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Health and Social Care Bill (Programme) (No. 2)

Volume 530: debated on Tuesday 21 June 2011

On a point of order, Mr Deputy Speaker. Will you find out from the parliamentary authorities whether the monitors are working throughout the parliamentary estate? Only one Liberal Democrat Back Bencher is present, and, given that the Liberal Democrats have laid claim to significant alterations to the Bill, it is very important that they are in the Chamber.

I beg to move,

That the following provisions shall apply to the Health and Social Care Bill for the purpose of supplementing the Order of 31 January 2011 (Health and Social Care Bill (Programme)):


1. The Bill shall be re-committed to the Public Bill Committee to which it previously stood committed in respect of the following Clauses and Schedules—

(a) in Part 1, Clauses 1 to 6, 9 to 11, 19 to 24, 28 and 29 and Schedules 1 to 3;

(b) in Part 3, Clauses 55, 56, 58, 59, 63 to 75, 100, 101, 112 to 117 and 147 and Schedules 8 and 9;

(c) in Part 4, Clauses 149, 156, 165, 166 and 176;

(d) in Part 5, Clauses 178 to 180 and 189 to 193 and Schedule 15;

(e) in Part 8, Clause 242;

(f) in Part 9, Clause 265;

(g) in Part 11, Clauses 285 and 286;

(h) in Part 12, Clauses 295, 297 and 298.

2. Proceedings in the Public Bill Committee on re-committal shall (so far as not previously concluded) be brought to a conclusion on Thursday 14 July 2011.

3. The Public Bill Committee shall have leave to sit twice on the first day it meets.

Let me say at the outset that, because of the number of Members who wish to speak in the debate, I will take only a small number of interventions and will respond to them briefly.

The vital importance of our national health service cannot be overstated, nor can the Government’s determination to do all in our power to make it as good as it can be for the patients who depend on it by putting patients at the centre of care and putting outcomes first—outcomes such as survival rates, speed of recovery, and the ability to lead a full and independent life. The Health and Social Care Bill represents a bold evolutionary programme of essential modernisation: a programme—[Interruption.]

It is a programme that will end the culture of processed targets and diktats from politicians and of putting the convenience of institutions above the needs of patients.

On a point of order, Mr Deputy Speaker. I thought we were debating a programme motion, but the speech we are hearing seems to be a rehearsal of the Bill.

Hold on. Keep calm. I am absolutely certain that the Minister is about to move on to the programme motion.

If Opposition Members were more interested in listening than in trying to be disruptive, they would discover that after setting the scene I will deal precisely with the recommittal and our reasons for proposing it.

We will replace that culture with a bottom-up culture of clinical leadership and patient choice and an unfaltering focus on improving health outcomes.

While there has always been widespread agreement on the principles of modernisation—a fact that even the shadow Secretary of State now accepts—there have been concerns in some quarters that the Bill could support those principles better.

On a point of order, Mr Deputy Speaker. Some of us wish to talk about the programme motion that we are supposed to be debating, and indeed to intervene on the Minister if he will give way, as he said that he would at the outset. Can the Minister be persuaded to discuss the motion that is before the House?

Several Members wish to participate in this very short debate. It will last for only an hour, and we are already well into that hour. Will the Minister now refer directly to the programme motion?

Absolutely, Mr Deputy Speaker.

Given our commitment to, and the paramount importance of, the NHS, we decided to take the unprecedented step of pausing at an appropriate point in the legislative process. The independent Future Forum produced its report. We shall be able to make some changes to our plans that will not require legislation, but a number of changes will need to be scrutinised again by a Committee. All our proposed changes will be subject to further detailed parliamentary scrutiny through a further Committee stage and on Report. We propose—

I was about to come on to what we propose to do, but I will give way to the hon. Member for Penistone and Stocksbridge (Angela Smith), and then I will make progress.

I thank the Minister for giving way.

It is not unprecedented for Bills to come back to the House having been changed by the Government, but previously the whole Bill has gone back to Committee. Why are the Government not doing that?

The hon. Lady might not be too familiar with the past. Two previous Bills have been recommitted, both in 2003, and if she will wait I will put them in the context of what we are doing.

We propose to recommit 63 of the Bill’s clauses and to add a further five to the Bill. About 35 of those 63 clauses will need to be amended. The remainder will provide context and allow the Committee to have a sensible debate about the revisions. These clauses will cover the key areas of the Bill, including the role of the Secretary of State, clinical commissioning groups, the NHS commissioning board, the role of Monitor, foundation trusts, health and wellbeing boards and HealthWatch. We are demonstrably committed to subjecting the Bill to the full and proper scrutiny of Parliament. The Health and Social Care Bill spent a very long time in Committee, with 28 sittings over seven weeks, which, in fact, is the longest series of sittings of a Committee since we considered the modernisation of this Chamber and the House of Commons. Indeed, the hon. Member for Halton (Derek Twigg), who led for the Opposition in Committee, acknowledged at the time that the Committee had

“scrutinised every inch of the Bill.”––[Official Report, Health and Social Care Public Bill Committee, 31 March 2011; c. 1310.]

