Wednesday, 14 March 2012

Respecting the public's views - An MP replies on the Health and Social Care Bill

Like many ordinary people over the last few weeks and months, I have been doing my bit to try and halt the Health and Social Care Bill, which is now on its final stages through the House of Lords before gaining royal assent.

Last week the government lost an appeal against an ruling from the Information Commissioner that they should publish the Transitional Risk Register. In yesterday's debate on the 'drop the bill' epetition, Andrew Lansley said he wouldn't be doing so until the tribunal published its reasons. I expect that once that happens, he will then appeal to the High Court, and during the ensuing delay, the bill will become law.

With this in mind, Lord Owen, a former GP, and Labour Foreign Secretary in the Callaghan government, has tabled an amendment for debate next Monday asking that the bill be paused, until the Risk Register has been published, so all aspects can be properly considered. This amendment will almost certainly be defeated, unless a number of Liberal Democrat peers, and a large proportion of the cross-benchers support it. Hopefully sufficient consciences will be pricked to support it.

This all goes against David Cameron's recent pronouncements that his government will be known for its transparency, though recent rumours that the government is seeking to amend the Freedom of Information Act, and perhaps start charging for it, doesn't inspire much confidence.

Anyway, this debate has been much discussed, and will be over the years, as the HSC Act begins to affect the way health services are provided in England (Wales, Scotland and Northern Ireland run their own affairs.

What I intend to just mention today is the way many MPs have responded to this campaign. In that vein, I would like to pay tribute to the many who have tried to engage properly with correspondents, and not just tried to fob them off because they aren't constituents.

I wrote principly to Liberal Democrat MPs, and recieved many courteous replies, explaining their positions and dilemmas, particularly Stephen Gilbert, Charles Kennedy and Tim Farron. I will also mention is despatches Nick de Bois who was happy to correspond via twitter.

I beleive this shows MPs at their best, willing to engage with the public over issues, and not pretending they are just there to be told what to do. I know many of my colleagues who also campaigned can speak of similar experiences. So below I will post the reply I recieved from Tim Farron, as I made a last ditch attempt at persuasion this week.

I do not agree with much of what Tim says, but he deserves great respect fro taking the time to reply properly, to me and no doubt many other correspondents. This is in marked contrast to my own Conservative MP Priti Patel, who I wrote to a number of weeks ago, and did not even deign to acknowlege my email. That is until I complained and copied the mail to the cheif whip, when I recieved a rather snippy reply from an adviser. To date that is the only reply I have had.

So, again I pay tribute to those MPs from all parties who took the time, and had the courtesy to reply to all correspondents, despite having been deluged over recent weeks. This is Tim's reply:

Dear Mr Hough,
Thank you very much for your message on the Government’s NHS Bill. I am aware that in your correspondence you raised some specific concerns. As you can understand, I have been inundated with correspondence on this matter and therefore it would take a huge amount of time for me to respond to each and every point, but thought it might be useful to outline my position on this Bill here.

I share your deep concern about this Bill. You may know that I did not vote with the Government on this Bill when it was last in the House of Commons. I was a critic of Labour’s competition reforms when they were in power and I am equally critical of these reforms.

When I am in Parliament, my approach is to try and make a difference, and so if I disagree with a Bill I will try to stop it, but I will also be pragmatic and do everything within my power, using amendments and parliamentary procedure, to make such a Bill better – that’s what I did when my party was in opposition and it is what I do now. That has been my approach on the Health and Social Care Bill. I don’t like the Bill, but I have also worked very hard to amend it beyond all recognition. This is not Andrew Lansley’s Bill of 14 months ago, yet almost all of the complaints I receive are from people who do not see how vastly different it is now.

The NHS is financially unsustainable in its present form because the increase in life expectancy and in the cost of medical treatments means that either the NHS drives down costs and is more efficient or else we will end up in the horrific situation of rationing. But whilst reform of the NHS is clearly vital, this Bill obviously has not secured the confidence of the British people or of the medical professions. For those reasons I will continue to vote for amendments to improve the Bill but I will not vote to endorse it.

Having said all of that, I hope you will take my word – without spin or partisan presentation - that this Bill is almost infinitely better than it was 14 months ago when it was first introduced (if that wasn’t true, I really wouldn’t insult you by trying to pull the wool over your eyes). A staggering one hundred and forty amendments were made to this Bill, mostly submitted by Liberal Democrats with some support from Labour and Conservative backbenchers. Whatever you think of the Bill, it would be unfair to ignore the impact that these amendments have made – especially when it comes to undoing the privatisation that Labour did to our NHS via the NHS Act 2006 and blocking the privatisation that the Conservatives have been pressing to include in the Bill.

It is also important to remember that the Bill contains important elements that protect the NHS from the effects of Labour’s privatisations. The 2006 Labour NHS Act let competition out of the bag – competition on price and not quality. For instance, my local hospital has a private surgical unit and we have a privatised out of hours GP unit all as a result of Labour reforms. This Bill contains new regulations to prevent private providers getting the advantages they were given by Labour. So, politically, it’s really tempting to want to ‘kill the Bill’, but anyone who wants to prevent US style competition should want those parts of the competition chapter of the Bill passed.

Here is a short list of some of the critical changes we have made to this Bill:

· reigned in the Tory’s instinct for competition without control by demanding that any competition is entirely based on quality and not price. Patients will be able to choose which care they receive, but this choice will be driven by quality and not by how much it costs to provide it. This contrasts sharply with Labour’s reforms which emphasised competition on the basis of price and which saw private providers being given a 14% premium over NHS providers.

· realigned the purpose of the health regulator Monitor so that it promotes the interests of patients, and not competition, as an end in itself – again, a huge step forward from the competition-focus that Labour left us with and which Mr Lansley wanted. Without this change, there was a real danger that Monitor could end up defending the interests of providers over patients. Thankfully, this danger has been averted.

· made sure that there are much clearer lines of accountability to local authorities and communities, so that clinical experts making the decisions about which health services to provide locally will have to be open about how and why they make their decisions. Some senior clinicians base their opposition to the Bill on their concern that these new lines of accountability will make it too hard for them to close hospitals – something I haven’t heard Labour talk about in public!

· insisted that Foundation Trusts have to demonstrate how the money raised from private income is being used to improve services for NHS patients as part of their annual report. At the moment, thanks to Labour reforms, private income can be solely pocketed by shareholders.

· established a stronger, clearer line of accountability of the NHS to the Secretary of State and to Parliament.

· changed GP commissioning groups Clinical Commissioning Groups, which means that other clinical professions e.g. nurses, pharmacists, physios etc. must be on the group.

· require the Secretary of State, NHS Commissioning Board and CCGs to not only tackle health inequalities, but also to report annually on their progress towards this goal.

· ensure the Secretary of State has a duty to secure comprehensive health care for the whole population and ensure that Clinical Commissioning Groups (CCGs) fulfil this duty.

· require each provider of healthcare services to co-operate with other providers of health and social care services.

· make it clear that the health regulator Monitor has the power to require healthcare providers to promote integration of NHS services.

· make sure patients have a greater say in their health, with the NHS Commissioning Board and CCGs having stronger duties to promote patient involvement in their own care.

I will keep fighting to protect our NHS and to keep it public.

Best wishes,

Tim Farron

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