Oral Answers to Questions

Diana Johnson Excerpts

Tuesday 12th June 2012 Commons Chamber

[Mr Lansley]

My hon. Friend will be aware—and, I am sure, will understand and support—the devolution of commissioning responsibilities locally. He is right to pursue the matter in the way he proposes. Over a number of years, including under the previous Administration, efforts were made to secure additional access to dialysis. For a long period, we in this country had lesser access to dialysis than in other countries—particularly when people were not only working but likely to be on holiday. I welcome the point my hon. Friend is pursuing and, when he has had his conversation locally, perhaps he would like to tell me the outcome.

[Diana Johnson (Kingston upon Hull North) (Lab)]

The Government blocked Labour’s plans to introduce public health as one of the licensing conditions. I wonder whether, in the spirit of localism, this power should now be given to health and wellbeing boards.

[Anne Milton]

As I am sure the hon. Lady is aware, we have proposed in the alcohol strategy to make sure that public health and other health considerations can be used in making decisions about licensing applications. This is what we have achieved from having a cross-government strategy and approach, moving public health responsibilities back into local government.

Health and Social Care Bill

Diana Johnson Excerpts

Tuesday 20th March 2012 Commons Chamber

[Diana Johnson (Kingston upon Hull North) (Lab)]

Will the Minister give way?

[Paul Burstow]

No. I shall make some progress, if the hon. Lady does not mind.

In addition, Monitor could also, in exceptional circumstances, use the enduring powers that I was describing to direct a foundation trust to remove its directors or governors. In other words, a direct intervention power is preserved by the amendments and changes that we have made.

The Government’s ambition is that eventually foundation trusts should have more responsibility for their governance than they do under the current arrangements. This will depend, in particular, on strengthening the role of foundation trust governors in holding their boards to account. We have listened to the concerns about the pace of change. Hence, we have amended the Bill so that Monitor will also have, on a transitional basis, express powers to remove, suspend or replace directors or governors of a foundation trust directly, without the prospect of an appeal to the first-tier tribunal. We would expect Monitor to use these powers to address failure of governance, which puts the trust at risk of not meeting its licence conditions, such as the requirements that I have already described.

Health and Social Care Bill

Diana Johnson Excerpts

Tuesday 28th February 2012 Commons Chamber

[Mr Lansley]

I bring good news to my hon. Friend. Out there in the real world, things are changing: there are clinicians, doctors and nurses across the country who are taking the opportunity of this responsibility to improve services for patients; there are patients who realise that they will get additional voice and choice; and there are local authorities that realise that, through their health and wellbeing boards, they can use this to drive improvements in health for their population. Those are the things that are changing. Unfortunately, not only is the Labour party not changing but it is going backwards.

[Diana Johnson (Kingston upon Hull North) (Lab)]

I listened carefully to the Secretary of State’s answer to my hon. Friend the Member for Worsley and Eccles South (Barbara Keeley), but it struck me as gobbledegook. Will he spell out in plain English the additional safeguards to the private income cap that the Deputy Prime Minister is seeking to ensure that foundation trusts cannot focus on private profit before patients?

[Mr Lansley]

The hon. Lady will have to look at the amendments tabled in the other place tomorrow.

NHS Risk Register

Diana Johnson Excerpts

Wednesday 22nd February 2012 Commons Chamber

[Diana Johnson (Kingston upon Hull North) (Lab)]

I want to start by praising the tenacity of my right hon. Friend the Member for Wentworth and Dearne (John Healey) in pursuing this issue, which is another unfortunate aspect of the Health and Social Care Bill. From its start until today, this botched Bill has been an unmitigated disaster. The Secretary of State has said many times, “No decision about me without me,” but when we listen to the arguments being put forward by Government Members we see that that is not what is happening. They are saying that patients cannot be given information or told what is in the risk register. That is all very poor. Also, when Parliament has so little business to deal with on the Floor of the House we ought to have proper pre-legislative scrutiny of major Bills such as this one. There was no opportunity at the outset to look carefully at each clause, but that might have been a much better way of dealing with this and coming up with something that all Members of the House could get behind.

I am also concerned that the only voices to which the Government seem to be listening in this whole debate are the private health care providers. When we see that £8.3 million has gone into Tory coffers and £540,000 has gone into the Lib Dem coffers from private health care providers, we wonder why we are hurtling at such a breakneck speed towards a free-market NHS.

