– in the House of Commons at 1:04 pm on 8 July 2003.
I beg to move,
That,
(1) Paragraphs 4 and 5 of the Programme Order of 7th May 2003 relating to the Health and Social Care (Community Health and Standards) Bill shall be omitted.
(2) Proceedings on consideration shall be taken in the order shown in the following table, and each part of the proceedings shall (so far as not previously concluded) be brought to a conclusion at the time specified in the second column.
Proceedings | Time for conclusion ofproceedings |
Amendments relating to Clauses in Part 1; New Clauses relating to Part 1; new Schedules relating to Part 1; amendments relating to Schedules 1 to 4. | 3¼ hours after the commencement of proceedings on the motion for this Order. |
New Clauses relating to Part 2; amendments relating to Clauses in Part 2; new Schedules relating to Part 2; amendments relating to Schedules 5 to 8. | 4¾ hours after the commencement of those proceedings. |
New Clauses relating to Part 4; amendments relating to Clauses in Part 4; new Schedules relating to Part 4; amendments relating to Schedule 10. | 6½ hours after the commencement of those proceedings. |
New Clauses relating to Part 3; amendments relating to Clauses in Part 3; new Schedules relating to Part 3; amendments relating to Schedule 9; New Clauses relating to Part 5; amendments relating to Clauses in Part 5; new Schedules relating to Part 5; amendments relating to Schedules 11 and 12; New Clauses relating to Part 6; amendments relating to Clauses in Part 6; new Schedules relating to Part 6; amendments relating to Schedule 13; remaining New Clauses and new Schedules; remaining proceedings on consideration. | 7 hours after the commencement of those proceedings. |
(3) Proceedings on Third Reading shall (so far as not previously concluded) be brought to a conclusion 8 hours after the commencement of proceedings on the motion for this Order.
I think that those are probably the only cheers that I will get this afternoon.
We have drafted the programme motion in an attempt to be fair to all sides of the House. The amendments selected for debate today concentrate largely on part 1 of the Bill. That is why the motion devotes the lion's share of the House's time this afternoon to consideration of those amendments.
Clearly, the rest of the Bill is no less important. I hope that the House will find the divisions that we propose acceptable. We have allowed one and three quarter hours for debate of the new GP contract clauses. Many hon. Members will know that the contract is the result of two years of negotiations between the NHS Confederation and the British Medical Association. The clauses make the changes to the primary legislation that will allow us to make the new contract a reality. It may help the House if I explain that both the NHS Confederation and the chairman of the BMA's general practitioners committee, Dr. John Chisholm, have indicated to me their support for the Government's amendments.
Aside from the GP contract clauses, the Government's amendments are intended—
I am extremely grateful to the Minister for giving way, but does he think that those eminent doctors will be satisfied with what they took two years to decide being disposed of by the House in less than two hours?
Given the very high quality of the debate that we will have on that part of the Bill, I have no doubt that they will be perfectly satisfied with an hour and three quarters. I hold the hon. Gentleman in high regard, and I do not want to minimise the point that he makes, as the provisions are very important. I refer to the agreement on these clauses that we have reached with the confederation and the BMA simply to try and reassure hon. Members that the Government's proposals command widespread support in the NHS. I hope that the House will find that helpful.
The Bill provides that much of the detail in it may be prescribed in regulations. The Minister will understand that that has relevance for the amount of time being allocated for debate. To what extent will those regulations be subject to debate in the House, under the affirmative resolution procedure? That such debates will be required is obvious not from the structure of the new clauses themselves, but from reference to previous legislation.
The regulations will be passed under the negative resolution procedure. I am sure that the hon. Gentleman will want to raise that point in the debate, and that the matter will arise in another place. However, the proposed format is the one used in the existing legislation for the regulations concerning the general medical service contracts, and we are not suggesting that the new proposals receive any less parliamentary scrutiny in this place. Last week, we circulated a set of explanatory notes and information about how the regulation-making powers are intended to be exercised. I hope that the hon. Gentleman and other hon. Members have found that helpful.
This part of the Bill deals with primary care services and, as usual, looks fiendishly complicated. However, the Government are proposing a simplified and more streamlined system for implementing the GMS contract. A smaller volume of secondary legislation will be needed to underpin it. That is one of the principles that we have adopted in framing the provisions.
