. That was the specific inspiration for his reorganisation. He sold his Bill on the basis that doctors would decide, but doctors tell us that they have no choice but to put services out to the market. Section 75 says that commissioners may not run a tender if there is only one available provider. That is never the case, which is why CCG lawyers conclude that they have no choice but to put services out to tender.
That is why we see, according to figures from the NHS Support Federation, that 865 contracts for NHS services, worth £18.3 billion, have been offered to the market. Some 67% of the contracts awarded so far have gone outside the NHS. It is this decision to mandate the tendering of services which places the NHS in the full glare of EU procurement and competition law. Because Ministers have refused to exempt the NHS from the TTIP treaty, we could soon have private US health care providers ringing up CCGs to challenge them on their commissioning decisions.
This Bill legislates to remove that threat. It repeals section 75 and it really does let doctors and local commissioners decide. It restores the role of the Secretary of State and brings much needed ministerial accountability back to this House. No longer will Ministers be told to write to NHS England when they have concerns. Instead, there will be answers from the Government Dispatch Box about the service that matters most to their constituents. It removes the role of the competition authorities that the Government’s Act introduced. It stops the ludicrous situation where hospitals such as Bournemouth and Poole are not allowed to collaborate. Importantly, it stops hospitals devoting half their beds and half their facilities to the treatment of private patients.
Mr Slaughter: Since Hammersmith and Central Middlesex A and E departments closed two months ago, we have had people waiting in ambulances and waiting rooms with every seat taken. We have even had people waiting on floors. The Government’s answer to that is to close two more A and E departments, those at Charing Cross and Ealing in west London. Is that not just preparing the NHS for failure and for privatisation?
Andy Burnham: What is happening in west London should send a shiver down the spine of every community in the country. The NHS is being torn apart, which is damaging patient care and leading to the consequences that my hon. Friend outlines.
This is how the character of the NHS is changing under this Government and before our eyes. With every year that the Health and Social Care Act stays on the statute book, the private sector will be more embedded in the NHS and the public NHS weakened as a result. The Government have undermined the “N” in NHS. They are letting our hospitals become part-privatised and they must be stopped. If the Government continue on their current course, in the next Parliament the NHS will be overwhelmed by a toxic mix of cuts and privatisation.
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If the Government stop this Bill receiving Royal Assent, it will form the basis of the repeal Bill that the next Labour Government will lay before the House in May next year. But it will do more than that: it will remove the competition role to allow the full integration of health and care to build and lay the foundations for a 21st-century NHS.
One final thing needs to be said. Before we vote, there is a simple truth that all Members in all parts of the House must confront: nobody here has permission from their constituents to put the NHS up for sale. Today is their last chance to put that right before they face their constituents in six months’ time. The people of this country value and trust a public NHS that puts people before profits. This Bill restores that. The party that created the NHS is proud to support it, and I urge all Members to vote for it.
12.21 pm
The Parliamentary Under-Secretary of State for Health (Dr Daniel Poulter): I shall begin by returning to the founding moment of our NHS, when a national health service was created which remains to this day a world-class health service where care is available to all, irrespective of ability to pay and free for all at the point of delivery. These fundamental principles of our NHS have been cherished and protected by each and every Government throughout its proud history, and were in 2012, for the first time, put on to statutory footing by this Government through the Health and Social Care Act.
Angie Bray: Will my hon. Friend give way?
Dr Poulter: If my hon. Friend will bear with me, I am going to make a little more progress and then give way later on.
Those who believe that our NHS has always been run solely through public providers are of course very wrong. From its very inception, the NHS that Nye Bevan created has comprised providers in the public and the non-public sectors. In 1948, independent GPs, community pharmacists and dental practitioners contracted with our health service to provide primary medical services to patients, and they continue to do so to this day as part of the public-private partnership. It is worth reflecting on the fact that Tony Blair’s former political secretary, John McTiernan, said only this August that
“an NHS without private providers is unimaginable. For one thing, no one—even on Labour’s extreme left—is arguing that we should nationalise general practice. But GPs are private providers, acceptable to opponents of the ‘private sector’ because most encounters with the NHS are visits to your local doctor”.
We also take for granted the key role played by charities and the voluntary sector in providing NHS care to patients across the country, notably Macmillan Cancer Support and Marie Curie Cancer Care.
In opening my contribution to this debate, I reaffirm this Government’s commitment to the founding principles of our NHS, a health service free at the point of delivery, and recognise that since its creation by Nye Bevan in 1948 our NHS has always been a public-private partnership. For public services to be equitable and free at the point of use, they did not all need to be provided on a monopoly basis within the public sector, controlled in a rigid way by local bureaucracies often deeply resistant to innovation and genuine local autonomy.
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“The aim should be to change fundamentally the way the NHS was run: to break up the monolith; to introduce a new relationship with the private sector; to import concepts of choice and competition”.
Those are not my words, but those of Labour Prime Minister Tony Blair about the reforms to the NHS that he introduced under the previous Labour Government.
Angie Bray: Does my hon. Friend agree that the most damaging thing for the NHS—patients and staff alike—is a lot of misleading scaremongering? I am afraid that we have heard more of that in the Chamber today. Will he correct the record to make sure that it is very clear that the pledge made by the Secretary of State for Health that the A and Es at Ealing and Charing Cross hospitals will both remain open for the long term still stands, and that they will allow themselves to be directed by Bruce Keogh’s report such that whatever recommendations he makes on A and E, they will make sure that they meet those requirements?
Dr Poulter: I am happy to confirm and to put on the record the points that my hon. Friend has made. It is important that the NHS is not used as a political football, and that services are always designed and delivered in the right way for patients. There is often too much scaremongering in these debates. I reiterate that what she said about the local A and Es is absolutely correct.
Mr Slaughter: Will the Minister give way on that point?
Dr Poulter: I have just dealt with it, and I am going to make a little progress.
I want to deal with the contribution made by the hon. Member for Rochester and Strood (Mark Reckless). He failed to address the issues that I had raised earlier about the support that the hon. Member for Clacton (Douglas Carswell), his party colleague, gave to the Health and Social Bill—now the Health and Social Care Act. In fact, as the right hon. Member for Leigh (Andy Burnham) said, the hon. Member for Clacton thought that the reforms did not go far enough. Indeed, the leader of his party is on record as talking about the need, in effect, to privatise our NHS. I would like to reaffirm the commitment that that will absolutely never happen under this Government or any Conservative Government.
Another important point needs to be made. Earlier this week, the hon. Member for Rochester and Strood expressed frankly unacceptable and distasteful views on repatriation. We must of course bear in mind that 40% of staff in our NHS come from very diverse, multicultural backgrounds. We very much value the contribution that doctors, nurses and health care staff from all over the world make to our NHS. I do not want to see those people repatriated; I want to see them continuing to deliver high-quality care for patients in our NHS—something that UKIP clearly opposes.
Mark Reckless: I have made absolutely no such remarks; I have said only that we wanted such people to be able to stay. The disgraceful remarks were actually made by the Conservative candidate, who juxtaposed the issues of unlimited immigration and fear of crime.
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Dr Poulter: I think that the hon. Gentleman’s remarks are very clearly on the record, and I am sure that NHS staff, many of whom come from very diverse, multicultural backgrounds, will be very aware of them. In this Conservative-led Government, we are very proud of the contribution that people from all over the world make to our NHS, and I believe that that needs to continue in the future. As we have seen from the hon. Gentleman’s leader, his party makes it up as it goes along on things to do with the NHS. It is in favour of privatisation and does not value the contribution—[Interruption.]
Sir Tony Baldry: On a point of order, Madam Deputy Speaker. There is so much noise coming from the Opposition Bench below the Gangway that it is impossible even for someone who is as near to the Minister as me to hear what he is saying. Given that Labour Members appear to support this Bill, it would be a courtesy for them at least to listen to the Minister with some attention.
Madam Deputy Speaker (Mrs Eleanor Laing): The right hon. Gentleman knows very well that all Members exercise their right to speak loudly, quietly, in stage whispers and in other ways in this Chamber. I am listening very carefully to the level of noise, and if it reaches much higher than it already has, I will ask Members to be more courteous to the Minister. However, I am quite sure that the Members present will wish to be courteous to the Minister and to hear what he has to say.
Dr Poulter: Thank you, Madam Deputy Speaker. I am sure that Members in all parts of the House—although perhaps not the hon. Member for Rochester and Strood—would like to reaffirm their commitment to and the value they place on all NHS staff, no matter what background or culture they come from. We want those staff to continue to practise in and work for our NHS to the benefit of patients.
Dr Poulter: I think that the hon. Gentleman has said quite enough already, and I need to make some progress.
Let me move on to the second, substantive, point in this debate, on which I hope there will be a large amount of agreement. It was articulated—
Madam Deputy Speaker: Order. The Minister is not giving way.
Dr Poulter: Thank you, Madam Deputy Speaker.
The point was articulated very well by my right hon. Friend the Member for Banbury (Sir Tony Baldry) in one of the best and most accurate speeches of this Parliament in an NHS debate.
Mark Reckless: On a point of order, Madam Deputy Speaker. The Minister has made a false allegation to which he has not given me the right of reply. Of course I welcome all those immigrants in the NHS. They are very welcome and we want them to stay as much as he does.
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Madam Deputy Speaker: There has been much discussion this morning about who has said what about what. My concern in the Chair is that the Bill should be discussed. That is the matter before the House, and we will discuss it.
Dr Poulter: Thank you, Madam Deputy Speaker. I think the tone of that point of order made my point for me better than I could have done.
As my right hon. Friend the Member for Banbury said in what was one of the best speeches on the NHS I have heard in this Parliament, the Health and Social Care Act 2012 did not introduce competition into our NHS. To say that it did is factually incorrect, scaremongering and distracts the NHS from addressing the key issues it faces. It was the creation of a mixed health economy, implemented by the previous Labour Government, that exposed our NHS to competition law, not the introduction of the Health and Social Care Act.
Andy Burnham: That is a very important point that goes to the heart of this debate and that really needs to be cleared up for those listening and watching. The Minister said that the Act did not introduce competition. Will he confirm that it gave, for the first time, a role to the competition authorities under the Enterprise Act 2002 and that since then they have intervened, for the first time ever in the history of the NHS, in Bournemouth and Poole?
Dr Poulter: What I will confirm is that it is factually correct, as my right hon. Friend the Member for Banbury made clear, to say that it was the previous Labour Government—Tony Blair’s Government—who introduced competition into our NHS. At the end of Labour’s time in office, I believe that £6 billion a year was going to NHS providers. The right hon. Member for Leigh was quite happy to pay private sector providers 11% more than NHS providers for providing the same service. That was Labour’s commitment to the private sector, which we have cleared up and put right in the 2012 Act.
Let us remember what the Labour party said in its last general election manifesto. I am sure Labour Members will remember it well—the right hon. Gentleman may well have written it. It said:
“All hospitals will become Foundation Trusts…Foundation Trusts will be given the freedom to expand their provision…and community care, and to increase their private services”.
That is from the manifesto that every Labour Member stood on at the last election. The facts are clear: competition in our NHS was introduced well before this Parliament and well before this Government came into power. It was introduced by policies made by Members who now sit on the Opposition Benches—the policies of the previous Labour Government.
