Jos Bell reports on this week’s House of Commons and House of Lords debates on the health and social care bill.
David Cameron was not in the Commons for Tuesday’s health bill debate. He is currently on a trans-Atlantic three-day ‘special relationship’ flesh-press with Barack Obama in the land of home-spun private health insurance.
As health select committee member Valerie Vaz (Labour, Walsall South) said during the debate, when Obama visited Britain in May 2011 he said of the NHS it was “something that Brits take for granted – a health care system that ensures you don’t go bankrupt when you get sick”.
On Tuesday both Houses historically debated the health and social care bill – the Lords weary from seemingly endless weeks of detailed scrutiny and every clause, producing almost 2,000 amendments in total; the Commons fired by desperation, anger and indignation.
It is noteworthy that at one point when health secretary Andrew Lansley, in mid defensive shout, tried to justify himself, he referred only to patient access to healthcare – not to national health.
“This bill has the handprints of the US insurance industry all over it.”
With a career of more than 20 years in said industry, he should know.
Clearly in addition to importing the likes of Humana, other US companies notorious for poor practice who are already advertising their services to Clinical Commissioning Groups, the government has also adopted the US Tea Party art of flip-flopping truth and untruth.
• Clegg still has a chance to save the NHS – and his party 12 Mar 2012
Throughout the Commons debate, where the Opposition and other disquieted members of both Houses offered evidence, the government benches cried ‘shallow!’ For every truth a falsehood, for every detail an insult, for every risk alert a mocking accusation of calumny.
The fact the word privatise does not appear in the bill they maintained was proof that Gang Lansley were seriously anti-privatisation. As for competition, why perish the very thought, they seek nothing but cosy integration.
In which case, as shadow health secretary Andy Burnham said, what is the point of spending vast quantities of public funding on a 500-page complete reworking of NHS legal structures pitching doctor against doctor?
At least when Thatcher was doing something unpleasant she didn’t try to hide the fact. According to the government benches in both Houses the bill is designed to wrap every single patient in a snuggle blanket of unending free at the point of need care.
If that were so, then why, asked Burnham, are patient groups such as Diabetes UK, and even those who originally supported the bill, including Asthma UK, now so very concerned, particularly as there are now so few routes for patients to appeal when treatment is blocked or taken away.
In the most heated of Commons debates Grahame Morris (Labour, Easington) highlighted senior GPs expressing great concern at the impact of the introduction of their new CCG roles, resulting in them spending only one or two days per week in surgery along with the need to cover an extraordinary level of spend on locum costs.
What’s that? Cost saving and a reduction in bureaucracy do we hear you cry Mr Lansley? More time and money for patients? Barely any involvement from the private sector? Fabrication will soon be an official NVQ qualification.
Faced with the four coalition horsemen of the NHS apocalypse – sitting identically, by turns sniggering, smirking and sulking, when Burnham asked in a ‘simple but sincere call’ for a cross-party coalition of common ground in support of the NHS he was immediately accused of being uncooperative and partisan – indeed anyone who spoke up against the bill but in support of the NHS was accused of being disloyal to the self same service by being anti-reform per se.
Over in the Lords, health minister Earl Howe had surprised his brown tie-rack with a large shocking pink sateen number – perhaps in a bid to show us his inner man or to divert attention from the poor battered NHS. This was not a day for human wins.
The Lords rattled through a fruit machine of amendment tweaks to the bill in the afternoon following a very odd morning where although the statutory registration of public health workers were carried and social workers were rescued from professional oblivion, the long overdue professional recognition of various clinical specialist areas was blocked.
When on all sides there was support for an amendment overturning the voluntary registration for nurses, midwives and social care staff, for a compulsory safeguard, Baroness Williams (of Crosby, Liberal Democrat) interjected in near inaudible embarrassment to support Howe to the effect that light touch regulation for patient care was an entirely wonderful thing.
The vote could have been won but the amendment was withdrawn – to the detriment of patient safety and professional recognition.
Howe tried to appease surrounding frustration by promising the new structure will be subject to review in three years’ time – although how many more Winterbourne Views there will be in the meantime we dare not imagine.
