British Government aligns itself with some dubious company on ILO convention

Blog / July 13, 2011 / 1616Comment nowhttp://grahamemorris.com/2011/07/british-government-aligns-itself-with-some-dubious-company-on-ilo-convention/British+Government+aligns+itself+with+some+dubious+company+on+ILO+convention2011-07-13+12%3A15%3A18grahame

Read my speech on the Convention on Domestic Workers in Westminster Hall

From the Slave Trade Act 1807 to signing into law the Human Rights Act. Britain is rightly proud of its history and role in the abolition of slavery. It would be naive to believe modern-day slavery does not exist – it still exists in Britain.

The exploitation of the vulnerable, in particular women and girls, has been raised recently in two international conventions, the EU Directive on Human Trafficking and the International Labour Organisation’s Convention on Domestic Workers.

However, the Government has shown themselves to be increasingly reluctant to sign up to any international convention no matter how worthy the cause.

It took a lot of political pressure and intensive campaigning before the Prime Minister reversed his decision to opt-out of the EU Directive on Human Trafficking.

The facts and statistics from the United Nations speak for themselves:

• Sexual exploitation, usually forcing a person into prostitution, is the most widespread form of human trafficking, making up 79 percent of all recorded human trafficking cases, followed by forced labour accounting for 18 percent of recorded human trafficking cases.
• One out of every seven sex workers in Europe is thought to be enslaved into prostitution through trafficking and at any given time more than 140,000 victims are trapped in human trafficking in Europe, with no sign of that figure decreasing.
• One in five victims are children; two thirds of victims are women.
• The International Labour Organisation estimates there are 2.4 million people throughout the world who are lured into forced labour.

Conviction rates for these crimes remain horrendously low. In Europe on average there is less than one person convicted of human trafficking per 100,000 inhabitants. In Hungary, the rate is 0.24 per 100,000 inhabitants.

The original decision to opt out of the Directive on Human Trafficking was met with shock. Dr John Sentamu, Archbishop of York hit out at the Government stating:

“Sex trafficking is nothing more than modern-day slavery. This is women being exploited, degraded and subjected to horrific risks solely for the gratification and economic greed of others. I am therefore stunned to learn that the Government are ‘opting out’ of an EU directive designed to tackle sex trafficking.”

The UK has recently stunned campaigners again by refusing to support a new international convention to protect domestic workers from exploitation. The convention received overwhelming support with 165 out of 173 Governments in favour including the United States and China.

The UK is only one of eight countries who failed to support the convention and now resides in some dubious company alongside El Salvador, Panama, Czech Republic, Sudan, Malaysia, Singapore, Thailand and Swaziland.

What outrageous rights would the new convention afford domestic workers?

They state that domestic workers around the world who care for families and households, must have the same basic labour rights as those available to other workers.

• reasonable hours of work,
• weekly rest of at least 24 consecutive hours,
• a limit on in-kind payment,
• clear information on terms and conditions of employment,
• respect for fundamental principles and rights at work including freedom of association and the right to collective bargaining.

In its introductory text, the new Convention says that “domestic work continues to be undervalued and invisible and is mainly carried out by women and girls, many of whom are migrants or members of disadvantaged communities and who are particularly vulnerable to discrimination in respect of conditions of employment and work, and to other abuses of human rights.”

You may assume that those working legally in the UK would already enjoy these protections. However, just one story of many shows this is not the case. Frances, a migrant domestic worker from Africa, was thrown out onto the street, her employer retaining her passport, bank card and national insurance number. Frances crime was to ask for one day off from working in excess of 12 hours a day, seven days a week, for a wage of £250 a month.

The Convention would provide clear rights to the 53 million domestic workers globally. However, experts say that due to the fact that this kind of work is often hidden and unregistered, the total number of domestic workers could well over 100 million. Research by the International Labour Organisation found that for over 56 per cent of domestic workers the law does not establish a limit on how long a working week can be. About 45 per cent of all domestic workers are not entitled to at least one day off per week. About 36 per cent of female domestic workers have no legal entitlement to maternity leave. With over 90 per cent of domestic workers being women and girls the implementation of this convention will have a tremendous impact on gender equality ensuring women enjoy the same rights as those in other work places.

These are not extreme demands, just a request for basic human rights. Juan Somavia, Director-General of the International Labour Organisation stated the simple aim of the convention:

“[To] bringing the domestic workers into the fold of our values is a strong move, for them and for all workers who aspire to decent work”

A modest move too far for a Coalition Government that opposes any co-operation with international organisations to promote basic human rights.

The Coalition Government’s position leaves a stain on Britain’s reputation as an advocate of basic human rights casting a cloud over our democratic values. The Prime Minister has betrayed Britain’s 200-year history of anti-slavery and has isolated itself to the margins of the world stage.

Britain has aligned itself alongside countries where worker’s rights are routinely infringed and as stated by the Department for Business, Innovations and Skills, does not intend to ratify the convention “for the foreseeable future”

It has been a long struggle for migrant domestic workers in fighting for their human rights. A Labour Government in 1998 introduced a visa for domestic workers.The specific purpose was to protect migrant domestic workers from abuse and exploitation. It recognised their vulnerable position in the under-regulated work environment, their isolation from co-workers, and their absolute dependency on their employer for finance, accommodation, immigration status, and information about their general rights.

Signing the convention would be a first step in putting the employment relationship, visa demands and working choices in the hands of migrants to some degree. Migrant domestic workers could, for the first time, enforce their rights.

I believe the British public would deplore the Government’s position, standing alongside despicable regimes that wish to deny basic human rights to women.

The Prime Minister’s position has isolated Britain, aligned us with some of the most deplorable regimes, damaging our reputation and standing on the world stage. I believe Britain should be promoting human rights, not denying them.

The verdict of the Anti-Slavery Campaign:

 “The UK can no longer claim to be a global leader in tackling the menace of modern slavery”.

Speech to the Health & Social Care Bill Committee

Blog / July 7, 2011 / 1614Comment nowhttp://grahamemorris.com/2011/07/speech-to-the-health-social-care-bill-committee/Speech+to+the+Health+%26+Social+Care+Bill+Committee2011-07-07+14%3A49%3A04grahame

Grahame M. Morris: I am grateful, Mr Gale. The Minister is looking perplexed, but I did indicate earlier that I wished to speak.

The Minister of State, Department of Health (Mr Simon Burns): I look forward to hearing you.

Grahame M. Morris: Other hon. Members have highlighted in this debate and on previous occasions, not least in the initial exchanges between my hon. Friend the Member for Oldham East and Saddleworth and the Secretary of State in the initial consideration of the Bill, the dubious relationship between what the Government say and what the Bill actually does. During his first attendance at an evidence session, the right hon. Gentleman was asked by my hon. Friend if he could explain why he decided to repeal the duty placed on the Secretary of State to provide a comprehensive health service. His reply was,

“I have not… Clause 1 effectively reproduces the 1948 duty on the Secretary of State and it applies it to the other organisations through the rest of the Bill.”

He went on to say,

“It is in the original language. It is reproduced the same way.”––[Official Report, Health and Social Care Public Bill Committee, 10 February 2011; c. 166, Q402-04.]

The duty of the Secretary of State under the National Health Service Act 2006, repeating the language of section 1 of the National Health Service 1946, is, for the purpose of promotion of a comprehensive health service, to

“provide or secure the provision of services in accordance with this Act”.

Clause 1 of the original Bill replaced that duty—the point made by my hon. Friend that the Secretary of State sought to push to one side. It provided instead that the Secretary of State

“in exercising functions in relation to a body mentioned in subsection (2A), must act with a view to securing the provision of services for the purposes of the health service in accordance with this Act.”

For the information of the Committee, new subsection (2A) lists the NHS commissioning board, the commissioning consortia, which we are now calling commissioning groups, and local health authorities in respect of their public health functions.

Our concerns about the clause, voiced in the original Committee, were that the Secretary of State sought to reduce the accountability of his role in the delivery of health services. That was vigorously denied. The recommendations of the NHS Future Forum are clear:

“The NHS should be freed from day-to-day political interference but the Secretary of State must remain ultimately accountable for the National Health Service. The Bill should be amended to make this clear.”

The clause establishes an NHS commissioning board, the commissioning groups as well as passes responsibilities to local authorities for public health. The importance of the clause is the way in which the Secretary of State’s responsibilities would change. He would lose his current duty to provide or secure the provision of services for the purpose of the health service. Instead, the new duty on the Secretary of State is the simple promotion of the comprehensive health service, which is an important and fundamental difference of approach. [ Interruption. ] The hon. Member for Southport says it is the same thing, but in fact it is quite a fundamental difference, placing a direct responsibility or duty on the Secretary of State, which is what the Future Forum indicated the Government should do.

