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The current situation is extraordinary: the Liberal Democrats originally denied our criticisms of the Bill, but they have now suddenly jumped on board, and all I can say is that they are very welcome.
Both Lib Dem and Tory Ministers have claimed that the NHS is a failure, and the Secretary of State said today that he had inherited Labour’s mess. Labour’s mess was to leave the national health service in the best situation it has ever been in: more successful than ever before and improving rapidly, with waiting lists and waiting times reduced to the lowest they have ever been, and with massive improvements in survival rates. From listening to Opposition Members, people would never imagine that when we came to power 5.9 million operations were being carried out in NHS hospitals, yet when the current Government came to power we—or, rather, the people working in the national health service—had increased that to 9.7 million, which is a rise of 64%. For instance, the number of cataract operations carried out each year had increased from 165,000 to 346,000.
There have been massive improvements, and I personally do not give a toss what the OECD says. The national health service is more cost-effective than practically any other system, and it achieved that by making many different sorts of local changes—not structural changes, but by people going about their professional business trying to do things better. The Labour Government facilitated that in a body that is essentially co-operative in its organisation, ethic and culture. That is because it is based on the pooling of costs: all of us pay in, and if we get ill we get treated without having to pay. That is not going to happen any longer, because under the Bill’s provisions both the commissioning bodies and the hospitals will be able to decide to charge for some of the services that are currently free. The new chief executive at the Whittington hospital has told us all that.
There is not just a pooling of cost and risk in terms of patients. There is a pooling of risk and cost across the national health service, so that these co-operative organisations share the costs of providing treatment and care. That will not prevail if they are forced to compete with the private sector because, as John Pugh pointed out, the first, and only, legal priority of private sector organisations is to look after the interests of their shareholders. They will therefore concentrate on creaming off the profitable work, leaving the national health service to try to provide the services that are too expensive for the private sector.
I did not support the bits of privatisation that the previous Labour Government introduced so, unlike the Tories, I have been consistent. UnitedHealth took over three GP practices in my area not that long ago and that American-based company has just sold those three franchises to another supplier without any consultation with local people, patients or staff. It regards its function as taking part in a commercial set-up and a commercial transaction, and that is what we face if this Bill goes through.
The problem is that the transaction costs—the bureaucratic costs—will actually rise. Before the previous Tory Government introduced the internal market, the money spent on NHS bureaucracy was just 4%, but that has increased to 12%. I am willing to bet any Member on the Government Benches that the level will go well above 12%, because once legal contracts are required, once the lawyers, accountants and God knows who else gets involved and has to be paid, and once we end up with court actions, the transaction costs will rise. That is why these proposals are a disaster.