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I am saying to the hon. Gentleman that the previous Government had a process at the end of which was an independent panel—the independent reconfiguration panel—to take a decision on whether a proposal was right or wrong in the interests of patient safety, which was the driving principle. I will defend the changes we made to improve services. I have given him the example of stroke services in London. The Opposition are not against making change in the NHS, but we are emphatically in favour of local people in areas such as his having the ability to have their say in the process. Clause 119 seeks to drop solutions on local people from on high.
Our policy was set out in the Carruthers review, commissioned by Patricia Hewitt in 2006, which concludes:
“Reasons for change should be built on a clear evidence base of clinical and patient benefits.”
That principle guided the Darzi review towards the end of the previous Government, which put quality centre stage. The Darzi review influenced the plans for stroke services in London and others, and the difficult changes we planned to make in south-east London before the last election. A detailed consultation, “A Picture of Health”, had brought together a case for change to how services were delivered across the area. It was given formal approval before the election, but was subject to the Government’s moratorium after it.
In the space of a few years, Ministers have gone from campaigning outside hospitals to save services to campaigning for extra powers to close them down without debate. That will leave the NHS more top-down than ever before, with the patient and public voice utterly marginalised.
I want to deal with whether clause 119 gives powers to shut down services for clinical reasons. The fact is that the CQC already has power to take urgent action to shut down unsafe hospital wards or services. Nothing in the clause allows the failure at a single trust to be dealt with any quicker than it was previously. In fact, the clause extends the period the TSA can spend on drafting the report, elongating what was designed to be a very quick process.
Opposition Members are clear that the clause adds nothing, but instead takes away the patient, public and professional voice, and establishes the dangerous principle that changes to hospitals can be financially and not clinically driven. We will vote for amendment 30 to delete the clause, but we will also back new clause 16, tabled by Paul Burstow, which returns a degree of power to local people.
I am sorry that the Secretary of State is not here, but I ask the Minister to pass on my message to him. The NHS does not belong to him to chop and change as he pleases. It belongs to everyone. He would do well to remember that. The way to achieve change is to involve the public early on, give them a meaningful say and build confidence in the clinical case for change. Clause 119 sets back that cause and will damage already fragile confidence in hospital reconfiguration. In the end, that is the most powerful argument against it. By shutting the public out, the measure risks creating a backlash against change in the NHS when it needs to change to survive. I appeal to Members on both sides of the House to think about that and to put constituency before party when voting on this crucial measure.