I agree with the Secretary of State when he said:

“Where the NHS embraces a culture of transparency, of learning from its mistakes and constantly striving for higher performance, it is a world-beater.”

I fail to understand the argument that he makes about why the risk register cannot be produced to allow Parliament to scrutinise properly the Bill that is before it. It is disappointing that we need to have this debate today.

I am struck by the tone that the Liberal Democrats are taking. I understand that 15 Members signed the early-day motion that mirrors the motion before the House, and I know the Liberal Democrats have always championed transparency and information being made available to the public, so I hope that those 15 Liberal Democrats will join the Opposition and vote for the motion. I know that at the general election in 2010 the Liberal Democrats were not arguing for a top-down reorganisation of the NHS. As I recall, what they wanted was elected representation on PCT boards. The person who stood against me in Hull argued that to save the NHS, the next Government must end the break-neck pace of NHS reforms. That was what he stood on in 2010, yet the party that he stood for is now arguing in the House of Commons for reforms of the NHS at break-neck speed. Just as we have seen with tuition fees, armed forces pay, VAT and police numbers, there is likely to be another Lib Dem betrayal on this subject as well.

I shall focus on my major concerns about what might be in the risk register. I am extremely concerned about poorly performing doctors and how that will be dealt with. I know that PCTs, especially my own PCT in Hull, were taking positive action to deal with such doctors, and I am worried that with the chaos that will be created by the new structure, we will not be able to tackle those GPs. I am also concerned about Haxby Group, which has GP practices in my constituency. We have heard from my right hon. Friend the Member for Leigh (Andy Burnham) about what was happening in York. At present the PCT can keep an eye on what is happening with Haxby in Hull, but as I understand it, in future there will be five different NHS regulators involved in controlling the position that Haxby takes on offering private health care to its patients.

I am concerned about medical education. Hull and York medical school is in my constituency. How will we get a planned approach to medical education for the future? How does fit with the NHS Bill? I am also concerned about social care. The acute trust in my constituency has the fourth highest number of bed-blockers. How will we deal with that under the new structure? Finally, on health inequalities, the Under-Secretary of State for Health, the hon. Member for Guildford (Anne Milton), has said that northerners are “boozed-up smokers who are addicted to unprotected sex”. That is a paraphrase, but I am worried that the good work that the primary care trust has done through collaboration and co-operation on health inequalities will be lost because of the Bill.

Haemophilia

Diana Johnson Excerpts

Wednesday 8th February 2012 Westminster Hall

[Diana Johnson (Kingston upon Hull North) (Lab)]

I am delighted to serve under you today, Mr Weir, and I am pleased to have secured this debate on an issue that I know is of interest to a number of Members from all parties. I pay tribute to the Minister present, the Under-Secretary of State for Health, the hon. Member for Guildford (Anne Milton), who has taken a keen interest in this area, and with whom I have had a number of meetings. I am a little disappointed that the debate is a short one and that I can give only the headline figures. There are many issues to raise, but I will try to concentrate on just a few.

I pay tribute to my constituent, Glenn Wilkinson, and to his family, who first came to see me in 2010 to tell me their story, and to raise the scandal of how he and thousands of others had received contaminated blood products as part of their treatment as haemophiliacs. There are two main parts to what I want to say today: the first is on the ongoing treatment for haemophiliacs, and the second is on the care, support and treatment offered to people who have contracted viruses such as HIV and hepatitis C through NHS treatment for haemophilia. I also want to pay tribute to the work, over many years, of the Haemophilia Society, and of campaign groups such as TaintedBlood and the Manor House Group, and also to the work of the Newcastle initiative, which was born out of a multidisciplinary workshop on haemophilia care held in the city in autumn 2010.

Turning first to treatment, I want to concentrate on the need to ensure that the care and treatment of people affected by bleeding disorders is addressed in the NHS reforms that are currently before Parliament. The haemophilia community has been the subject of what Lord Winston described in his evidence to the Archer inquiry as the

“worst treatment disaster in the history of the NHS”.

There has been much progress in haemophilia treatment over the past decade, but it is now under threat, as is much else, from the Health and Social Care Bill, and I will go on to explain why. Standards of care vary considerably around the country, and there is the risk that the new commissioning arrangements for specialist services will result in a levelling down, rather than up, in haemophilia care.