However—[Interruption.] However, as the changes we are making are—

Earlier, Opposition Members complained that I was not discussing why the Bill was being recommitted, yet as I now go through, point by point, why we are doing that they do not seem interested in listening. As I have said, I will not accept interventions frequently, because the House wants to know what we are doing and why are doing it, and that is the right way to proceed.

I will give way once more, to the hon. Member for St Helens North (Mr Watts), and then I will make progress.

I thank the Minister for giving way.

So far today, the Minister has used the precedent of 1983. Will he confirm that when a similar Bill came back in 1983, the whole Bill was recommitted to the House?

The hon. Gentleman seems a little confused. He is talking about 1983, but if he had been listening he would know that I have already said that two Bills were recommitted in 2003. I also said that if Opposition Members wait, I will explain the context of those Bills vis-à-vis the current situation. I therefore urge them to show patience, as they will then learn something.

On a point of order, Mr Deputy Speaker. In fact, the last Bill to be partially recommitted to a Committee was the Mineral Workings Bill in 1951, some 60 years ago, but the Minister is not referring to that.

That is just an extension of the debate. I reiterate that we have only one hour to debate this programme motion, so may we make progress? May I also ask Members to calm down, because I am finding it difficult to listen to the Minister?

Thank you, Mr Deputy Speaker, and you can rest assured that I am doing my bit. If only Opposition Members would listen, they would get the plot.

As the changes we are making are substantial and significant, we have decided to recommit relevant parts of the Bill to Committee. I can tell the House that we expect to make around 160 amendments to the Bill, which we will table in good time. We will also go further and publish briefing notes to help explain the amendments to parliamentarians and those who follow our proceedings outside.

The hon. Lady, from a sedentary position, rather like a Greek chorus that ill-befits her, asks when. The answer is that we expect to table the amendments by 23 June, which, if it helps her, is in two days’ time. That is despite the fact that many previous Bills—[Interruption.] The hon. Member for Islington South and Finsbury (Emily Thornberry) should listen to this because it has some direct relevance that she will not like. We are doing this despite the fact that many previous Bills were not recommitted under the previous Government despite their having undergone significant change. For example, the Local Government and Public Involvement in Health Bill in 2007 had 54 new clauses and three new schedules added by Government amendment, but rather than returning it to Committee the previous Government added them on Report. The Planning Bill of 2007-08 had 29 new clauses and three new schedules added by Government amendment; again, rather than return that Bill to Committee, the previous Government added the clauses on Report. Indeed, a Bill has not been recommitted for eight years since the Planning and Compulsory Purchase Bill in 2003.

No fair-minded person can claim that we are not subjecting the Bill to the closest possible scrutiny. Our recommitting the Bill will give hon. Members additional time to examine parts of the Bill that the Government propose to change. Of course, hon. Members will have further opportunity to scrutinise the entire Bill on Report in the Commons and the Bill will receive full scrutiny in another place. We do not believe that it is necessary for the entire Bill to be recommitted—[Hon. Members: “Why not?”] If hon. Members will listen they will find out why not. We do not believe that it is necessary for the entire Bill to be recommitted in order for proper scrutiny to take place. Indeed, we feel very strongly that that would unnecessarily delay the progress of the Bill to the ultimate detriment of patients. It is now time to give greater clarity and direction to staff and patients. As Professor Steve Field said in the Future Forum report:

“It is time for the pause to end.”

Professor Field is not alone in the opinion that now is the time to move forward and to enable proper and thorough scrutiny of those parts of the Bill that will change but without delaying the Bill’s passage beyond what is absolutely necessary. The Academy of Medical Royal Colleges said in its response to the Future Forum report:

“We hope the Government will now accept the Future Forum’s recommendations in full and move swiftly to make the changes to the Bill and the proposals that are required”.

The King’s Fund has also emphasised the need to avoid unnecessary delay. It said:

“The ‘pause’ has served the NHS, its staff and patients well”—

On a point of order, Mr Deputy Speaker. I tabled a named day question to the Minister, of which he is aware, in which he made it very clear that the changes to the Bill that he says relate to the recommendations of the Future Forum were in fact—

Order. Please resume your seat. That is not a matter for the Chair; it is an extension of the debate. Yet again I reiterate that we are now 13 minutes into a one-hour debate and we have yet to hear from the shadow Minister and a number of Back Benchers who wish to participate, so, please, could we restrain bogus points of order—that is No. 1 —and could we also have more quiet?

