NHS Outsourcing and Privatisation Debate

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Department: Department of Health and Social Care

NHS Outsourcing and Privatisation

Lindsay Hoyle Excerpts
Wednesday 23rd May 2018

(5 years, 11 months ago)

Commons Chamber
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Anna Soubry Portrait Anna Soubry
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Would the hon. Gentleman like to speak to Nottingham City Council, which is run by Labour? It has repeatedly refused to unblock beds at NUHT, unlike Conservative-run Nottinghamshire County Council, which always ensures that it has social care available so that there is no bed-blocking in Nottinghamshire. The problem is Labour in the city—

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Anna Soubry Portrait Anna Soubry
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On a point of order, Mr Deputy Speaker. Could the record please record that indeed the leader of Nottingham City Council does not run NUHT, but he is responsible for social care in the city? That was the point I was making.

Lindsay Hoyle Portrait Mr Deputy Speaker
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I think that is clarification.

Jonathan Ashworth Portrait Jonathan Ashworth
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I am grateful to the right hon. Lady for that. I invite her to make another point of order, because Nottinghamshire County Council is closing five care homes.

Anna Soubry Portrait Anna Soubry
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I am happy to take that up. My understanding is that Nottinghamshire County Council is looking responsibly at the provision of—[Interruption.] Well, the hon. Gentleman invites me to give him information; I am trying to assist him. In my constituency, the county council is making sure that the money that it spends on social care goes to the very many care homes in my constituency that are rated as good or outstanding—

Lindsay Hoyle Portrait Mr Deputy Speaker
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Order. May I just help a little? We have 25 speakers to come in after the Front Benchers, so I appeal to the Front Benchers to leave time for Back Benchers to contribute.

Jonathan Ashworth Portrait Jonathan Ashworth
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I shall take your guidance, Mr Deputy Speaker. It is always a pleasure to indulge the right hon. Lady, but I have to point out to her that Councillor Cutts of Nottinghamshire County Council is cutting care homes across Nottinghamshire. The record will show that.

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Helen Whately Portrait Helen Whately (Faversham and Mid Kent) (Con)
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I thank the hon. Gentleman for giving way. I remember well when I worked in the NHS under a Labour Government, before I was a Member of Parliament. All around me was talk of independent sector treatment centres, offering more choice through bringing in more private sector provision to the NHS, and PFI contracts. That was under the previous Labour Government, who I believe were trying to make the NHS give better patient care, but Labour has changed its tune. I am concerned that this seems to be all about ideology. I care—

Lindsay Hoyle Portrait Mr Deputy Speaker (Sir Lindsay Hoyle)
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Order. Members cannot make speeches in interventions.

Jonathan Ashworth Portrait Jonathan Ashworth
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I greatly respect the hon. Lady, and I greatly enjoyed her Red Box blog on mental health provision last week. I know she thinks carefully about these matters, but this is not about ideology. It is about what works. Let us take the example of the East Kent contract for integrated NHS 111 and GP out-of-hours services, which began in January 2017. After only seven months of Primecare running it, the service was placed in special measures after it was rated inadequate. That is happening in her own backyard. This is not working, and that is the point we are making.

The history of PFI is that when we came into government, a third of hospitals were more than 50 years old. That is why we carried on with the John Major PFI scheme, which was the creation of that Government. Current Cabinet Ministers such as the shadow Health Secretary at the time, now the Secretary of State for International Trade, stood at the Dispatch Box and congratulated the Labour Government on taking up the private finance initiative developed under the previous Government. He said he would not object to the use of PFI

“exclusively to fund private capital projects”—[Official Report, 8 January 2003; Vol. 397, c. 181.]

In this House, the current Chancellor of the Duchy of Lancaster gave a “warm welcome” to a PFI in his own constituency. The Brexit Secretary said in this House:

“The PFI has many virtues—after all, it was a Conservative policy in the first instance.”—[Official Report, 10 March 1999; Vol. 327, c. 429.]

The Business Secretary said:

“PFI was initiated by the previous Conservative Government”—[Official Report, 12 February 2013; Vol. 558, c. 787.]

The Scottish Secretary has said that PFI is a “successful basis for funding”. The Welsh Secretary said:

“I am a fan of PFI in general.”—[Official Report, 4 November 2010; Vol. 517, c. 1124.]

We will take no lessons from the Tories when it comes to PFI.

We have not only seen facilities management contracts having to be brought back in-house in Leicestershire and Nottingham; we have also seen them deliver a poor quality of service across Lewisham and Greenwich. Those contracts at Lewisham Hospital should come back in-house. I know that the Labour candidate in Lewisham East will be campaigning to bring them back in-house, and I hope the Tory candidate will do the same.

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Jonathan Ashworth Portrait Jonathan Ashworth
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My hon. Friend, who is an authority on these matters and campaigned on them for many years before entering this place, speaks well and she is absolutely right.

I will take an intervention from the hon. Lady from Wales, but then I will not take any more because I fear I am really testing your patience, Mr Deputy Speaker.

Lindsay Hoyle Portrait Mr Deputy Speaker (Sir Lindsay Hoyle)
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It is not about my patience, but about Back Benchers.

Liz Saville Roberts Portrait Liz Saville Roberts
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I have only one question: will the hon. Gentleman explain why the Welsh Labour Government have outsourced dialysis services at Wrexham?

Jonathan Ashworth Portrait Jonathan Ashworth
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We have always said that there is a small role for the private sector. This is what I said earlier—[Interruption.]

Lindsay Hoyle Portrait Mr Deputy Speaker
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Order. I want to hear Members on both sides, and I certainly want to hear the answer, but I cannot do so if everybody is shouting.

Jonathan Ashworth Portrait Jonathan Ashworth
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We have always said that, and I do not know why Government Members are so surprised about it. Indeed, the Prime Minister, thinking she had a humdinger, quoted me at Prime Minister’s questions, but I was decidedly nonplussed by her response to my right hon. Friend the Leader of the Opposition.

Perhaps the biggest area in which private contracts have gone out is in community services, where the private sector has taken over 39% of contracts compared with the 21% in the NHS. NHS Providers said last week:

“The fragmentation of the community sector is…due to the private provider share of the community…service market being much larger than in other sectors”.

It also said:

“it is almost always a legal requirement for commissioners to go out to tender competitively for community services. Tendering for contracts is therefore much more competitive in the community sector than in the acute sector, and contracts are sometimes won on cost savings, rather than improvements in the quality of care.”

We have seen this time and again. For example, Serco was awarded a £140 million contract in Suffolk, but could not meet key response times, such as the four-hour response time for nurses and therapists to reach patients at home 95% of the time. Before Serco took over the contract, the target was achieved 97% of the time.

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None Portrait Several hon. Members rose—
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Lindsay Hoyle Portrait Mr Deputy Speaker (Sir Lindsay Hoyle)
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Hopefully we will get some Back Benchers in, but I warn them that they will get no more than four minutes each. That may have to come down and some Members may not get in.