The programme motion also provides an hour for the Third Reading debate. I believe that it is a fair and balanced attempt to ensure that the House has appropriate opportunity to consider the amended Bill properly. I hope that the House will support the motion.
The Minister's opening statement that the programme motion has been drafted in an attempt to be fair to all sides of the House gives us a good indication of what the Government's definition of "fairness" is. Before today's debate, 60 clauses had not even been considered in Committee. A total of seven hours for debate today is an insult to the House, in terms of the sheer volume of amendments that we might have to consider. There are 250 amendments and new clauses in the first group selected for debate, Mr. Speaker. I do not know whether you can recall a Bill with that sheer volume of amendments and new clauses, but I doubt that there has been one that has been guillotined to this degree.
Thus, in an extremely short time, we have to consider the whole issue of foundation hospitals, their complexity, their borrowing rights, the role of the regulator, cross-border matters, terms and conditions of service, asset disposal, governance, the role of centrally determined targets, the effects of creating a two-tier system, the interface with the private sector, the cost of maintaining a foundation hospital board and the complexity of the electoral process—and that is just the first group. We then get to the complaints procedure, standards for health and social care—another hugely important issue—provision in cross-border areas and the regulation of social care services, including those for children.
We shall then have one and three quarter hours to debate the whole of the contract that will shape the future of primary care—the whole of it. Until now, we have had no chance, during the whole passage of the Bill, to debate that matter. That shows the importance that the Government accord the whole issue of the forward path for primary care—one and three quarter hours.
We then have to deal with NHS charges and welfare food schemes. To try to squeeze all that and a Third Reading into the time on offer is hugely offensive to many Members; they may hold differing opinions on the issues, but they believe none the less that the House should be given appropriate time so that every voice can be heard.
To add insult to injury, leading the debate for the Government is a Secretary of State who represents a Scottish constituency. He will be trying to push forward measures in England that he will not be forcing through for his constituents in Scotland, using up debating time in this place. Furthermore, the Bill will be backed and voted for by Members representing Scottish and Welsh constituencies who have no say on health in their own constituencies but will be trying to apply these measures to voters in England.
The hon. Gentleman may not have noticed that Northern Ireland is also represented in the House and that we try to play our part in United Kingdom business. Will he accept that although we would like to play a full part, that is being denied us today, because the Northern Ireland Grand Committee is sitting while this important measure is being debated in the Chamber?
That is an important point and I am sure that you will have taken note of it, Mr. Speaker, on behalf of the smaller parties that would like to have their say.
The whole debate is an insult to patients in England; it is an insult to the House itself. The contempt it reveals in the Prime Minister's regard for the House shows that the House of Commons has become little more than Downing street in Parliament.
I shall be relatively brief, as I do not want to eat into the time.
We in the Scottish National party and Plaid Cymru also oppose the programme motion, but for different reasons. Dr. Fox said that the measure does not impact on Scotland and Wales; indeed, this morning, I heard an hon. Member say on the radio that the Scots should keep their noses out of English business. In fact, however, significant parts of the Bill will directly affect Scotland and significant parts will have secondary effects in Scotland, including the provisions on foundation hospitals.
We believe that much more time is needed to debate the full implications of the establishment of foundation hospitals in England for health service provision in both Scotland and Wales. For example, the programme motion could give as little as two and a half hours fully to debate the implications of foundation hospitals, and although clause 1 states that foundation hospitals will be only in England, there is increasing concern in both Scotland and Wales that there could be severe knock-on effects on health service provision owing to the operation of the Barnett formula.
Scottish and Welsh health care is funded from the block grant, which is driven by Barnett consequentials, based on English funding for services devolved to Scotland and Wales. Although the Scottish Executive and the Welsh Government decide what proportion of the block is spent on health care, the extent to which the size of the overall block is affected may affect the choices open to them.
We do not believe that the timetable motion gives enough time for a full debate on that issue. Wider debate, involving the Treasury as well as the Department of Health, is required on the whole funding issue.
Ours is a national health service and the whole kingdom has been proud of it over the years. Because there is movement across borders, it is important that we look at the measure in greater depth than is proposed today.
