Health and Social Care Bill

The issue of accountability for this House—what we can and cannot do—is important and I will come on to it if I have time. I turn to the Liberal Democrats. The hon. Members for Burnley (Gordon Birtwistle) and for Manchester, Withington (Mr Leech) suggested that the Bill will protect hospitals and wards from closure. I am afraid that it will not. They need to read the Bill again. Monitor will be driving a lot of this, and they need to be clear about what the Bill actually does. They should join the hon. Member for St Ives (Andrew George), who is taking the interesting stance of not voting for the Bill tonight. He understands it better than other Government Members. Concerns over fragmentation and obstacles to integrated working have been raised by numerous bodies in the health service and by those who work in the health service. The Commonwealth Fund states that the UK has the best co-ordination between health care providers and professionals, with the lowest percentage of patients having experienced co-ordination problems in their care. Only 10% of patients have received conflicting information. The more privatised, competition-driven systems in Australia and the US experience greater co-ordination problems. The King's Fund brief for this debate states:"““The Bill signals a significant shift towards a more competitive market for health care. While we support increased competition in areas where it demonstrates benefits to patients, the Bill appears to move towards promoting competition at the expense of collaboration and integration.””" That is from one of the most respected think-tanks. One cannot underestimate the huge powers that will be given to Monitor. It will expose the NHS to a rigorous competition regime, with services going out to tender. The explanatory notes state that Monitor will become the"““economic regulator for all NHS-funded health services””," with the power to"““do anything it needs to in order to exercise its functions.””" In other words, the NHS will become like a utility. Of course, the Government are full of broken promises. The Prime Minister said that there would be real-terms increases in NHS spending, but there are not. He said that there would be no cuts, but there are. He said that there would be no top-down reorganisations, but we have a top-down reorganisation. David Nicholson said that"““no one could come up with a scale of change like the one we are embarking on at the moment. Someone said to me 'it is the only change management system you can actually see from space'—it is that large.””" This is a massive change. There are other issues, such as the cuts in staff that are taking place and the vacancies that are not being filled. We are being told about that by people who work in the health service. That is the true nature of the health service under the Conservatives and the coalition. We are in favour of improving the quality of care, driving up standards, greater clinical involvement and giving a greater say to patients. We are therefore not anti-reform, but we are against this reckless, top-down reorganisation with a cost of £3 billion, which was hidden away during the general election campaign. It is reckless, it is not in our best interests and many believe that it will be the end of the NHS as we know it.