Ebola

Lord Brennan of Canton Excerpts

Monday 13th October 2014 Commons Chamber

[Mr Hunt]

The hon. Lady is absolutely right to say that we have fantastic research on the spread of infectious diseases at a number of institutions in this country, including in Liverpool, and we are not only using that research in the battle that we are leading in Sierra Leone, but making it available to partner countries leading the battle in other parts of west Africa. The advice that I get from my experts, from Public Health England and from the chief medical officer takes full account of the research done in places such as Liverpool.

[Kevin Brennan (Cardiff West) (Lab)]

In his statement, the Secretary of State said that the screening measures would reach 89% of passengers from the three affected countries; it is therefore hoped that one in 10 will self-identify. Will he tell the House the numbers that the estimate is based on, not just the percentage, so that we have an idea of how many people will be involved in these screening measures?

[Mr Hunt]

For the month that we looked at, September, we are talking about around 1,000 people arriving from the directly affected countries, which is about 0.03% of all Heathrow travellers for that month. It is important to say that the vast majority of those will be low-risk passengers, but those are the people with whom, initially, we would want to have a conversation, so that we could understand whether they had been in contact with Ebola patients or had been in the areas particularly affected by Ebola, and so that we could decide whether we needed to put in place tracking procedures to allow us to contact them quickly, should they develop symptoms.

Tobacco Products (Standardised Packaging)

Lord Brennan of Canton Excerpts

Thursday 3rd April 2014 Commons Chamber

[Jane Ellison]

I urge my hon. Friend to look at the report and to reflect on the fact that anything we can do to discourage children from taking up smoking is likely to have a lifelong effect not only on them, but on their families. I urge him to look at the detail of Sir Cyril Chantler’s report.

[Kevin Brennan (Cardiff West) (Lab)]

I urge the Minister not to be swayed by those lobbying on counterfeiting and packaging, because this is a deadly, addictive drug. Coffin nails are coffin nails whatever packaging they come in. Given the interest in this subject, does she intend to introduce regulations on the Floor of the House to be debated and voted on?

[Jane Ellison]

It is indeed our intention to put the regulations through the affirmative procedure, so the House will have the opportunity that the hon. Gentleman mentions. He is right to draw the House’s attention to the issue of children and addiction. There are some extremely interesting points about that in Sir Cyril’s report, reflecting academic studies on children and addiction, including the fact that children become addicted at a faster speed than adults.

Urgent and Emergency Care Review

Lord Brennan of Canton Excerpts

Tuesday 12th November 2013 Commons Chamber

[Mr Hunt]

Because it is going to save the lives of the hon. Gentleman’s constituents; it will mean that 800 more people are employed in out-of-hospital care; it will mean three brand-new hospitals for the benefit of his constituents; it will mean seven-day working; and it will mean seven-day opening of GP surgeries. That is why.

[Kevin Brennan (Cardiff West) (Lab)]

On reflection, does the Secretary of State regret the fact that he described people who felt ill enough to have to go to A and E on a number of occasions as “frequent flyers”? And would he like to apologise?

[Mr Hunt]

I am sorry, that is a completely ridiculous thing to say. I was using the phrase to talk about people who have to go back to the NHS time and again. The whole purpose of the reforms is to make sure that we give a better service to people who regularly use the NHS, and he should understand perfectly well what I was talking about.

Immigrants (NHS Treatment)

Lord Brennan of Canton Excerpts

Monday 25th March 2013 Commons Chamber

[Kevin Brennan (Cardiff West) (Lab)]

In answer to the hon. Member for Rossendale and Darwen (Jake Berry), the Secretary of State said that when someone does not have the funds, treatment will not be refused if it is a life-and-death situation. For clarity, will he will us what the threshold will be? For example, if someone has a broken leg, or if someone needs another treatment that requires hospital admission, and they do not have the funds, will treatment be refused under his scheme?

[Mr Hunt]

The hon. Gentleman will be relieved to know that that will be a matter for clinicians, not politicians.