As my right hon. Friend the Member for Banbury reminded us, it was Labour that introduced the use of independent treatment centres in 2003, the “any willing provider” policy and the advent of patient choice in 2006, and it was Labour’s policies when in government that brought NHS commissioning under the scope of European competition law through the Public Contract Regulations 2006.
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Mr Mike Weir (Angus) (SNP): There is an interesting argument taking place between the two Front Benchers about who is responsible for bringing competition into the health service, but the fact is that, no matter who is responsible, the health service could now come under the transatlantic trade and investment partnership. Why will the Government not specifically exclude health services from TTIP before it is negotiated?
Dr Poulter: I will come on to TTIP later, and I hope I will be able to reassure the hon. Gentleman.
The previous Labour Government attempted to make commissioners compliant with the law by publishing the “Principles and rules for cooperation and competition” in 2007 and establishing the competition and co-operation panel in 2009, to oversee Labour’s NHS marketplace. Let us be clear: it was the previous Labour Government who chose to introduce private providers into our NHS and it was the previous Labour Government who set up the legal framework to support private providers in the health service.
“the private sector puts its capacity into the NHS for the benefit of NHS patients, which I think most people in this country would celebrate.”—[Official Report, 15 May 2007; Vol. 460, c. 251WH.]
Once again, those are not my words, but those of the right hon. Member for Leigh when he was a Minister in the previous Government. That is a fitting memory of the previous Labour Government’s expansion of private providers in the NHS. Let us remind ourselves of the right hon. Gentleman’s words again: he said that most people in this country would celebrate the private sector in the NHS.
Mr Ronnie Campbell: The Minister talks about Labour privatisation, but why is it that so many Conservative Members are being paid by private companies? What are you getting money off them for? What are you doing?
Dr Poulter: I am just a doctor who still works in the health service and I practise medicine for free. Of course, we could go into the fact that I am the only Front Bencher present who has front-line experience of looking after patients. Professional politicians on the Opposition Benches are outlining a case that is incoherent with their record in government. We could also talk about the huge union funding that goes towards many Labour policies, but time would forbid us from doing so and I am sure that the Deputy Speaker would not want me to digress from the subject of this debate.
Let us come on to what the Health and Social Care Act actually did. First, it stripped out an entire layer of management from what was at the time an overly bureaucratic NHS. This is an important point that hon. Members would do well to listen to. The reforms will save our NHS £5.5 billion in this Parliament alone, and £1.5 billion every following year. That money is being put back into front-line patient care. In addition, as I notified the House in an answer to a recent written question, spending on administration as a proportion of the total NHS budget has fallen under this Government from 4.3% in 2010-11 to 2.9% in 2013. More money is going into front-line patient care because we have stripped out bureaucracy and administration and freed up that money to look after patients.
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Between 2010 and July 2014, the number of infrastructure and administration support staff in the NHS has reduced by 10.3%, which is about 21,000. That includes a 17.7% decrease in managers and senior managers combined. Savings from reducing bureaucracy in this manner are being ploughed back into front-line patient care. For instance, we now employ 8,000 more doctors and 5,600 more nurses on our wards than in May 2010, and our NHS can do nearly 1 million more operations every year.
Clive Efford: The hon. Gentleman is taking us through a very detailed list of bureaucratic costs. Obviously, the Government are paying close attention to that, but why is it that when I asked them about the cost of overseeing the tendering process—the cost of lawyers, accountants and other advisers—they said that they do not collect that information?
Dr Poulter: I will come on later to the costs that the hon. Gentleman’s Bill would directly create. The point is that we should be proud—the Labour party should be supporting the Government—that we are reducing administration and bureaucratic costs, because that money is now being spent on patients. Why cannot Labour for once accept that a good thing has happened and that more money is now going into front-line patient care?
The second effect of the 2012 Act is that it empowered local doctors and nurses, as those closest to and most able to determine the needs of their patients, to design and lead the delivery of services around the needs of those patients. Thirdly, the Act placed great importance on and sought to drive increased integration across our NHS, a point clearly articulated by my hon. Friend the Member for Bosworth (David Tredinnick). Commissioners had duties placed on them by the Act to consider how services could be provided in a more integrated way, and we have since built on the Act by supporting a number of integration pioneer sites, which will trail-blaze new ideas to bring care closer together, particularly for frail elderly people and people with complex care needs. They will be leaders of change—a change we have to see in the health system, if we want to offer the very best quality of care to patients.
We are also supporting the health and care system through the £5.3 billion better care fund, with commissioners working in partnership with local authorities to deliver more integrated person-centred care. Offering seven-day services and delivering care that is centred on patients’ needs will encourage organisations to act earlier to prevent people from reaching crisis point. That is the sort of clinical leadership that the Act has fostered. It will refocus the point of care towards more proactive community-based care, for the benefit of so many patients.
Grahame M. Morris: The Minister is defending fragmentation, but may I, as a former member of the Health Committee, remind him that Sir David Nicholson, the former chief exec of the NHS, summed up the situation last year by saying:
“You’ve got competition lawyers all over the place, causing enormous difficulty. We are getting, in my view, bogged down in a morass of competition law which is causing significant cost in the system”.
Is the Minister saying that the chief exec is wrong in his assessment?
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Dr Poulter: The chief executive makes exactly the point. It was of course the Labour Government who introduced competition into the NHS. If the hon. Gentleman has a problem, he should take it up with his colleagues further along the Front Bench who they introduced competition into the NHS. Monitor, as the sector regulator, must now have regard to having better integrated services, reducing fragmentation and putting more emphasis on the best interests of patients.
The fourth effect of the Health and Social Care Act has been to provide clarity about existing NHS practices on patient choice and competition that were introduced by the previous Government. Under the Act, nothing changed from the rules laid down under Labour on how commissioners should behave when they procure services. That has been borne out, despite the myths and scare stories surrounding the Act. Simon Stevens, a former Labour special adviser under Tony Blair and now head of NHS England, said to the Health Committee that
“if the claim was that CCGs have to start putting all of their health service purchases out to public procurement, that is clearly not true and it isn’t happening”.
That was the current head of the NHS making it clear and putting the record straight on the Opposition’s scaremongering. The NHS agrees: the NHS Confederation stated in its briefing on the Bill:
“The current rules are clear that no-one can pursue competition in the NHS if it is not in the interests of patients.”
Our NHS finances bear that out. In the last financial year, spending on independent health care provision by commissioners was shown to be about 6%, compared with 5% under Labour in 2010. That is hardly evidence of the sweeping privatisation of NHS services, but it is evidence of clinical commissioners making informed, clinically led choices for the benefit of patients.
Dr Steve Kell, chair of the NHS Clinical Commissioners, has made it clear that there is not a clinical commissioning group in the land that has any kind of “privatisation agenda”. What CCGs all share is clinical expertise and an unflinching desire to improve local health services for their patients. This Government will not stand in their way or play party politics with the judgments of doctors and nurses who are making the right choices in the best interests of their patients. Indeed, Dr Michael Dixon, chair of the NHS Alliance, and others wrote in The Daily Telegraph this morning:
“As NHS doctors, we are deeply concerned about the misguided and potentially disruptive National Health Service Bill being debated today.”
Working with other key health care organisations, NHS England—I hope that Labour Members will agree with this uncontroversial point—has set out how the health system must change over the next five years, looking at new models of care delivery and taking a more integrated approach to the delivery of health and care. Earlier in the year, the head of NHS England, Simon Stevens, made it clear that if the procurement, patient choice and competition rules stood in the way of delivering the required changes, he would say so. Clearly, he has not done so.
Let me be absolutely clear: the NHS England “Five Year Forward View” did not call for further legislative change—that is what the Bill proposes—or for structural upheaval or a return to Whitehall control of our NHS.
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I am sure that we can all agree that NHS England’s “Five Year Forward View” was an important piece of work that deserves to have broad cross-party consensus.
Politicians now need to leave the NHS to get on with the job: let the doctors and nurses run the NHS as we have freed them up to do. We can support leaders in the system, and help to free more money for front-line care through improved NHS procurement, better estate management and reduced spending on temporary staff. However, making top-down legislative change to the system, as the hon. Member for Eltham proposes, would be disastrous at a time when we should focus on supporting our NHS to deliver better care for patients.
It is important to look at what the Bill would do. It is quite simply wrong to believe that removing the parts of the 2012 Act that relate to the competition will stop competition law applying to our NHS.
Mr Anderson: Is the Minister happy that, because of competition, groups such as Care UK have cut professional health workers’ pay by between 35% and 40%? How does he expect those people to feel motivated to go to work every day when they cannot afford to pay their mortgage or to look after their kids properly? Is that really what we should expect in this day and age?
Dr Poulter: The hon. Gentleman will be aware that Care UK provides a lot of the care in the social care sphere. I understand that much of the social care commissioned by local authorities is already provided by the private sector. The big idea of the right hon. Member for Leigh is about driving further integration. Under the integration plans that he has outlined, more power would of course be given to companies such as Care UK. We support integration, but it must be done in a way that always meets the best needs of local patients, and it must be evolutionary change rather than revolutionary change, working with front-line professionals to do the best for their patients.
Dr Poulter: Let me make a little progress on the damage that the Bill might do. As I have said, the belief that removing the parts of the 2012 Act that relate to competition will stop competition law applying to our NHS is simply wrong. That important point goes to the heart of what the right hon. Member for Leigh has said.
Dr Eilidh Whiteford (Banff and Buchan) (SNP): rose—
Dr Poulter: If the hon. Lady will let me make some progress, I will come to her shortly.
The fact that such a belief is wrong was recently made clear in correspondence from Simon Stevens to the right hon. Gentleman—from one former Labour special adviser to another—which stated:
“We are, as appropriate, required to observe European procurement regulations, originally introduced in 2006, and related UK law. In everything we do we are also required to exercise our functions effectively, efficiently and economically. As a result we are advised that a blanket contracting ban would not be permissible.”
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It would not be permissible because of regulations introduced by the previous Labour Government. That is another reminder that Labour introduced competition into the NHS.
As I explained earlier, under changes introduced by the previous Labour Government, health commissioners were subject to EU competition law for several years prior to the Act, and they would continue to be subject to it even if the Act was repealed.
Dr Whiteford: The points the Minister is making about competition take us back to the transatlantic trade and investment partnership. He must be aware that the NHS across these islands is developing in very different directions, and competition has not been at the heart of what has happened in other parts of the UK. I want him to give us cast-iron guarantees today that there will be no obligation on the NHS in Scotland to open up because of that trade agreement, even if the UK decides in its favour. What opportunities are there, if the treaty exposes the Scottish Government to—
Mr Deputy Speaker (Mr Lindsay Hoyle): Order. The hon. Lady must sit down.
Dr Poulter: I will come to TTIP shortly, and I think that I will be able to reassure the hon. Lady and the hon. Member for Angus (Mr Weir).
The Health and Social Care Act put in place an alternative route to the courts, through Monitor, to address abuses of the rules around procurement. The Bill would remove that alternative route, meaning that future complaints under the law would result in hugely costly legal processes for health care commissioners, and complaints would be considered by the courts, rather than by Monitor, a health expert regulator. That cannot be good for patients. The Bill would result in more money for the lawyers, and much less money for our NHS and the patients that it looks after.