Fiona O’Donnell (East Lothian) (Lab): My hon. Friend and I share the experience of being new Members, which is perhaps why we are so perplexed. Does he share my concern that the Government are seeking to amend a piece of legislation while saying that that will make no difference to it?

Grahame M. Morris: That is spot on the heart of the matter. Time and again, our interpretation has been different and Ministers have said that we misunderstood the intent, but the NHS Future Forum, other organisations and, indeed, the Liberal Democrats have indicated that this is a major concern. It is, therefore, reasonable to highlight it.

John Pugh (Southport) (LD): I might be wrong, but when the hon. Gentleman referred to the Bill as previously drafted, I think he said that the Government’s intention was to put in the clause only a reference to “promoting”, yet new clause 1 uses the verb “secure” twice. The hon. Gentleman should speak to the new clause, rather than to a clause that will be altered however we vote.

Grahame M. Morris: If the hon. Gentleman will bear with me, I am seeking to expose or identify the original arguments made by the Ministers. They are now moving away from that position and accepting the arguments made by Opposition members of the Committee, who, to be fair, were the first to discover that the emperor had no clothes. It seems to have been generally accepted that that is the case. A significant bone of contention is that Opposition members of the Committee believe that an elected official—a Minister—should be accountable for the performance of the NHS.

Nick de Bois (Enfield North) (Con): On a point of order, Mr Gale. Perhaps you can give me some guidance. We have tight time limits and want to give due scrutiny to the Bill, so is it right for prepared texts to be used when speaking?

The Chair: That is not strictly a point of order, but I will seek to answer it. The Speaker has indicated, and the traditions of the House suggest, that wherever possible Members should speak from notes rather than from prepared speeches and that they should most certainly not read speeches prepared by any outside organisation. However, I have no indication at present that that is what is taking place.

Grahame M. Morris: I am grateful to you, Mr Gale. Many of the issues are highly technical. I am not absolutely familiar with the detail of the NHS Future Forum report, so I am afraid that I need to refer to a written text. It is important that the issues are placed accurately on the record.

Karl Turner (Kingston upon Hull East) (Lab): On a point of order, Mr Gale. I find it outrageous that Government Back Benchers should make such points. I have spent many days and weeks on this Committee, and have heard the Minister read prepared speeches into the record, with no criticism from either side of the Committee. I know that my hon. Friend the Member for Easington is not reading a prepared speech, but even if he was, it would be his own work, not that of an outside body.

The Chair: I listened very carefully to the question that was put to me and I answered it. I do not recall any suggestion being made, and I indicated that I had not seen any evidence to suggest, that the hon. Member for Easington was reading a prepared speech. I answered the question that I was asked. I have ruled on the matter. I think that we had better leave it there.

Grahame M. Morris: I am grateful to you, Mr Gale. We have identified a contentious point. An elected official—a Minister in this case—should be held accountable for the performance of the NHS, and the Secretary of

State should exercise responsibility for the provision of high-quality health care in a comprehensive national health service.

Until now, the Secretary of State has been directly responsible for securing the provision of all health services, as set out in the National Health Service Act 2006. If my memory serves me correctly, the disagreement with Opposition members of the Committee was based on the difference, which the hon. Member for Southport has just indicated, between whether the Government were delegating or conferring on other bodies the specific duties that were previously placed on the Secretary of State—essentially, delegating his responsibilities.

Dr Daniel Poulter (Central Suffolk and North Ipswich) (Con): I am following the hon. Gentleman’s argument and the case that he is making. The hon. Member for Islington South and Finsbury made the point that it is important for the Secretary of State to have a duty to reduce health care inequalities. Is the hon. Gentleman disappointed that such a duty was not put into legislation by the previous Government during their 13 years in power?

Grahame M. Morris: Mr Gale, I will confine my remarks to the issue in hand. I have some specific points in relation to health inequalities, but to move things along a little more speedily, I will not refer to them.

The Secretary of State should have a responsibility for a truly comprehensive national health service, as was previously the case.

Mr Burns: It still is.

Grahame M. Morris: The Minister says that, but our concern is that under the original Bill, those functions were delegated to other bodies—the NHS commissioning board, local commissioning groups and other organisations. The NHS Future Forum recommended that that was not an appropriate course of action, which is a view that was first highlighted by the Labour party.

Mr Burns: I am not sure whether the hon. Gentleman fully appreciated what the Future Forum said about this. Let me help him by reading what it said in its “Patient Involvement and Public Accountability” report. It says:

“We have heard concern from various quarters that the Secretary of State for Health will no longer have a responsibility or duty in respect of promoting a comprehensive health care service… We understand that this is not in fact the case as far as the proposed Bill is concerned.”

It continues:

“The Secretary of State will remain ultimately responsible for improving the health of the nation”.

Grahame M. Morris: I am aware of what the Future Forum said. Indeed, we took evidence from representatives of the forum and questioned them at greater length in the Select Committee on Health, but I question some of the responses of Professor Steve Field on the basis on which he arrives at some of his contentions, not least in

relation to taking independent legal advice. Under questioning, Professor Field was asked whether European competition law applied and whether the Future Forum had taken independent legal advice. His response was that the only legal advice that it had taken was from the solicitors from the Department for Health. I can cite other examples of inconsistencies in Professor Field’s evidence to this Committee and the Health Committee.

Emily Thornberry: I do not know whether my hon. Friend is aware that an application was made by Opposition Members to have an expert in international competition law called to give evidence, but that was voted down by the Government.

Grahame M. Morris: Yes, I was aware of that. It is disgraceful that the Government were not prepared to clarify this issue and have some independent legal advice.

John Pugh rose—

Dan Byles (North Warwickshire) (Con) rose—

Grahame M. Morris: I am happy to give way, but I am being berated for not making enough progress.

Dan Byles: I am a little concerned about the hon. Gentleman’s comments about the apparent inconsistencies in Professor Field’s evidence. Are you accusing him of incompetence or of misleading us? What exactly are you saying about Professor Field?

The Chair: Order. The hon. Gentleman must address his remarks through the Chair. I am not commenting upon it at all.

Dan Byles: I apologise, Mr Gale.

Grahame M. Morris: I am grateful to the hon. Gentleman for raising that because my observations are based upon fact. It calls into question the reliability of Professor Field’s evidence.

Fiona O’Donnell: Will my hon. Friend give way?

Grahame M. Morris: I will in a moment. When Professor Field came before the Health Committee in his capacity as one of the leaders of the Future Forum, he was asked about its role and independence. He was asked whether the Future Forum had taken representations from the trade unions and the staff involved in the health service as legitimate stakeholders in the exercise and whether they had raised with him their concerns about the fragmentation of the service caused by implementation of the proposals and the threats to national bargaining on pay and conditions. He replied that no such representations had been received, yet the written evidence that this Committee received on Tuesday from the trade union representatives Professor Field consulted states that they had made that very point. To my mind and that of many other people, hat calls into question the reliability of Professor Field’s evidence. I do not know if he is a reliable witness on that basis. He said one thing to the Select Committee and something

completely different to the Bill Committee, which was directly contradicted by a stakeholder group with whom he had had dealings. That is a simple point.

Fiona O’Donnell: I am sure my hon. Friend will remember that on Tuesday Professor Field also acknowledged that he had omitted caps on private patients in foundation trust hospitals from the report.

Grahame M. Morris: That is a relevant point when the whole basis of this Committee’s deliberations is the recommendations of the Future Forum report. Many of the issues that have been raised have not been taken up either as clauses referred back or as Government amendments. There is an issue of consistency and fairness in this.

Returning to the clause stand part debate, we were dealing with delegating or conferring duties from the Secretary of State and on to other bodies. It was the Minister or the Secretary of State, I think, who in their evidence coined the expression that when the bedpan is dropped the noise should be heard in Whitehall.

Mr Burns: I rise to help the hon. Gentleman. That is actually a quote from his hero, Nye Bevan.

Owen Smith (Pontypridd) (Lab): He is my great hero and the bedpan in question was in Tredegar.

Grahame M. Morris: Anyway, it was referred to in this Committee as a way of saying that the Secretary of State should be in tune with problems and issues in the health service.

I accept that, under current arrangements, it is only possible for the Secretary of State to do that. My hon. Friend the Member for Islington South and Finsbury made an excellent point this morning about the Secretary of State for Defence not being responsible for equipping individual soldiers with items of kit—army boots were given as an example—but is ultimately responsible for ensuring that the Army is properly equipped and able to deal with the tasks that it faces. Similarly, I am not suggesting that the Secretary of State should be hands-on and micro-manage, as Government Members often say, every single issue. I accept that he cannot do that because, at the moment, those functions are exercised through structures such as the strategic health authorities and primary care trusts, which will not exist under the new arrangements. It is therefore all the more important that the duty is conferred upon an accountable individual. Despite the delegation under the current arrangements, it is quite clear that the SHAs and the PCTs remain under the duty of care of the Secretary of State, who—this is the key point—remains accountable to Parliament for the provision of services.