NHS Commissioning Board

Lord Brennan of Canton Excerpts

Tuesday 5th March 2013 Commons Chamber

[Norman Lamb]

Indeed. That is precisely the lesson to be learnt from Mid Staffordshire hospital and the Francis report. The last Administration and the top-down culture of targets lost sight of the importance of the quality of care for patients, but the current Government are absolutely intent on always putting the patient first, and that is what this legislation is about.

[Kevin Brennan (Cardiff West) (Lab)]

The Government seem to be saying, “There is nothing wrong with the regulations that we have laid, so we must amend them as a matter of urgency.” Will the Minister tell us when that decision was made, and why the Secretary of State has not come to make a statement to the House about it rather than the Minister’s having to come here as a result of an Opposition urgent question?

[Norman Lamb]

I made it clear during Health questions last week that I was anxious to ensure that the regulations faithfully implemented the commitments that had been given in the other place during the passage of the Health and Social Care Bill, and indeed we have worked since then to ensure that the regulations achieve that. I believe that we need to make it absolutely clear that clinical commissioning groups will not be forced into competitive tendering, which is why we are amending the regulations. That is entirely sensible and entirely rational.

NHS Commissioning Board (Mandate)

Lord Brennan of Canton Excerpts

Tuesday 13th November 2012 Commons Chamber

[Mr Hunt]

The mandate sets some very high ambitions in challenging times, but those ambitions can help to reduce costs and make the NHS more sustainable. Embracing the technology revolution should mean that we give people better care, as should allowing clinicians more time to spend with patients and allowing nurses to spend more time with the people they are responsible for, but those things should also save the system money. There is not an either/or, but I accept the hon. Gentleman’s point that this is very ambitious.

[Kevin Brennan (Cardiff West) (Lab)]

Does the Secretary of State’s commitment to parity of esteem for mental health services include a promise that under his watch spending on mental health services will not decline in proportion to spending on physical health services?

[Mr Hunt]

The hon. Gentleman will understand that the purpose of such a mandate is not to set specific financial objectives but to set outcomes for patients, and then to let local professionals on the ground—doctors and nurses—decide how best to deliver them. The mandate is clear, however, that we want parity of esteem for mental health and to improve equality of access, which at the moment is much better for physical health than for mental health.

Business of the House

Lord Brennan of Canton Excerpts

Thursday 6th September 2012 Commons Chamber

[Mr Lansley]

I did, indeed, hear the answer rightly given by the new Department for Business, Innovation and Skills Minister. I should put this matter in context. The post office local model is an excellent model, and we are seeing substantial take-up, which is in many instances reviving post office services. The Government are absolutely clear that we will not entertain a process of post office closures, which is what happened under the last Government. On the specific point, this contract process is currently live and it would not be proper for Ministers to comment or interfere during the course of that.

[Kevin Brennan (Cardiff West) (Lab)]

I welcome the new Leader of the House and his deputy to their posts, and as the right hon. Member for East Yorkshire (Mr Knight) is on the Treasury Bench, may I also congratulate him on his appointment to his new post of Vice-Chamberlain of Her Majesty’s Household, prompting the headline “MP4 drummer joins Queen”? May we have the debate on the honours system that has just been suggested, because is not giving honours to losers in a reshuffle to console them an example of the “all shall have prizes” culture that the Prime Minister claims to denigrate?

[Mr Lansley]

I will give the hon. Gentleman the prize of best joke of the day, if I may. I merely reiterate the point I made earlier: in this House, people give public service. It is not simply a job; it is much more than that. People do far beyond what I think people in most jobs would expect to do. They give of themselves and their time, and their families and their lives, especially when they are in government, as many Opposition Members will know from their past experiences. Being in government is an onerous and demanding task. For example, my parliamentary neighbour, my right hon. Friend the Member for South East Cambridgeshire (Mr Paice), has had Front-Bench responsibilities for over 22 years. That is a dramatic contribution to public service, and I think it is right that it is properly recognised.