Another important point is that by favouring NHS over non-NHS providers, the Bill would be a move against the voluntary and charity sector providers, such as Macmillan and Marie Curie, who have done so much to help care for patients for many years.
Jeremy Lefroy: I am glad that my hon. Friend has mentioned Macmillan. At the moment, Macmillan is in the middle of tendering for end-of-life and cancer care in Staffordshire, which hon. Members have mentioned. Although the integration that the tender requires is absolutely vital—I think that it is supported by all Members, including the hon. Member for Stoke-on-Trent Central (Tristram Hunt) in a recent article—one of the real problems involves the mechanism. The fact is that the integration seems to require the tender to be for the entire service, rather than for just a small contract, say, to help with integration. Will my hon. Friend comment on that, because this is one of the problems at the heart of the matter? We do not want large private companies to run our cancer and end-of-life services.
Dr Poulter:
In a moment I will address in a little more detail a couple of the points that were raised. I reassure my hon. Friend that the section 75 regulations that underpin the 2012 Act, which are almost identical to regulations that the previous Government were involved
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with, outline very clearly, under regulation 10, that integrated service, or encouraging co-operation between providers in the interests of patients should not be seen as anti-competitive. Regulation 15 makes it clear that Monitor cannot direct a commissioner to hold a competitive tender. There is strong support throughout those regulations, as there is throughout the 2012 Act, for integrated service delivery in the best interests of patients, where that is appropriate.
Joan Walley: Will the Minister give way?
Dr Poulter: I am going to make some progress—I hope the hon. Lady will forgive me—because Mr Deputy Speaker is looking at me.
Mr Deputy Speaker (Mr Lindsay Hoyle): Yes, I am looking at you.
Dr Poulter: Points were made about the voluntary and charitable sector supporting innovative new models of care. Through the Newquay pathfinder project Age UK has provided volunteer support to vulnerable older people considered at risk. Under the home scheme the British Red Cross provides volunteer support to patients in their homes, which is aimed at preventing admission to, or facilitating discharge from, hospital. The charity has care in the home contracts with more than 30 NHS trusts and social services departments, and the scheme enables reduced admissions, increased convenience to patients, and many other associated benefits.
My hon. Friend the Member for Stafford (Jeremy Lefroy) mentioned Macmillan. I like to talk about Macmillan, which has long provided vital support to patients right across the UK. It is collaborating with doctors in Staffordshire to transform cancer care and end-of-life care, and together they aim to commission care right across the patient journey. In cancer, that means commissioning prevention and health promotion, ensuring early diagnosis and prompt treatment through survivorship and improving end-of-life care.
In reality, the only route proposed in the Bill for recourse against unfair treatment by commissioners is to take us back to the previous Labour Government’s competition laws in 2006 and open up legal challenge through the courts. Only private providers with enough resource behind them are likely to be able to afford to exist in that court-based system, to pay high legal fees, and to invest in providing NHS care to patients, and smaller providers, especially charities, will lose out. Surely we do not want to see that in our NHS—an NHS in which, I hope we all agree, charitable and small local health care organisations have something important to contribute for the benefit of patients.
Before I conclude, I must briefly address some of the misleading commentary that has surrounded TTIP, which is serving only to distract from the real debate about our NHS. First, may I state that there is absolutely no agenda whatsoever to privatise our NHS through the back door? TTIP cannot force the privatisation of public services by EU member states. This position has been made explicitly clear by us and by the relevant negotiating parties. To suggest otherwise would be disingenuous and, frankly, wrong. I encourage Members to look at the recent negotiating mandate published by the European Commission, where this position is made absolutely
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clear. I note the comments of Ignacio Garcia Bercero, EU chief negotiator, on the record at the end of round 7 negotiations—
Dr Poulter: I am addressing the hon. Lady’s point, so I hope she will let me do so. Ignacio Garcia Bercero said:
“I wish…to stress that our approach to services negotiations excludes any commitment on public services, and the governments remain at any time free to decide that certain services should be provided by the public sector.”
That is a very clear reassurance, and I hope it will be accepted by all hon. Members. I will give way just once more, because I do not want to test Mr Deputy Speaker’s patience as I come to a conclusion.
Dr Whiteford: I am grateful to the Minister, but my understanding is that the Commission has said that if one part of the UK market is opened up through privatisation—perfectly democratically, as it could be—then all parts will be opened up. I want his assurances that Scotland will not be forced, by the back door, to privatise its NHS on the coattails of this House.
Dr Poulter: I believe I have given the hon. Lady those reassurances.
Dr Poulter: The Government’s health care reforms ensured that, as under the last Labour Government, day-to-day decisions of care delivery became the responsibility of clinically led NHS commissioners. It is for the local NHS to decide which providers, whether from the public, private or voluntary sectors, can best meet the needs of their patients and deliver high-quality care.
Dr Poulter: I will give way one more time in a moment, and then that really will, I am afraid, be the lot, because I know that Mr Deputy Speaker would like me to come to a conclusion.
Mr Barry Sheerman (Huddersfield) (Lab/Co-op): On a point of order, Mr Deputy Speaker. I do not know what is going on with this speech. I know that the Minister is a distinguished medical person, but he is presenting the speech with so much jargon and such technical terms that very few people out there will understand the main thrust of it. The only thing many people have understood in the last few minutes is the back-door privatisation.
Mr Deputy Speaker (Mr Lindsay Hoyle): That is absolutely not a point of order, but we will hear from some other speakers if we can get to the end of this speech. We might then hear some other parts of the debate.
Dr Poulter: Thank you, Mr Deputy Speaker.
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I have mentioned the benefit to patients many times in my speech, because that is, after all, what I care about as a doctor and what I care about as a Health Minister, and what I hope all hon. Members care about; I know that the hon. Member for Huddersfield (Mr Sheerman) does so.
Additionally, and contrary to claims made by some, TTIP will not prevent any future Government from changing the legal framework for the provision of NHS services. Neither will it prevent the termination of the private provision of such a service in accordance with the law or contracts entered into, as is already the case today. The reassurances that we and the European Commission offered were sufficient for the right hon. Member for Wentworth and Dearne (John Healey), a previous shadow Health Secretary, when he stated:
“On the NHS....my direct discussions with the EU’s chief negotiator have helped produce an EU promise to fully protect our health service including, as the chief negotiator says in a letter to me, so that: ‘any ISDS provisions in TTIP could have no impact on the UK’s sovereign right to make changes to the NHS.”
If it was good enough for the right hon. Gentleman—
Dr Poulter: I will give way to the hon. Member for Eltham and then I will conclude.
Clive Efford: That really will not wash. The Minister is saying that we must trust the Government and that they will not allow TTIP to apply to the national health service. The Bill says that this House will be sovereign; this House will decide whether TTIP applies to our national health service. Does he support that?
Dr Poulter: I was simply quoting the reassurances that his right hon. Friend had given to all hon. Members, which was that
“any ISDS provisions in TTIP could have no impact on the UK’s sovereign right to make changes to the NHS”.
If TTIP is good enough for the right hon. Member for Wentworth and Dearne , it should be good enough for everyone in the Labour party.
John Healey: Would the Minister be good enough to concede that that has absolutely nothing to do with what the Government have been arguing; that is to do with the EU and their negotiation. The Trade Minister in charge has said that he does not want the NHS to be excluded in the way that we want.
Dr Poulter:
No; I am simply quoting what the right hon. Gentleman has already put on the record about reassurances that he has received from the EU about an EU trade settlement. Surely, if the reassurances were good enough for him when he wanted to communicate them more broadly to his colleagues, and more broadly to members of the public, they are good enough now. It is very difficult to climb down from those reassurances, which he has previously given, and in the remarks I have
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made I have further reassured the House about the protection that this Government have made for the NHS in TTIP.
I am immensely proud of the way our NHS has already responded to the challenges of a growing and ageing population, meeting increased demand through a purpose and drive to improve the quality of patient care. That is why our NHS was recently ranked No. 1 in the Commonwealth Fund’s assessment of 11 global health care systems. This is at a time of unprecedented challenge to public finances across the globe, and testifies to the incredibly hard work of NHS staff and a very tough choice by this Government to protect our NHS budget and increase it by £12.7 billion between 2010 and 2015—a decision that the right hon. Member for Leigh called irresponsible but one of which we are very proud.
I remind the House of the words of the right hon. Member for Leigh when he was a Health Minister defending Labour’s record on introducing private providers into our NHS:
“I think the NHS can finally move beyond the polarising debates of the last decade over private or public sector provision”.
I agree: it is definitely time to move on. Our NHS focus needs to be on delivering for patients, so let us put distractions aside and let our hard-working doctors, nurses and health professionals get on with the job.
12.58 pm
Barbara Keeley (Worsley and Eccles South) (Lab): I congratulate my hon. Friend the Member for Eltham (Clive Efford) on his excellent opening speech—I think it was one of the best speeches I have heard in the House—and on introducing his Bill so that we can review and reform some of the more pernicious effects of the Health and Social Care Act 2012. One of the worst was to force market tendering of services, meaning that millions of pounds are wasted on the process, money that should be spent on improving front-line patient care.
As a member of the Health Committee, I am very concerned about the increasing role that private companies are paying in providing NHS services. We recently looked at what is happening in Stoke and Staffordshire. There have been a few references to that in this debate and I will talk some more about it, but we looked at it under the label of the integrated care pioneers pilot. I want to talk more about that development as an example of just what can happen under this Government’s market framework—[Interruption.]
Mr Deputy Speaker (Mr Lindsay Hoyle): Order. There are a lot of conversations and I am struggling to hear the hon. Lady. If we need to have the conversations, can we turn them down a little?
Barbara Keeley: Thank you, Mr Deputy Speaker.
The clinical commissioning groups involved plan to tender by summer 2015 a £1.2 billion contract to deliver cancer services and end-of-life care for 876,000 people across the area. The witnesses we heard from made it clear that commissioning on a disease-specific basis like this is risky. There are only a few small-scale examples of that being done anywhere, and nothing on the scale of this project. Despite the risk, we heard some worrying
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things about local people or local MPs not being listened to and about a lack of consultation with or involvement of hospital-based clinicians. The Minister has just referred a number of times to letting doctors get on with running the NHS, but the CCGs involved in driving this pilot are not even involving or listening to local clinicians. I and other colleagues on the Committee found that bodies such as Healthwatch England and Macmillan Cancer Support were cheerleaders for—and in Macmillan’s case, a funder of—development work on a project that could end up privatising cancer and end-of-life care for almost a million people. I for one found that disturbing. I felt, and I know that some of my colleagues did too, that there was a conflict of interest. Healthwatch England was meant to be the consumer champion of health and care.
By contrast with what Government Members have said, there was also a fair amount of concern among Committee members about the role of Macmillan Cancer Support in funding the development work when many believe that the money they give to Macmillan goes directly to cancer care. Indeed, the example I saw on the Macmillan website yesterday was that a donation would pay for a Macmillan nurse for a period to help people living with cancer and their families receive essential medical, practical and emotional support. It does not appear to be a selling point for that charity that funds would be used on a project to privatise end-of-life and cancer care in Staffordshire and Stoke.