Despite the Secretary of State’s denials to the Committee, the Opposition have been clear from the very start that the duties outlined in the Bill would no longer be delegated and that direct responsibility would be taken away from the Secretary of State through the modified clause 1. It is also clear that direct responsibility for securing the provision of health services would be conferred on the bodies that I referred to earlier—the NHS commissioning board and the local commissioning

groups—and that provision is set out explicitly in clauses 5 and 6. We will deal with those later, so I will not say any more about that.

Government new clause 1 changes the role of the Secretary of State, but it is disingenuous to pretend that the original duty on the Secretary of State has been fully applied. As I have said, these concerns have been raised by several organisations and, indeed, by the Liberal Democrats as one of the three key issues. The hon. Member for Southport mentioned the number of e-mails that he has received, and I have received a similar number, including some that also highlighted the duties that are to be placed on the Secretary of State. New clause 1 reiterates the

“duty to promote comprehensive health services”

and, although it uses the original language, it adds a key point:

“For that purpose, the Secretary of State must exercise the functions conferred by this Act so as to secure that services are provided in accordance with this Act.”

We have an ever more complicated set of intertwining and cross-cutting stipulations about who is responsible for what.

I found the grouping of amendments slightly confusing this morning, Mr Gale, but I now appreciate that we are dealing with similar themes. I shall refer briefly to clause 5 because it covers some of the same elements. That clause creates a new section 1D of the 2006 Act, whose wording is similar to clause 1, giving the NHS commissioning board its general duty. This group of amendments also affects clause 5, but new section 1D(2) remains, meaning that the board will be concurrently bound with the Secretary of State to the duty in section 1(1) of the 2006 Act, which is to promote comprehensive health services—except for public health, which is going to local government. However, where the duty on the Secretary of State is to act

“with a view to securing the provision of services”,

that has now been changed, and it remains applicable to the board.

Government amendment 55 outlines the board’s duty to

“exercise the functions conferred upon it by this Act in relation to the commissioning consortia so as to secure that services are provided for those purposes in accordance with this Act.”

However, the changes to section 3 of the 2006 Act, which is the successor to section 3 of the 1946 Act, remain intact, and it currently states that the Secretary of State

“must provide throughout England, to such extent as he considers necessary to meet all reasonable requirements”.

For the Committee’s information, those requirements are:

“ (a) hospital accommodation,

(b) other accommodation for the purpose of any service provided under this Act,

(c) medical, dental, ophthalmic, nursing and ambulance services,

(d) such other services or facilities for the care of pregnant women, women who are breastfeeding and young children as he considers are appropriate as part of the health service,

(e) such other services or facilities for the prevention of illness, the care of persons suffering from illness and the after-care of persons who have suffered from illness as he considers are appropriate as part of the health service,

(f) such other services or facilities as are required for the diagnosis and treatment of illness.”

As for the issue of consistency between clause 1 and some of the other clauses where similar changes would make sense, clause 9, which we will come to later, replaces the duty on the Secretary of State that we have just been talking about with a duty on the commissioning consortium. As the Minister kindly pointed out this morning, we have changed the nomenclature, so that the commissioning consortium

“must arrange for the provision of the following to such extent as it considers necessary to meet the reasonable requirements of the persons for whom it has responsibility”.

Again, on ensuring consistency and a similar approach throughout all the clauses, clause 10 will add to the 2006 Act new section 3A, which provides that consortia

“may arrange for the provision of such services”—

The Chair: Order. When the hon. Gentleman got to clause 5, he was referring to Government amendments, which was fine and in order. Clauses 9 and 10 will be considered through other amendments, so I trust that he will not seek to speak on the same subject when we reach those clauses.

Grahame M. Morris: I accept that, Mr Gale. Overall, the Government amendments go some way towards restoring the duty on the Secretary of State. I acknowledge that, but I regret that the Government were not prepared to admit that initially when Opposition Members made exactly the same arguments in the original Bill Committee. As I say, the Government’s amendments go some way towards restoring the duty on the Secretary of State, and apply it to the commissioning board with regard to securing the provision of services, but only in so far as it is exercising functions conferred by the Bill. Indeed, the Bill as amended by clause 1 gives the commissioning board a duty to ensure that services are provided through its functions in relation to the local consortia, but specific services are left to local determination.

Despite the Government’s amendments, the Bill as a whole still considerably weakens the Secretary of State’s duties and places the most significant weight of duty at the national level, with the NHS commissioning board. If there is not an accountable individual—a politician in the form of the Secretary of State—and those duties are exercised by the national NHS commissioning board, Opposition Members will have concerns about accountability issues. We have already been told that we should refer to clinical commissioning groups, rather than commissioning consortia. The legal framework places the bulk of power with clinical commissioning groups, which will be able to determine what services are provided on the NHS to a far greater extent than local commissioners ever could under existing arrangements.

Dalton Park Charging Forward

Blog / June 20, 2011 / 1605Comment nowhttp://grahamemorris.com/2011/06/dalton-park-charging-forward/Dalton+Park+Charging+Forward2011-06-20+14%3A28%3A01grahame

There has been cause for a double celebration at Dalton Park this month. In the same month as being unveiled as only the second site in the North East to install a quick charging point for the new generation of electric cars, Dalton Park was granted planning permission for Phase II.

Both are good news for jobs in the North East.

Dalton Park is at the forefront of new green technology. The 50kw post – the first was at the Metro Centre – can charge electric cars, such as the Nissan Leaf which will be produced on Wearside, to 80 per cent capacity in just 30 minutes, compared to eight hours for a full charge using a standard 3kw charging point.

This is great news for the region that is pioneering green technology as part of the ‘Plugged-in-Places’ initiatives. Through the support of One North East over 1,000 charging points and 12 quick chargers will be installed across the region by 2013, just in time for the first zero emission Nissan Leaf electric cars to roll off the production line at the Sunderland car plant.

Nissan Sunderland beat off fierce competition from other Nissan factories from across the world to secure production of the new Leaf electric car.  It is a testament to the hard-work and dedication of Nissan’s 6,000 employees that have built a reputation for efficiency and quality.

Turn the clock back 25 years, Nissan were the first Japanese company to build cars in the UK. In 1986, the region was still reeling from the decline of our traditional industries in shipbuilding and mining.

In the first year of production Nissan’s 350 employees built 5,139 Bluebird models. Today, Nissan have built over six million vehicles and in 2009 built a record 423,262 cars in a single year.

In 2010, with the support of Prime Minister Gordon Brown and Business Secretary Peter Mandelson, Nissan announced a £420 million investment in electric cars. This was backed by £20.7m government grant and up to £220m from the European Investment Bank.

The contract to build the Nissan Leaf will see Sunderland become Europe’s biggest electric car plant. This is another accolade for Nissan Sunderland who are currently the biggest car manufacture in Britain building 1 in 3 of all new cars in the UK.

Sunderland’s success continues with this week’s decision by Nissan to invest £200m in producing the new model Qashqai on Wearside.

Dalton Park is not only leading the way on green technology. The North East’s biggest outlet shopping centre was given the green light for Phase II. The planning committee unanimously overturned the officer’s decision to refuse Dalton Park Phase II.

The £24 million development will create 500 jobs on the former coalfield site. The delivery of new facilities for leisure, the cinema, associated restaurants and supermarket will boost economic regeneration in the Easington District.

The original Dalton Park always envisaged the future provision of leisure facilities in a second phase of development. This was part of the permission that was granted in 2000.

It has been over 10 years since the local communities campaigned and lobbied 10 Downing Street. The fight for jobs continues and that is why I have passionately taken up the causes to secure a better future for East Durham.

I took the unprecedented step of writing to each of the elected representatives on the planning committee advocating my support for Phase II.

I dispute the planning officer’s claims that a second phase to Dalton Park would have an adverse impact on trade at shopping centres in nearby Peterlee and Seaham. This was the same objection that was given when they turned down the original Dalton Park application in 2000 and has proven to be wide of the mark.

I believe a stronger Dalton Park will prove to be an attraction that will attract people from outside the region to come and visit. The benefits will be felt beyond Dalton Park itself and I believe will benefit areas such as Seaham and Peterlee.

The region is attracting high profile events. The recent Take That concerts at Sunderland highlighted a shortage of hotel facilities in this area. As we continue to attract events of this nature it is vital additional hotel rooms are available and I know Dalton Park’s development can fulfill this need.

Confident and ambitious, I am delighted to see East Durham charging forward into the future. Being at the cutting edge of new green technologies and winning investment and growth we can look forward to creating a better future for our region.