Organ Donation

Lord Brennan of Canton Excerpts

Wednesday 30th November 2011 Westminster Hall

[Glyn Davies]

I absolutely agree, but I do not necessarily agree with having a list identifying people. I hope to cover that point. Having people’s views identified outside the traumatic circumstances that surround a death is absolutely key if we are to increase the number of organ donations in this country. That is what the evidence in other countries tells us.

When the taskforce was set up, the Prime Minister of the day expected it to support a transplant revolution, but of course it did not. A similar conclusion was arrived at by a cross-party group of Assembly Members who looked at the same issue. The Members I talked to went into that committee expecting to support presumed consent, but they said in the Assembly that it should not be presumed. They did not think it would deliver the increase in organ donation levels that was generally anticipated.

The second report of the organ donation taskforce in 20008 recommended an improvement in transplant co-ordination, and that is being implemented. The number of organ donors in the UK has risen from just over 800 in 2008 to more than 1,000 last year. That is an extraordinary and dramatic improvement that has saved hundreds of lives. I have searched pretty hard, and the evidence I found is that the way forward is to look at the problem logically and in depth, conduct serious research and then take well-considered action.

Many people support presumed consent because they intuitively feel that it must make a difference. Opinion polls show support, and it is not surprising that they do. When people are going around saying that the change to presumed consent will increase the number of organs available, others will automatically say that they are in favour, but the reality is not what they think. There is a misconception that, if a citizen does not put their name on a centralised, opt-out register, their organs can be used for transplantation. This is a half-consent system, and it is not the presumed consent system that is being proposed. With soft opt-out, or presumed consent with safeguards—these are the phrases used—the actual decision to donate still rests with potential donor’s family, as happens under the current system. The key issue—the point raised earlier by my hon. Friend the Member for Cardiff North (Mr Evans)—is that the donor’s wishes are known by his or her next of kin.

It is always dangerous to draw conclusions from international examples but, for many years, Spain was presented by those who support presumed consent as proof of the effectiveness of that system. Since the late 1980s, Spain has had the best rate of organ donation in the world and has rightly been recognised as a model for other countries. Because Spain legalised presumed consent in 1979, it has been assumed that this played a key part in its success. However, the 1979 legislation to introduce presumed consent had no impact whatsoever on Spanish donation rates. Key organisational changes introduced 10 years later, in 1989, delivered the success of which Spain is so rightly proud. Spain does not have, and has never had, an opt-out register.

The director of the Spanish organ donation body, Dr Rafael Matesanz, has said that the 1979 legislation is dormant and plays no role in Spain’s outstanding organ donation rates, but this fact does not deter the supporters of presumed consent. They now ignore Spain, citing cultural differences to explain why Spain is not a good example to follow. They also ignore the fact that the United States has one of the best organ donation rates in the world, despite there being no presumed consent there. In fact, civil liberties issues in the States would almost certainly prevent presumed consent being introduced there.

The focus now has moved to Belgium and to studies performed in Belgium 25 years ago, between 1984 and 1987. I tried to discover what happened, because I want to see more organs donated. If a system works, and there is evidence to show that it works, it is important that we study to such examples, so I have gone to a lot of trouble to find out what happened in Belgium.

Belgium introduced presumed consent legislation in 1986. The key result was that the rate of kidney transplantation in Belgium rose from 200 per annum in 1984-85 to 300 per annum in 1987. Again, under more detailed examination, the claim that this is the consequence of presumed consent just does not stand up to scrutiny. The results of these studies were published, as a page and a half meeting report, in 1990, by L Roels and co-workers, Transplantation Proceedings, volume 22, pages 2078 to 2079. The authors state clearly that the presumed consent legislation

“was consolidated by a nationwide information campaign about the benefits of organ donation…and is being maintained by continuous efforts to inform healthcare professionals about the modalities of organ procurement procedures.”

More importantly—crucially—the authors go on to say:

“Whereas before 1986 most smaller non-university hospitals were reluctant to participate in organ donation activities, by lack of any legal security in the absences of an adequate legislation. The majority of organs harvested” —

I do not like that word; I prefer “donated” —

“during the last 3 years were performed in this particular group of hospitals.”

