Private sector involvement in the NHS will always be an emotive and contentious subject. As members of the party that founded the NHS, we on the Labour Benches are clear that there are, have been and always will be times when the private sector can and should provide an important function in supporting the delivery of NHS care, but recognising that role is in no way comparable to opening up the NHS to full-blown privatisation, which is the clear intention of the Government’s Health and Social Care Bill, a shambolic piece of legislation that is quickly acquiring the same level of popularity as the poll tax. There is a world of difference between using private providers to support the work of the NHS and privatising the NHS. This legislation and the Government’s desire to set free the ravages of the market on what we believe to be the country’s most treasured institution commands no public support and no democratic mandate.
The reality is that the NHS, as a publicly owned and publicly funded world-class health care service providing medical care free at the point of need, is one of the defining institutions of our society and one of the most important hallmarks of our national identity. Established in the aftermath of the greatest conflict our country has ever faced, the NHS was built by a tired nation and an exhausted people from the wreckage of the second world war. They knew that it would help to build a better country and that it could not be done by the private vested interests that so bitterly opposed its creation, and they were right. Every Member of Parliament must recognise that to the people we serve and to our country as a whole the NHS is more important that any of us, collectively or as individuals, and that it is much more important, more trusted and more respected than any one of the political parties represented in the House.
Politicians across the House must recognise that they damage the NHS at their peril. The public do not want the NHS to be opened up to the market, because they know where that leads: the wealthy customer will take priority over the patient in need. The Government know that the public would never have voted for any party with that objective at the heart of its health policies. For that reason, the privatisation of the NHS is being undertaken by stealth. It was a former Conservative Secretary of State, Michael Portillo, who told the BBC’s Andrew Neil last January that the Conservatives
“did not believe they could win an election if they told you what they were going to do because people are so wedded to the NHS.”
We in this Chamber are often too slow, too ungracious and, frankly, too partisan to pay tribute to those outside our own parties when tribute is deserved, so I now commend the four Liberal Democrat MPs who voted against the Bill on Second Reading. They did so not simply because it was not in the coalition agreement and has no democratic mandate, and not just because they recognise that the NHS is bigger and more important than any of us or the fortunes of any political party, but because they recognise that the Bill paves the way for the privatisation of the NHS. May I just say “Ahoy” to the Education Secretary, who has just entered the Chamber?
To paraphrase Andrew George, for whom I have a great deal of respect, those Liberal Democrats at least did not want to become the architects of the NHS’s demise.
We have heard many promises from the Prime Minister on the NHS, none of which, sadly, is backed up by his or his Government’s actions. He promised real-terms increases for the NHS, but in his first year in office he delivered a real-terms cut. He promised no top-down reorganisation, yet he delivered the biggest and most unwanted reorganisation since the NHS’s creation. Most sickeningly of all, he played fast and loose with the trust of health campaigners across the country when he promised a bare-knuckle fight against hospital and ward closures. Now the Department of Health talks openly of nationwide hospital closure programmes, and wards and services are being lost all over the country.
It is essential to listen to health professionals on matters of health service reconfiguration, but it is deceitful to pretend to oppose those reconfigurations, to trade on the hopes and fears of ordinary patients and to say one thing in opposition and do another in government. But it is perhaps the Prime Minister’s assurance of “no privatisation” in the NHS, given in May last year, that illustrates that pattern of behaviour most clearly.
Last year, Mark Britnell, one of the Prime Minister’s hand-picked health advisers, told a conference of private health care providers:
“In future, the NHS will be a state insurance provider, not a state deliverer.”
“The NHS will be shown no mercy and the best time to take advantage of this will be in the next couple of years”—[ Interruption. ]
I advise those Government Front Benchers who are chuckling—perhaps the bars have closed early—to dwell upon the phrase “no mercy”.
With the shambles of a Bill plunged into crisis, the Prime Minister was forced to demonstrate that he was across the detail of the legislation, and in a speech at Ealing hospital he said:
“Let me make clear: there will be no privatisation… These are red lines we will not cross.”
Yet just before the Christmas period, perhaps ignorant of the Prime Minister’s guarantee or based on the fact that there is no mandate for the changes and the Government are not in the habit of ever doing what they say they will, the Secretary of State tabled amendments to his health care Bill which would allow NHS hospitals to devote 49% of their beds and theatre time to private patients, opening the door to an explosion of private work in NHS hospitals and inevitably resulting in longer waiting times for ordinary NHS patients and widening health inequalities not just between but within different communities throughout England.
I therefore call on the Government to answer this simple question: how can it be right to allow the wealthiest in our country to use publicly funded services, paid for by the taxes of those most in need, to jump the NHS waiting lists that are now growing under this Government?
That is a Mickey Mouse policy, and speaking of Mickey Mouse I should say that Members who have been to Disneyland or any other holiday park for that matter—perhaps on a Tory party policy seminar—will have seen fast-pass systems in operation. The fast-pass system works in exactly the same way that the Government hope 49% private sector involvement in the NHS will: everyone pays to get into the theme park, the queues are too long so the richest pay more to beat them, and eventually all but the poorest buy the fast pass and the queues become as long as they were in the first place. The only difference is that everyone ends up paying double for the same queues they were suffering at the beginning.
The Prime Minister may not want to admit to the privatisation of the health service, and he may not be able to acknowledge that his attempt to change his party, based on a cosmetic change of attitude to the NHS, was never real and was always hollow, but the inescapable reality is that his Government, through the Health and Social Care Bill, are taking a sledgehammer to Britain’s most valued public service by not simply allowing but encouraging, as a matter of principle, a private sector free-for-all in England’s health service.
That is why in a speech in November last year the Prime Minister stated that he wanted the NHS
“to be a fantastic business for Britain”— a line strangely omitted from the official transcript of the speech—[ Interruption. ] The Minister of State, Department of Health, Mr Burns, chunters from a sedentary position, but he himself told “Newsnight” in January last year that the Prime Minister’s Bill would turn the NHS into a “genuine market”.
Labour Members believe that the NHS is an unprecedented force for good in our society, the mainstay of so many of our communities and the guarantor of a fairer, better society. We believe it speaks to who we are and what kind of nation we aspire to be. It is not the Prime Minister’s to sell, and it is not for sale.
“I don’t want you to trust David Cameron…he has values that I don’t share.”
The Minister was right then, and if we listen the to the rank and file membership of the Liberal Democrats we find that that is what they believe now.
The inescapable reality is that the Liberal Democrats find themselves in a constitutionally and historically unique position. They can now determine the future of the NHS in England, as either a world-class public service treating people equally, providing medical care to those who need it and free at the point of use, or as a fragmented, US-style health system, which will see publicly owned hospitals, publicly funded services and health professionals employed by the public purse giving up 49% of hospital beds and theatre time not to those who need them but to those who are most able to pay for them. That is an enviable responsibility, and the Liberal Democrats Members can stop that creeping, stealth privatisation of the NHS. The Minister was right to distrust his Prime Minister, and his party colleagues can stop this attempt to take a wrecking ball to the NHS as we know it.
“What we will see with private providers is a fragmentation of the NHS, with no accountability…we will see the diminution in the quality of care. And unfortunately what we are seeing with the breast implant scandal is the future of the NHS, it will be destroyed.”
Tonight, the Secretary of State has dissembled and fumbled his way through an attempted defence and explanation of the Bill, but he could not provide it. He does not know what he is for, what he is against, what he is replacing or what he is introducing. It is no wonder that the medical profession neither believes nor trusts him. He either does not know what his policy is or he is afraid to say. The country deserves better. This is now a bare-knuckle fight and the Government must think again.