As I was saying, although the pause may have ended, we will never stop listening. [Laughter.] That is why a team of top health experts will continue to provide independent advice to the Government. [Interruption.] It is extraordinary, Mr Deputy Speaker, that hon. Members giggle and scream hysterically when they do not like what they hear. What they will not accept is that we did listen through the independent forum—we listened, we strengthened the Bill and they do not like it that more people and more organisations outside the House now believe that the plans that my right hon. Friend the Secretary of State introduced have been strengthened and will meet the needs of a modernised health service. That is the problem. That is why they are behaving in that way.

Of course, we need to give right hon. and hon. Members ample opportunity to examine the amendments in detail, but unnecessary delays will only cause harm for patients and add to the pressure on hospitals and commissioners as they make their modernisation plans. They will prevent clinicians on the ground from making the changes they believe will help to improve and save people’s lives. That is why we can have proper scrutiny through the recommittal of the parts of the Bill we are changing, as outlined in the motion, and I urge my hon. Friends and the House to accept it.

Last week, we had a political fix on the Government’s health Bill. This week, we have a procedural fix. The way the Government are dealing with the national health service and with the House of Commons is a disgrace. Last week, the Prime Minister was forced to backtrack in some areas to buy off the many critics of his health plans. This week, to head off proper parliamentary scrutiny of his plans, he refuses to put the whole Bill back into Committee.

The changes announced last week to the Prime Minister’s NHS changes are not a proper plan for improving patient care, or for a better or more efficient NHS. Those aims could largely be met without legislation, and certainly without the huge risk and cost of the biggest reorganisation in NHS history. The big quality and efficiency challenges the NHS must meet for the future will be made harder, not easier, by the reorganisation and the announcements last week.

The NHS has seen a wasted year of chaos, confusion and incompetence from the Government. Today, it is clear from the motion that that will continue. The motion signals the onset of sclerosis in the health service. The Bill will mean that the NHS is deeply mired in more centralisation, more complex bureaucracy and more wasted cost in the years to come. There will be five new national quangos and five new local bodies doing the job that one—the primary care trust—does at present.

Today, the motion signals that the essential elements of the Tories’ long-term plan to see the NHS broken up as a national service and set up as a full-scale market are still intact.

Regardless of the merits of the Bill, does the right hon. Gentleman accept that what the NHS and the public want is to find out whether the House supports it? They do not want to prolong the agony.

What the public and patients want is to get to the bottom of the changes the Government said they were bringing in. They want us to do our proper job of scrutinising the detail, and for that we need the time to do so, with the full Bill recommitted to the Public Bill Committee. Even some of the hon. Gentleman’s Lib Dem colleagues are beginning to see through this. Yesterday, the hon. Member for St Ives (Andrew George) wrote that the Government

“leaves many of the previous concerns—about the risk of a marketised NHS, a missed opportunity to better streamline health and social care and a lack of accountability—still unresolved.”

But does the right hon. Gentleman accept that those concerns will all be covered in the areas of the Bill to be discussed? Nothing will be left out.

I do not normally quote the hon. Gentleman’s party leader, but a few weeks ago, the Deputy Prime Minister said:

“It is very important that MPs, who represent millions of patients up and down the country, have the opportunity to really look at the details that we are proposing…I have always said that it is best to take our time to get it right rather than move too fast and risk getting the details wrong.”

The Prime Minister has stopped listening to the Deputy Prime Minister, and that is exactly the mistake the Government are making with the motion.

Does my right hon. Friend agree that despite the Conservatives saying that they are against cherry-picking, that is exactly what they are doing? They are cherry-picking the elements to be referred to the Bill Committee. Clause 60, for example, which deals with Monitor and the regulation of the NHS, is not included. There are so many inconsistencies in the Bill.

One of the deep flaws in the motion is that it is hard to see how the Committee can properly consider the changes that the Government say they want to make without being able to consider the consequences for other parts of the Bill and other parts of the NHS.

Moderation in these debates is always to be welcomed. Surely the right hon. Gentleman must see that he cannot have it both ways. He cannot complain about the money and the length of time spent on the listening exercise. When I was in the House last week to listen to the statement, he said it was time to get on and get it done, yet he argues that we should drag the process out for even longer. He cannot have it both ways.

I can and I have. This is a reckless and needless reorganisation, which has led to confusion and chaos over the past year. If the House does not help to get the legislation right by doing its proper job, that chaos and confusion and the wasted cost—money that should be spent on patient care—will continue.

Is it not an abuse to use this procedure, which is very rare? According to the Library, the most recent example of a partial recommittal of a Bill to the same Committee was the Mineral Workings Bill in 1951 because of an inadvertent error in the original Committee stage. It is totally wrong to use the procedure. The whole Bill should be recommitted.

My hon. Friend has a point. What is wrong is a partial recommittal of the Bill, because the Bill requires full scrutiny of the full provisions with the changes that the Government propose to make, once we have had a chance to see them.