Still a clear and present danger

Blog / June 16, 2011 / 16031 Commenthttp://grahamemorris.com/2011/06/still-a-clear-and-present-danger/Still+a+clear+and+present+danger2011-06-16+10%3A48%3A10grahame

Morning Star Feature

Having established the “independent” NHS Future Forum back in April, effectively cutting his Health Secretary Andrew Lansley loose from his own reform agenda, Future Forum chairman Professor Steve Field delivered his report on Monday with the government response given just 24 hours later.

Field began his list of recommendations with a direct criticism of the government’s handling of the Bill, saying it had caused a “destabilising period for the NHS and an unsettling time for staff and for patients.”

His critique of the Health and Social Care Bill was damning. In just eight weeks he ripped apart a Bill which Lansley had apparently spent the last seven years planning.

Key elements that were rejected by the forum included Monitor’s role to promotion competition throughout the NHS.

It went on: “Its primary duty to ‘promote’ competition should be removed and the Bill should be amended to require Monitor to support choice, collaboration and integration.”

The founding principle of Tory-led reforms, that competition would reduce costs and improve quality, was rejected.

Lansley had spent the last year telling every critic of the Bill that they were either wrong or “did not understand” the Bill.

This week he had to admit he was wrong. He and his health ministers had time after time rejected Labour’s call to remove the competition elements at the heart of the Bill.

It is apparent that many of its strongest supporters on the Tory benches have commercial interests in private health-care companies.

The report heavily criticised the wasteful loss of experienced managers stating that government must ensure their retention in order to ensure a smooth transition and support clinical leaders in tackling the financial challenges facing the NHS.

This in particular was an indictment of Lansley’s vilification of NHS managers and administrators and his willingness to spend over £1 billion from NHS coffers paying redundancies to staff of primary care trusts and strategic health authorities.

Many of these managers would be likely to take up employment with new commissioning bodies. Most uncomfortable for the coalition was Field’s outspoken opposition to plans “to increase the role of the private sector as an end in itself.”

The government response to this slicing and dicing of its flagship Health and Social Care Bill was to say they had “listened and learned” and would implement all major recommendations.

David Cameron took the limelight, announcing the end of the “pause” at a well-organised lunchtime media event at Guy’s Hospital.

Following the Prime Minister’s spinning exercise and his latest take on his NHS reforms he sent Lansley, unaccompanied, to take the flack in a heated emergency statement in the House of Commons.

While this week was one of interminable embarrassment for Lansley, it may turn out to be a short-term political coup for Cameron and Nick Clegg.

They both claim to have safeguarded the NHS for the future – ironically from their own Health Secretary.

In reality they have kept the key privatising elements of the Bill, handing over 65 per cent of the NHS budget to private bodies and opening up every NHS service to challenge from the private sector.

The NHS Future Forum, while having uncovered many faults throughout the legislation, was never asked to consider the ideological foundations behind the Bill.

This leaves Field between a rock and a hard place, having ensured new safeguards are applied while at the same time adding legitimacy to a significant departure from the founding principles of the NHS.

The Health and Social Bill remains a real threat to the NHS as a comprehensive service free at the point of use.

The government’s stated aims of clinical commissioning and more integrated care could have been developed within the current structures and without the need for new legislation.

Indeed in some parts of the country, such as in Cumbria and in the south-west, where greater clinical involvement in commissioning and design of integrated care pathways have already been piloted.

Lansley’s determination to save his Bill is based on his ideological drive to break up the NHS and his Bill will still achieve this.

The new commissioning groups will continue to be able to subcontract to the private sector to manage their commissioning functions, while the taxpayer pays to put existing NHS staff on the dole queue rather than employ them to do the same job.

The “right to challenge” for NHS services by private companies will remain and while the government says it will not promote an increased role for the private sector, it continues to lay the foundations for a growing reliance on private health care.

All this means that the threat to NHS services and staff remains a clear and present danger. The Future Forum did little to assuage the fears of NHS staff who still face losing nationally determined pay, terms and conditions and will have little confidence in their job security which has been a hallmark of our National Health Service, established over 60 years ago by a Labour government.

The Health and Social Care Bill will now return to a public Bill committee of MPs of which I will be one.

How the coalition implements the NHS Future Forum recommendations in legislation and to what extent these recommendations change the direction of travel charted by the Bill will be known shortly.

One thing is certain – the Bill does far more than the coalition’s stated aims. Otherwise we would not need a Bill at all.

As I said in the Commons earlier this week, the changes set out by government this week are largely cosmetic. “You could put lipstick on a pig, but at the end of the day it was still a pig.”

How Coalition wrangling continues to damage the health of the NHS

Blog / June 12, 2011 / 15971 Commenthttp://grahamemorris.com/2011/06/how-coalition-wrangling-continues-to-damage-the-health-of-the-nhs/How+Coalition+wrangling+continues+to+damage+the+health+of+the+NHS2011-06-12+13%3A42%3A34grahame

This week we will move a step closer to finding out how the Tory-led Coalition will attempt to save its faltering shake-up of the National Health Service. In April, the NHS Future Forum was set up as part of the Prime Minister’s attempt to take control of Andrew Lansley’s plans to create an extensive health market within the NHS. Its recommendations for changes to the Health and Social Care Bill will become known this week as will the Coalition’s willingness to implement them.

Whatever becomes of the Health and Social Care Bill, its introduction to Parliament on 19^th January 2011 has led to a damaging few months for the NHS which has been characterised by unprecedented uncertainty. During its first stages passing through Parliament there was little or no sign of the controversy brewing up in Liberal Democrat or Tory circles. Only the Labour party was warning of the significant privatising elements contained throughout the Bill. Indeed, David Cameron, Nick Clegg and Andrew Lansley signed the Bill personally and every Liberal Democrat MP voted for the Bill at Second Reading.

The media, which has shown itself to be broadly supportive of the Tory-led Coalition, has been quick to buy the Lib Dem line that they have forced their Tory bedfellows into a rethink. But you do not need a long memory to know the Lib Dem’s synthetic anger followed a comprehensive electoral battering in the local elections in May. It is also worth noting that during the long and arduous committee stage of the Health and Social Care Bill, Lib Dem opposition to much of what is now being ‘rethought’ was non-existent. The Lib Dem Health Minister Paul Burstow defended the government line and his backbench colleague John Pugh voted against almost every Labour amendment to the Bill. So what really caused the rethink on the Bill?

There was never any intention by either party leader in the Coalition to take on board political or clinical criticisms of the Bill. Nor did Andrew Lansley or his Health Ministers feel that the Bill was flawed in any respect. Throughout the Bill Committee they supported the introduction of competition, ignored Labour’s warnings about clear conflicts of interest between private companies and the commissioning of healthcare and refused to listen to the growing dissent within the clinical and professional bodies across the NHS. Even when a newly elected Tory MP and former GP Sarah Wollaston, who I serve alongside on the Health Select Committee, raised her worries she was reportedly threatened by whips and kept off the Bill Committee.

In the end, the rethink was forced on the government as a result of clinical, professional and expert opinion growing against the Health and Social Care Bill. The biggest surprise was how long it took for a concerted attack against the aims of the Bill to materialise. But one thing is certain: Labour MPs were the first to oppose the measures during two months in the Health and Social Care Bill Committee, harnessing the evidence from health think tanks and professional bodies opposing the Lansley reforms.

Even once the underlying privatising elements of the Bill began to be picked up by the media the Lib Dems continued to back Lansley’s flagship policy. Health Ministers were put on the defensive by the Labour opposition, trade unions and professional bodies such as the Royal College of Nursing and the British Medical Association. Only after a crushing defeat in May’s election did Nick Clegg put his head above the parapet for the simple reason of political expediency, not principled opposition. Indeed, in 2005 he had said: “I think breaking up the NHS is exactly what you do need to do” in an interview with The Independent newspaper.

Therefore it is unsurprising that those who work in the NHS and their representatives will remain sceptical until they see decisive action that reverses the original Lansley plan for an NHS completely opened up to the private sector and to competition.  Labour has always said it will wait to see what action the government takes rather than believing what David Cameron says about the Bill. And I remain clear that, having sat on the Bill Committee and studies in detail all 300 Clauses, the Bill cannot be saved and must be dropped.

The right-wing of the Tory Party, lead by Nick deBois, have consistently indicated in the media and on their blogs that they are not serious about listening to public concerns but instead are pressing ahead with their privatisation agenda. The argument against this ideological move towards free-market healthcare is gaining some ground including in The Economist this week which pointed out that systems with strong private sector delivery can “cost more and deliver inferior care than strongly regulated systems with heavy government involvement”.

Both the Tories and the Liberal Democrats share a vision of the NHS that is broken up and set against itself in competition. The Coalition partners’ support for introducing competition, with all the associated risks of fragmentation and failure, rather than encouraging closer integration through co-operation should never be forgotten. The determination of Andrew Lansley to move the NHS away from the founding values of Nye Bevan was allowed to run too far, too fast. This vision has been rejected by health professionals and the British public and the desperate attempt to save the Health and Social Care Bill will simply do further damage to the National Health Service.