Haemophilia services are currently commissioned by 10 regional specialist commissioning groups, with funds pooled from their constituent primary care trusts. The Department of Health has also injected extra funding for haemophilia care, which rose to £88 million per annum between 2003 and 2006, to finance the provision to all patients of recombinant rather than plasma-derived clotting factors. That money remains important to the quality of care, but has more recently been absorbed into PCTs’ baseline budgets, and I seek reassurance from the Minister that the money will still be available for haemophilia care post the NHS reforms. I understand that from April 2013 specialist services will become the responsibility of the NHS Commissioning Board rather than of the 10 specialist commissioning groups. That could mean that best practice is spread across England, but equally, there is the danger that under financial pressure standards will be levelled down.

I also want to raise with the Minister the question of where responsibility for haemophilia policy will sit. Because of the contaminated blood scandal, the Department of Health has taken a leading role in the development of that policy, and it is unclear whether after the passage of the Health and Social Care Bill that role will be maintained, or all responsibility will pass to the NHS Commissioning Board. It would help if the Minister could set out her understanding of where that responsibility will sit. Also, will the twice-yearly liaison meetings between the Department and the Haemophilia Society continue? Those meetings were established in direct response to the Archer inquiry’s recommendation that a statutory committee be established to advise the Government on clinical, financial and other provisions for people with haemophilia. There is also a call for a new national policy statement on haemophilia care to replace health service guidance (93) 30, which is now nearly 20 years old and no longer reflects best practice. Can the Minister confirm that that will happen at this stage?

Does the Minister agree with the need to support the development of robust haemophilia networks to combine the best of local care with access to tertiary expertise 24 hours a day? For example, in a recent survey by the Haemophilia Society, only 15% of respondents were aware of having been offered a care plan. In both the report of that survey, entitled “Fit for the Future: Haemophilia Services in the New NHS”, and in the Newcastle initiative’s paper, “Learning from the past to inform the future”, it was found that standards of treatment and care were generally high, which is very encouraging, but that access to the provision of associated services, including dentistry, physiotherapy and psychological support, required significant improvement. The reports also concluded that patients must be given a comprehensive care plan, that they must be able to access home treatment, and that they must be involved in all decisions about all their treatment. Those goals are partially but not consistently met under the current system, and we would, of course, like to see consistency across the whole country.

All Governments have said that lessons about treatment have been learnt from the contaminated blood scandal and that there is a need to maintain the highest standards of care so to avoid any repetition of it.

[Jim Shannon (Strangford) (DUP)]

I congratulate the hon. Lady on bringing this matter to Westminster Hall. Is she concerned about the level of support given to haemophiliacs who have received blood contaminated with HIV or hepatitis C? Should an additional level of care and assistance be given to those who suffer through no fault of their own but because of the blood?

[Diana Johnson]

I will come on to deal with the financial support that is available to individuals who have had contaminated blood products and now have HIV or hepatitis C, because that is an important issue.

To finish this first section on the treatment of haemophilia, may I ask the Minister to confirm that there should be continued research, for example into sterilisation in areas with a high risk of variant Creutzfeldt-Jakob disease contamination, in order to support the need to ensure that a contaminated blood scandal never happens again?

The second part of my speech relates to contaminated blood. In recent months, along with many other Members of Parliament, I have been raising the issue of care and support offered to victims of the NHS contaminated blood scandal, as it has come to be known over the past 30 years. My constituent Glenn Wilkinson has campaigned tirelessly for proper support for those who have received contaminated blood products as part of treatment for haemophilia or via other medical treatments, such as blood transfusion in childbirth.

This week, Glenn and other campaigners established the contaminated blood campaign. The treatment of people who contracted hepatitis C from NHS-administered blood products has been particularly unfair, and many of those people have, unfortunately, died already. The campaign set up by Glenn is also fighting for an independent public inquiry on the same lines as the report in Ireland and the Scottish Penrose inquiry, which I believe is due to conclude shortly.