The Health Minister and Government Members urge us to go faster. Everything this Government have done with their NHS reorganisation has been rushed and reckless, and the motion signals that they are set to repeat the mistake by railroading the Bill through at breakneck speed and denying this elected House its proper role in scrutinising the legislation. Labour tabled a motion a month ago for the full Bill to be reconsidered in Committee, for more time to look at the detail of the amendments and for proper scrutiny and debate in Committee.

Is it not important to take into account the written answer that I received to the named day question—a very good question—that I put to the Minister? He gave me a very good answer: far from recommittal being a consequence of the NHS Future Forum, the Government were consulting on these very amendments to the Bill prior to the announcement that they made on the consequences of the Future Forum. Is not the entire process a sham?

My hon. Friend is right. We know that the Prime Minister is a PR man. We know that he was forced to call the pause and that, when he did, he was looking for a PR solution. The answer that my hon. Friend flushed out of the Government stands that up clearly.

To return to the motion before the House and the question whether the Bill requires, as we argue, recommittal in full, parliamentary precedent demands this, proper parliamentary scrutiny demands this and, above all, our responsibility to NHS patients to try to get the legislation right demands this. The parliamentary precedent is clear, as my hon. Friend the Member for Cardiff West (Kevin Brennan) said. The House of Commons Library tells me that the last time a Bill was recommitted in part was 60 years ago. In response to a point of order, the Health Minister cited the Planning and Compulsory Purchase Bill of 2003 as a precedent. The Labour Government recommitted that Bill in full and gave Committee members the whole of the summer recess to examine the detailed amendments before the Committee sat again. Why are the Government not acting as they should and as Labour acted in government with that Bill?

The NHS, the legislation and the changes to the changes announced last week are all complex, and the House cannot do its proper job unless the Government’s changes to one clause can be considered alongside the consequences for other parts of the Bill and for the health service. How can the promised changes to Monitor’s role be considered without looking at all 29 clauses dealing with its licensing powers? The House cannot do its proper job unless all the areas that the Government say they will change are recommitted.

Why are the clauses on the failure and designation regime for hospitals, which the Government say they will change, not covered in the recommittal motion? The House cannot do its proper job, and organisations cannot give proper evidence to the Bill Committee, unless all the amendments are tabled in good time, so why will there be only two full working days between the tabling of amendments and the Committee sitting? The House cannot do its proper job unless the Bill Committee has sufficient time for scrutiny.

The 64 clauses in the recommittal motion took 45 hours of debate in Committee last time. The Government are now cutting that time in half. The Minister said that he expects 160 amendments in Committee. That allows less than 10 minutes for each amendment that the Government table, and that is before the Opposition table our own amendments and before taking into account the six schedules that are being recommitted.

As a former Minister, the right hon. Gentleman knows about taking legislation through Committee. Given that a number of the 160 amendments will be technical and drafting amendments, will he please tell the House how many minutes he needs for each technical and drafting amendment to be debated in Committee?

The Minister, his colleagues and the Prime Minister have broken their word so often so far on the NHS that we cannot take at face value what the Minister says. We will wait to see and we will judge what he does when we see the detail of the amendments that he tables.

Does not this go to the root cause of the way the Government are dealing with the NHS? They are dealing with it piecemeal. At present we have an integrated health service. Does not their approach show that they want to break that NHS up?

My hon. Friend is right. What the Government are doing is reckless and rushed. The NHS is still intact, but what they are doing will break it up as a national service, as we know it.

The Committee had 28 meetings, 100 Divisions and hour upon hour of debate. That has been reflected in public opinion. The electorate who put us all in the House to represent their views are clear about what they want: a full debate in Committee, not a short-term Committee. They want it to sit until 18 October, not until 14 July.

The hon. Gentleman served on the Public Bill Committee. I hope he will continue to serve when the Bill is recommitted. He is right. The public and NHS patients expect us to do our best to get the legislation right. To do that, we require the detail, we require the time, and we require the whole Bill to be recommitted.

The House cannot do its proper job without an impact assessment. The current assessment says that

“the full benefits of these changes will not be realised unless there is a change to regulation to promote competition”.

The Government now say that this policy will be altered. There will also be greater bureaucracy, longer time scales and more bodies with more complex accountabilities. Both the supposed benefits and the stated costs have changed, yet the Government tell us that the new impact assessment will not be published until the Bill reaches the Lords.

How much will this reorganisation now cost? How much can the Government now claim this will save? What are the risks? Why has the Health Secretary being blocking my freedom of information requests to release the official risk register since November? Why will the Government not welcome and allow full scrutiny of the Bill in view of the significant policy changes they say they are making? Why are they preventing this elected House from doing its proper job of fully scrutinising the legislation?

