Health Bill [Lords]

I congratulate the Secretary of State on his promotion and wish him well. I start by praising NHS staff—our doctors, nurses and all other staff—for the wonderful work that they do. That is worth putting on the record. I was proud to vote for the ban on smoking, and we have just heard an impassioned speech on that subject. I truly believe that voting for the ban is one of the best things that I have done since becoming an MP. I hope that the proposal to introduce a display ban is evidence-based. If I am convinced that it is, I will vote for it, but any legislation should take account of any losses to the businesses involved. It is slightly hypocritical for some Labour Members to say that Conservative Members are addicted to smoking. Unless I am very much mistaken—it may be a selective memory loss—I rather think that the former Prime Minister might have had an addiction to Formula 1 and the advertising of smoking. Perhaps there is some addiction on both sides of the House. [Interruption.] I am pleased to hear that some Labour Members spoke against that. I welcome the concept of an NHS constitution, but I am of the view that what the Bill proposes needs to go further. We need to stop any interference from Whitehall and the constitution needs to recognise that it should be left to professionals to control the day-to-day running of the national health service. Managers, doctors and other health care workers are frustrated by the one-size-fits-all system and structures imposed from the centre. It is time to set them free and to trust them to use their professional judgment. Health care inequalities exist, so it is not sufficient to focus purely on treatment. The real priority must be recognising the causes that led to those problems. Poverty, family breakdowns and location all play a part. It is time to start fixing the problems. It is not just where we are born, however, as where we live can have the most devastating impacts on the care that we receive. I welcome the fact that, according to the constitution, drugs approved by the National Institute for Health and Clinical Excellence will now be available to all who need them, but how can we explain a doctor having to tell a patient that they cannot have a drug that has not been recommended by NICE? We must look further at that problem. If a national health service is to mean anything, it must mean that treatment is prescribed on the basis of clinical need and not home address. Such key issues should be set out in the NHS constitution handbook only after the Secretary of State has guaranteed a wide consultation with interested bodies. Those involved at the sharp end deserve to have their views taken into account—they know best; far better than us. I believe that many of us would share the view expressed by Age Concern that dignity must be at the heart of the NHS. The constitution must provide a firm guarantee of the care that older patients can expect. The constitution has some omissions. For example, where is the recognition of the vital role played by dedicated staff and the need to support them? Also absent is any move to give patients a meaningful say over their health care. The Government may say that they are determined to engage clinicians, but is it not true to say that the early drafts barely mentioned general practitioners? It is widely reported that the Royal College of General Practitioners had to fight to get GPs in the constitution. In fact, is it not also true to say that the constitution is, in its current stage, nothing more than engagement and window dressing? I say that without wearing any stiletto heels. I move on to touch briefly on the issue of innovation prizes. I do not have a problem with rewarding staff, but I do have a problem with how it will be funded and carried out. Getting the NHS suspension policies absolutely right is vital. If we do not do so, we will end up unable to sack senior managers who have proved to be utterly hopeless—or we will see them walk away with huge payouts. The former chief executive of the Barking, Havering and Redbridge NHS Trust in my area walked away with a payoff after working up a £90 million deficit, which I personally find disgusting. I pay tribute to his successor, John Goulston, and his team for turning the situation round. Rewarding failure should no longer be an option. Failed managers should no longer be re-employed by the NHS as consultants and paid with public money. The Bill also attempts to deal with the quality of provision, stating that quality accounts must be produced by all health care providers working for or on behalf of the NHS. I seek some reassurance from the Minister on the accuracy of those data. I am sure that I am not alone in asking whether those supplying the information would not be best served by predicting as rosy a picture as possible. There needs to be rigour. That means publishing only the unvarnished truth, including mortality rates and other key data. Patients will not be empowered unless they know the real story. We must stop talking only about patients' rights. The facts must speak for themselves, so that patients can make up their own minds about where and by whom they want to be treated. Two years ago, the new Secretary of State for Health told the Fabian Society that the next decade would be all about quality, not quantity. Why, then, is Labour still doggedly focused on targets? Even Tony Blair's former adviser admits that they are inherently flawed. Perhaps if the Government had not failed to act on the advice of the new Secretary of State for Health to the Fabian Society, the families of those who have died in places such as Mid Staffordshire would not be grieving today. That is a classic example of the way in which clinical judgment suffers when targets are prioritised. Labour saw the problem—the fault line that threatened to rupture the foundations of its own policy—but, instead of being responsible and doing something about it, lumbered on without regard for the consequences. It is time to stop putting one's own political survival first and to put patients first instead. I want to make three brief points in the limited time available to me. Over the past three years, medical negligence payouts in the London region have totalled a quarter of a billion pounds, with the first amount going to the legal profession rather than the patients involved. That must be looked into as a matter of urgency. When accusations have been made against doctors—I refer not to malicious accusations, but to accusations with substance—those doctors must be suspended while investigations take place. I also want to say something about the accuracy of checks on doctors' qualifications. In my own trust, a Mr. Iwegbu, who used to call himself Professor Iwegbu, has now been told that he can no longer use that title. We do not yet know the reasons, but all qualifications of all doctors must be checked as a matter of principle to ensure that they are what they say they are, and to ensure that the patients on whom they operate know who is treating them. Earlier, the Secretary of State spoke about what he described as the achievements that had been made over the lifetime of the Labour Government. All I can say is that this Labour Government may now be receiving life support.