Presumed consent was clearly a major factor in increasing organ donation in Belgium in the 1980s, but it is irrelevant to the current position in the UK because the legal certainties have never been an issue. It may have had some influence in Belgium but it is clear that Belgium is a very weak example of evidence on which to base a major change in UK policy.

[Kevin Brennan (Cardiff West) (Lab)]

As I understand his argument, the hon. Gentlemen is saying that in other countries other measures have worked to increase the level of donation, but he also seemed to be arguing that presumed consent would make matters worse, and reduce the number of organs donated. Can he explain how that mechanism would work?

[Glyn Davies]

I thank the hon. Gentleman for that intervention, because I would not want there to be a misunderstanding. I gave a direct quote from the organ donation taskforce set up by the previous Government, which said that there was no evidence of an increase, and indeed some danger that there might be a negative effect. I used that quote as a challenge to those who are suggesting that the taskforce report shows positive support. I did not suggest that presumed consent will decrease the level of donation.

--- Later in debate ---

[Kevin Brennan (Cardiff West) (Lab)]

This is a political issue. It may not be a purely party political issue, but it is a political issue, because ultimately it is decided by politicians. If a similar proposal were introduced for other parts of the United Kingdom in this House, it would probably be whipped by the Government, who I imagine would take a political position on the issue. That may or may not be the case, but whether or not the issue is party political, it is political because it is about life-and-death matters affecting our constituents, matters that are ultimately decided by politicians. That is our duty and we should not give politics a dirty name by saying it is not a political issue, because politics is important—often, it is a life-and-death matter—and this is one example.

I listened carefully to the arguments of the hon. Member for Montgomeryshire (Glyn Davies). I absolutely accept that he is entirely sincere in making those arguments and that he has considered the matter very seriously. I know that, through a close friend, he has personal experience of the issues involved. I also know of his work with the Kidney Wales Foundation, a charity that is located in my constituency and has done such sterling work to move the issue up the agenda in Wales and to help develop the proposal brought forward by the Welsh Assembly Government.

However, I struggle to understand the logic of the hon. Gentleman’s position. He appeared to be saying something with which we can all agree—that increasing the levels of organ donation will not simply happen through a proposal such as soft presumed consent and that other things could and should be done to increase organ donation. As he rightly said, the very fact that the previous Prime Minister raised this matter from the top and generated a taskforce and a debate has helped to improve organ donation, in the same way that the Alder Hey scandal had the opposite effect on rates of organ donation in the past decade.

There are things that can be done. One study cited in the science section of the Library’s note, which hon. Members may have read, stated that the four main factors for high donation rates are “an opt-out policy”, which we are here to debate, and

“a large number of transplant centres…a high percentage of the population enrolled in university education…and a high percentage of Roman Catholics”.

That may explain the sanctimonious hyperbole of the Archbishop of Wales on the issue. He may want to reconsider the position that he has taken and to consult some of his ecumenical colleagues in other parts of the Christian faith.

The reason why I struggle with the logic of the hon. Member for Montgomeryshire is that he said that his objection was not ethical. We do not therefore have to deal with the issue of whether the proposal is an imposition by the state, which should not in any way presume anything about what should happen to the organs of someone who has died. He said at the outset of the debate that his objection was not on such grounds; he said that he wanted to cite the evidence. When I asked him whether he thought such a soft organ donation proposal would make matters worse, he said that a line in the taskforce report stated that that was a possibility, but that that was not his position and that he was not arguing that a proposal for soft organ donation would make matters worse. At the very least, all the proposal would do, according to his own argument, is make things no better. Yet he accepts that, by raising the debate and the issue, organ donation rates are likely to increase.

My argument is that the proposal is not a significant imposition on the individual human rights of people, because it is soft organ donation. In practice, what would happen is that, when an organ becomes available, it will be presumed that the donor had consented but there is still the safeguard that the relatives of that donor have to be consulted. All that would change would be the nature of the question. It would no longer be, “Your loved one did not carry a donor card and did not indicate consent before this misfortune befell them, would you agree to their organs being donated?” Instead, the question would be, “As you know, in this jurisdiction it is presumed that consent is given unless somebody opts out, and therefore we intend to proceed unless you decide to veto that process.” That is the difference. In my view, logic tells us that, in those circumstances, it is likely that more organs will be donated. Even if that was not the case, and even if, as has been said, it made no difference whatever, are we not right to try?