[Jason McCartney (Colne Valley) (Con)]

I congratulate the hon. Lady on securing this excellent and timely debate. I have worked closely with her on the all-party parliamentary group on haemophilia and contaminated blood. Her constituent was instrumental in setting up the new contaminated blood campaign. It would be good if the Minister could pledge to meet leaders of the new campaign to discuss some of the issues and move forward. I know that the Minister has met regularly with some victims of the contaminated blood scandal. This would be a good opportunity to pledge to meet those campaigners and to keep that good communication going.

[Diana Johnson]

I am grateful for that intervention. I pay tribute to the hon. Gentleman for his involvement in and hard work on behalf of the all-party group. He makes an excellent point in asking the Minister whether she will find time. I know that she has a busy diary, but she has made time in the past to meet victims and Members of Parliament. I hope that that will happen in future as well.

On compensation for those infected by contaminated blood products, the Macfarlane Trust was set up in 1988 for people infected with HIV. In 2004, the previous Labour Government established the Skipton fund. In 2010, the incoming Government undertook to review the support available to individuals. Some progress was made, but unfortunately, there are still problems with the system.

In particular, I am concerned about the fact that the Government have introduced a two-stage payment for hepatitis C, but the criteria for determining the second stage are still fraught with difficulties for many. As I understand it, only about 20% of those people with hepatitis C are eligible for assistance via the second stage payment. That must be looked at. My constituent Glenn has produced evidence that removing the artificial distinction between stages 1 and 2 could be achieved and would cost about £22 million, which I am led to believe could be reallocated from the under-spend of other available compensatory pockets of money.

Welfare reform is an issue for the group of people we are discussing. We have had a lot of discussion in the House of Commons about the impact of welfare reform on cancer patients, but there is a special case to be made for people with hepatitis C.

[Paul Goggins (Wythenshawe and Sale East) (Lab)]

I join other hon. Members in congratulating my hon. Friend on obtaining the debate. She speaks powerfully for her constituents, as well as for my constituents, Fred Bates and Peter Mossman, who will be grateful.

The core theme of my hon. Friend’s powerful speech is trust. The trust of that community was shattered by their experience. This Minister is trying hard to restore that confidence, and her work is important, but is it not the case that the needs of our constituents with haemophilia who have been infected with hepatitis C and other infections should always come first now, not last, after the dreadful experience that they have had?

[Diana Johnson]

My right hon. Friend makes a powerful point about trust and the need for us all to work together to ensure that those people do not suffer further, and that they get the compensation and support they are clearly due.

I want to concentrate on hepatitis C sufferers for a minute. I believe that they will be unfairly penalised by the Government’s plans in the Welfare Reform Bill. In a debate in October 2010, I asked the Minister whether it would be possible for people with hepatitis C and HIV to be passported on to the new system. The Haemophilia Society has also asked about people with fluctuating medical conditions, such as bleeding disorders, particularly those with viral infections from contaminated blood products. People suffering from fluctuating medical conditions such as haemophilia, HIV and hepatitis C tend to have good days and bad days.

The Haemophilia Society recommends that the work capability assessment be suspended for people with fluctuating conditions until Professor Harrington has considered the representations of the Disability Benefits Consortium. Many people living with hepatitis C in particular have been placed in the work-related activity group of the new employment and support allowance, rather than in the support group, where benefits will continue indefinitely. That has two consequences: it means that sufferers will have to have annual assessments, and that, after 12 months, their benefits will become means-tested. That is effectively penalising people for prudent behaviour and hard work while they were well enough to be employed.

People diagnosed with hepatitis C know that they are unlikely to be able to continue working until normal retirement age. Furthermore, people must currently wait up to 11 months for a tribunal appeal. It is to be noted that appeals for hepatitis C sufferers have a particularly high success rate. Automatically moving contaminated blood product victims into the support group would save patients stress and the Government money.

[Jim Shannon]

I thank the hon. Lady for her graciousness in giving way. Many haemophiliacs have suffered from poverty and discrimination because of contaminated blood. Does she not feel for that reason that the Government must urgently address those still suffering from such maladies?

--- Later in debate ---

[Diana Johnson]

The hon. Gentleman makes that point powerfully. To quote from the report “Fit for the Future”, to which I referred earlier, an individual was asked what could be done to improve their quality of life and said:

“I think the most obvious thing to do would be to be spared the ordeal of having to do battle with the Government for financial security and not having to justify my right to sickness benefit”.

