Clause 40 - Short title, interpretation,commencement and extent

NHS Reform and Health Care Professions Bill – in a Public Bill Committee at 2:45 pm on 13th December 2001.

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Question proposed, That the clause stand part of the Bill.

Photo of Simon Burns Simon Burns Shadow Spokesperson (Health)

I will be brief, but as we are nearing the end of the Bill, it would be remiss of me not to end, or almost end, on the point on which I began. The clause deals with, among other things, the commencement of the Act, if and when it becomes one. That brings us back to the argument of whether the Government are rushing the introduction of PCTs and strategic health authorities too quickly.

I will not test your patience, Miss Widdecombe, by rehearsing yet again the arguments that Opposition Members made vigorously in the early stages of the Committee. However, I want to put it on record, if only to protect myself in a year or 18 months' time when there is an utter shambles, that we the Opposition flag up that we are as concerned as we were at the start of the Committee that the Government's reforms, on PCTs in particular, are being rushed. We still believe that it would have been wise and sensible to have postponed enabling PCTs to act as they will under the legislation for six months, until April 2003.

I will leave it there, having simply put it on the record that we have warned the Government and shown them what we believe is the folly of their undue rush. If, sadly, our fears become reality, the Government must realise—unusually for this

Government—that they have only themselves to blame for the shambles and confusion. They have been more than adequately warned.

Photo of John Hutton John Hutton Minister of State, Department of Health, Minister of State (Department of Health) (Health)

The purpose and effect of clause 40 are self-evident. I do not want to say much about it. It is a standard clause, setting out the Bill's short title and a range of other technical matters concerning commencement.

I want to respond briefly to the hon. Gentleman's final, acerbic comments about the process of NHS reform. I understand, as do, I think, all my hon. Friends, that the hon. Gentleman and his party are opposed to the reforms that we are introducing, and to the scale and pace of them. That is well documented. His comments in that regard do not need to be added to the record any further.

It is untrue to describe the present process either as a shambles or as in any way dependent on the provisions of the Bill. I tried to explain to him earlier—it seems like a long time ago—that the PCTs that are being, or that have already been, established are not being set up under the terms and provisions of this Bill. How could they be?

Photo of John Hutton John Hutton Minister of State, Department of Health, Minister of State (Department of Health) (Health)

The hon. Gentleman says that he understands that, but he has repeated the argument that we are using the Bill to rush forward the establishment of PCTs. That is simply untrue. The power to establish them was contained in the Health Act 1999. All that this Bill does in relation to PCTs is to require the Secretary of State to maintain universal coverage of them. The process of establishing them has nothing whatever to do with the passage of this Bill.

We do not want to be swapping prophecies and predictions of the future across the Committee—that would be pretty tedious. If either I or the hon. Gentleman should be proved wrong in future about the passage of these reforms, I have a strong feeling that it will not be me.

Photo of Simon Burns Simon Burns Shadow Spokesperson (Health) 3:00 pm, 13th December 2001

May I just correct something? We fully understand that the powers to set up PCTs are not in the Bill. We have never said that; PCTs were established under the Health Act 1999. The Minister does not seem able to grasp that. Perhaps I am not making myself clear enough. Without going into great detail, the 1999 Act provided the statutory power for PCTs to be established on a voluntary basis.

The Minister said that by October next year every area will have a PCT and a strategic health authority. That is a complete change from the current system, and 75 per cent. of the funding will go to the PCTs. That situation is a consequence of the Bill, even though it does not create it. Many PCTs are in a fragile state. That is not a criticism, because they are new bodies finding their feet and establishing themselves. Some of them have not yet even become PCTs, so they are even more fragile.

We are simply saying that instead of ensuring that every area has a PCT by October next year and that they are getting the 75 per cent. funding and carrying out the functions envisaged under the Bill, the Government should leave it for another six months to give them a breathing space to bed themselves in and to gain more experience and expertise to be able to carry out those functions.

The Minister says that we are against all this, but he is a fair man, so he should admit that we are not opposed to the concept of PCTs and never have been. We did not fight the last general election on a policy of getting rid of PCTs. It is unfair for the Minister to draw the conclusion that we are against PCTs per se, and it would be gracious of him to recognise that. We simply think that they should have a little more time to bed in and establish themselves before taking on this massive transformation in their roles once they start receiving the money to provide local health care.

Photo of John Hutton John Hutton Minister of State, Department of Health, Minister of State (Department of Health) (Health)

I do not want to maintain this argument, because it is running the risk of becoming rather repetitive. We have been over the tracks many times.

I am prepared to accept the hon. Gentleman's assurances that Conservative Members support PCTs and their new role. He is right to say that he has made their position clear in the past. I recognise that what they object to is the pace at which we are moving towards PCTs assuming their responsibilities. Nevertheless, I think that he is wrong. If we believe in devolution to the front line by creating a devolved NHS that looks less like the monolithic top-down command-and-control organisation that it is, the sooner that we can do so the better.

However, I take to heart the hon. Gentleman's admonition that we must do it in a way that allows the PCTs to discharge their responsibilities effectively. Conservative Members have made reasonable criticisms in the course of our proceedings. We have been working hard to support PCTs in taking on their new responsibilities, and I am confident that as we move to 100 per cent. coverage under the voluntary

provisions in the Health Act 1999 they will be fully adequate in discharging their important responsibilities.

Question put and agreed to.

Clause 40 ordered to stand part of the Bill.

Question proposed, That the Chairman do report the Bill, as amended, to the House.

Photo of John Hutton John Hutton Minister of State, Department of Health, Minister of State (Department of Health) (Health)

I welcome the progress that we have made, Miss Widdecombe, and express to you and Mr. Hurst my appreciation, and that of my hon. Friends, for the expert way in which you have both chaired the Committee's proceedings. I know that Ministers often say that at this point, but I mean it most sincerely. You have been firm, clear, decisive and, above all, fair to both sides of the Committee.

I am also grateful to the Clerks and all those who have facilitated the prompt and efficient dispatch of this important Bill.

Photo of Simon Burns Simon Burns Shadow Spokesperson (Health)

On behalf of the Opposition, Miss Widdecombe, I join the Minister in thanking both you and Mr. Hurst for the way in which you have chaired our proceedings. This has been a hard-fought Committee on points of policy, and we, as a responsible Opposition, have sought to help and guide the Government and to encourage them to avoid some of the pitfalls that we believe that they are opening up for themselves. However, the proceedings have not been marred by rancour or unpleasantness. Of course, it would have been marvellous to have heard more contributions from Labour Members. I was awaiting with interest the speech by the hon. Member for Crawley on the manuscript amendments, owing to her great concern about the issue. Overall, it has been a pleasure to serve on the Committee.

Photo of Ann Widdecombe Ann Widdecombe Conservative, Maidstone and The Weald

I thank both hon. Gentlemen for those comments, and add my thanks to the police, Hansard, the Clerks and, indeed, members of the Committee, who made it easy for me to learn about the role of Chairman and ease myself into it. I am sure that as a result of this Committee's model conduct I shall now be unleashed on something much worse.

Question put and agreed to.

Bill, as amended, to be reported.

Committee rose at seven minutes past Three o'clock.