I believe that the proposal will be a success, and we should try it. This is the advantage of devolution: it is possible for the proposal to be tried in one part of the United Kingdom just as the smoking ban was tried despite massive objections from all sorts of people. That proved a huge success and the ban was adopted in other parts of the United Kingdom. I think the same will happen in this instance.

[Glyn Davies]

I accepted in my speech that the proposal in Wales may have triggered my debate in some way, but this is an issue for the United Kingdom. We have all spoken about a situation that needs to be improved, and that needs to happen across the United Kingdom. That is what today’s debate is about.

[Kevin Brennan]

Indeed, and I accept that. As I just said, I believe that the proposal in Wales will, eventually, lead to an improvement right across the United Kingdom.

On the constitutional point, the Welsh Government have taken legal advice and believe that they have the necessary jurisdiction to undertake the reform. If the United Kingdom Government and their legal advisers do not believe that to be the case, how should the Welsh Government react? I will tell you, Mr Crausby: they should react by making sure that they make any necessary changes to ensure that it is absolutely clear that the Welsh Government have the necessary jurisdiction to make that reform. Otherwise, we are heading for an unnecessary constitutional crisis. I hope that the Under-Secretary of State for Health will make the issue clear when she replies to the debate.

Ovarian Cancer

Lord Brennan of Canton Excerpts

Wednesday 12th October 2011 Westminster Hall

[Stuart Andrew]

I am grateful for that intervention, which proves the need for the debate. I hope that we can take forward many of the issues raised today to try to tackle the disease. The hon. Gentleman’s point is incredibly valid and important.

NICE’s information is a step forward because it offers women, and importantly GPs, the chance to distinguish between ovarian cancer and more common but less serious conditions such as irritable bowel syndrome, which is the most common misdiagnosis. The ovarian cancer awareness measure, which is an accredited tool used by Target Ovarian Cancer in its pathfinder study, showed that only 4% of women felt confident of spotting the symptoms of the disease, and just 9% were aware that persistent bloating is the most common symptom of ovarian cancer. Compare that with 76% of women who recognise that a lump is the most common symptom of breast cancer.

[Kevin Brennan (Cardiff West) (Lab)]

Does the hon. Gentleman agree that because of the specificity of the symptoms of ovarian cancer, there is a case for a specific campaign to raise awareness of the disease, rather than relying on a generic campaign, which is the approach that the Government have tended to favour so far?

[Stuart Andrew]

The hon. Gentleman is in danger of stealing my thunder, but I am glad that he has emphasised my point before I have made it.

--- Later in debate ---

[Kevin Brennan (Cardiff West) (Lab)]

I congratulate the hon. Member for Pudsey (Stuart Andrew) on securing this important debate. I am sure that other hon. Members will not mind if I also single out my hon. Friend the Member for Slough (Fiona Mactaggart), who gave such a personal and passionate speech about how ovarian cancer has affected her. Like so many others here, my family has been affected by the disease. My first cousin, Mary, died in her 30s from ovarian cancer, leaving behind a young son. I am sure that all of us here are aware of the impact of this terrible disease.

The recently published report “Cancer in Wales: 1995-2009”, which my hon. Friend the Member for Blaenau Gwent (Nick Smith) mentioned, highlights the fact that, on average, 394 women a year have been diagnosed with ovarian cancer in Wales over that period. The average number of mortalities due to ovarian cancer between those years was 237, which translates into 60.3% of those diagnosed with the disease ending up dying from it. Such startling statistics demonstrate what all hon. Members have been saying about the lack of awareness of the symptoms of this disease.

If ovarian cancer mortality rates in this country were the same as those in other EU countries, we could save 500 lives a year. That statistic on its own should make us all sit up and take notice and realise that, over many years, not enough has been done to highlight this terrible disease.