Jeremy Lefroy: As I have already said, I have major concerns about the form of the contract. The hon. Member for Stoke-on-Trent Central (Tristram Hunt) wrote, and I say this in defence of Macmillan:
“This is the context for our new cancer contract and we should not pass knee-jerk judgments upon new ideas which aim for better outcomes and efficiency.”
That is what Macmillan is after.
Barbara Keeley: I thank the hon. Gentleman for that comment, but the point is that Macmillan Cancer Support is using money fundraised by the public in ways that I do not think the public would approve of. That was the key thing we explored. It is not at all clear, if we look at the Macmillan website, how it is using approaching £1 million of the public’s money, donated on that basis.
Valerie Vaz: My hon. Friend mentions conflicts of interest. Is she aware that one of the companies bidding for the privatisation of cancer services is UnitedHealth Group, which was advised by the chief executive of NHS England?
Barbara Keeley: Indeed. Now that the shortlist for bidding has been announced for end-of-life care, we find that five of the shortlisted bidders are private companies, with only two NHS trusts on the list. For cancer care, there are three private companies and two NHS trusts. Given the seemingly headlong drive for change we found in those commissioning this large and risky contract, a great number of questions were left unanswered. For instance, despite the key role that GPs play in end-of-life care for patients choosing to die at home, the prime provider of end-of-life care will not have control over the actions of the GPs involved in that care unless a specific contract is drawn up and GPs are paid for extra tasks.
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The contracts for cancer and end-of-life care are to be placed in early summer 2015, and I invite anybody with an interest in this to review the evidence and, in particular, the unanswered questions in the session the Health Committee held on 14 October. I have yet to find assurances in the evidence I have heard that the profit motive of private providers can be squared with the objective of improving cancer care and end-of-life care for patients.
Chris Ruane (Vale of Clwyd) (Lab): Cancer care for north Wales is provided by bodies in the north-west of England. MPs on the Government Benches are saying that I, as a Welsh MP, should not have a vote on this matter. What does my hon. Friend think about that? Should I be concerned about standards of care and the privatisation of the English health service? My constituents will suffer if it is hollowed out and privatised by the Government.
Barbara Keeley: My hon. Friend absolutely should be concerned and I know that he is.
One of the elements of cancer and end-of-life care given to us as an example of where improvement is needed in Staffordshire and Stoke was patient transport. However, we know in the north-west that going to new private providers does not tend to help. We have already had a negative experience since patient transport was contracted out to the bus company Arriva.
A number of my constituents have had problems with Arriva’s patient transport. One contacted me following a wait of more than three hours for ambulance transport to be arranged for her husband. He has terminal cancer and needed to be transported back to Salford Royal after oncology treatment at the Christie hospital. That was the second time in three weeks that this terminally ill patient had to wait two or three hours for transport. Staff at the Christie hospital told my constituent that such long waits were common, despite the fact that many oncology patients are very sick.
Mr Slaughter: I am very grateful to my hon. Friend for giving way, particularly because the Minister did not in the course of his very long speech. Of course, that might have been because the main emergency hospital in my constituency, Charing Cross, is being demolished, losing all but 24 of its 360 beds, losing the best stroke unit in the country and losing its A and E, which, according to board papers, is moving from the site. There will be no emergency consultancy services at all. Is not what is happening on the ground very different from the jargon-filled rubbish we heard from the Minister today?
Barbara Keeley: Absolutely, and I am saying what is happening on the ground to a terminally ill cancer patient.
In her letter to Arriva, my constituent told the company:
“Your company should not have this contract if it displays such a lack of concern for very ill patients causing distress to both them and their relatives”.
Not only was the delay unacceptable to a terminally ill patient, but the reply to my constituent’s complaint was one of the worst I have ever seen, as we are talking about gobbledegook. For instance, the explanation for the long wait included the following sentence:
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“When an outpatient booking is made, the expected outbound blocking is automatically populated, using the throughput assumption.”
The jargon that starts at the top permeates down even to the complaint handling. It took a lot more letters to get an apology for such appalling service and such a poor reply.
Another constituent has told me of unsuitable transport and untrained staff—we have heard about this happening across the country—sent to the home of a patient who needed to use a wheelchair. That meant that the patient missed their appointment and an important investigation of their health was delayed by a number of weeks. I trust that the commissioners driving the privatisation of cancer services in Staffordshire and Stoke are aware of just how wrong transport services can go with a private transport provider.
This Government’s measures have put competition and privatisation above the needs of NHS patients. The Health and Social Care Act has put pressure on regulators to make clinical commissioning groups and NHS trusts adopt tendering processes that are not in the best interest of patients. That means wasted money, resources and time. This Bill would remove these damaging reforms, and patient care would be prioritised instead of unnecessary competition. The Bill would not prevent competition within the NHS, but it would prevent competition at the expense of patient care.
Our national health service is different from other sectors and needs a different approach. Integration to improve patient care needs collaboration rather than competition. It is a great pleasure to be in the Chamber today to speak and vote in support of the Bill.
1.8 pm
Sir Oliver Heald (North East Hertfordshire) (Con): I am grateful to have the opportunity to make a few short remarks. The hon. Member for Worsley and Eccles South (Barbara Keeley) is right to be concerned about any problem that occurs in the NHS, but I am sure she would accept that it is an enormous organisation and that the key point is that when things go wrong, the lessons are learned and things are put right. Most of the life of the NHS has been under Conservative Governments, and we on the Government Benches are as proud of the NHS as Labour Members are.
I congratulate the hon. Member for Eltham (Clive Efford) on being a strong voice for Labour principles, but I am concerned that the effect of his Bill will be to undermine the operational independence of the NHS, cause disruption and introduce unnecessary bureaucracy. Putting powers back with the Secretary of State through the re-establishment of powers of direction is going in the wrong direction. Preventing illness, diagnosing and treating patients are not political activities. They should be in the hands of professionals and the operational independence of the NHS means that clinical considerations are paramount. When I was a health spokesperson, I went to look at health systems in Europe, and the key point I took away was that the best systems were those with a lot of clinical input in management.
It is not necessary to rewrite the Act. Instead, the changes we have made need to work their way through. The shadow Secretary of State said that the competition
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element is dominant in the Act, but that is not true. The procurement policy is set out to secure the needs of patients and improve quality and efficiency. I want to give an example from my constituency of how the reforms are working. Royston is part of the Peterborough and Cambridge CCG. Before that was so, we had a proposal for the redevelopment of Royston hospital. A Royston hospital action group was formed, while the friends of Royston hospital were concerned about the proposals, which were top down. However, Tom Dutton, the CCG strategic lead, has worked tirelessly with the NHS and the local community, as has the local chairman, Dr John Hedges, a GP in Royston, and they understand local needs, so we are now getting tailored provision that suits the needs of my constituents.
I meet the CCG, councillors, local groups and other stakeholders every six weeks, and I believe that we are now getting a service for Royston and a proposal that meet local needs. The £1 billion tender for older people’s services was in our CCG area. The hon. Member for Eltham criticised the cost, but we had a consultation meeting in Royston that 150 local people attended, while 250 local people filled out the questionnaire. The proposal and consultation will have cost money, yes, but the end result was that the tender process was won by the Uniting Care partnership, an NHS partnership involving Addenbrooke’s hospital and the Cambridge and Peterborough NHS trust, and it is now delivering more joined-up care.
Dr Huppert: I was delighted with that outcome. One of the successes I hope the hon. and learned Gentleman will mention is the better joint working between acute care, mental health care and community services to avoid delays in the transfer of care. This could be a very good outcome for the NHS and patients.
Sir Oliver Heald: That is exactly the point I was going to make. The process, which involved local people, has resulted in a reform that gives us the sort of joined-up care the hon. Gentleman mentions.
To conclude, the Bill seeks to prevent privatisation that is not happening on the ground, while some of the changes we have made are bringing positive benefits for people in my constituency.
1.13 pm
Mrs Emma Lewell-Buck (South Shields) (Lab): I would like to offer my support for the Bill and congratulate my hon. Friend the Member for Eltham (Clive Efford) on bringing it to the House.
Members will be pleased that I intend to keep my comments brief. Our NHS is a monumental achievement and one that my party remains deeply proud of. There are many people alive today who remember what life was like before the NHS and who would never go back to a time when the poor could not afford treatment for preventable illnesses. That is the generation that truly understands what the NHS means and why we must protect it.
That is not to say that people today take the NHS for granted. In fact my inbox, like those of other hon. Members, has been overflowing with e-mails from constituents worried about the future of our health service. They want the principle of free and equal access
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protected and the needs of patients put before profit, as they should be. I and those people are afraid of the direction the NHS is heading in under this Government. We see the Tories wedging open the door for private companies to come in and deliver services, and we see hospitals encouraged to take on ever more private patients.
People do not believe the Government’s spin: they know that the changes are part of the creeping privatisation being encouraged by the Tories and that the reorganisation in the 2012 Act was all about Tory ideology, not patient care. The reorganisation wasted £3 billion and has seen millions more spent on tendering exercises and competition lawyers which could have been spent on treatment for those who genuinely needed it. They also know that they cannot trust a Health Secretary who has previously backed calls to dismantle the NHS or a party that brought the NHS to the brink of collapse the last time it was in power. Back then, it took a Labour Government to save the NHS, and now history is repeating itself.
The constituents who have written to me, the people I was proud to join on the NHS march earlier this year and those I joined last night for a vigil outside Parliament understand what is at stake. The NHS is more than just a service; it is a principle of fairness. Illness and accidents strike us all at some point, often without warning and leaving us little time to plan, and before the NHS, this kind of misfortune could destroy lives and condemn families to extreme poverty. Now we have a service that says nobody, whether rich or poor, should have their life ruined by misfortune. That is the principle that my hon. Friends and I are standing up for today.
1.15 pm
Jeremy Lefroy (Stafford) (Con): I welcome the Bill and congratulate the hon. Member for Eltham (Clive Efford) on introducing it; I shall be supporting its Second Reading today.
My support derives mainly from my and my constituents’ experiences over several years of some of the workings of the Health Act 2006, introduced by the previous Government, and the 2012 Act, introduced by this Government. In particular, two matters have been, and continue to be, of great significance: first, the two Francis inquiries into cases of dreadful care in my constituency, and secondly, the reports that have had such a major influence on the entire NHS. Just yesterday, my wife was giving a lecture to medical students on aspects of the Francis reports. It is vital that these lessons, particularly on patient safety and zero avoidable harm, are not forgotten, which is why I introduced a Bill on the subject two weeks ago.
The second concerns a more recent matter referred to already today: the review, supported by Macmillan, of cancer and end-of-life services in north Staffordshire, Stoke-on-Trent, Stafford and Cannock, which has resulted in a tender of all these services to be managed through an integrator. Just to correct the record, it is not just private companies on the tender—NHS organisations are also on it—but I still have major concerns. I am looking at this through the eyes of patients everywhere. The NHS must not be about structures or be in thrall to political dogma of any kind; it must be about safety and quality of care for all patients. I hope the Government might see the Bill in that way and use it as an opportunity to make improvements to both the 2006 Act and the 2012 Act.