60th Anniversary of Easington Colliery Mining Disaster

Blog / June 7, 2011 / 15891 Commenthttp://grahamemorris.com/2011/06/60th-anniversary-of-easington-colliery-mining-disaster/60th+Anniversary+of+Easington+Colliery+Mining+Disaster2011-06-07+16%3A06%3A09grahame

On 29^th May 1951 Easington Colliery suffered the worst mining accident in the history of the National Coal Board. The explosion claimed the lives of 81 miners. The final death toll would be made worse when two members of the rescue team lost their lives trying to save those trapped underground. The Colliery was the main employer in Easington and no family would be left untouched by the tragic consequences of the disaster.

On Tuesday, 29^th May at 4:35am a spark from a coal cutting machine ignited a pocket of gas sending a wall of fire throughout the mine, fuelled by excess coal dust. By a cruel trick of fate the explosion occurred just as the day shift was relieving the night shift.

The first rescue team arrived from the Miners Rescue station at Houghton-le-Spring amid some confusion over the number of miners involved in the disaster. Having descended the shaft to begin the rescue, the Houghton Rescue team made it as far as the first major roof fall and could go no further.

10th North Low Main sub-return after 1951 disaster. Easington Colliery, 1954 (Photos courtesy of Beamish)

Further rescue teams from around the district quickly descended on Easington to help with the rescue of their colleagues. The miners were trapped 900 feet underground and the rescuers toiled in nonstop shifts to move tons of rocks and debris that blocked their way to the trapped miners.

By early afternoon the rescuers had driven through more than 300 yards of debris. Mining officials said the coal seam where it was believed the majority of men were still trapped was another 700 yards. Fresh air was being forced through neighbouring seams in the hope it would filter through to the men.

However, as the rescuers went further into the mine they were confronted by a rush of poisonous air as they moved mounds of earth to reach those trapped.  

On 30^th May Lord Hyndley, Chair of the National Coal Board, confirmed the worst fears of friends and family

“Though everything has been done and is still being done at the pit, there is now no hope of any of the entombed miners being alive”

There were six emergency phones in the blast area where the men had been working but no calls came through. The Notice Board where names of survivors would be posted remained tragically bare.

News of the Mining Disaster brought Easington to national prominence. Relatives waiting for information at the pit were joined by cabinet ministers and messages of condolence were sent from around the world, including from King George VI. The telegram read,

“The Queen and I have learned with the deepest distress of the explosion at Easington Colliery, and of the severe loss of life there.  We send our heartfelt sympathy to those who have lost husbands and sons.”

However, Easington soon fell from the headlines and the Colliery was back in production before the last body had been recovered.

In the aftermath of the disaster, Easington Colliery Miners’ Disaster Fund was established with the first donation from Manny Shinwell, Minister of Defence and M.P. for Easington.

A disaster fund was set up for relatives of the deceased.  Donations from across the nation and around the world raised £180,000, a massive amount for those days,

All widows and children of the deceased miners and rescuers were to be cared for.  Each child was to be provided for until the age of 21.  In many cases this involved funding the child through education and college.

 The administrators of this fund did not receive a penny for their work. A Garden of Remembrance was created in Easington Colliery Cemetery for those who lost their lives in the disaster.  A Memorial Avenue was also created with a tree planted for each of those who lost their lives

Sixty years after the great mining disaster in N.C.B history Easington remembers the 83 men. Hundreds of people attended the service to mark the tragedy.

The dedicated memorial garden at the former colliery site was blessed by the Bishop of Jarrow, The Right Reverend Mark Bryant and Alan Cummings, Secretary of Easington branch of the NUM gave a moving address to those gathered.

At the miner’s mass grave in Easington Colliery Cemetery floral tributes were laid and I was honoured to unveil a miner’s lamp in memory of those who paid the ultimate sacrifice.

Less than two months after the disaster Easington Colliery Band gathered in for the Durham Miners Gala. A pennant taken from a wreath sent from the miners of Yugoslavia was hung from the banner.

It will be an honour and a privilege to march alongside Easington banner and colliery band at this year’s Durham Miners Gala. The 127^th Gala to be held on Saturday 9^th July 2011 will be another opportunity to remember and commemorate those who paid too high a price for coal.

END.

ALL PHOTOGRAPHS COURTESY OF BEAMISH MUSEUM

For more information on Easington Mining Disaster:

Beamish, People’s Collection, Easington Colliery Disaster – http://collections.beamish.org.uk/pages/easingtondisaster

Beamish Museum Photographs – www.flickr.com/photos/beamishmuseum/tags/1951/

Durham Mining Museum -  www.dmm.org.uk/names/n1951-01.htm

Easington Remembers – www.eastdurham.co.uk/easington1951/disaster.htm

Peterlee Mail, Monday 30^th May 2011 – Community Marks Pit Disaster – http://www.peterleemail.co.uk/news/local/community_marks_pit_disaster_1_3430124

Grahame Morris Commons’ Speech on Future of the NHS

Blog / May 11, 2011 / 1585Comment nowhttp://grahamemorris.com/2011/05/grahame-morris-commons-speech-on-future-of-the-nhs/Grahame+Morris+Commons%27+Speech+on+Future+of+the+NHS2011-05-11+11%3A38%3A40grahame

I pay tribute to the thoughtful contribution by the right hon. Member for Charnwood (Mr Dorrell), who chairs the Select Committee on Health.

I come to this debate as, I believe, one of the longest-standing opponents of the Bill, both as a member of the Health Committee and as a member of the Health and Social Care Bill Committee. As such, I have consistently raised serious concerns about not only some of the detail contained in the Bill but the direction of travel charted by these reforms since they have developed from manifesto to coalition agreement to White Paper, and finally morphed into the Bill itself. I have become accustomed to the protestations and rebuttals of Health Ministers on every issue that I have raised, so I am somewhat sceptical about the listening exercise.

Those issues include the pace and scale of reform, the lack of a credible large-scale pilot to assess the impact of the changes, the conflicts of interest inherent throughout the Bill, as identified in the Channel 4 “Dispatches” TV documentary, and the threat of privatisation by stealth.

Despite the protestations and groans of Government Members, there is nothing in the Bill to rule that out. I can cite some examples, not least in relation to the prison health contract that was recently awarded to Care UK to provide health services for eight prisons in the north-east of England, resulting in 120 NHS staff being displaced and made redundant. There is a clear and present danger of privatisation of the service.

Perhaps the strongest advocate of the Bill, as it stands prior to any changes, has been the Minister of State, Department of Health, the hon. Member for Sutton and Cheam (Paul Burstow), who is no longer in his seat, and who was the Lib Dem steward of the Bill in Committee. On 10 March, he said in an interview in The Guardian:

“This is a change that liberals can embrace.”

On 17 November, in the Commons Chamber, he called Labour’s record on the NHS a “failed status quo” and wholeheartedly backed the Tory NHS reforms. This year, we found out that the Department of Health had at that time been trying to suppress an internal IPSOS Mori poll of public satisfaction with the NHS. That is interesting, because the poll shows record levels of public satisfaction. Perhaps even more disturbing are rumours that next year the Department intends to cancel the commissioning of such a survey. Rather than saying that Labour has failed on the NHS, the survey showed the highest ever levels of public satisfaction.

An even bigger supporter of the Bill, until now, has been the Deputy Prime Minister. On 23 January this year, on the “Andrew Marr Show” he was asked by Mr Marr, of the Health and Social Care Bill,

“Was that in the Liberal Democrat manifesto?”

The Deputy Prime Minister responded:

“Actually funnily enough it was. Indeed it was…I agree it’s an ambitious programme of reform—but over time I think it’ll leave patients with the feeling that they are at the centre of it.”

I am slightly perplexed by the hasty posturing and sudden synthetic explosion of anger by senior Liberal Democrats in the coalition, perhaps in the wake of the meltdown following last Thursday’s elections. I take those criticisms with a pinch of salt.

Tony Baldry (Banbury) (Con): The hon. Gentleman is a member of the Health Committee, so one would expect him to be well informed on these matters. I assume that he reads other reports of the House relating to health. I wonder what he would say about the report of the Public Accounts Committee that was recently published, under the chairmanship of one of his right hon. Friends, which says:

“The trend of falling NHS productivity will have to be reversed if the NHS is to deliver, by 2014-15, savings of up to £20 billion each year for reinvestment in healthcare.”

The PAC found that there were serious problems with productivity—

Madam Deputy Speaker (Dawn Primarolo): Order. Interventions, by their nature, must be brief, particularly when so many Members are waiting to speak.

Grahame M. Morris: I am grateful, Madam Deputy Speaker.