If the programme motion is passed, more will need to be done on Report in this House and during the Bill’s passage through the other place. We will continue to oppose this reckless and needless NHS reorganisation, lead the detailed scrutiny this legislation requires and speak up as patients start to see their NHS services suffer again under the Tories. We will oppose the motion.

Order. Many Members wish to participate and there is only half an hour left, so long speeches would not be appropriate, to be fair to Back Benchers.

I will briefly specify three linked reasons, good and bad, why we support the Government’s programme motion. We oppose the Opposition’s amendment to the motion because it would simply lead to unnecessary delay. The Government have identified through the listening exercise, perhaps belatedly, the controversial, difficult and unworkable aspects of the legislation and want to change them. In deference to the people they have consulted, they want to change those aspects promptly and subject them to proper scrutiny, not only in Committee, but in an evidence session that we will also have.

Surprisingly, many areas of the Bill are relatively uncontentious and ought not to detain the House a great deal longer, such as the aspects relating to social work, the health and care professions or the National Institute for Health and Clinical Excellence. Those areas are relatively uncontentious and need not be massively reconsidered. In addition, there is the summer recess, as the right hon. Member for Wentworth and Dearne (John Healey) said, which means that after the Committee has concluded its considerations there will be ample time for him and anyone in the NHS, including all the consultees, to make adequate representations. The Bill will then go to the Lords and return for our further consideration.

The hon. Gentleman will have been lobbied by constituents in the same way that I and other Members have been. Does he agree that the public’s real concern is the potential for cherry-picking by private companies, even with the amendments that are being made, and that this approach will be unable to stop such a process?

The public are perfectly entitled to an answer on whether the Bill contains cherry-picking or not, but it is better that they have that answer sooner rather than later. There is a second reason—[Interruption.] May I just set my stall out? The second reason why this must be done properly is that the Bill has so far led to uncertainty and the implosion of primary care trusts. Whoever’s fault it is—[Interruption.] People will know that I did not support the original Bill. It has led de facto to the implosion of PCTs and to some irregular adjustments and appointments being made on the hoof—Members can ask their constituents about that—and to some premature arrangements being made.

I am obliged to the hon. Gentleman for giving way. How many times did he support my colleagues and I in the Bill Committee?

None is not the correct answer. The issue that Labour Members need to understand is that the NHS, as a result of the Budget that most of them voted for in 2010, needs to find £20 billion, and we cannot do that unless—[Interruption.] If it is a disgrace, it is a disgrace that the Labour party inflicted on us. We cannot do that against a background of complete and utter uncertainty, not knowing who will be running the NHS and having to find those savings. Members can check for themselves, but that is the view of the local people running their hospitals. Regardless of the merits of the legislation, they now want a decision.

Given that the hon. Gentleman voted for the Bill on Second Reading and got that wrong, how can we be confident that he has got it right today?

If the hon. Lady checks Hansard, she will find that I did not vote for the Bill on Second Reading––okay?

A third and more consensual reason—I might now withdraw it—is that I can assure the House that, having served on the Bill Committee, it could not find a better or more informed set of individuals who are on the ball. The Opposition drilled down on every clause with laser-like precision. There are some very talented individuals sitting on the Opposition Benches, and there is still that galaxy of informed talent. They might feel, as I do, that it is a little like being sent back to the trenches, but the fact is that if that team cannot win the arguments for either accepting or rejecting these changes in the time allotted, frankly there is no hope for this House. They must approach the matter in the right spirit, although that seems somewhat in doubt. I urge Opposition Members to have confidence in their team, the timetable and the ability of the British public to judge if it all goes horribly wrong, but it will not go horribly wrong simply because of the programme motion.

The problem with what the Government are presenting this evening is that, having had a pause, they have decided to fast forward without the intervening period. The truth of the matter is that they will not inspire confidence in the running of the NHS by moving at a gallop and they will not improve morale by moving at such speed without proper scrutiny. I must say to Government Members that last night’s business motion, which stated that no amendments could even be moved today, was an absolute disgrace. What are they frightened of?

In a moment.

Are the Government frightened that some of their Back Benchers might vote for an amendment? I can assure them that there are very few courageous people on their side of the House, but the hon. Member for Wellingborough (Mr Bone) is one of them.

I agree with the sentiments that the hon. Gentleman is expressing, but could he explain to me why the official Opposition did not object last night?

Because there was no opportunity to have a debate last night. It would have been nice to be able to expose the problems with the way the Government are dealing with the Bill, but unfortunately such an opportunity was unavailable to us. It is a disgrace that there is no opportunity for amendment. It is also a disgrace that the whole Bill is not being recommitted. We have seen none of the amendments. The Government are basically saying, “We’ve decided where we want to change the Bill, and only those bits shall be available for discussion by the Committee.” That is a completely inappropriate abrogation of the powers of this House to the Crown. The person who should be most disgraced by that is the Deputy Leader of the House, because he has said so many times that he believes in better scrutiny and yet is now abandoning that.