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I welcome clause 1. During the trust special administrator process that we had to go through, the inability of providers and commissioners to speak to one another—in some cases because of so-called commercial confidentiality —was ridiculous and without doubt delayed the process. At certain points, the whole process cried out for someone, if necessary the Secretary of State, to put everyone in a room for a day with instructions not to leave until everything had been sorted out. However, everybody was walking on eggshells in case they did something that might result in a judicial review and a reversion to square one. That was not in the interests of patients. That is not to be critical of those involved: for the most part they tried very hard and we got a better result than at some points we feared.
I want to make a serious point about clause 1 and the desire for the Bill to place the running of the NHS firmly in the hands of the Secretary of State. It is vital that there should not be too much hands-on running of the NHS by the Secretary of State—the British Medical Association, which has some very positive comments about the Bill, says that as well.
I am short of time, so let me conclude by talking about cancer and end-of-life services, which have been raised today. The problem is the way in which the NHS is funded and the fact that the tender is for all services involved in those pathways. It would have been much more sensible for the tender to help the work of integration, which would have involved a much smaller amount, rather than the full amount of services.
Clive Efford claimed to move the closure (Standing Order No. 36).
Question put forthwith, That the Question be now put.
The House proceeded to a Division.
Mr Deputy Speaker (Mr Lindsay Hoyle): I ask the Serjeant at Arms to investigate the delay in the No Lobby.
The House having divided:
Ayes 239, Noes 20.
Division No. 89]
[
1.19 pm
AYES
Abbott, Ms Diane
Abrahams, Debbie
Ainsworth, rh Mr Bob
Alexander, rh Mr Douglas
Alexander, Heidi
Ali, Rushanara
Allen, Mr Graham
Anderson, Mr David
Ashworth, Jonathan
Austin, Ian
Bain, Mr William
Balls, rh Ed
Banks, Gordon
Barron, rh Kevin
Beckett, rh Margaret
Begg, Dame Anne
Benn, rh Hilary
Berger, Luciana
Blackman-Woods, Roberta
Blears, rh Hazel
Blomfield, Paul
Blunkett, rh Mr David
Brennan, Kevin
Brown, Lyn
Brown, rh Mr Nicholas
Brown, Mr Russell
Buck, Ms Karen
Burden, Richard
Burnham, rh Andy
Byrne, rh Mr Liam
Campbell, rh Mr Alan
Campbell, Mr Ronnie
Carswell, Douglas
Caton, Martin
Champion, Sarah
Chapman, Jenny
Clark, Katy
Clarke, rh Mr Tom
Clwyd, rh Ann
Coaker, Vernon
Connarty, Michael
Cooper, Rosie
Cooper, rh Yvette
Corbyn, Jeremy
Creagh, Mary
Creasy, Stella
Cryer, John
Cunningham, Alex
Cunningham, Mr Jim
Cunningham, Sir Tony
Curran, Margaret
Darling, rh Mr Alistair
David, Wayne
Davidson, Mr Ian
Davies, Geraint
De Piero, Gloria
Denham, rh Mr John
Dobson, rh Frank
Docherty, Thomas
Donohoe, Mr Brian H.
Doughty, Stephen
Dowd, Jim
Doyle, Gemma
Dromey, Jack
Dugher, Michael
Durkan, Mark
Eagle, Ms Angela
Eagle, Maria
Edwards, Jonathan
Efford, Clive
Elliott, Julie
Ellman, Mrs Louise
Engel, Natascha
Esterson, Bill
Evans, Chris
Farrelly, Paul
Fitzpatrick, Jim
Flello, Robert
Flint, rh Caroline
Flynn, Paul
Fovargue, Yvonne
Francis, Dr Hywel
Galloway, George
Gapes, Mike
Gardiner, Barry
George, Andrew
Gilmore, Sheila
Glass, Pat
Glindon, Mrs Mary
Godsiff, Mr Roger
Goodman, Helen
Greatrex, Tom
Green, Kate
Greenwood, Lilian
Griffith, Nia
Gwynne, Andrew
Hamilton, Mr David
Hamilton, Fabian
Hanson, rh Mr David
Harman, rh Ms Harriet
Harris, Mr Tom
Havard, Mr Dai
Healey, rh John
Heath, Mr David
Hendrick, Mark
Heyes, David
Hillier, Meg
Hilling, Julie
Hodgson, Mrs Sharon
Hoey, Kate
Hosie, Stewart
Howarth, rh Mr George
Hunt, Tristram
Huppert, Dr Julian
Irranca-Davies, Huw
Jackson, Glenda
James, Mrs Siân C.
Jamieson, Cathy
Jarvis, Dan
Johnson, Diana
Jones, Graham
Jones, Mr Kevan
Jones, Susan Elan
Jowell, rh Dame Tessa
Kane, Mike
Kaufman, rh Sir Gerald
Keeley, Barbara
Kendall, Liz
Khan, rh Sadiq
Lammy, rh Mr David
Lavery, Ian
Lazarowicz, Mark
Lefroy, Jeremy
Leslie, Chris
Lewell-Buck, Mrs Emma
Lewis, Mr Ivan
Long, Naomi
Love, Mr Andrew
Lucas, Caroline
Lucas, Ian
MacNeil, Mr Angus Brendan
Mactaggart, Fiona
Mahmood, Shabana
Malhotra, Seema
Mann, John
Marsden, Mr Gordon
McCann, Mr Michael
McCarthy, Kerry
McDonagh, Siobhain
McDonald, Andy
McDonnell, John
McFadden, rh Mr Pat
McGovern, Alison
McGuire, rh Mrs Anne
McInnes, Liz
McKechin, Ann
McKenzie, Mr Iain
McKinnell, Catherine
Meacher, rh Mr Michael
Meale, Sir Alan
Mearns, Ian
Miliband, rh Edward
Miller, Andrew
Mitchell, Austin
Moon, Mrs Madeleine
Morden, Jessica
Morrice, Graeme
(Livingston)
Morris, Grahame M.
(Easington)
Mulholland, Greg
Murphy, rh Mr Jim
Murphy, rh Paul
Murray, Ian
Nandy, Lisa
Nash, Pamela
O'Donnell, Fiona
Onwurah, Chi
Osborne, Sandra
Owen, Albert
Pearce, Teresa
Perkins, Toby
Phillipson, Bridget
Pound, Stephen
Pugh, John
Qureshi, Yasmin
Raynsford, rh Mr Nick
Reckless, Mark
Reed, Mr Jamie
Reeves, Rachel
Reid, Mr Alan
Reynolds, Emma
Reynolds, Jonathan
Riordan, Mrs Linda
Robertson, Angus
Robertson, John
Robinson, Mr Geoffrey
Rotheram, Steve
Roy, Mr Frank
Ruane, Chris
Ruddock, rh Dame Joan
Sarwar, Anas
Sawford, Andy
Seabeck, Alison
Sharma, Mr Virendra
Sheerman, Mr Barry
Sheridan, Jim
Shuker, Gavin
Skinner, Mr Dennis
Slaughter, Mr Andy
Smith, Angela
Smith, Nick
Smith, Owen
Spellar, rh Mr John
Straw, rh Mr Jack
Stringer, Graham
Stuart, Ms Gisela
Tami, Mark
Thomas, Mr Gareth
Thornberry, Emily
Timms, rh Stephen
Trickett, Jon
Turner, Karl
Twigg, Derek
Twigg, Stephen
Umunna, Mr Chuka
Vaz, Valerie
Walley, Joan
Watson, Mr Tom
Watts, Mr Dave
Weir, Mr Mike
Whiteford, Dr Eilidh
Whitehead, Dr Alan
Williams, Hywel
Williamson, Chris
Wilson, Phil
Winterton, rh Ms Rosie
Wishart, Pete
Woodcock, John
Wright, David
Wright, Mr Iain
Tellers for the Ayes:
Nic Dakin
and
Tom Blenkinsop
NOES
Baldry, rh Sir Tony
Baldwin, Harriett
Bray, Angie
Chope, Mr Christopher
Davies, Philip
Eustice, George
Goodwill, Mr Robert
Gyimah, Mr Sam
Hands, rh Greg
Heald, Sir Oliver
Hollobone, Mr Philip
Letwin, rh Mr Oliver
Metcalfe, Stephen
Mordaunt, Penny
Nuttall, Mr David
Patel, Priti
Penning, rh Mike
Poulter, Dr Daniel
Swayne, rh Mr Desmond
Vaizey, Mr Edward
Tellers for the Noes:
Anne Milton
and
Mr David Evennett
Question accordingly agreed to.
21 Nov 2014 : Column 599
21 Nov 2014 : Column 600
Question put accordingly, That the Bill be now read a Second time.
The House proceeded to a Division.
Mr Deputy Speaker (Mr Lindsay Hoyle): I ask the Serjeant at Arms to investigate the delay in the No Lobby.
The House having divided:
Ayes 241, Noes 18.
Division No. 90]
[
1.34 pm
AYES
Abbott, Ms Diane
Abrahams, Debbie
Ainsworth, rh Mr Bob
Alexander, rh Mr Douglas
Alexander, Heidi
Ali, Rushanara
Allen, Mr Graham
Anderson, Mr David
Ashworth, Jonathan
Austin, Ian
Bain, Mr William
Balls, rh Ed
Banks, Gordon
Barron, rh Kevin
Beckett, rh Margaret
Begg, Dame Anne
Benn, rh Hilary
Berger, Luciana
Blackman-Woods, Roberta
Blears, rh Hazel
Blomfield, Paul
Blunkett, rh Mr David
Brennan, Kevin
Brown, Lyn
Brown, rh Mr Nicholas
Brown, Mr Russell
Buck, Ms Karen
Burden, Richard
Burnham, rh Andy
Byrne, rh Mr Liam
Campbell, rh Mr Alan
Campbell, Mr Ronnie
Carswell, Douglas
Caton, Martin
Champion, Sarah
Chapman, Jenny
Clark, Katy
Clarke, rh Mr Tom
Clwyd, rh Ann
Coaker, Vernon
Connarty, Michael
Cooper, Rosie
Cooper, rh Yvette
Corbyn, Jeremy
Creagh, Mary
Creasy, Stella
Cryer, John
Cunningham, Alex
Cunningham, Mr Jim
Cunningham, Sir Tony
Curran, Margaret
Darling, rh Mr Alistair
David, Wayne
Davidson, Mr Ian
Davies, Geraint
De Piero, Gloria
Denham, rh Mr John
Dobson, rh Frank
Docherty, Thomas
Donohoe, Mr Brian H.
