Part of the debate – in the House of Lords at 5:45 pm on 24 January 2008.
My Lords, the noble Earl, Lord Howe, deserves an unusually large pat on the back for bringing this subject forward. It is one of those unpopular, unsexy subjects that has to be addressed.
As I was thinking about what to say, I found that most of what I thought of had already been mentioned. The noble Baroness, Lady Royall, and I have a little game in which we talk about the follow-on costs of government spending. They were mentioned by everyone involved in the debate today. The noble Baroness, Lady Wilkins, gave the best example when she summed up her remarks by saying how what we were doing tied in with the rest of government policy. The Government are spending a great deal of money on welfare to work interviews and so forth for disabled people, which was in the last Welfare Bill. If you remove a product that works, that means people are not mobile. Are you not then counteracting another part of government policy? I will leave that point there because I have made it dozens of times.
The last time we spoke about this I mentioned kicking through the Chinese walls in Westminster to try to get the Government to realise what was happening. That still applies. To concentrate purely on the Department of Health, has the department assessed what it would cost to change a product that is satisfactory at the moment to something does not work in 10 per cent of cases? That is a reasonable question.
If the department finds itself having to provide other services, such as emergency services and admissions to hospital, what would that do to the pricing structure? The general consensus from the briefing that I have received—and people have been on their toes—seems to be that the system is delivering happy customers, patients, clients; call them what you like. There seems to be a degree of satisfaction with the current system. The phrase, "If it ain't broke don't fix it" comes to mind.
Whatever criticisms have been made of the Conservative Benches, being wasteful of public money as a matter of principle is not one that we can readily throw at them—certainly not in theory. One's normal allies in cost-cutting are saying, "Wait a minute, there may be a problem about the implementation of this. It may stop the innovation. Patients who are stable and able to carry on with the rest of their lives will make fewer demands". Has that been factored in? Is that on the balance sheet and, if so, where?
If the Government can answer these questions and address some of these concerns most of us will say "fine". If some of the other services that are provided—the follow-on costs in this process—can be factored in, the answer would probably still be "fine". How will the Government address these concerns? Please let us know, because I have very seldom received, for any debate, briefing that says, "Please don't touch it: it's working reasonably well".
I advise the Government to tread very carefully here because they may incur greater costs further down the line and affect people's lives in a negative way, which would counteract many of their other areas of activity. Can we please be assured that those considerations have been factored in? If they have not, a well intentioned step may counteract good activity in other areas. Can the Government make sure that they address these fears up front in future? At the very least they would save time and energy in Parliament by making sure that parliamentarians—if not people in the outside world—know what is coming. Either the Government's policy or their presentation is wrong. Can they please tell us exactly what is the thinking behind this measure and how they factored in the considerations to which I referred, if they did so? If they did not, I advise them to back off and think again.