My Lords, I rise to offer Green support for all the amendments in this group. I will split them into two groups internally. First, I will speak to Amendments 6, 19, 60 and 215; I will then deal with Amendment 21 in the name of the noble Lord, Lord Davies, separately.
All these amendments are about transparency and targets. When we look back to when targets were a particular focus—when the NHS was under the control of the party on these Benches—there were concerns that targets could sway provision and medical judgments.
There was a concern that this was about the management of targets rather than the outcome for the patient. However, if we think of targets as foundations and basic standards that need to be met, it is really important that we ensure that there is enough funding for local priorities and concerns to be addressed to reach a higher level.
Amendment 215, which refers to an annual report, is particularly interesting; I know that it has full cross-party support. This is about people knowing what the NHS is achieving and, importantly, whether there is enough provision in it. Of course, your Lordships’ House is not in a position to demand that more money goes into the NHS; by constitutional norms, we cannot deal with spending. However, I think that we should frame this debate—this is my first contribution in Committee—by looking at the pre-Covid figures. The UK was spending £2,989 per person on healthcare; this was the second-lowest in the G7. France was spending £3,737; Germany, £4,432.
Of course, the great outlier in this is the US, spending £7,736 a year. It is worth noting that we seem to be chasing so much after the US healthcare model, which is so absolutely disastrous. Most of the amendments in this group are a way for your Lordships’ House to give the public the tools to say that we need to improve the resources of our NHS.
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The noble Lord, Lord Warner, really got to the point of just how much under pressure the system was, even before we hit Covid-19. I briefly draw your Lordships’ attention to the Central Bylines website, and the tragic report of the death of Jacob Roche, written by his wife, June Roche. I was going to talk about this in detail, but I am aware of the time and will not. However, I urge noble Lords to look at the incredibly stretched nature of our NHS—the report is about December, so before omicron—which cannot be solely attributed to Covid, as the noble Lord said.
Amendment 21 sits rather oddly in this group, and I think many issues I raised at Second Reading will come up in later groups. I associate myself with all the comments of the noble Lord, Lord Davies of Brixton, about the concern around private sector involvement. My reading of his amendment is that it does not address a community-run hospice or a local consortium of physiotherapists. It is particularly looking at integrated care boards and the involvement of the private sector in management systems. If we analyse why the US system is so expensive for such disastrous results, we see that administrative costs are a really important part of that.
I would say that the profit motive should have no place in healthcare. Think about the cost of the profit motive. It has an influence on decisions because, after all, the private companies’ job is to make profits; there is also the fact that money going into profits is not going to healthcare.