Doughty, Stephen
Dowd, Jim
Doyle, Gemma
Dromey, Jack
Dugher, Michael
Durkan, Mark
Eagle, Ms Angela
Eagle, Maria
Edwards, Jonathan
Efford, Clive
Elliott, Julie
Ellman, Mrs Louise
Engel, Natascha
Esterson, Bill
Evans, Chris
Farrelly, Paul
Fitzpatrick, Jim
Flello, Robert
Flint, rh Caroline
Flynn, Paul
Fovargue, Yvonne
Francis, Dr Hywel
Galloway, George
Gapes, Mike
Gardiner, Barry
George, Andrew
Gilmore, Sheila
Glass, Pat
Glindon, Mrs Mary
Godsiff, Mr Roger
Goodman, Helen
Greatrex, Tom
Green, Kate
Greenwood, Lilian
Griffith, Nia
Gwynne, Andrew
Hamilton, Mr David
Hamilton, Fabian
Hanson, rh Mr David
Harman, rh Ms Harriet
Harris, Mr Tom
Havard, Mr Dai
Healey, rh John
Heath, Mr David
Hendrick, Mark
Heyes, David
Hillier, Meg
Hilling, Julie
Hodgson, Mrs Sharon
Hoey, Kate
Hollobone, Mr Philip
Hosie, Stewart
Howarth, rh Mr George
Hunt, Tristram
Huppert, Dr Julian
Irranca-Davies, Huw
Jackson, Glenda
James, Mrs Siân C.
Jamieson, Cathy
Jarvis, Dan
Johnson, Diana
Jones, Graham
Jones, Mr Kevan
Jones, Susan Elan
Jowell, rh Dame Tessa
Kane, Mike
Kaufman, rh Sir Gerald
Keeley, Barbara
Kendall, Liz
Khan, rh Sadiq
Lammy, rh Mr David
Lavery, Ian
Lazarowicz, Mark
Lefroy, Jeremy
Leslie, Chris
Lewell-Buck, Mrs Emma
Lewis, Mr Ivan
Long, Naomi
Love, Mr Andrew
Lucas, Caroline
Lucas, Ian
MacNeil, Mr Angus Brendan
Mactaggart, Fiona
Mahmood, Shabana
Malhotra, Seema
Mann, John
Marsden, Mr Gordon
McCann, Mr Michael
McCarthy, Kerry
McDonagh, Siobhain
McDonald, Andy
McDonnell, John
McFadden, rh Mr Pat
McGovern, Alison
McGuire, rh Mrs Anne
McInnes, Liz
McKechin, Ann
McKenzie, Mr Iain
McKinnell, Catherine
Meacher, rh Mr Michael
Meale, Sir Alan
Mearns, Ian
Miliband, rh Edward
Miller, Andrew
Mitchell, Austin
Moon, Mrs Madeleine
Morden, Jessica
Morrice, Graeme
(Livingston)
Morris, Grahame M.
(Easington)
Mulholland, Greg
Murphy, rh Mr Jim
Murphy, rh Paul
Murray, Ian
Nandy, Lisa
Nash, Pamela
O'Donnell, Fiona
Onwurah, Chi
Osborne, Sandra
Owen, Albert
Pearce, Teresa
Perkins, Toby
Phillipson, Bridget
Pound, Stephen
Pugh, John
Qureshi, Yasmin
Raynsford, rh Mr Nick
Reckless, Mark
Reed, Mr Jamie
Reeves, Rachel
Reid, Mr Alan
Reynolds, Emma
Reynolds, Jonathan
Riordan, Mrs Linda
Robertson, Angus
Robertson, John
Robinson, Mr Geoffrey
Rotheram, Steve
Roy, Mr Frank
Ruane, Chris
Ruddock, rh Dame Joan
Russell, Sir Bob
Sarwar, Anas
Sawford, Andy
Seabeck, Alison
Sharma, Mr Virendra
Sheerman, Mr Barry
Sheridan, Jim
Shuker, Gavin
Skinner, Mr Dennis
Slaughter, Mr Andy
Smith, Angela
Smith, Nick
Smith, Owen
Spellar, rh Mr John
Straw, rh Mr Jack
Stringer, Graham
Stuart, Ms Gisela
Tami, Mark
Thomas, Mr Gareth
Thornberry, Emily
Timms, rh Stephen
Trickett, Jon
Turner, Karl
Twigg, Derek
Twigg, Stephen
Umunna, Mr Chuka
Vaz, Valerie
Walley, Joan
Watson, Mr Tom
Watts, Mr Dave
Weir, Mr Mike
Whiteford, Dr Eilidh
Whitehead, Dr Alan
Williams, Hywel
Williamson, Chris
Wilson, Phil
Winterton, rh Ms Rosie
Wishart, Pete
Woodcock, John
Wright, David
Wright, Mr Iain
Tellers for the Ayes:
Nic Dakin
and
Tom Blenkinsop
NOES
Baldry, rh Sir Tony
Baldwin, Harriett
Bray, Angie
Chope, Mr Christopher
Davies, Philip
Dunne, Mr Philip
Eustice, George
Goodwill, Mr Robert
Gyimah, Mr Sam
Hands, rh Greg
Heald, Sir Oliver
Letwin, rh Mr Oliver
Nuttall, Mr David
Patel, Priti
Penning, rh Mike
Poulter, Dr Daniel
Swayne, rh Mr Desmond
Vaizey, Mr Edward
Tellers for the Noes:
Anne Milton
and
Mr David Evennett
Question accordingly agreed to.
21 Nov 2014 : Column 601
21 Nov 2014 : Column 602
Bill accordingly read a Second time; to stand committed to a Public Bill Committee (Standing Order No. 63.)
Clive Efford: On a point of order, Mr Deputy Speaker. I understand that, in order to go into Committee, this Bill requires a resolution from the Government. Given the overwhelming number of people who turned up on a Friday to support it, would it not be churlish of the Government not to pass that resolution and make sure that this Bill goes into Committee forthwith?
Mr Deputy Speaker (Mr Lindsay Hoyle): As you pointed out, it is something for the Government, but not me, to take on board.
21 Nov 2014 : Column 603
Zero Hours Contracts Bill
1.50 pm
Ian Mearns (Gateshead) (Lab): I beg to move, That the Bill be now read a Second time.
In politics, it is said that there are no final victories and no final defeats; that each generation must fight many of the same battles that the generation before have, and that the generation after may have to fight as well. Today, I am fighting for the same thing that people of every generation have fought for: the right to decent and secure conditions and terms of employment.
It is not a great ask. A well-paid and steady job is the bedrock on which people build their lives. It is the starting point for planning for the future, and the platform of stability needed to pay the bills, meet the rent, pay the mortgage and start a family. Those are not extravagances, but the minimum that should be available to any person who is prepared to work to pay their way in a wealthy nation such as ours. Yet that stability and security is denied to millions of workers in this country. Increasingly, people are finding themselves plagued by job insecurity, not knowing from one day to the next whether they will be working or earning.
In recent years, the rise in the number of those feeling insecure at work has been startling. In 2011, 6.5 million people surveyed said that they felt insecure in their work. By this year, that number had almost doubled to 12 million people.
Mr David Nuttall (Bury North) (Con) rose—
Ian Mearns: Let me make some progress. What we have witnessed is not so much an economic recovery as an economic transformation. Almost daily, the Government boast about job creation in the private sector, but the truth is that the jobs that were lost due to the global economic crash and the Government cuts have been largely replaced by low-skilled, low-waged and, sadly, insecure jobs. It is leaving large swathes of the work force living on, or just above, the breadline.
As they are so keen to remind us, the Conservatives have a long-term economic plan, but it is not one for the working person. Nowhere is that clearer than in the explosion in the use of zero-hours contracts. As recently as last year, the coalition was claiming that slightly more than 200,000 people were employed on zero-hours contracts. The true figure, as revealed by the Office for National Statistics, was in fact seven times higher than Government Ministers admitted—a staggering 1.4 million people engaged in zero-hours employment contracts.
Zero-hours contracts—if they are used at all—are supposed to be used for short-term or seasonal work, occupying a niche in the labour market, but the reality is that they have become the norm across many sectors.
Mr Nuttall: The hon. Gentleman makes reference to the number of zero-hours contracts that exist at the moment. Back in 2000, the ONS estimated that there were 225,000 people on zero-hours contracts. Why is it all right for people to be on a zero-hours contract under a Labour Government, but not under a Conservative- led one?
21 Nov 2014 : Column 604
Ian Mearns: If the hon. Gentleman had been listening, he would have heard me point out that Ministers in his own Government were admitting to 200,000 such contracts only three years ago, but there are now 1.4 million of them, which is a massive burgeoning in the use and exploitation of workers through the abuse of zero-hours contracts.
Ian Murray (Edinburgh South) (Lab): My hon. Friend is making a powerful speech on the use of zero-hours contracts, but is not the proof of the pudding always in the eating? Although unemployment has gone down in this country, the tax-take to the Treasury from income tax has stayed flat, despite the Treasury predicting a huge increase. That shows that we have under-employment and a massive explosion in zero-hours contracts.
Ian Mearns: I am grateful to my hon. Friend for making that point. Government Members celebrate the fact that 3 million workers have been taken out of tax completely, but they are also celebrating the fact that 2 million of them are earning £200 or less a week. I do not think that is anything to celebrate in this day and age.
Given the variety of employers now using zero-hours contracts, from Sports Direct to Buckingham palace even, it is clear that they are not just filling a niche; they are also being exploited by unscrupulous employers looking to dodge their responsibilities to their staff.
Philip Davies (Shipley) (Con): The hon. Gentleman talks about employers exploiting their workers by giving them zero-hours contracts. I presume that within that group he includes all the Labour councils that employ people that way. Has he done any investigations into why so many Labour councils employ so many people on zero-hours contracts?
Ian Mearns: As a matter of fact, I have. I would ask colleagues engaged in public service provision up and down the country to think very deeply about their employment practices. I do not condone it, but I know that for some workers zero-hours contracts are a handy way of gaining part-time employment, but only part-time employment. Many find it very difficult to sustain an ordinary family life on a zero-hours contract.
Ian Lavery (Wansbeck) (Lab): Is not the fact of the matter that the Bill, if we manage to pass it, would prevent anyone, whether a Labour council, a Tory council or even a Tory MP, from employing people on zero-hours contracts? They would be abolished entirely.
Ian Mearns: I am grateful to my hon. Friend for that intervention. The Bill seeks to curtail the use of zero-hours contracts severely.
Mr George Howarth (Knowsley) (Lab): My hon. Friend is being generous in giving way. He is making a powerful case for how morally repugnant that kind of employment is, but does he also agree that more enlightened employers say that it is actually a lazy form of employing people and that, with more thought, those employees could have proper contracts and proper hours?
Ian Mearns: I will be developing that point in due course.
21 Nov 2014 : Column 605
The gross weekly average wage for a zero-hours contract worker is £236, which is a full £246 less than the average wage for those in regular, full-time employment. We really need to think about the fact that in a nation such as ours, and in this day and age, so many people are employed on irregular hours and earn a mere £236 a week. Workplaces that utilise zero-hours contracts have a higher proportion of staff on low pay, and those employed on zero-hours contracts also work fewer hours—they work an average of 21 hours a week—than those in other part-time jobs who are not on zero-hours contracts, who work an average of 31 hours a week.
Zero-hours contracts are an employer’s paradise. In fact, they are a one-way street, because they demand total flexibility and commitment from individual employees but offer very little in return from the employer.
Mrs Sharon Hodgson (Washington and Sunderland West) (Lab): My hon. Friend is making a powerful speech. Does he accept that while those employers want it all their own way, they often penalise young people, in particular? For instance, when people cannot agree to work an extra shift, they find that they are offered no shifts the following week.