Let us keep working on compensation and related issues to improve life in the longer term for haemophiliacs and all innocent victims of contaminated blood products. In the shorter term, when considering NHS and welfare reforms, let us ensure those people’s lives do not get any worse.

--- Later in debate ---

[Anne Milton]

Yes. I thank the right hon. Gentleman for that point. The discretionary ability to distribute funds is important. He is absolutely right to raise the issue of carers, who are all too often forgotten.

The hon. Member for Kingston upon Hull North mentioned the capability assessment. She might want to initiate a similar debate on that issue. Health conditions are not automatically a barrier to work, but we recognise that they are for some people. Indeed, some people will never work and we must make sure that we support them. It would probably not be right—this is certainly not in my gift—to give automatic exemptions, but I urge the hon. Lady to raise the issue with the Secretary of State and the Minister responsible.

[Diana Johnson]

It would be powerful if the Minister made representations to a fellow Minister. Has she had the opportunity to do that with her colleagues in the Department for Work and Pensions?

[Anne Milton]

As the hon. Lady rightly states, in my ministerial role, my responsibility is the health and well-being of the population. I will always continue to make representations, which often taken place—although sometimes they do not happen in the public eye. Just a word about the Lord Penrose inquiry: we will give assistance, but we will not be commenting on that. I have had a few letters about that. I will comment at the end of the inquiry.

The issue of trust has been raised. I will finish by saying that I know a lot of trust was damaged and that that has flavoured many things since then for good but also for ill. That is an extremely difficult issue and I would not presume to say that I can ever get anyone’s trust back for what has happened and what successive previous Governments have done or failed to do. I hope that we will continue to work constructively with other hon. Members to ensure that this group of people get the help and support that they need.

Oral Answers to Questions

Diana Johnson Excerpts

Tuesday 18th October 2011 Commons Chamber

[Mr Burns]

I am extremely grateful to my right hon. Friend; speaking with the authority of the Chair of the Health Committee, he is absolutely right. It is the way forward to drive improvements in service, raise standards and ensure that there is high-class, quality care at an urgent care level and across the acute sector.

[Diana Johnson (Kingston upon Hull North) (Lab)]

4. What assessment he has made of the potential effects of NHS reorganisation on the protection and improvement of public health.

[The Parliamentary Under-Secretary of State for Health (Anne Milton)]

Our reforms put public health at the heart of the new system. The creation of Public Health England, alongside significant new functions and, for the first time, ring-fenced budgets for local authorities, will give public health an unprecedented level of priority. The new local authority role integrates public health with other local authority functions that impact on people’s health.

[Diana Johnson]

Under the previous Government, NHS Hull saw excellent results in improving public health. Under the current Government, Kingston upon Hull’s teaching primary care trust has seen a 2.6% cut this year compared with Kingston upon Thames PCT getting a 2% increase—and Hull city council has a 9% cut in its funding as well. What does the Minister think will happen to public health in areas such as Hull with those kinds of cuts?

[Anne Milton]

I think that public health in areas such as Hull will do exceptionally well. I point out to the hon. Lady that under the previous Government, what happened in practice was that public health budgets were raided constantly and we did not get improvements. If she looks at the figures, she will see that inequalities in health widened.

Health and Social Care (Re-committed) Bill

Diana Johnson Excerpts

Tuesday 6th September 2011 Commons Chamber

[John Pugh (Southport) (LD)]

I wish to speak to my amendments 1219 and 1220, and against amendment 10. The House is right to be sceptical about the blessings of the internal market in health. It is right to be worried about price competition, which everyone thinks is a race to the bottom. It is right to be concerned about the reckless extension of “any willing provider”, and it is correct in fearing that health services will be increasingly exposed to competition law, including EU competition law. It should fear the huge transactional costs that will be incurred in the hardening of the commissioner-provider split. It should fear the threat to integration, and it should fear cherry-picking, particularly in a narrow tariff system based on payment by results. It should also fear the blurring of the difference between public and private hospitals, and the financial incentives given to the private sector under the banner of choice.

That is why I dislike the greater part of what Tony Blair did to the NHS. Those who are now Opposition Members voted for all that, and that is where we are now: it is the default position. As one Opposition Member said, Labour has put all the bricks in place. A few moments ago we witnessed the strange anomaly of the hon. Member for Oldham East and Saddleworth (Debbie Abrahams) complaining about a feature of foundation trusts—their ability to borrow on the private market—which I consider to be a direct consequence of Labour legislation.