If the Deputy Leader of the House had allowed more than an hour for debate today, I would give way to him, but I am not going to give way now. We have already heard from a Minister for 15 minutes.

It is a bizarre selection of clauses that the Committee will be allowed to discuss. For instance, it will not be allowed to discuss clause 239 on NICE’s charter, nor clause 240 on its functions, but it will be allowed to consider clause 242, on the failure of NICE to discharge its functions. There is absolutely no logic to what is being presented to us.

In addition, the programme motion does not allow enough time. The Prime Minister is profoundly confused about all this, because he said many times this morning that 10 days would be allowed. Indeed, he said:

“Ten days… I don’t want to sort of misquote the Monty Python sketch but when we were in opposition we used to dream of tens days to debate a government bill”.

Well, yes, we are dreaming of 10 days now. We would love to have 10 days, but there will not be 10 days; there will be 10 sittings.

The Prime Minister is not very good on detail, because the Criminal Justice Bill to which he referred, and whose Committee he sat on, actually had 38 sittings over eight weeks.

My hon. Friend is absolutely right, but surely the key point is that we need to do this scrutiny properly. The Government may think that they are doing themselves a favour by trying to get the Bill out of this House by the summer recess, but all it means is that those in another place will have to do a proper job of scrutiny, and I bet that they will not get it out of the second Chamber before next year.

Finally, the motion states that we have to commit the Bill to the same set of people. Now, some splendid people sat on the Government Benches in that Committee, including the hon. Member for Preseli Pembrokeshire (Stephen Crabb). He is a splendid Member of Parliament whose integrity I do not want to be questioned, but he will now have to force all the people whom he forced previously to vote for one set of proposals in the Bill to vote for exactly the opposite. I therefore beg Government Members, if they value the hon. Gentleman’s career, to vote against the motion.

I say that because, theoretically, the Committee Chairman could rule that some amendments cannot be taken or selected because we have already presented them and the same Committee is re-sitting. We will find, however, that many Government Members have to stand on their heads and vote for the exact opposite of what they voted for earlier.

I understand that one of the great passions in life of the hon. Member for Southport (John Pugh), who speaks for the Liberal Democrats, is weight-lifting. Well, he did no heavy lifting of any kind on the previous Committee, and if there are changes to the Bill they are the work of Opposition Members, not the hon. Gentleman. He said that it was a wonderful Committee and could not have been better. Well, why was the hon. Member for Totnes (Dr Wollaston)—somebody who knows about general practice—not put on it? Of course, we know the reason: she did not agree with the Government.

I do not believe that the new Committee should include the same set of people, in particular because the hon. Member for Stafford (Jeremy Lefroy), on the final day in Committee, asked the Minister one of his great insightful questions: “What is the point of clause 249?” He is clearly a man of insight. In addition, he later said:

“I am still a member of the Committee, I think.”––[Official Report, Health and Social Care Public Bill Committee, 31 March 2011; c. 1268.]

We should have a new set of Committee members. There is no point in every Member who sat on the previous Committee, including those with direct financial interests in the Bill, being on the Committee in future, so I say, “Vote against this ludicrous, shameful and disgraceful programme motion.”

It is always a pleasure to follow the hon. Member for Rhondda (Chris Bryant). He is a parliamentarian before anything else, and he made some very important points, which we must consider.

The House must make up its mind whether to vote for a programme motion. I start from the position that I should always vote against a programme motion, because they are a Labour party invention and not good for scrutiny, so I gently say to the hon. Gentleman that, when I sat where he now sits, the Government whom he supported railroaded Bills through without proper scrutiny on many occasions. He was personally against that, but it happened, and whole rafts of Bills were not scrutinised.

On procedure, I congratulate the Secretary of State for Health and the whole Government on something that some Opposition Members do not understand but parliamentarians on both sides of the House will. We have a new Parliament and a new way of doing business. The Government no longer make their mind up and railroad through a Bill—[Interruption.] Some people laugh and scoff, but they are the people who do not get it. This Parliament is about scrutiny, and it has been proved that this Parliament can do it. People talk about U-turns, but this is not a U-turn; this is parliamentary scrutiny, and it is an amazing improvement on the previous Parliament.

Does the hon. Gentleman think it right in principle that the Government should be able to choose the parts of the Bill in Committee to which Members from any party, Front Benchers or Back Benchers, might want to introduce amendments?

The hon. Gentleman makes a really important point, one that I am wrestling with before I decide how to vote. If we had a business of the House committee, that problem would not arise, because the decision would be made in public and not by the Executive, but we are where we are. To the Government’s credit they avoided Standing Orders by allowing us to have a debate—however short—today. Standing Orders called for this motion to be decided forthwith and without a debate, so the Government should get credit for that.

