Privatisation of NHS Services

Alex Sobel Excerpts

Monday 23rd April 2018 Westminster Hall

[Alex Sobel (Leeds North West) (Lab/Co-op)]

It is a pleasure to serve under your chairmanship, Mr Hosie. I thank all those who signed the petition, including the 512 signatories in my constituency. I spoke at a “Save the NHS” rally a couple of weeks ago, and privatisation was one of the top issues for people who attended that rally and spoke to me afterwards. I will make some the points I made when I spoke at that rally.

Week after week, people stop me, come to my surgeries and write to me asking why their local GP has left and been replaced by locum doctors, why A&E waiting times are increasing or why the services they rely on are verging on unsatisfactory and in some cases negligent— I have some negligence cases running. The short answer to those questions is a lack of money in the system. The more complex answer is that the decline in NHS funding has placed strong pressures on healthcare providers right across the NHS to adopt new practices and governance structures. Many of those changes have taken place beyond the public eye and without sufficient scrutiny. The benefits from those changes are far from evident. My hon. Friend the Member for Stroud (Dr Drew) asked many of the questions I had intended to, which will reduce the amount of time I will take in this debate —so I thank him for that—but that allows me to make some broader points. I support all the questions he asked the Minister. However, there is one point, which I will come to, on which I have a slightly different point of view from my hon. Friend.

The Leeds Teaching Hospitals NHS Trust, in an attempt to balance its books, has proposed to take 1,000 NHS workers out of the public sector and place them in a wholly owned subsidiary company. There was a meeting on 29 March to make a decision. After interventions by myself, four other colleagues in Leeds, the trade unions, campaigners and members of staff, there was a stay of execution on that decision and it will be looked at again. Therefore we are not quite in the situation that my hon. Friend has in Gloucestershire, where the change has already happened, but we are approaching it, which makes it all the more important for us to have the debate and to engage with the Department of Health and Social Care and its Front-Bench team. The wholly owned subsidiary company would take staff who have spent their entire career in the public sector and place them in a highly uncertain position regarding their working conditions, salaries and pensions—all points that my hon. Friend made.

A wholly owned subsidiary company structure has already been implemented elsewhere in Yorkshire—in Airedale and Barnsley—and the primary driver is financial. Once the subsidiary company is in place, it can recoup VAT and make significant savings. What is the solution? My hon. Friend suggested that the Treasury close the loophole, but my suggestion is quite different: the NHS, at trust level, should also be able to recoup VAT. Let us create a level playing field in which the NHS has the same rights and benefits as a wholly owned subsidiary company. That would effectively just be a technical change. I hope the Minister will talk to his Treasury colleagues and look at whether those same benefits can be given directly to an NHS trust.

I am not asking for that change for ideological reasons, although I have heard a lot of ideology today. Rather, I am speaking up for the porters, cleaners, lab technicians, receptionists and administrative officers who work in the trust and in other trusts that are considering going down that road or have done so. They tell me that they are motivated to work above and beyond at the trust because they are part of the NHS. They work the hours that they need to work because they are part of a family. They and their colleagues are born of the NHS—an NHS born alongside my hon. Friend the Member for Ealing North (Stephen Pound) in 1948. They do not want to be seen as a moveable commodity. They view themselves as a core part of the NHS, just as much as the clinicians. We need to recognise that.

[Rachael Maskell]

York Teaching Hospital is going down the same lines in creating a wholly owned subsidiary company, yet the staff want to belong to the NHS—that is their ethos and that is what drives them. It is also important for full integration across the whole service, because people who work as porters and cleaners are as much about patient care as anybody else in the NHS. Does my hon. Friend agree?

[Alex Sobel]

Absolutely. When I go into our local hospitals as an MP or as a patient, I see that they are the beating heart of the NHS.

I ask trusts, such as Leeds, that are considering setting up a subsidiary company to put a halt to those plans and to work with their staff, representative trade unions and local MPs prior to making the decision. I ask them to do what is best for all involved, whether patients, staff or the community.

Cost pressures create perverse incentives for people to consider privatisation. We have rehearsed that argument quite well. They affect not just NHS hospital trusts but clinical commissioning groups for primary care services, NHS England and other NHS bodies. We need to take those perverse incentives out of the system so that privatisation does not happen by the back door—instead of being done by the Government through statute—which is what is happening.