The choice for the House is not between Aneurin Bevan’s NHS and the Bill, but between Blair’s NHS and Secretary of State’s version. If I were to sum it up neatly, I would say that the Secretary of State’s version most closely resembled Blairism with clearer and more equitable rules. First, there is an overt sector regulator instead of the powerful covert regulating body, the Co-operation and Competition Panel, which has been making all the decisions that Monitor will make in a more overt way. Secondly, there is the outlawing of subsidy to the private sector, which is perfectly possible: the Secretary of State is not minded to take such action at present, but current legislation does not prohibit him from doing so. Thirdly, as Members must acknowledge, the Bill makes a clear attempt to forfend cherry-picking and protect clinical networks by safeguarding integrated provision. It is possible to have an argument about how well that is done, but there is certainly an explicit intention to do it—as, to be fair, there was in some of the activities of the CCP, although in that instance the constraints were somewhat weaker.

Fourthly, since the pause a clear attempt has been made to ensure that Monitor merely regulates, without performing a strategic role in promoting much except the interests of patients. It functions as a regulator and adjudicator on what it is intended to do, rather than occupying an unaccountable strategic role in promoting competition. Clearly much will depend on the mandate that it continues to be given and on its personnel: that will vary over time, and we should be watchful in that regard.

I recently had the benefit—as I think other Members have, too—of the legal advice of 38 Degrees, which is in danger of rapidly becoming the provisional wing of the “Evan Harris organisation.” I carefully read what Mr Roderick said, and I would like to share the details of his comments with the House. He says:

“contracting out services to the private sector is anything but a novel proposition in the NHS”

and

“the government has for some years rolled out the policy of Any Qualified Provider”.

Presumably, that is a reference to the previous Government, not the current one.

Mr Roderick also says:

“the application of procurement law is not by any means new to the NHS”.

Referring again to Labour party principles, he says:

“the current internal Principles and Rules for Cooperation and Competition”—

which were set up by Labour—

“seek to inject…promotion of choice and competition principles into the operation of the NHS”.

On the thorny subject of the definition of “undertaking”, which we debated ad nauseam in Committee, he has this to say:

“The NHS has already developed a structure whereby it is more likely than not that NHS Trusts are undertakings for the purposes of competition”.

Mr Roderick is often cited by Labour Members as representing independent legal advice, but that is what he says. He concludes by saying that Labour’s

“recent reforms…have done much to alter”

the basic

“landscape, even in the absence of legislative change.”

As we have both commissioning and a mixed economy—people are not saying that we ought not to have such an economy—there is a chance that there will be challenges from disappointed providers, and we must try to understand how that would go. In terms of EU law it does not matter how many providers there are out there, as even one will do, and it does not even have to be in the UK. The law can be applied in such circumstances. If these issues are to be taken up by providers who are disappointed in one context or another, it is better for that to be handled by a sector regulator such as Monitor than by the Office of Fair Trading, which would be the default situation.

[Diana Johnson (Kingston upon Hull North) (Lab)]

I have been listening carefully to the hon. Gentleman’s contribution. He has been talking a lot about Labour party principles—but I wondered about Liberal Democrat principles, and whether he feels completely relaxed about the opening up of the NHS to privatisation.

[John Pugh]

Perhaps the hon. Lady has not understood the point that I was making. Her own Government were responsible for the opening up that she talks about and fears, and most Labour Members voted for it. I did not vote for foundation trusts, nor did many of my party colleagues. Clearly Labour Members did, however, and we will return to that.

It is a fair point to say that if we have Monitor, that does not take us out of the whole legal web, as it cannot stop other legal processes, or a disappointed provider going further. However, it dramatically lessens the impact, and dramatically reduces the probability of that happening. We can only escape this legal web effectively if we take Mr Roderick’s advice and re-examine each and every element and characteristic of the NHS structure—or, to put it simply, if we reverse Blairism.

--- Later in debate ---

[Grahame M. Morris]

That is a fair and reasonable point and I concede that.