There are a number of issues, but an important one is whether the whole Bill should be recommitted. I can see many arguments for that, but I can see also an alternative view, which says, “You’re going to look in more detail and have more time if you look at provisions that have effectively been changed.”

The Government talk about moving 160 amendments, and the Opposition will move amendments, but I hope that in Committee Back Benchers will do so, too. The problem for the Committee’s Chairmen is that they will have to consider how to deal with those amendments that are approved and consequential to earlier parts of the Bill, but I think that they will do so sensibly.

I have some doubts about the same people being on the Committee. I volunteered to sit on it and wrote to the Chairman of the Committee of Selection. There is an argument for fresh faces on the Committee, but the really important point is how Members on both sides behave in Committee. If they go there to scrutinise the Bill, if they are willing to table sensible amendments and if they vote according to their conscience and not on party lines, we will have real scrutiny.

I appreciate what the hon. Gentleman says, but under the programme motion the Bill has to be completed by 14 July, meaning a maximum of 12 sittings. How can that possibly be adequate time to scrutinise the changes being brought forward?

The hon. Lady asks another important question on which we as parliamentarians have to decide today. As I have said, I am against programme motions that include end dates; I am against programme motions anyway. We could recommit the Bill without including a timetable on when it must leave Committee, but unfortunately we live in this world and that tactic was invented not by my right hon. and hon. Friends on the Treasury Bench, but by the previous Government—[Interruption.] The hon. Member for West Ham (Lyn Brown), the Opposition Whip, who of course did not actually say anything, makes the point that two wrongs do not make a right, and I agree.

I know other Members want to speak, but I wish to return to my previous point. If Committee members, at least those on the Government side, vote according to their conscience and are not whipped, we will have a much better Bill. Of course, that is what the Prime Minister said in his famous speech on 26 May 2009, but I encourage such behaviour, because, if the Government do not like any amendments that are carried, they can always reverse them when the Bill returns to the House on Report.

Does the hon. Gentleman really believe that his own Whips are going to stand aside regarding this Bill? Frankly, he is living in a dream world if he thinks they are going to choose people who will not toe the party line and will vote for every amendment that they want.

If I am put on the Committee, I shall certainly make up my own mind. I know that that concept is foreign to Labour Members, who have always done what they are told and voted how they are told. Conservative Members are different—we vote according to conscience.

As a member of the Committee, I point out to the hon. Gentleman that throughout all 38 sittings I watched Conservative Members dragooned by the Whips and not once voting according to their conscience, if they have one, but with their Front Benchers.

I am afraid that I did not serve on the Committee, and my bid to get on it still stands. I hope that this new-found way of doing business will eventually make progress. If this House is ready to take back control of business, that is the way it has to be.

I welcome what the Government have done throughout this whole process, and I welcome today’s debate. I have reservations about the programme motion, and I will make up my mind on how to vote at the end of the debate. When the Bill comes back to the House on Report, I hope that there will be enough time for Members to deal with all the amendments and new clauses, because at the moment only members of the Committee can do so. In general terms, I welcome the new process and congratulate the Secretary of State for Health.

I rise to oppose the programme motion. I remember sitting and listening to some eloquent speeches against programme motions by Conservative Members when we were in government. What we uniquely have tonight, as has been highlighted by my hon. Friend the Member for Rhondda (Chris Bryant), is a double programme motion, because this debate is being limited to one hour, and then we will have a programme motion that rushes the Bill through by 14 July. Another unique aspect is that this is the first time since the coalition Government came into being that a Conservative Member has opened the debate following a major U-turn or embarrassment, when a Liberal Democrat is usually put up as a human shield. On this occasion, the Minister has obviously fallen for the trick.

It is important that this Bill gets proper scrutiny, but that will be difficult. The Minister has already said that the Government are going to table 160 amendments, and that is before any others have been proposed. He said that some would be technical, and I accept that, but we do not know what they will be about or how many there will be.

Does my hon. Friend agree that it is disgraceful that we are not even seeing those amendments until two days before the Bill goes into Committee, giving outside organisations and members of the Committee no time to scrutinise them? Does that not show that the Government are running scared of proper scrutiny?

My hon. Friend makes a good point. One innovation is the introduction of pre-legislative scrutiny of Bills by a Committee. In 2001, I served on one of the very first such Committees, which considered the Civil Contingencies Bill. That was an extremely good process during which the then Government accepted well over 100 recommendations and amendments. With a timetable of 10 sittings—not 10 days, as the Prime Minister said today—there will be very little time for outside bodies to scrutinise and have professional input into the Government’s amendments.

The hon. Member for Southport (John Pugh), who speaks for the Liberal Democrats, says that we cannot prolong the agony or uncertainty faced by the health service. I remind him that we are in this position because his party is supporting the back-of-a-fag packet proposals dreamed up by the Secretary of State for Health. If he really wants to be able to say that he has made a difference, he should have voted with the Opposition when he had the opportunity. It is interesting that he is again the sole Liberal Democrat on the Government Benches, even though we are being told that it is the Liberal Democrats who have made major changes to the Bill.