I accept the hon. Gentleman's point. The proposals for foundation hospitals give rise to serious issues that affect Scotland, Wales and Northern Ireland. For those reasons, we need more time to debate the measure both on Report and on Third Reading than has been provided under the programme motion, so we oppose it.
As one of the unwhippable Members to whom Mr. Hogg referred, I speak on behalf of many ordinary people who are amazed and concerned that we are given only eight hours to discuss this extremely important Bill. Other right hon. and hon. Members have pointed out the limited number of hours for each item.
What makes it worse is that we have been presented with so much new information in the last 24 hours. The paper on the GP contract has 53 pages. The response to the Select Committee on Health report on foundation trusts, which amazingly came out only yesterday, two months after the report was published, contains a further 30 pages. The Bill is so vast that only a small proportion of it will be covered today.
May I remind the House of an old proverb? My book claims that it is an English proverb, but it would be close to the hearts of Scottish people, too. It is:
"Wilful waste makes woeful want."
Wilful waste of parliamentary time on less important issues has led to a woeful want of time to debate all the vital issues raised by the Bill.
I have some sympathy for the remarks of Dr. Fox about the consequences of devolution, but I have complete sympathy with, and subscribe wholeheartedly to, the rest of his views on the programme motion.
Part of the reason for our despair at the short time for the debate is that it is difficult to hold a proper and wide debate in Committee of issues such as foundation trusts when none of the Committee's members share the strongly held views of the Labour Members who have tabled so many of the amendments. All their concerns have to be expressed and all their points made on Report, where time is always limited, rather than in Committee. Even so, it seems astonishing that such a Bill should be allocated only one day on Report. Indeed, when I heard that the new proposals on the GP contract would be dealt with only on Report I thought that we should need three days rather than two, so to find that only one day had been provided was a bitter disappointment, not only to those of us, on both sides of the House, who want to scrutinise the Government's proposals, but also to our electors who expect us to do that job.
The part of the Bill that deals with the future and independence of the quality inspectorate is even more important than the provisions on foundation hospitals. Despite representations from the Liberal Democrats in the Standing Committee and in the Programming Sub-Committee, we did not reach many of those clauses in Committee, even though, compared with other Committees on which I have served, we made brisk progress. Indeed, a whole section on the social services inspectorate was not covered at all. Under the timetable, it is extremely unlikely that we shall reach the clauses on the inspection of children's services and social care.
Given that there is no desperate urgency about the passage of the Bill, and that the programme motion provides for less than one minute to be devoted to debate on each new clause and amendment relating to foundation hospitals, can the hon. Gentleman think of any reason for the programme motion other than a desire on the part of the Government to limit to an absolute minimum the opportunity for their Back Benchers to excoriate them?
The hon. Gentleman's suggestion is the favourite runner. There may be other reasons, but I have heard none more persuasive.
The new clauses on the GP contract are also of concern. Presumably, they were prepared on the assumption that GPs would support a contract that they had negotiated, before the realisation that someone had got their sums wrong so the contracts would have to be renegotiated and the ballot postponed. One has to ask why we were presented with the new clauses on the Order Paper only yesterday and why, uniquely, a letter dated
I should have thought that we would be given more time to consider such serious issues and to suggest amendments. Indeed, the only amendment that has been selected to those new clauses is, of necessity, starred. I suppose that I am grateful that it has been selected at all, but hon. Members have not been given time to consider those new clauses. In effect, we will have no real scrutiny of those new clauses.
The Government have to understand that the impact of our failure to give proper scrutiny to those new clauses in this House makes it much more likely not only that the other House will despair of the ability of this House to hold the Executive to account, but that the Lords will feel it incumbent on them to do so, and I would support them if they considered that factor.
If we could debate and divide on some of those measures, the Government's objection to being held up in the House of Lords might have more merit, but their failure to provide the House with the ability to scrutinise gives more power to the arm of those in the House of Lords who desire to ensure that adequate scrutiny takes place. So I join the hon. Member for Woodspring in being appalled at the short time that we have been given to debate these serious matters.