[Diana Johnson]

Does my hon. Friend agree that if this Bill had been properly drafted in the first place and there had been proper pre-legislative scrutiny, we would not have to have this cartload of amendments brought in at the last moment?

--- Later in debate ---

[Chris Leslie]

I intended to make only a short intervention, but given the Minister’s cap on interventions, I decided that I needed to find a brief opportunity to say that removing the private patient cap is the wrong thing to do. The Minister’s basic argument— “I do not think I’m wrong”—really does not cut it. Removing the cap will remove an incentive for reducing waiting lists. The two issues of waiting lists and waiting times and the degree of private business within the NHS cannot be separated: they go hand in hand.

In a sense, a bit of ancient history is required, because it is important to note that the previous Labour Administration reduced waiting times so much that many of the private health insurers were, frankly, complaining. Long waiting lists matter because they are also the lifeblood of the private medical industry. We need only look at the advertising slogans of many private medical insurers to see how they try to entice people with promises of “speedy service” and “getting your health situation sorted out quickly”. This, however, can happen in the context of NHS hospitals.

What we must do is ensure that we put the needs of NHS patients first. My worry about removing the private patient cap is that it changes the incentives relating to how the foundation trusts will work, putting revenue generation ahead of patient treatment. The allure of revenue will, of course, be there, but keeping waiting lists high is, in a sense, part of ensuring that revenue continues to come in. I want to see trusts focused absolutely and completely on reducing waiting times. That is incredibly important.

It has been interesting to hear some of the important points raised by some Government Members—and not just about state aid rules. To me, however, the issue of waiting times and, particularly, this Administration’s watering down of the targets set for them and the issue of removing the patient cap are two sides of the same coin. It is all about driving people to go in a direction that they often do not want to go. People might have some savings and feel they have no choice but to use them for private provision because of the fear of long waiting lists in future. That might be the only way people feel that they can get treated quickly. It is all part of the design to change the whole fabric and nature of the NHS. That is the wrong direction in which to head, and I hope that we can retain the private patient cap.

[Diana Johnson]

I support amendment 1165. Although I have a great deal of respect for the Minister, his comments did not persuade me. The proposal to remove the cap is an example of the shambolic way in which the Bill has been presented. There seems to me to be very little evidence to back up what the Minister thinks might happen. He thinks that everything will be OK, but the NHS has never been in the position of having to make £20 billion-worth of efficiency savings—or cuts, which is what they really are. I believe that when the cap is removed, trusts will want to increase the income that they can obtain from private patients. My hon. Friend the Member for Warrington North (Helen Jones) made the good point that when waiting lists lengthen—which we know they are already beginning to do—those who pay will do so in order to receive the medical treatment that they want.

After 1997, NHS waiting lists in Hull fell to their lowest ever level. A private hospital that sat in the middle of an NHS trust—it was then the Hull and East Riding acute trust—was sold to the NHS. It had not been getting enough business, because the NHS was doing so well. We have heard in today’s debate about the high level of support for the NHS and about the current high levels of satisfaction, and I do not think that we should take this step.

Earlier, I spoke of the lack of principles that the Liberal Democrats were exhibiting yet again in respect of the NHS. It was interesting to hear the hon. Member for Southport (John Pugh) say that he was not doctrinaire on the issue. So the hon. Gentleman has no principles, and is not doctrinaire either. I recall that, in 2010, the Liberal Democrats campaigned in my constituency on a platform of saving the NHS, not increasing the number of private patients. I think that when this measure reaches the House of Lords, Liberal Democrat peers must stand up and be counted, because it is a disgrace that Liberal Democrat Members should support it today.

My main concern relates to evidence. Where is the evidence that removing the cap will work? I do not think that the safeguards exist to ensure that NHS patients will be protected, and I know that waiting lists are rising, which means that people in my constituency, and in poorer parts of the country, will not be able to gain the access to health care that they deserve. I believe that removing the cap is entirely wrong.

[Andrew George]

It is a pleasure to follow the hon. Member for Kingston upon Hull North (Diana Johnson), but I do not think she did herself or her party any favours in trying to persuade my Liberal Democrat colleagues and me to follow her or her party’s lead by launching a completely unacceptable attack on my hon. Friend the Member for Southport (John Pugh).