We have debated the kind of awareness campaign that needs to be run. A generic campaign is clearly not adequate in this case. There needs to be a specific campaign around ovarian cancer. As other hon. Members have said, only 3% of women recognise that increased abdominal size is potentially a serious symptom of ovarian cancer. That compares with three-quarters of women who know that a lump in their breast is potentially a serious symptom of cancer. If educating the public about the symptoms of this disease is important, of equal importance is the need for GPs to consider ovarian cancer as a possibility when patients display the symptoms.

It has been mentioned already that nearly a third of women who are diagnosed are diagnosed following an admission into accident and emergency, which also tells us that there is a serious problem.

My constituent Hazel Burrows contacted me via her granddaughter earlier this year. In her e-mail, Georgette Burrows said:

“Everywhere you look, whether it’s when you're watching your favourite soap opera or doing your weekly shop, there are campaigns for breast cancer, and rightly so. Although I do believe more needs to be done in order to make women aware of ovarian cancer.”

She is right and today’s debate has demonstrated that very clearly.

I will work with my hon. Friend the Member for Blaenau Gwent in relation to Wales and with Mark Drakeford in the Welsh Assembly on this matter. Let me say to the Minister that all of us come into politics because, whatever our views, we believe in the possibility of changing things for the better. If today’s debate has highlighted anything it is that that is possible and that we can save people’s lives. Being able to achieve that rests partly with the Minister who is in his seat today.

As all former Ministers know—I include my hon. Friend the Member for Slough—we go on in a job for some time, getting our submissions from officials, turning up at Adjournment debates, reading out the speech that has been provided and then carrying on as before. The Minister cannot do that after today’s debate. He must go back and say to his officials, “I want fresh on my desk, as soon as possible, a new strategy for raising awareness around ovarian cancer because what we have now is not good enough.” He has that opportunity to make a difference. It is a great privilege to be a Minister—I told myself that every day I walked into my ministerial office. The Minister has a chance to save people’s lives and I hope that he takes that opportunity.

Health and Social Care Bill (Programme) (No. 2)

Lord Brennan of Canton Excerpts

Tuesday 21st June 2011 Commons Chamber

[Mr Burns]

If Opposition Members were more interested in listening than in trying to be disruptive, they would discover that after setting the scene I will deal precisely with the recommittal and our reasons for proposing it.

We will replace that culture with a bottom-up culture of clinical leadership and patient choice and an unfaltering focus on improving health outcomes.

While there has always been widespread agreement on the principles of modernisation—a fact that even the shadow Secretary of State now accepts—there have been concerns in some quarters that the Bill could support those principles better.

[Kevin Brennan (Cardiff West) (Lab)]

On a point of order, Mr Deputy Speaker. Some of us wish to talk about the programme motion that we are supposed to be debating, and indeed to intervene on the Minister if he will give way, as he said that he would at the outset. Can the Minister be persuaded to discuss the motion that is before the House?

[Mr Deputy Speaker]

Several Members wish to participate in this very short debate. It will last for only an hour, and we are already well into that hour. Will the Minister now refer directly to the programme motion?

--- Later in debate ---

[Mr Burns]

The hon. Gentleman seems a little confused. He is talking about 1983, but if he had been listening he would know that I have already said that two Bills were recommitted in 2003. I also said that if Opposition Members wait, I will explain the context of those Bills vis-à-vis the current situation. I therefore urge them to show patience, as they will then learn something.

[Kevin Brennan]

On a point of order, Mr Deputy Speaker. In fact, the last Bill to be partially recommitted to a Committee was the Mineral Workings Bill in 1951, some 60 years ago, but the Minister is not referring to that.

--- Later in debate ---

[John Healey]

I can and I have. This is a reckless and needless reorganisation, which has led to confusion and chaos over the past year. If the House does not help to get the legislation right by doing its proper job, that chaos and confusion and the wasted cost—money that should be spent on patient care—will continue.

