Health and Social Care Bill

My Lords, I, too, support my noble friend Lady Thornton. I suffer from the disadvantage that it seems to me the amendments are totally clear and it is perfectly obvious what they are saying. I totally agree with them for one specific reason which noble Lords opposite will find extremely disagreeable; namely, that I believe that this Bill paves the way for the end of the National Health Service as it was founded and as we know it and have experienced it. The whole purpose of our deliberations in Committee is to try to save the National Health Service. I am not optimistic that we can do it, because the Government do not seem to be in listening mode on this Bill. The noble Lord, Lord Hennessy, puts his finger on the main question here, which is the ethos of the National Health Service. If someone does not understand the difference between a market ethos and, if you like, a public service ethos, they ought not to be taking part in these debates, as the two are completely different. The purpose of a market ethos is to make money and perhaps then do good as a result. I refer to the famous Adam Smith quotation regarding the baker and the butcher and why they provide their services. However, that is not the nature of the health service. Noble Lords opposite cannot wriggle out of that. Noble Lords may also find it disagreeable that the only reason I am alive today and addressing them is because I have had marvellous service from the NHS over the past few years in my time of need. That service was as good as any that one could pay for. I, of course, paid for it though my taxes, but you cannot buy a better service. That is the fundamental point, and noble Lords opposite cannot wriggle out. If they support the Bill and do not like these amendments, they are paving the way for the end of the service as we know it. That is a completely different question from: ““Is the health service as efficient as it could be?””. Anybody who knows much about it knows that it is not. I was writing articles 30 or 40 years ago saying that those of us who were devoted to the public sector must also be devoted to efficiency in the public sector. That is still my view. To take an obvious example, there is vast overprescribing in the NHS. One reason for that is that, in many cases, when a patient goes to see a doctor, the doctor feels unable to say, ““There’s nothing I can do to help you””. It happens that I am lucky with my neurological problems: I have to see my consultant regularly because he wants to make sure I am still alive, but other than that, when I see him, he says, ““Of course, there is nothing I can do for your condition””, and then we talk a bit about the world in general and then he says, ““See you again in three months””. In the case of prescribing, the patient wants something done and will not be told that there is nothing to be done to help him, but the poor old GP does the best he can, so he writes another prescription. If noble Lords have ever had to clear up after an elderly relative who has died, they will have discovered in the medicine cabinet loads of prescribed medicines that were never taken, never used. As my noble friend Lord Rea said, I am not suggesting for one moment that the health service is perfect, but this Bill is not the way to remedy that kind of deficiency. So I have two hopes: first, that my noble friend divides the House on this issue, because it is so fundamental that we really ought to hear the voices as to who goes one way and who goes the other. I also hope that enough noble Lords vote for this amendment so that we can start as best we can to rescue the health service that we love.