Indeed, that was the point that I wanted to make when the right hon. Member for Charnwood was speaking about the level of the challenge faced by the NHS. Sir David Nicholson rightly pointed out that major efficiency savings have to be made and he identified the figure. However, he did not advocate massive organisational change on top of the drive for efficiencies in the system.

During the 28 sittings of the Public Bill Committee, I raised countless issues and made numerous interventions against the health reforms. Unfortunately, the Secretary of State was unwilling to take them earlier in this debate. I have followed this matter very closely. The hon. Member for Banbury (Tony Baldry) asked if I had read the Bill. As a matter of fact, I have read it inside out and could probably give some lessons to a few Members who are in the Chamber. My conclusion is that the policy has remained basically the same, and that only the public relations strategy and the spin has changed.

Mr Chuka Umunna (Streatham) (Lab): Will my hon. Friend give way?

Grahame M. Morris: I will give way just one more time.

Mr Umunna: My hon. Friend said that he sat on the Public Bill Committee and he is also a member of the Health Committee. Has any clarification been given during this reorganisation on the operation of the Transfer of Undertakings (Protection of Employment) Regulations 1981 and 2006 with regard to employees in the NHS?

Grahame M. Morris: That is a key point, and I know that whether TUPE will apply under the terms of the Bill is a legitimate concern of trade unions. However, I will leave it to the Minister to give a definitive response.

My argument is that we need an end to the gesture politics and a radical shift in policy. The Conservatives’ rhetoric and that of their coalition partners must match the reality on the ground. If the opportunity to

“pause, listen, reflect and improve”

is the Health Secretary’s chance to engage with NHS staff, the 98% vote of no confidence against him by the Royal College of Nursing must have been a major hiccup.

It seems to me that this week’s strategy is to let the Deputy Prime Minister flex his muscles. He said yesterday:

“Protecting the NHS, rather than undermining it, is now my number-one priority.”

Perhaps he can tell us what has changed since the White Paper was published in July last year. So far, we have heard that as a result of the listening exercise there may be tweaks to GP-led commissioning consortia to make them more inclusive and accountable, that scrutiny arrangements may be strengthened and that the pace of change from PCTs to GP consortia may be slowed. If that is all the Deputy Prime Minister can negotiate as No. 2 in the Government, it demonstrates, particularly to his own supporters, that he has prostituted his party and the NHS for a position in power.

The Deputy Prime Minister must take heed of the lesson from the Royal College of General Practitioners:

“Intensifying competition in the NHS will lead to the service breaking up, drive up costs, damage patient care, and mean less integration of services.”

The future of the NHS requires him to put aside gesture politics and use his clout to force out the central privatising elements of the Bill; drop Monitor, the economic regulator of the health service; protect national pay terms and conditions for NHS staff; and limit the ability of private health care companies to enter the NHS at every level. He must ensure that the Government do not privatise the health budget, but bring GPs and other health professionals into PCTs to achieve clinical excellence in commissioning, without there being ulterior motives for private profit.

I know that time is short and that many Members wish to speak. My final point is that if the Deputy Prime Minister is serious about protecting the NHS and achieving substantial and significant changes to the reforms, he must force his coalition partners to drop the Bill and start again.

‘Pause, listen, reflect’ and stop. Momentum of the Health Bill continues to damage the NHS as uncertainty breeds fear.

Blog / April 18, 2011 / 1576Comment nowhttp://grahamemorris.com/2011/04/pause-listen-reflect-and-stop-momentum-of-the-health-bill-is-continuing-to-damage-the-nhs-as-uncertainty-breeds-fear/%27Pause%2C+listen%2C+reflect%27+and+stop.+Momentum+of+the+Health+Bill+continues+to+damage+the+NHS+as+uncertainty+breeds+fear.2011-04-18+12%3A22%3A55grahame

Andrew Lansley’s stewardship of the NHS in his first year as Health Secretary, which was never expected to be controversial, now looks likely to leave a permanent scar on the Tory-led Coalition. More worryingly his disastrous tenure is raising serious doubts over the future of the National Health Service. Since taking control of the NHS in May 2010 he has received widespread professional and public condemnation for his handling of day-to-day health policy as well as his proposed plans to shake up Britain’s health service which would put the whole of the NHS at risk of privatisation by stealth.

We are told that his radical plans to shake-up the NHS have now been put on hold for a natural break, however the Health and Social Care Bill will be neither practically easy to discontinue nor politically easy to bulldoze through in the face of mounting opposition from the public, health professionals and backbench MPs of government and opposition parties. It will be even harder to amend the Bill in any meaningful way. Lansley’s plans are not simply another reorganisation but a root and branch upheaval which will allow private health providers a potential foothold in every layer of the NHS.

All this makes a mockery of the ‘pause, listen, reflect and improve’ stance of the government. This stalling mechanism may provide a welcome breathing space for the coalition but in the end only drastic action from the top of government will persuade the public that David Cameron’s personal pledge to protect the NHS was genuine.

There is further evidence of the deterioration in frontline care and treatment which the government promised would be protected from their package of austerity measures. An open letter from the Federation of Surgical Specialty Associations (FSSA), the professional body representing surgeons, has raised major concerns over the increased rationing of basic operations. They claim that patients are being wrongly denied treatments, from new hip operations to cancer treatment, as a direct consequence of NHS cost-cutting. Such cost-cutting is now commonplace regardless of the effectiveness of treatments and the consequences for patients who are being forced to endure pain and worsening health as a result.

The Guardian has reported the FSSA’s concerns that “lists of surgical procedures and interventions, deemed of low clinical effectiveness or of ‘lower value’, are being used by PCTs to limit access to certain procedures [when a] review of the lists reveals that there is little or no evidence to support the view that many of the procedures are of limited value to individual patients”.

As a member of the Health & Social Care Bill Committee and the Health Select Committee I have had the opportunity to scrutinise Andrew Lansley’s plans for the future of the NHS in detail. In January I raised concerns that his radical reforms were already being implemented across the NHS before Parliament had even had a chance to consider the proposals. And recent reports and criticisms of the cost-cutting and reorganisation being forced onto the NHS seem to support my concerns.

The ‘pause, listen, reflect and improve’ stance of the government will not be able to overturn the deficiencies inherent throughout the Health and Social Care Bill. It is disingenuous of the Coalition’s leaders to pretend that such a substantial piece of legislation can be amended to the satisfaction of widespread concerns.

Andrew Lansley’s plans for the NHS were not tested with the public at the General Election and it is time for him to admit that his vision for the NHS is not shared by the British people.  Nowhere in the Tory manifesto did he explain his plan to apply 1980’s style privatisation mechanisms to the NHS; create an economic regulator for health costing upwards of £500 million over one parliament; or allow EU competition laws into the NHS. Instead the Health Secretary spent six years as opposition spokesman doing everything possible to avoid giving any indication that he planned radical change for the NHS.

No one that voted Conservative at the last General Election could have anticipated his radical reform package: abolishing PCTs; giving the NHS budget to unaccountable private bodies; putting out to tender every NHS service to allow entry points for the private sector at every level of the NHS; and removing the private patient cap to allow an uncontrolled focus on profit-making in hospital foundation trusts.

In his first year in the job Andrew Lansley has lost the confidence of the NHS, its professional staff, the public and his own Cabinet due to his reckless reforms. If the government was really pausing, listening and reflecting then it would drop its damaging Health & Social Care Bill and tell the Health Secretary to return to the job of improving the NHS for the years to come.

Speech to the Health & Social Care Bill Committee – 24th March 2011

Blog / April 7, 2011 / 1572Comment nowhttp://grahamemorris.com/2011/04/speech-to-the-health-social-care-bill-committee-24th-march-2011/Speech+to+the+Health+%26+Social+Care+Bill+Committee+-+24th+March+20112011-04-07+10%3A23%3A01grahame

Speech against the removal of the Private Patient Cap

[Clause 150 of the Health and Social Care Bill would allow hospitals to carry out unlimited private health care in order to make profits and push NHS patients to the back of the queue.]

Grahame M. Morris (Easington) (Lab):  I want to speak against the inclusion of the clause [150] in the Bill. Essentially, the clause removes the cap on foundation trusts providing private health care. Practically, that means that they will expand their private health business to form as big a proportion of their overall service as they wish. Ultimately, that will have a negative impact on the NHS provision of care. 

NHS patients are even more likely to find themselves being second-class patients in their own hospitals. Representations from the NHS Confederation, the Royal College of Nursing, UNISON and Unite have made us aware of the pressures that the foundation trusts are facing. The trusts are already struggling to balance their books with the unilateral tariff reduction, and they will face further pressures under the new system that is set out in the Bill to trade at a profit. If they fail, they could be taken over or even closed. 

