My Lords, it is for me a great privilege to follow the noble Lord, Lord Walton of Detchant He made an astonishingly wise and helpful contribution to debates in this House on the Health and Social Care Act. I found myself in exactly the same position as he was in. I have a total commitment to the National Health Service. That has not changed
in any way. In my whole life none of my family has ever used any other medical service. But I cannot find in the most careful reading of the regulations and our long debate on these two sets of regulations anything that bears out the widely spread view—extensively spread by the social networks—that this is all about bringing to an end the National Health Service as a public service and introducing overall privatisation.
I will quickly say three things. First, the Liberals Democrats intervened immediately when we saw the first set of regulations, laid on 11 February and promulgated in the House on 13 February. We did not like them at all. The day that the House came back, my noble friends Lady Jolly and Lord Clement-Jones were at the Minister’s door, asking him to see us that same day. Although there were widespread press discussions about how the campaigners and the Opposition had essentially stopped the regulations, it was not true. At the end of that discussion on 25 February, the day that the House came back, the Minister had listened closely to everything that we had to say and agreed at the end that the regulations could be misunderstood, and that there was therefore a strong case for looking again at making them clearer.
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We have learnt in the debates in this House to trust the noble Earl, Lord Howe. One of the sad things about all these debates is the way in which the idea of trust has been kicked about and almost lost in the discussions. On this occasion, we trusted the noble Earl, and promised that we would not publicise in any way the fact that the regulations were being withdrawn after our intervention. That is the truth of the matter. It is no good the noble Lord, Lord Hunt, shaking his head: I was there, first hand, from the beginning to the end of what I am talking about. I am not referring to any other sources; I am talking about my own personal experience, and that of my noble friends Lady Jolly and Lord Clement-Jones. I am not trying to spin anything at all.
At the end of that discussion, the noble Earl, Lord Howe, agreed to two things which have gone into the new regulations, both of them referred to by the noble Lord, Lord Walton of Detchant. The first was that there should be an additional demand upon Monitor, which will oversee the whole vision and the setting out of contracts. It replaces, as some people remember, the famous co-operation and competition regulations under the previous Labour Government. In exactly the same way, Monitor will be a regulator of the giving out and oversight of contracts in the same way that the CCP was before. The additional demand that we placed upon Monitor was that everything that it did must ultimately be in the interests of patients. That cannot be something that encourages privatisation. It must make it much more difficult, meeting a whole new set of requirements.
The second thing that happened was that we agreed, within the structure, what would happen if there was a bundling of services together. It is crucial to say that some of the charities objected to bundling, but if you want a single provider to cover an integrated set of services there is a strong case for bundling. I simply raise the question of whether bundling cannot be
something which charities are brought into and involved in. There is nothing in the legislation to say that they cannot be. A great deal suggests that that would be a very rich way forward.
On the third and final change that has been made, we made it plain, and it was accepted by the Government, that the concept of the sole provider could be a flexible instrument and not a single, rigid decision.
Secondly, much of this was conducted against the background of a total blaze—a kind of blizzard—of strangely distorted information. I got a bit fed up with being constantly described as either a turncoat or a traitor. I did not respond in kind, and I notice that the Minister and my colleagues have not responded in kind, either. Frankly, however, it has not made an attempt to get a sensible, rational debate easier. It has made it much more difficult.
I will say one last thing. The new Minister of State at the Department of Health, Norman Lamb is, again, a man widely known to be deeply committed to the National Health Service. He went out of his way when the new regulations were laid to invite the leaders of 38 Degrees to meet in his office, so that he could talk openly and discuss with them and to say, what is more, that he would be happy to consider and consult with them about the guidance to which the noble Lord, Lord Walton of Detchant, and the noble Earl, Lord Howe, have both referred, before the department went firm on what it would be. Norman Lamb listened to what they had to say for many hours and replied in detail, and discussed with them what might be done. I have to tell the House that, to my great disappointment, not a single word of the Minister’s reply to the positions laid out by 38 Degrees has appeared on its website or anywhere else. It is against this extraordinary background of deeply distorted information that we have to operate, and I find it, if I may say so, deeply disturbing and insulting.
The noble Lord, Lord Warner, is absolutely right to say that if we want to save the National Health Service as the great achievement of public services throughout this country we have to ask the question put by my noble friend Lord Owen about whether we can change the very strong binding effects of procurement law and competition law. They are difficult to get around, but as he rightly says, why is it that the Scandinavians seem to have managed and we have not? I do not know the answer to that question, but I do know that that is the present legislation.
If this House tonight decides to vote with the noble Lord, Lord Hunt, it will do two things. First, it will knock out Monitor completely, and send those who wish to protest about an unfair contract off to the courts to spend taxpayers’ money in arguing their cases for having been unfairly treated—