[Kevin Brennan]

Is it not an abuse to use this procedure, which is very rare? According to the Library, the most recent example of a partial recommittal of a Bill to the same Committee was the Mineral Workings Bill in 1951 because of an inadvertent error in the original Committee stage. It is totally wrong to use the procedure. The whole Bill should be recommitted.

[John Healey]

My hon. Friend has a point. What is wrong is a partial recommittal of the Bill, because the Bill requires full scrutiny of the full provisions with the changes that the Government propose to make, once we have had a chance to see them.

The Health Minister and Government Members urge us to go faster. Everything this Government have done with their NHS reorganisation has been rushed and reckless, and the motion signals that they are set to repeat the mistake by railroading the Bill through at breakneck speed and denying this elected House its proper role in scrutinising the legislation. Labour tabled a motion a month ago for the full Bill to be reconsidered in Committee, for more time to look at the detail of the amendments and for proper scrutiny and debate in Committee.

--- Later in debate ---

[Kevin Brennan]

Does the hon. Gentleman think it right in principle that the Government should be able to choose the parts of the Bill in Committee to which Members from any party, Front Benchers or Back Benchers, might want to introduce amendments?

[Mr Bone]

The hon. Gentleman makes a really important point, one that I am wrestling with before I decide how to vote. If we had a business of the House committee, that problem would not arise, because the decision would be made in public and not by the Executive, but we are where we are. To the Government’s credit they avoided Standing Orders by allowing us to have a debate—however short—today. Standing Orders called for this motion to be decided forthwith and without a debate, so the Government should get credit for that.

There are a number of issues, but an important one is whether the whole Bill should be recommitted. I can see many arguments for that, but I can see also an alternative view, which says, “You’re going to look in more detail and have more time if you look at provisions that have effectively been changed.”

The Government talk about moving 160 amendments, and the Opposition will move amendments, but I hope that in Committee Back Benchers will do so, too. The problem for the Committee’s Chairmen is that they will have to consider how to deal with those amendments that are approved and consequential to earlier parts of the Bill, but I think that they will do so sensibly.

I have some doubts about the same people being on the Committee. I volunteered to sit on it and wrote to the Chairman of the Committee of Selection. There is an argument for fresh faces on the Committee, but the really important point is how Members on both sides behave in Committee. If they go there to scrutinise the Bill, if they are willing to table sensible amendments and if they vote according to their conscience and not on party lines, we will have real scrutiny.

--- Later in debate ---

[Andrew Percy]

I take the hon. Gentleman’s point. That has already been discussed. The key thing now is to debate the parts of the Bill that the Government have said they intend to amend, and perhaps that will mean that we can debate them in more depth. I want to know what the provisions are going to be to prevent cherry-picking. The shadow Secretary of State said that this is an attempt by the Government to break up the NHS and bring in market forces. I would not want to be a member of any political party that attempted to do that, so I want to know about the Government amendments.

[Kevin Brennan]

I respect the hon. Gentleman’s respect for Parliament and therefore put to him what I said earlier: on a point of principle, is it not wrong that the Government should be able to select the parts of the Bill that they want to have scrutinised and not allow Members from all parts of the House an opportunity to do so? Does that not set an extremely dangerous precedent?

[Andrew Percy]

We have discussed where these procedures come from and who is accountable for them, and that certainly cannot be laid at the door of this Government. Over the past few months, we have heard first that there has been too much delay, and now that there is not enough delay.

As we have heard, professionals in the health service and the public have been saying that they wanted to know where we were heading and that they needed some clarity. The Government wanted that brought to an end, and they have had their listening exercise. On that basis alone, although I do not like the idea of curtailing debate, I hope that we can get on with this so that we all know what the changes are going to be, and that we end up with an NHS that is on a stable footing for the long term and do not have any more reorganisation for a considerable time.

--- Later in debate ---

[Kevin Brennan (Cardiff West) (Lab)]

I just reiterate the point that 1951 is the last time that this exact procedure was used. The Government are setting a dangerous precedent. This is an abuse of parliamentary procedure and it does not enable the House to consider all parts of the Bill. The recommittal of Bills is quite a rare procedure in this House.