I do not always agree with Dr. Harris, but I agree with everything that he said in his brief speech. I am appalled that we have such a short time to debate the Bill, and I would have hoped that the Secretary of State for Health would be appalled too. He was beginning to show the House that he was a robust defender of the House's privileges, when he was Leader of the House, all too briefly. He was beginning to show the House that he understood the importance of holding the Government to account. He was beginning to show the House that he really believed that legislation should be properly scrutinised and thoroughly debated before passing on to the statute books. He was beginning to show the House that he thought that this House, as well as the House of Lords—the other place—should debate things thoroughly, with care and diligence.
After 10 short weeks, the right hon. Gentleman was translated into a new job, and he seems to have forgotten all the principles that he was beginning so impressively to embrace. I find that deeply distressing because he is now party to an exercise that is an insult to each of our constituents—frankly, Mr. Speaker, it is an insult to you too—because the House is not being given an adequate opportunity to debate a measure that directly or indirectly affects the lives of each of our constituents. That is monstrous. The Government's distortion of priorities is shown by the fact that, just over a week ago, we spent a whole day on fox hunting, time which could have been devoted far more properly and profitably to this measure, which touches the lives of our constituents far more than fox hunting does.
Does my hon. Friend share my concern that today's hypocrisy may be considerable? The scent of the blood of a ban on fox hunting may be still in Labour Members' nostrils to such an extent that they think that they can reduce opposition to foundation hospitals and squeeze the proposal through. In fact, the link that he makes between fox hunting and today's proceedings could be considerable and very cynical indeed.
Oh yes, of course, we all know that almost everyone has his or her price, but I do not have one, and I am most anxious to ensure that, once again, the House is regarded throughout the country as the place where the nation's affairs and the legislation that touches the lives of its people are thoroughly and properly debated. We are now in an era of the compulsory guillotine. Every measure brought before us—there are far too many of them—is put in the straitjacket of a timetable, and hon. Members are not given an opportunity for debate.
This happens to be an issue where many Labour Members have honourable differences with their Government. Frankly, I am rather inclined to agree with the Government, rather than those Labour Members, but the fact is that the issues that they would raise are important and far reaching and they deserve very thorough debate; but hon. Members will not have the opportunity to take part in those debates. That is a monstrous affront to the parliamentary integrity of this country, and the Secretary of State should be thoroughly ashamed of himself.
I want briefly to agree with my hon. Friend Sir Patrick Cormack, but I want to express a slight note of disagreement with Dr. Harris, who expressed surprise that the Government had introduced the timetable motion. Over the past few years, the one thing that we have not needed to be surprised about is the Government's willingness to guillotine and closely schedule debates either on the Floor of the House or in Committee. Although I agree with the general thrust of his argument, surprise is not an emotion that washes over me this afternoon.
I wholeheartedly agree, however, with my hon. Friends the Members for Woodspring (Dr. Fox) and for South Staffordshire and with the hon. Gentleman, and I worry at times that the Government have completely lost sight of what they are for and what Parliament is for. We all agree that, by and large, a Government who are elected with a large majority are entitled to get their business through the House. We also accept that, on free vote issues—I understand that this is not a free vote issue—the will of the House of Commons is entitled to have its way, but if we are to admire democracy to that extent, we fool ourselves if we suborn the process.
I fear that the Government are guilty of suborning the democratic process, and a democratic process that is only that in name is no democracy at all. Hardly a day goes by now without some sort of timetable motion being put to the House by the Government, as though it were a matter of real choice. It is not a matter of real choice; it is thought up in No. 12 Downing street by the Chief Whip and the other business managers. It is imposed on the relevant Secretary of State or junior Minister who has to carry that business, and it is then imposed on the House by a compliant and suborned majority. The longer the Government go on like that, the more they will resemble the Government of the current president of Zimbabwe. [Interruption.] Those groans speak volumes, and Mr. Field and I have our differences with the Government over their handling of pensions issues, debate on which they have crushed by using timetabling. Our political views differ on a whole host of things, but both of us, as democrats, share an understanding that the need to respect the process of democracy is every bit as important as the right of a Government with a majority to get their business through the House.
We can bleat about the Government's role in this timetable motion—I will continue to bleat as often as I possibly can, even though I am entirely powerless—but eventually hubris will overtake the Government, and eventually the public will have their say and the guillotine will be of a rather different nature.