It is a pleasure to serve under your chairmanship, Ms Bardell. I congratulate my hon. Friend the Member for Leeds East (Richard Burgon) on securing this important and extremely timely debate.
The NHS is under great strain. Nurses I met over the summer told me how over-stretched the service is, not just because of covid but because of staff shortages, which my hon. Friend the Member for Rhondda (Chris Bryant) spoke so eloquently about. In June, there were almost 94,000 full-time equivalent vacancies in the NHS, and then of course we have the backlog of patients waiting for hospital treatment in England, which is getting worse. In July, 5.6 million people were waiting. Sadly, that is not just because of the impact of covid; the upward trend was in progress before the pandemic. In February 2020, there were about 4.4 million people waiting for hospital treatment, up from 3.7 million in February 2017.
Yet instead of addressing those extremely serious issues, the Government are pressing ahead with a major reorganisation of the NHS in the form of the Health and Care Bill, through which they will establish statutory integrated care boards and statutory integrated care partnerships, thus breaking the NHS up into 42 local integrated care systems. Each will set out which services to prioritise and which to reduce in their area, embedding a postcode lottery into the NHS in England. It is clear that that variation in the offer, depending on where people live, coupled with strict local financial limits, would lead to increased rationing of healthcare. If that is allowed to happen, I am concerned that people will have to wait longer for care or go without. That is contrary to the founding principles of the NHS.
It is important that we understand just how fortunate we are to have the NHS and why we must defend it. Looking across to America makes very clear our good fortune. Over there, typical costs for health treatment, as advertised by insurance companies looking for business, are as follows. People can expect to pay anything between $400 and $1,200 for an ambulance; between $9,000 and $17,000 for a baby to be delivered; and between $7,000 and $10,000 to have surgery for a broken wrist. Typical annual insurance costs for an individual are around $1,440 and for families around $5,700. That covers only part of the cost because, in America, employers pay the bulk of insurance costs for the individual, with all the cost that that adds to the business communities. Clearly, we do not want an American-style insurance-based system here.
As it stands, the Government’s Bill would put big business at the heart of our NHS. The Government have indicated that they would ensure that individuals with significant interests in private healthcare are prevented from sitting on ICBs, but that is simply not good enough. Private companies should have absolutely no say in how public money should be spent in the NHS. There should be no place whatsoever for private companies on ICBs or integrated care partnerships.
The Government intend to revoke the national tariff and replace it with an NHS payment scheme, with NHS England consulting with ICBs, NHS and independent sector providers. There are real concerns that this will give big business the opportunity to undercut NHS providers. We will see healthcare that should be provided by the NHS increasingly being delivered by big business, with all the implications that that has for patients, for all those working in the service, “Agenda for Change”, and the future of national collective bargaining.
The Government’s reforms would also create a power to deregulate NHS professions, and would have serious implications for the quality of care as well as the employment status, pay, terms and conditions of workers in the service. The NHS is our finest social institution and it has served us well since 1948 but now its future is in peril.
During the campaign against the Conservative-Lib Dem privatisation Bill, which became the Health and Social Care Act 2012, a man told me of his experience of life before the NHS. When he was about eight years old, his baby brother was seriously ill. Everyone in the street was worried for the child. One of the neighbours called for the doctor but, on hearing that, the mother said to the boy, “Run up the street and tell the doctor he is fine and there is no need to call.” The boy ran to the doctor, who had just turned into their street, and sent him away, just as his mother had told him to. Shortly after, the baby died, as the mother knew he would. She had told him to send the doctor away because she knew she could not afford to pay him.
We cannot begin to know the agony that that woman went through. The man who told the story had carried the burden of that action with him through life. That was life and death before the foundation of the NHS, when that family and countless others could not afford medical treatment. It is sobering to think that, after 73 years, the Government’s Bill undermines the principles of the NHS as a comprehensive and universal service.
History will not be kind to those who support such changes. I believe we all have a responsibility to protect the NHS and fight for it as a universal, comprehensive, public service for this generation and those to come. I ask Government Members to reflect on the importance of the decisions that they face in the coming weeks and months, and I urge them to consider the needs of their constituents and oppose the Health and Care Bill.
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