In the Commons, with deputy prime minister Nick Clegg absent, Lib Dem deputy leader Simon Hughes (Liberal Democrat, Bermondsey and Old Southwark) had attempted to clarify what Burnham referred to as his conference ‘smoke signals’:
“The motion that the Liberal Democrats passed on Sunday did not tell the Lords that they should or should not support the bill. It simply reserved our party members’ judgment until we see the work that the Lords are continuing to do.
“That is our position. I think that that is sensible and fair for the NHS and our party.”
Amendment 300a, dubbed the sunrise clause, asked for the acceptance of a pause for consultation on section three with the Commissioning Board, the independent regulator of Foundation Trusts, the Care Quality Commission, patients and staff.
Result? A disappointing no, also bearing in mind the number of crossbenchers who voted against it, seemingly many having decided that to side with the Opposition on the matter was ‘too political’. Would that they viewed the unalloyed assault on the NHS in similar light?
After that, with the report stage completed, the Lords packed up their copious ring binders and departed the Chamber leaving only one more weary day of debate in the third reading on Monday.
Simultaneously in the Commons, the debate brought forth a blistering ‘this is a perfect storm’ speech from David Miliband (Labour, South Shields), followed by a detailed analysis from Valerie Vaz (column 181, Hansard) who asked why Lord Clement-Jones’ solution to European Union competition law had been rejected.
Then to a distressed Gerald Kaufman (Labour, Manchester Gorton), shaking with historically emotional rage, decrying the coalition for “destroying that which Ted Heath accepted as being part of the national consensus and even Margaret Thatcher never targeted the National Health Service” (column 188, Hansard).
Dame Joan Ruddock calmly asked as private waiting list figures were not available how could NHS compare their place on the list?; daughter of the NHS and shadow public health minister Diane Abbott summed up the emotional attachment that the vast majority of this country has for the service; while Northern Ireland MP Jim Shannon (DUP, Strangford) also gave rousing support.
Meanwhile Minster of State Simon Burns’s PPS Anna Soubry (Conservative, Broxtowe) kept her comb and paper completely quiet until she embroiled herself in an off-Broadway gossip resulting in yet another reprimand from the Deputy Speaker. Angie Bray (Conservative, Ealing Central) and Priti Patel (Conservative, Witham) caused their usual level of hilarity.
And health select committee chair Stephen Dorrell (Conservative, Charnwood) made it his business to attack the Opposition rather than protect the NHS.
Where once we all expected that government to varying degrees would safeguard our essential services and build towards excellence in the widest range of suitable service, we are now faced with skilled GPs kept out of their surgeries, huge administration bills, lack of professional accreditation, emerging evidence of patients being denied treatments, reduced data gathering and skewed representation of detail – and that’s just this week.
Once again Andrew Lansley barked out misleading figures to support his argument – referring vaguely to ‘since the election’ – whilst Andy Burnham had the real quarterly detail and former shadow health secretary John Healey (Labour, Wentworth and Dearne) was forensic in his use of damning figures. (See here for a useful summary).
The Liberal Democrat benches were largely bare during the debate – Andrew George (Liberal Democrat, St Ives) and John Pugh (Liberal Democrat, Southport) standing up unequivocally for the NHS, whilst the Gordon Birtwistle (Liberal Democrat, Burnley) spoke about previous local closures which said absolutely nothing about the bill.
As a passionate and direct Andy Burnham said (Hansard, column 161), having urged his party support an amendment proposed by Andrew George:
“Today is not just an Opposition day but Merseyside derby day. Usually both occasions put me in a highly partisan mood, yet despite having double reason to be in tribal mode, I am going to take the unusual step of urging Labour members not to vote for our motion but to consider the amendment tabled by the hon. Member for St Ives and his Liberal Democrat colleagues.
“We will listen with interest to what he has to say. The amendment sets out a sensible way forward that we can all unite around. It sends out the simple message that the importance of the NHS to us all and to our constituents should trump any tribal loyalty.
“It is important to say that, because I fear that sheer gut loyalty, political pride and the need to save face are the only forces driving a deeply defective bill towards the statute book.”
In the end more than 20 Liberal Democrat MPs abstained with seven voting against the government. Party members who voted against the bill at the weekend must be appalled at the short term careerism of the likes of Jenny Willott (Liberal Democrat, Cardiff Central) who bristled with self importance in her role as teller for the government in yesterday’s debate.
Could she not just stop and think and save the NHS – and her party?