Ian Mearns: Absolutely. It is that sort of intermittent work pattern that is often exploited, because sadly in many parts of the country there is a surplus of labour, with many people either unemployed or underemployed.
Employees must agree to make themselves available for work but receive no guarantee of work in return. Workers find themselves being called into work at the drop of a hat or having their shifts cancelled with only a couple of hours’ notice or, in some cases, after they have already incurred the expense of travelling to work or arranging child care. They turn up at their place of work, only to be told, “We’ve nothing for you today.”
Andy McDonald (Middlesbrough) (Lab): Does my hon. Friend agree that putting people in that position limits their ability to be economically engaged, because they cannot plan or apply for mortgages and all the rest of it? That might be to the benefit of the exploitative employer, but it does nothing to help the economy or people by giving them security of employment.
Ian Mearns: I could not agree more. I do not see the benefit to a local economy of having so many people on low pay. A low pay, low disposable income economy is not good for other small businesses in the area that are trying to sell their goods and services in the local market, which is deprived of disposable income.
Employees are expected to perform all the roles of a regular employee but have no entitlement to sick leave, holiday pay, overtime payments or many of the hard-won rights and protections that have been gained by work forces over the years.
Fiona O'Donnell (East Lothian) (Lab):
My hon. Friend is very generous in giving way; I realise that he is struggling to maintain the flow of his speech. Will he join me in celebrating the work of our citizens advice bureaux? Mine in Musselburgh highlighted in its annual report the case of a man who had gone from five days a week on a zero-hours contract to two days. His employer would not pay him statutory sick pay or paternity pay,
21 Nov 2014 : Column 606
and then it turned out that the employer was not even paying him the minimum wage. It is just not good enough.
Ian Mearns: My hon. Friend’s example exemplifies the exploitative practices and abuse by some employers. For Government Members to deny that this is happening is unbelievable.
These are employment practices from another era, which is where they should remain. Zero-hours contracts are a new manifestation of the casualisation of the labour market, a race to the bottom in wages and terms and conditions, and a return to the bad old days of workers queuing at the factory gates, the shipyard or the pit and hoping to be picked to be employed for the day.
John Cryer (Leyton and Wanstead) (Lab): The growth of zero-hours contracts, together with other practices such as the appearance of payroll companies and umbrella companies, and the growth of bogus self-employment, means that in certain sectors we are seeing the virtual abolition of permanent and full-time work.
Ian Mearns: I could not agree more. As was pointed out earlier, it is about sloppy planning on the part of employers. If they looked at the way they employ people, they could rationalise the way in which their production and output work, and it would be better for the company if they did so.
Dockers—I meet old dockers, and sons and daughters of dockers—remember queuing for work every day, and being told to “sling their hook” when there was none. When sufficient men had been selected for work on a particular day, the rest were told to go home. The same practice has acquired a modern veneer. Rather than queuing at their place of work, people simply receive a text a couple of hours before a shift starts saying, “No work today.” This creates a desperate and easily exploitable work force.
I am sure every Member is aware of the horror stories we have heard concerning adult social care, where 307,000 workers are employed on zero-hours contracts. Employers frequently use such contracts to circumvent their obligation to pay the national minimum wage.
Jim Sheridan (Paisley and Renfrewshire North) (Lab): Fast-food companies such as McDonald’s spend thousands and thousands of pounds in this place, providing hospitality to right hon. and hon. Members at receptions. Will my hon. Friend join me in asking colleagues who feel it necessary to go along and sup the wine of people who are profiteering from zero-hour contracts for young people either to refuse to go to such a reception or, if they do go, to ask how many workers are employed by the company on zero-hours contracts?
Ian Mearns: My hon. Friend makes a valid point. In our community leadership role, as Members of Parliament representing constituencies throughout the country, we should be giving the lead on this by not giving succour to companies which, as he says, are engaged in these exploitative practices.
Mr George Howarth:
My hon. Friend mentioned the old dock employment practices, which were known in Liverpool as the “pen system”, for all the obvious
21 Nov 2014 : Column 607
reasons. Is it not instructive that it was a Labour Government, when Harold Wilson was Prime Minister, who abolished that system? Who abolished that in its turn? The Thatcher Government.
Ian Mearns: That comes as no surprise. The deregulation of workplace practices is the stock in trade of Members on the Government Benches.
Anyone who has had any experience of the hospitality sector will be familiar with workers being too frightened to turn down shifts or to make a complaint at work because of the fear that they will be “zeroed out” and employed for zero hours per week—in other words, no work this week and no work next week. Since the recession, there have been countless stories of employers who have fired their staff only to rehire them on zero-hours contracts, meaning that their workers are no longer entitled to sick leave, holiday pay, and other rights and protections.
Catherine McKinnell (Newcastle upon Tyne North) (Lab): My hon. Friend is making a very powerful speech. He mentioned adult social care workers. A constituent who came to see me highlighted just how little economic sense zero-hours contracts make for the taxpayer as well. From one week to the next, he may or may not be able to pay his rent and may need housing benefit support. That creates a total mess for the systems that have to provide support to these people on very insecure work contracts. The cost to the taxpayer of sorting out that mess is adding to the problem. Employers need to step up to the mark.
Ian Mearns: My hon. Friend makes a powerful point.
With regard to people working in the adult social care sector, it is right that we want the very best quality of care for the most vulnerable people in society—the elderly, the frail, the disabled and so on—who rely on these social care contracts, yet we expect people who are being paid next to nothing to conduct that high-quality care. I find that bizarre.
Ian Lavery: Is my hon. Friend aware of the situation at HMP Northumberland, where Sodexo, a French catering company, has privatised the prison and sacked or made redundant more than a third of the work force? It does not have enough people to make the prison safe, but it is bringing in people on banked-hours and zero-hours contracts. That is an outrage.
Ian Mearns: I could not agree more.
I was talking about the hospitality sector. Whether we allow this exploitation and abuse to continue is a question not just of whether these contracts are fair on the employee but of what type of society we want to live in and what type of economy we want to work in. Do we really expect our sick and elderly to get the care they deserve when those we trust to care for them live in fear and trepidation, not knowing whether they will earn enough to keep the heating on or buy the weekly shop? Do we really think that we will reduce the benefits bill—the frequently stated intention of the Government—when only state subsidies for employers paying poverty wages are keeping our work force’s heads above water?
21 Nov 2014 : Column 608
Grahame M. Morris (Easington) (Lab): My hon. Friend is making a terrific speech, and I am proud to support his private Member’s Bill. I completely agree with his points about the hospitality sector. May I also draw his attention to very profitable companies where there is no real excuse for the employer to switch from existing contracts of employment to zero hours? I am thinking of JD Sports, for example, where 90% of the work force were switched from standard contracts to zero hours. It is sheer exploitation so that the workers cannot be paid pensions and other benefits.
Ian Mearns: My hon. Friend makes a pertinent and powerful point.
Given that there is an inextricable link between job security and consumer confidence, do we really think that workers with little or no job security, living in a climate of fear, are the foundation of a successful Britain in a globalised world? In the previous two centuries, tremendous and hard-fought-for progress was made on workers’ rights and conditions of service, and it is madness to spend the 21st century going into reverse.
The principle enshrined in the Bill is simple: if someone works regular hours they should have a regular fixed-hours contract, along with all the rights and protections afforded to regular workers. It is unacceptable that a person who works as a full-time employee, sometimes for many months, or even years, remains on a zero-hours contract.
Pat Glass (North West Durham) (Lab): Does my hon. Friend accept that this system does not work for the people who receive these services? Many constituents have said to me that they have people, particularly in the social care sector, coming into their homes and carrying out very personal tasks for them, and that they need consistency. They want to know that the same person is coming in and that they can trust that person, and that does not happen with zero-hours contracts.
Ian Mearns: I could not agree more with my hon. Friend. I repeat that if we really want to care for the most vulnerable in our society, we should have people in professional positions doing so on a regular basis. The familiarity of seeing the same person time and again is the bedrock of a care system.
Paul Flynn (Newport West) (Lab): Is my hon. Friend aware of the Social Action, Responsibility and Heroism Bill, which is going through the other place at the moment? It has been described as “utter tosh” by the right hon. and learned Member for Beaconsfield (Mr Grieve), the previous Attorney-General, and is designed to increase the number of volunteers. The big society seems to be an idea whose time has gone. The Bill is designed to push people not into zero-hours contracts, but into zero-pay contracts.
Ian Mearns: I am grateful to my hon. Friend for making that point. I have the greatest admiration for many people up and down the country who devote their time freely to volunteering for a whole range of charitable and local causes. At the same time, however, I detest the fact that those volunteers are replacing full-time, paid jobs, because that is not good for the local economy.
21 Nov 2014 : Column 609
My Bill states that if someone has been in a job for 12 weeks, they will become a regular employee entitled to a fixed and regular-hours contract with all the conditions of service that go with it. We will not prosper as a society or grow the type of economy we need as long as more than 1 million workers go to sleep at night not knowing whether they will have the much-needed earnings from the next morning’s shift. The Bill would allow workers to escape from the financial limbo in which many of them find themselves.
The Bill states that if someone’s employer requests or requires them to work without giving reasonable notice of three days, they should be paid time and a half for a shift ordered within those three days. It also states that if their employer cancels their shift at the last minute, they should not be plunged into financial instability but paid in full for the period in question.
That will take a measure of improved work force and production planning by employers, but that is not a bad thing in itself; it is actually good for companies to rationalise the way in which they engage people. The Bill would return a degree of mutuality and fairness to the employment arrangements with which many of the poorest and most vulnerable people in our society find themselves.
I am delighted that Labour Front Benchers have pledged to stamp out the abuse of zero-hours contracts when they are elected to government in 2015, but I do not believe that underpaid, insecure, zero-hours contract workers—our constituents—should have to wait until then.
People outside this place see zero-hours contracts for what they are: Victorian-era employment practices that have no place in a modern, 21st-century economy. Those employed on them know only too well what a zero-hours contract means: low pay, insecure work and zero rights in the workplace. If the Government will not support our plans, it will yet again fall to a Labour Government to protect the interests of ordinary working people doing a decent day’s work in workplaces up and down this nation.
2.13 pm
Philip Davies (Shipley) (Con): I congratulate the hon. Member for Gateshead (Ian Mearns) on promoting his Bill and on his speech. I very much enjoyed the time I spent working with him on the Backbench Business Committee and I would like to think that everybody would agree that he is one of the nicest people in this House. I wish him well personally, even though I cannot particularly guarantee that I will support his Bill. I hope he will realise that that is not meant personally in any way, because he is a good guy and I certainly do not doubt his sincerity in promoting the Bill. Anyone could tell from his speech that he clearly feels very strongly about it, and I am all for people who stand up for things they believe in. The hon. Gentleman believes in this Bill and more power to his elbow for that. [Hon. Members: “But?”] There is a “but” and it would be quite a lengthy one if I had the time.