If the Bill is to get proper scrutiny, if we in this place are to get the respect of electors in thinking that we are doing a proper job of scrutiny and, more importantly, if we are going to get the health service that this country deserves, this is not the way to do it. I predict that we will get to 14 July, when most of the amendments will not have been debated, and once again let the other place dismember the legislation. We can see the job it is doing up there at the moment, and that is because ill-thought-out and ill-prepared Bills are being brought forward by this coalition Government.

I did not intend to speak, but I have been provoked into making a few brief comments. Like my hon. Friend the Member for Wellingborough (Mr Bone), I have concerns about programme motions, despite having been here only a short time. I, too, have never been successfully placed on a Bill Committee, although his failure is perhaps greater than mine as he has been here a bit longer than I have.

Before I was elected to this place, I spent 10 years as a local government councillor in perpetual opposition, being one of only two Conservative councillors on an authority of 60 members. We spent all that time criticising the administration for not listening to us and not giving us the opportunity to scrutinise decisions correctly. Perhaps it is the role of an Opposition to make a great deal of noise about the issue of scrutiny, and I understand that that is partly the approach of Labour Members today.

Since being elected, I have been incredibly frustrated by how little time there is to debate anything. Everything seems to be time-limited, and one sometimes sits for hours and cannot get called. I hope that if anything comes out of these discussions, this issue will be looked at in future years and we will have a different way of doing things in this place so there is proper debate.

When I talk to members of the public and health professionals, they tell me that they want clarity in knowing where we are heading with the NHS. Having listened to the Secretary of State, I want to know what the provisions will be to prevent cherry-picking.

Does the hon. Gentleman not understand that recommitting only the parts of the Bill that the Government want to recommit, and not considering the knock-on impact on other parts of it, will create uncertainty about the aspects that are not going to be debated?

I take the hon. Gentleman’s point. That has already been discussed. The key thing now is to debate the parts of the Bill that the Government have said they intend to amend, and perhaps that will mean that we can debate them in more depth. I want to know what the provisions are going to be to prevent cherry-picking. The shadow Secretary of State said that this is an attempt by the Government to break up the NHS and bring in market forces. I would not want to be a member of any political party that attempted to do that, so I want to know about the Government amendments.

I respect the hon. Gentleman’s respect for Parliament and therefore put to him what I said earlier: on a point of principle, is it not wrong that the Government should be able to select the parts of the Bill that they want to have scrutinised and not allow Members from all parts of the House an opportunity to do so? Does that not set an extremely dangerous precedent?

We have discussed where these procedures come from and who is accountable for them, and that certainly cannot be laid at the door of this Government. Over the past few months, we have heard first that there has been too much delay, and now that there is not enough delay.

As we have heard, professionals in the health service and the public have been saying that they wanted to know where we were heading and that they needed some clarity. The Government wanted that brought to an end, and they have had their listening exercise. On that basis alone, although I do not like the idea of curtailing debate, I hope that we can get on with this so that we all know what the changes are going to be, and that we end up with an NHS that is on a stable footing for the long term and do not have any more reorganisation for a considerable time.

I just reiterate the point that 1951 is the last time that this exact procedure was used. The Government are setting a dangerous precedent. This is an abuse of parliamentary procedure and it does not enable the House to consider all parts of the Bill. The recommittal of Bills is quite a rare procedure in this House.

One hour having elapsed since the commencement of proceedings on the motion, the Deputy Speaker put the Question (Order, 20 June).


That the following provisions shall apply to the Health and Social Care Bill for the purpose of supplementing the Order of 31 January 2011 (Health and Social Care Bill (Programme)):


1. The Bill shall be re-committed to the Public Bill Committee to which it previously stood committed in respect of the following Clauses and Schedules—

(a) in Part 1, Clauses 1 to 6, 9 to 11, 19 to 24, 28 and 29 and Schedules 1 to 3;

(b) in Part 3, Clauses 55, 56, 58, 59, 63 to 75, 100, 101, 112 to 117 and 147 and Schedules 8 and 9;

(c) in Part 4, Clauses 149, 156, 165, 166 and 176;

(d) in Part 5, Clauses 178 to 180 and 189 to 193 and Schedule 15;

(e) in Part 8, Clause 242;

(f) in Part 9, Clause 265;

(g) in Part 11, Clauses 285 and 286;

(h) in Part 12, Clauses 295, 297 and 298.

2. Proceedings in the Public Bill Committee on re-committal shall (so far as not previously concluded) be brought to a conclusion on Thursday 14 July 2011.

3. The Public Bill Committee shall have leave to sit twice on the first day it meets.