Opposition Members believe that NHS patients will lose out. Private patients will occupy the beds and use the diagnostic facilities and other services. NHS waiting lists and waiting times might rise while patients will face the option of paying to jump the queue. Indeed it might create a perverse incentive deliberately to do that, cutting against even the Government’s limited concept of the NHS as a health care system provided free and allocated according to need. 

The point about lifting the cap and pushing foundation trusts into the private health care market is that care will be based no longer solely on the needs of the patient but on the needs of the financial trust to make a profit and survive. My hon. Friend the Member for Halton has already described the three cases set out in paragraphs B153 to B156 of the Government’s impact assessment. They give an interesting insight into where the Government think the additional activity will come from in the private sector. 

Dan Byles:  Is it not the case that under the existing regime the trusts are under a legal obligation to break even? When looking at their operations in a wider sense, they have also had to have regard for their budget. 

Grahame M. Morris:  That is a completely reasonable point. The hon. Gentleman is correct. Under the existing arrangements, there is a cap on private work, apart from on the areas that the Minister identified—the non FTs. I will come on to the main risks of removing the cap, not least the lengthening of waiting times and waiting lists. How do the Government intend to market such a measure to maximise the benefit? 

The new arm’s-length body, NHS Global, was set up by the previous Labour Government. Its aim was to extend NHS services overseas and to play a role in international development by providing a shop front for foreign health tourists to be sold clinical services by NHS foundation trusts in the United Kingdom. Does the Minister intend to go down that particular route? 

Paragraphs B154 and B156 of the impact assessment are also instructive. They acknowledge: 

“The impact of any such increase in private activity on NHS patients will depend upon how near to capacity an FT is operating and whether: NHS FTs respond to the additional private patient income by creating additional capacity to treat private patients; NHS FTs simply allocate more of their existing capacity to treat private patients.” 

That is quite a fundamental point. Paragraph B156 states: 

“If the latter, there is a risk that private patients may be prioritised above NHS patients resulting in a growth in waiting lists and waiting times for NHS patients.” 

Paul Burstow:  The hon. Gentleman is reading and referring extensively to the impact assessment. Will he read on in paragraph B156? He will find that it lists all the things in this Bill that mitigate that risk. 

Grahame M. Morris:  I acknowledge that the picture is mixed, but unless there is an increase in capacity the concept is different. Unless we plan to go out and create additional capacity within the FT, surely a choice must be made about how to use the existing capacity. 

I will move on. That eventuality—the risk of longer waiting times and waiting lists—caused the previous Government to introduce the PPI cap in the first place, so as to prevent such anomalies. I acknowledge that the impact assessment goes on to present the Government’s case, and that that does not happen despite highlighting other risks that emerge as a consequence. 

Dr Poulter:  The hon. Gentleman paints a pessimistic picture of how foundation trusts will operate. Does he accept that the private sector takes up more of the strain and generates income for the foundation trust? That money can be pumped into patient services elsewhere. 

Grahame M. Morris:  I do not accept that analysis. I suspect that the private sector is essentially parasitic in taking resources, facilities and opportunities that should be dedicated to NHS patients. 

Dan Byles:  I am curious to know what motive the hon. Gentleman thinks an NHS foundation trust would have to invite the private sector to use its resources. If that trust was not going to end up with more resources to spend on patients at the end of the process than it would have had at the beginning, why would it do such a thing? 

Grahame M. Morris:  There is a simple explanation. It is happening now with the tariff reduction of 1.5% that NHS foundation trusts are facing in the current financial year. For a big trust, that might be £20 million or £30 million. In the new world set out in the Bill, trusts will be under pressure to balance the books, just as they are currently. They were constrained by the cap that was in force, but when that lifted there was an opportunity. Would a director of finance of an FT not seize an easy opportunity to balance the books by taking more private patients? It is a simple choice and the line of least resistance. 

Dr Poulter:  Is that not the point? The hon. Gentleman calls the private sector “parasitic”, yet it was his Government who used the private sector in the first place. Either he likes the private sector, as the previous Government did, or he does not. Clearly, his party likes the private sector, so the point is difficult to argue. The previous Government were prepared to pay the private sector 11% more than NHS providers. Does he find that acceptable? 

Grahame M. Morris:  The hon. Gentleman has made that point numerous times during the passage of the Bill. The issue is one of capacity. I will move on in a moment as I do not want to drag the point out, but there are certain key areas that affect quality of life, and life-changing clinical interventions for things such as cataracts, hip and knee replacements. I am old enough to remember people waiting 18 months or longer in my locality. Through using the private sector because we did not have capacity in the NHS, we drove down the waiting times. There should be some acknowledgement of that positive move. 

The issue is relevant to the discussion because of the demand for private opportunities and operations. Now that the NHS has capacity, the waiting times and demand for private health care have gone down. 

Liz Kendall:  Will my hon. Friend acknowledge that the private sector was brought in to treat NHS patients, free at the point of use? We are now talking about charging private sector patients, which is a very different issue, as the hon. Member for Central Suffolk and North Ipswich knows. There would be the ability to charge extra to bring in extra money to balance the books. That is the issue under discussion. 

The Chair:  That point has been made several times. Can we move on? 

Grahame M. Morris:  I appreciate that, Mr Hancock. It is extremely helpful and I am pleased that we have had the opportunity to put that on the record. 

It seems that the incentive to generate new sources of income will be even stronger in the context of the market in health care created under the Bill; after all, the entire policy is predicated on that. The Department of Health’s chief executive, Sir David Nicholson, has said that the NHS constitution enshrines the 18-week waiting time as a right, so commissioners will need to give due regard to whether providers honour it. The Government are using that argument to say, “Well, although we don’t have an 18-week target, it is enshrined in the NHS constitution.” In practice, however, there is some doubt about whether its constitution is legally binding—or, indeed, enforceable, unless the Government intend to put it on a stronger statutory footing. 

Paul Burstow:  To make it absolutely clear, I should say that it is our intention to use a standing rule, which the Bill provides for, to ensure that that right is real and manifest. 

Grahame M. Morris:  I am grateful to the Minister for that. 

We know that Ministers have removed the duty for the Department of Health to pursue the targets, as part of the move away from Labour’s targets. However, I wonder whether even an 18-week limit will be effective over the next few years. I have already mentioned some of the problems with cataract, knee and hip operations; an 18-week wait is too long, given the life-changing interventions that need to be made. 

The Government also suggest that patients will choose providers that treat them sooner, and that that will incentivise providers to shorten waiting lists and keep waiting times down. Again, that argument is flawed. In many parts of the country—I am thinking of the north-east and the north-west—there may be only one willing provider within convenient travelling distance. Indeed, we touched on that aspect this morning. Any choice will be illusory. Instead, the choice will be between being an NHS patient at the local hospital or a private patient who can pay to jump the queue. 

In the face of financial pressures, commissioners may find providers deliberately lengthening rather than shortening waiting times in order to control costs. I have some knowledge of that, having worked in an NHS foundation trust. Being a non-executive director, I understand that they are sometimes manipulated, for reasons that many of us would question. In financial terms, the loss of income from NHS patients may not be a problem for foundation trusts if private patients occupy the same beds but bring in a higher income. Again, it is a recipe for an even greater share being taken by private patients, while NHS capacity is reduced and waiting times lengthen across the board. 

The Government argue that the plans currently being implemented are intended to substitute community-based care for acute provision in many cases, and that it would open up new capacity for the providers. Again, however, there is some scepticism about whether it will happen. Even if it did open up new capacity, it is not a strong enough argument to leave the clause unamended, because there is no provision for limiting the expansion of private provision to fill spare capacity. In short, it is an argument for raising the cap rather than abolishing it. 

The Government have advanced another argument. They say that most FTs do not operate to their PPI limit. Evidence suggests that many FTs do not automatically use their ability to earn private income, but the argument that foundation trusts have not maximised their private income ignores the realities of the situation. The planned market expansion relies on a period when demand for private health care was dramatically falling as NHS waiting times went down. 

There is strong evidence that reduction of waiting lists and times in the NHS had a knock-on effect on the private sector. People were not compelled to wait long periods so they did not feel that they should pay—where they had the means—for a private operation. That would suggest that as waiting times rise again—as we suspect they will—demand for private health care will rise, creating a completely new context. Furthermore, as noted in the impact assessment, the Government envisage non-EEA foreign patients being a major growth area, so domestic demand may be irrelevant. That could undermine community cohesion, given the likelihood of media stories about health tourists blocking NHS patients, with—potentially—effective taxpayer subsidy in the form of overheads. 

In short, the Government plan to create new demand for private health care in NHS hospitals. This is fundamentally different from previous arrangements, where NHS patients were treated in private hospitals for a particular purpose—because the capacity was not there. The argument that previous levels of demand were not high enough to cause a problem obviously does not hold. The Government admit that 

“it is not possible to predict how FTs will behave with the lifting of the caps”. 

