Health and Education

Part of Debate on the Address – in the House of Commons at 1:16 pm on 11 December 2008.

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Photo of Andrew Lansley Andrew Lansley Shadow Secretary of State for Health 1:16, 11 December 2008

What I said was that Ministers probably think that silence betokens consent, but in my view silence means contempt— [ Interruption. ] No, I have said it twice, and that is sufficient, even for the purpose of educating the Secretary of State for Children, Schools and Families.

I regret the lack of engagement with the idea of an NHS constitution. My third point is about substance, and there is an opportunity for substance there. We could have had legislation in prospect that would genuinely put the values of the NHS into primary legislation. We could have NHS bodies given greater freedom and autonomy, which the Prime Minister said—before he became Prime Minister—that he favoured. It turns out that he is not remotely interested in giving those freedoms to the NHS.

A constitution could do what constitutions are bound to do—define in statute for NHS bodies, often for the first time, their respective duties and responsibilities, both within the service and towards patients. A constitution could give patients choice, and a voice, after the Government have so disgracefully dismantled any effective statutory voice for patients at a national level. It could also strengthen the link between inspection and complaints. The Government have just legislated—wrongly—to remove from the new Care Quality Commission responsibility for the consideration of second stage complaints and hand it to the Parliamentary and Health Service Ombudsman. How can the new Care Quality Commission acquire and use intelligence about what is happening in the NHS if it does not have a responsibility to investigate unresolved complaints?

The ombudsman will get £4.6 million, which is less than half the amount of money that is currently being spent by the Healthcare Commission—between £10 million and £11 million—on second stage complaints. The Government blithely assume that the number of second stage complaints going to the ombudsman will be about half the number that currently go to the Healthcare Commission, but there is no basis for that belief. It is at best naive and at worst dangerous. The system is at serious risk, and if that carries on, the NHS will not be the learning organisation that it should be. I urge the Government to reconsider.

The opportunity is there for a health Bill in this Session that could make a real difference. Typically, the Government have failed to take that opportunity. The Secretary of State is pursuing a "do nothing" strategy for the Department of Health—least said, soonest mended. We should not be surprised by that, because before he became Secretary of State he described his approach to his responsibilities. He said, "I just drift along." At least that provides plenty of room for his Under-Secretary, Lord Darzi, to hog the limelight. It is a pity that Lord Darzi has not understood that he is just window dressing for a Government who are chronically incapable of delivering.

I shall give one example. Hon. Members will recall that in October 2007, in anticipation of a general election, Lord Darzi was prevailed on to publish rapidly his interim report. The headline proposal was the Health Innovation Council, which Lord Darzi was to chair. Many people were prevailed on to become members of the council. It was announced that it would spend £100 million on a new health innovation fund—half from the Wellcome Trust and half from the Government. The details of the fund were to be published early in 2008, bids would be sought by the second quarter of 2008 and innovation would, as a consequence, flow throughout the NHS. What happened? The council met, twice, for rather inconclusive discussions; no details of the fund have been published; no bids have been sought; no money has been offered; and nothing has happened. It has all just drifted, again.