The Minister seemed to be trying to win me over by describing me as “the hon. Member for Cornwall”. His description stimulated my Cornish imperialist tendencies, and I was tempted to change that to “Cornwall and bits of England”. However, I shall leave it for another Bill, perhaps one relating to boundary reviews.

In his response, the Minister said that the cap was a “blunt instrument”. I acknowledged that in my opening remarks: it is indeed a blunt instrument, which does not achieve what I think we all want it to achieve. However, although the current situation is not satisfactory, neither is the proposal to lift the cap. That too is a blunt instrument, as was made clear by many speakers this evening. I do not think the Minister entirely acknowledged that this is a conundrum that needs to be resolved. As I have said before, the Government are right to address the issue and are doing so with the best of intentions, but they have come up with the wrong answer. Indeed, lifting the cap is not an answer at all. Further work is needed, and deleting clause 168 would be a good start.

As I have said, mine are probing proposals. I will support amendment 1165, but I beg to ask leave to withdraw the motion.

Motion and clause, by leave, withdrawn.

Congenital Cardiac Services for Children

Diana Johnson Excerpts

Thursday 23rd June 2011 Commons Chamber

[Craig Whittaker (Calder Valley) (Con)]

I thank my hon. Friend the Member for Pudsey (Stuart Andrew) for his incredible hard work on this issue, not just this week but over many months.

Yesterday many MPs received an e-mail from the chief executive of the Children’s Heart Federation, who is also a member of the Safe and Sustainable programme steering group. She wrote:

“'Clinicians have led these changes and we believe it is wrong that some politicians are now trying to block the process that will lead to the vital improvements in children’s care.”

I do not agree with that assessment because I agree absolutely with the aims of the review, as do many of my hon. Friends. However, I have an issue with the process of the review and what it has missed out. In the case of Leeds, there has been no formal opportunity to correct factual inaccuracies in Sir Ian Kennedy’s pre-consultation assessment report, and no impact assessment was undertaken before the four options were announced in the consultation

As my hon. Friend the Member for Leeds North West (Greg Mulholland) said, Leeds delivers what is considered a gold standard of service, and is one of only two hospitals that offer this gold standard. However, the weighting in the criteria did not take account of that at all. It would be fair to say, therefore, that I, my fellow Yorkshire, Humber and Lincolnshire MPs and the more than 500,000 fellow Yorkshiremen who handed in a petition to the Prime Minister this week have little faith in an open and transparent process that is fair for the people in the current Leeds catchment area.

[Diana Johnson (Kingston upon Hull North) (Lab)]

And women.

[Craig Whittaker]

I apologise if I left out women.

Southern Cross Healthcare

Diana Johnson Excerpts

Thursday 16th June 2011 Commons Chamber

[Paul Burstow]

I have tried to give the House a number of reassurances on that point. I would add that there have been home closures over a number of years, from which we must learn lessons. One lesson is that we must minimise the possibility of closures and ensure that when they take place they are handled sensitively, slowly and carefully. That is why I welcome the work that the Association of Directors of Adult Social Services recently published—it sets out strong, clear, evidence-based guidance to assist local authorities in managing any closures in future.

[Diana Johnson (Kingston upon Hull North) (Lab)]

I have one Southern Cross home on Kesteven way in Hull and I am concerned about what the Minister said and the complacent attitude that the Department of Health is showing on the role of local authorities. Is there a co-ordinated plan for the whole country, bringing together all the local authority plans, so that we know that there is coverage for the whole country if the worst happens? I am not sure that there is.

[Paul Burstow]

Such work is in hand and has been for some time.

NHS Future Forum

Diana Johnson Excerpts

Tuesday 14th June 2011 Commons Chamber

[Mr Lansley]

The Future Forum is perfectly clear that there is a benefit associated with integrating health and social care if clinical commissioning groups do not normally cross local authority boundaries. But it is clear, and we are clear, that they should be able to make a case to do so if they think it appropriate. We have the benefit of being able to look at the pathfinder consortia, of which there are 220 and I think that 16 cross local authority boundaries, so it is already the exception rather than the rule.

[Diana Johnson (Kingston upon Hull North) (Lab)]

Will the NHS be the preferred provider of choice for health care services for my constituents?

[Mr Lansley]

No, I have said that we will legislate to ensure a level playing field, so her constituents should have access to whichever provider their clinical commissioning group views as best able to deliver quality care.