To proceed with lifting the cap on the assumption that foundation trusts will choose not to use the power that they are being given, based on very flimsy evidence, is not only illogical but reckless. Combined with the forced opening of NHS facilities to private companies—which we discussed on Tuesday in the debate on clause 89 on licensing conditions—this is another step towards opening hospitals to EU competition law, especially if a major part of their income is private, in which case it might be deemed an undertaking, rather than primarily performing a social purpose. 

There is also a legal opinion, although the Minister challenges this and is at pains to say that European competition law will not apply. However, there is a legal opinion from Beachcroft which suggests that expanding private provision would leave NHS foundation trusts open to a state aid case, due to the effective cross-subsidy of private patients given that the wider hospital infrastructure was built and is maintained using public funds. There is every reason to believe that this proposal is fraught with risks at many levels, some of which the Government admit to in the impact study, and there are few reasons to accept the reassurances that they have given so far. I believe that this clause is a Trojan horse, driving privatisation into the heart of the NHS, and I urge Members to vote against it.

Speech on Public Satisfaction with the NHS

Blog / March 30, 2011 / 1561Comment nowhttp://grahamemorris.com/2011/03/speech-on-public-satisfaction-with-the-nhs/Speech+on+Public+Satisfaction+with+the+NHS2011-03-30+17%3A21%3A35grahame

Full version of an abridged speech in Westminster Hall:

This debate has been initiated following the debacle in the Department of Health over the last two year’s Ipsos MORI surveys: “Public Satisfaction with the NHS and Social Care: A Study Conducted for the Department of Health”.                                                                                                                                                                

As recently as the 22^nd March, the Health Secretary was still under the impression that he had successfully suppressed this report: telling the Health Select Committee (of which I am a member) “it was not published by my predecessors, it is not my intention to publish it”.

Unfortunately for the Health Secretary, it was published by his predecessors and his Department did publish it – regardless of his intentions.

In answer to my written question (and similar questions tabled by other honourable members), the Minster for Health, without reference to any u-turn or misunderstanding on the issue said:

“Every tracking survey [conducted annually by Ipsos MORI] received by the Department has been published.” In fact, the reports had been placed in the House of Commons’ Library on the 3^rd of December following a written question by my honourable friend for Leicester West.

It’s just no one told the Health Secretary.

There is good reason for the Health Secretary to want to keep the contents of the satisfaction report undisclosed because it confirms the outstanding NHS legacy that Labour passed on to the Health Secretary in 2010.

He is inheriting a National Health Service which was rescued from the last 18 years of Tory mismanagement and now enjoys the highest rate of public satisfaction in its history.

The survey says: “Public satisfaction with the running of the NHS remains very high at 72%. This level of satisfaction has now been sustained for over a year making the public’s perception of the NHS a real success story. Only one in eight people say they are dissatisfied with the NHS (13%) with just 3% saying they are ‘very’ dissatisfied.”

The real reason the Health Secretary hoped that his Department had not publish this report is that it shows him to be completely ‘out of step’ with the British Public.

He is the only man that does not appreciate the values of the NHS, and somehow he has found himself running it!

The Health Secretary who cites his former boss, Lord Tebbit, as his political hero does not understand what it is the public so value about the NHS.

He has wasted the last six years as Conservative Party Health Spokesman (since June 2004) when he could have at least tried to get to the bottom of just what it is the public so admire about the NHS.

Instead he is doing to the NHS exactly what he did to the utilities in the 1980s – when he was working for his hero Lord Tebbit – and applying 1980s privatisation policies to the health service.

Current polls of public satisfaction with the NHS are all the more important when we consider that the revolution now underway was not outlined to the British people until some months after the General Election.

The Conservative Manifesto said it would “defend the NHS from Labour’s cuts and reorganisations”. And yet this government is delivering a real terms cut in spending and the most radical reorganisation that will actually dismantle and undermine the NHS.

Nowhere did the Health Secretary explain his plan to apply 1980s style privatisation mechanisms to the NHS:

-          creating an economic regulator for health costing upwards of £500 million over one parliament;

-          bringing in European Competition Law to the NHS (which applies to our utilities);

-          and handing the £80 billion NHS budget to private bodies with GPs as figureheads – but to which Freedom of Information will not apply.

Instead the Health Secretary spent six years as opposition spokesman doing everything possible to avoid giving any indication that he planned radical change for the NHS.

He promised that PCTs would stay and said, in fact, they would be strengthened and made more democratic.

He said he would increase the NHS budget, but failed to mention that he would handing the whole lot over to private bodies.

And I don’t recall him every mentioning that every NHS service would be put out to tender under competition law to allow entry points for the private sector at every level of the NHS.

And, finally, I’m quite sure there was no mention of removing the private patient cap to allow an uncontrolled focus on profit-making in hospital trusts – a mechanism to push NHS patients to the back of the queue.

But, his coyness paid off, because the public – overwhelmingly satisfied with the National Health Service which Labour had rebuilt over 13 years in government – did not suspect a thing.

Health was not raised once in the last prime ministerial debate before the general election.

Quite the reverse will be the case at the next General Election I’m sure, with most of these harebrained reforms not coming into effect until 2013 or 2014.

I want to focus my remarks on how public satisfaction, and in some areas dissatisfaction, might apply to the proposals of the Health Secretary in the Health and Social Care Bill.

Now that the Ipsos MORI survey has found its way into the public domain we can consider its implications for the current upheaval planned by the Health Secretary.

The Ipsos MORI polls supplement another survey carried out in December 2010 by the National Centre for Social Research: The British Social Attitudes report.

It too found that public satisfaction with the NHS was at an all time high.

After 18 years of a Tory government in 1997, only 34% were satisfied with the NHS, the lowest level since this survey began in 1983. By 2009, satisfaction had nearly doubled to two thirds (64%).

The more recent Ipsos MORI polls put satisfaction even higher at 72%, with 71% agreeing that Britain’s National Health Service is one of the best in the world, a figure which is the highest level ever recorded (up 17% since July 2007).

Three specific polls in the Ipsos MORI survey give a clear indication of public preference for the future of the NHS, with between 63% and 65% agreeing with the statements:

-          The NHS provides good value for money to taxpayers;

-          The NHS provides patients with the best treatment possible;

-          And people are treated with dignity and respect when they use NHS services.

In-house NHS provision of a high quality is favoured by the public and this is something that Tory-led proposals in the Health and Social Care Bill threatens.

Because over time, as the private sector wins contracts from NHS bodies, the NHS provider will have to close – until all we are left with are private companies competing with each other for multi-million pound contracts.

This is the Lansley-vision of the NHS – completely out of step with the British Public.

I will not shy away from the polls in the survey which the Minister might seek to pounce on to claim support for his policies which does not exist. I will deal with them head on.

A stark 90% of those asked, supported the statement that: “More control over health services [should]…be given to doctors and nurses rather than managers and politicians”. And 75% agreed with “reducing the number of managers in the NHS by a third”.

No one will be surprised that doctors and nurses are favoured over managers and politicians. But he cannot pretend that his policies follow these statements.

 -          Instead, his policies will shutdown PCTs and SHAs and see the substantial loss of vital knowledge and expertise of key staff, to be replaced by private bodies which may have GP figureheads, but will be able to be hollowed out with all commissioning duties sub-contracted out to private companies.

-          His policies will remove clinical bureaucracy and management expertise only to see it replaced by a mammoth bureaucracy around economic regulation due to the extension of competition laws into the NHS – with Monitor having projected costs of over half a billion in one parliament.

-          And his policies – opposed by both doctor and nursing organisations – will see 27,000 nurses lose their jobs (according to the Royal College of Nursing) and bring complete instability across all NHS services as they are challenged by the private sector for contracts.

We know on this side that GP Commissioning is a red herring.

If he wanted clinical involvement in healthcare, the Health Secretary could have taken the existing PCT structure, pushed for efficiency savings, as Sir David Nicholson intended to do; put GPs and clinicians onto the board, democratically elected other board members, measured outcomes and made PCTs more accountable.

Instead he has chosen another route, dismantling the infrastructure of the NHS and enforcing competition and free access to every layer of the NHS for private healthcare companies.

I hope the Minister will answer some important questions:

Will he look again at the discontinuation of any long-established statistical surveys on the NHS and health issues? 

With the most dramatic shake-up of the NHS since its establishment, he must see that any such decisions would be viewed as an attempt to cover up for future policy failures.

Will he listen not just to us but the independent experts that are calling for continued funding for all NHS and health surveys?

And finally will he take on board the recently released survey of public opinion and look again at the Health and Social Care Bill which flies in the face of the views expressed?

Without polling, and without an understanding of the facts, the government will be taking a reckless step in the dark. And if they don’t take consideration of public opinion in annual surveys, they might end up getting a shock in the biggest survey of all. The one planned for May 2015.