To be perfectly honest, I must say, and we need to get this on the record before the clock counts us out, that it is a bit rich for the Labour party to come here en masse to pretend that they are massively opposed to zero-hours contracts, when if one believes what one reads in the press—I am one of those who does, rightly or wrongly—it
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appears that some of the worst offenders are not only Labour councils, but Labour MPs. I do not know whether any of those in the Chamber want to fess up today, but perhaps those who skulked out quietly at the start of this debate are the guilty parties. I read somewhere—so it must be true—that 62 Labour MPs, which I reckon is about a quarter of them, actually employ their staff on zero-hours contracts, which I cannot believe.
Andy McDonald: That was a very nice attempt at a smear. Will the hon. Gentleman say where that was published and where the information is, and how about naming some names? He cannot just cast that out on to the water as if it were true.
Philip Davies: The hon. Gentleman’s problem and mine is that the unnamed Labour MPs do not, for some reason, admit to it. They do not come out and say that they use zero-hours contracts.
Yasmin Qureshi (Bolton South East) (Lab) Will the hon. Gentleman give way?
Philip Davies: I will in a second. We can all understand why they do not want to draw attention to the fact.
Mr Deputy Speaker (Mr Lindsay Hoyle): Order. The hon. Gentleman will give way when he is ready. The hon. Member for Bolton South East (Yasmin Qureshi) does not have to remain standing. I do not want her knees to give way while she is waiting, because it could be a long time.
Philip Davies: I would be perfectly happy for us to have some way of admitting whether we employ our staff on zero-hours contracts. I do not, and I have no intention of doing so, but perhaps there might be something that we all sign.
Yasmin Qureshi: The issue is not about which councils or which MPs use zero-hours contracts. If the hon. Gentleman and the Government supported our Bill, everyone would be banned from using them. Surely the issue is about stopping the use of zero-hours contracts.
Philip Davies: I understand that point, and it was made in an intervention by the hon. Member for Wansbeck (Ian Lavery) during the opening speech of the hon. Member for Gateshead. I do not want to embarrass the hon. Member for Wansbeck, but I am a big fan of his as well. He is also a good guy, and he stands up for what he believes in.
Philip Davies: I will give way to the hon. Gentleman in a second.
My problem with such an argument is that no law currently makes it compulsory to employ somebody on a zero-hours contract. Nothing forces any Labour council to employ somebody on a zero-hours contract; it is their choice. My point is that if the Labour party genuinely wanted to end zero-hours contract, the best thing to do would be to start by smartening up their act and to make sure that no Labour MPs or councils employ people on such contracts.
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Philip Davies: There is not much time left, but I will do my best to squeeze in the hon. Gentleman.
It is not just any old Labour councils that go for zero-hours contracts. I know that Bury council, the council of my hon. Friend the Member for Bury North (Mr Nuttall), is one of the worst offenders, but so is the council in Doncaster, my home town. People in Doncaster have the honour, the privilege or the misfortune—I do not know which, but we can all choose an appropriate adjective—not just to have the Leader of the Opposition as one of their MPs, but to have their three local MPs in the shadow Cabinet. They are blessed with highly talented people, including the Leader of the Opposition, as their local MPs. If the abolition of zero-hours contracts was so important for the Labour party, one would think that its leader, who is the Leader of the Opposition, might just have enough clout in Doncaster, with an elected Labour mayor and a majority Labour council, to encourage it to get rid of zero-hours contract. There are two things at play. Either the Labour party really has no intention of getting rid of zero-hours contracts and does not really care about them, or the Leader of the Opposition has so little clout within his party, and so few persuasive skills, that he cannot even persuade a Labour council and an elected Labour mayor to do it.
Philip Davies: I am going to call the hon. Member for Paisley and Renfrewshire North (Jim Sheridan) my hon. Friend, because he is a great man, a fellow member of the Select Committee. I know that has probably finished off his career for good, but he is a great man. I give way to him, because he has been waiting patiently.
Jim Sheridan: I am sorry I stood up. First, I plead not guilty to employing people on zero-hours contracts—not guilty, your honour. I would also quite like to exonerate my local authority from engaging people on zero-hours contracts. Not only does it not engage people on zero-hours contracts, but it pays them the living wage.
Philip Davies: I very much welcome that intervention. To be honest, I would never have thought that the hon. Gentleman was one of the people who used zero-hours contracts. He is a good man and he does not only stand up for what he believes in; he practises what he preaches. I take my hat off to him for that.
We have a good process of elimination going on here. If we could just get every single Labour MP before us, we could go through them one by one and find out which have been using zero-hours contracts.
Philip Davies: I will give way in a second.
However, I think what we have safely also found out today is that the hon. Member for Paisley and Renfrewshire North has much better powers of persuasion than the leader of his party. If only he were leader of his party the party might not be in the dire straits that it is in at the moment.
Grahame M. Morris: I do not want to indulge this atmosphere of—
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Philip Davies: Go on—admit it!
Grahame M. Morris: I am not admitting it; I absolutely do not use zero-hours contracts. I think part of the problem is that many local authorities do not have tight enough procedures with subcontractors; I would encourage them so to do. The point I wanted to make is this: is not what we are all concerned about in-work poverty and the 59% increase in such in-work poverty?
Philip Davies: I am grateful. We have had a second Labour view. I think, if I heard correctly, the hon. Gentleman said that he does not employ anybody on a zero-hours contract. That is two down—plenty more to go.
Ian Mearns: I am aware that colleagues from all parties occasionally employ people on a task-and-finish basis—a fixed fee for doing a particular task, using the Independent Parliamentary Standards Authority payments system. That may have been interpreted by the Daily Mail as employing people on zero-hours contracts.
Philip Davies: We are getting nearer. I fear that if we go much further, we will get a full confession at some point.
Ian Lavery: This is a really serious debate, but we seem to be trivialising it, suggesting that the problem is perhaps the fault of my right hon. Friend the Leader of the Opposition. The hon. Member for Bury North (Mr Nuttall) hit the nail on the head. I think it was in 2000 that only 200,000 people in this country were on zero-hours contracts. As we sit in the Chamber today, there are 1.4 million people on zero-hours contracts. That is the real problem. I stand for the total abolition of zero-hours contracts for every single person, regardless of where they work.
Philip Davies: I am grateful to the hon. Gentleman for his intervention. There is a certain amount of dispute over the actual number of people who are on zero-hours contracts. The labour force survey, which collects data on individual workers, not on the number of contracts, and asks employees and not workers for the information, has an estimate for the fourth quarter of 2013 of 583,000 people on zero-hours contracts. There is clearly a dispute over the figures. I am not necessarily saying that the hon. Gentleman and his hon. Friends are wrong in their figures; they have obviously sourced those figures from somewhere. Those who compile the labour force survey have different figures.
I genuinely do not understand the hon. Gentleman’s logic. He seems to be saying that it is absolutely fine for 200,000 people to be on zero-hours contracts, but that it is an absolute scandal for 1.4 million people to be on those contracts. Either zero-hours contracts are a good thing or they are a bad thing. Surely it cannot be a question of, “Because there were only 200,000 people on zero-hours contracts when Labour was in office, that was fine; that was a reason to do absolutely nothing about it and bury our heads in the sand, but now there are a few more of them, it is a massive scandal and we need to do something about it.” Either zero-hours contracts are right or they are wrong. The number of people who are on them cannot be the determining factor.
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Graeme Morrice (Livingston) (Lab) rose—
Sheila Gilmore (Edinburgh East) (Lab) rose—
Philip Davies: I give way to the hon. Lady first.
Sheila Gilmore: The public might be interested to know whether the hon. Gentleman favours or opposes zero-hours contracts. Throughout everything he has said, he has not made that clear. Since he is attempting to criticise certain councils, that might mean that he is against zero-hours contracts. Perhaps he would like to support the Bill promoted by my hon. Friend the Member for Gateshead (Ian Mearns) today?
Philip Davies: If Labour Members were not so enthusiastic in standing up to admit whether they employ anyone on a zero-hours contract or otherwise, I might get around to starting my speech. If I were able to do so, we might get into the nitty-gritty of the debate, but I am afraid that all of my time thus far has been taken up in dealing with excitable Labour Members which means that we cannot have the debate that the hon. Lady wants.
Graeme Morrice: I just want to follow up on the point raised by my hon. Friend the Member for Edinburgh East (Sheila Gilmore). I appreciate that we only have about five minutes left and I know that the hon. Gentleman has said that he has yet to start his speech, but perhaps to save a bit of time he could tell us whether he is in favour of zero-hours contracts or not. If he is not, will he give me an indication of whether he will support the Bill promoted by my hon. Friend the Member for Gateshead (Ian Mearns)?
Philip Davies: I would like to think that I made it clear at the start of my speech that I do not support the Bill. For many workers, particularly students, zero-hours contracts are a good thing. They suit their patterns, they help them and they are a good way into the employment market. It suits their lifestyle to have zero-hours contracts. Some people have zero-hours contracts through choice; they are not all awful. I do not want to ban something that many people have by choice. So no, I do not agree with the Bill.
Mr Christopher Chope (Christchurch) (Con): My hon. Friend is making a brilliant speech. When is he going to get on to that part of the Bill that makes it clear that those proposing it are not against zero-hours contracts completely and do not wish to outlaw them? They just wish to limit them, yet all their rhetoric has been about outlawing zero-hours contracts.
Philip Davies: My hon. Friend makes a good point and I would have liked to have humoured him by going through all this in as much detail as he would want, but it appears that time is against us. He is right to draw attention to the fact that once again—the situation is very similar to the previous debate—the Labour party is trying to give an impression to its voters, perhaps running scared of UKIP in its constituencies, that its Members believe in something. Yet the Bill proposed is nothing like the rhetoric that accompanies it.
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The Minister for Culture and the Digital Economy (Mr Edward Vaizey): Does my hon. Friend agree that one can always make improvements to zero-hours contracts? This is the first Government to have consulted on zero- hours contracts, we have got rid of the exclusivity clauses and we are bringing in transparency to ensure that people know they are on zero-hours contracts.
Philip Davies: I have no doubt that the Government are moving towards the Labour party on this issue; they tend to move towards the Labour party on most issues. The Minister’s confirmation of that fact comes as no surprise to me and I do not think it will come as much of a surprise to anybody.
Mr Vaizey: Does my hon. Friend agree that it is always dangerous to try to get him on side and that it can often backfire on a Minister?
Philip Davies: That is probably true.
Toby Perkins (Chesterfield) (Lab): The hon. Gentleman was complaining about the direction in which his party is moving, so I wondered in which party’s direction he was moving.
Philip Davies: I am not moving in any direction. As I have for the past 10 years, I am staying where I am in every possible regard. I do not move my views and policies based on what the latest opinion poll says or what the other parties might say. If there is one thing the people might be able to agree about it is that I stick to what I believe in, no matter how popular or unpopular it is or whatever the passing trend or fad. I stick up for what I believe in, which is something I have in common with the hon. Member for Gateshead. He does much the same.
In the limited time left, I want to pick up on one more point. It was unfortunate, as I do not think the hon. Gentleman intended to say this, but he seemed to indicate that zero-hours contracts were linked to quality of care.
Philip Davies: He is nodding in agreement. I think that is unfair on those people who work in the care sector on zero-hours contracts. There is no evidence that they give any worse care than other people—
2.30 pm
The debate stood adjourned (Standing Order No. 11(2)).
Ordered, That the debate be resumed on Friday 28 November.