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Health and Social Care Bill

Volume 734: debated on Thursday 19 January 2012


Asked by

To ask Her Majesty’s Government what were the estimated costs of implementing the Health and Social Care Bill when it was originally introduced to the House of Commons one year ago, and whether they have changed.

My Lords, in January 2011, we estimated the costs of implementing the Health and Social Care Bill at £1.4 billion. When we published the revised impact assessment in September, we estimated the costs of implementing the Bill to be between £1.2 billion and £1.3 billion. This will reduce administrative costs across the system by one-third by the end of this Parliament, saving £1.5 billion per year from 2014-15 onwards.

My Lords, I thank the Minister for that Answer. Many people in the medical world believe that the cost is mounting and that the cost which the Minister cites is not accurate. It is safe to say that this upheaval is costly both in money and in the risk to patient care. As well as the cost, at a time when the NHS has to find £20 billion of efficiencies, today the nurses and midwives have asked for the Bill to be dropped, arguing that their concerns have not been answered. Can the Minister give the nation and the NHS a first birthday present by listening to what is said and advising his right honourable friends Mr Lansley and the Prime Minister that it is time to pull back—

I am asking a question; I am in the middle of asking it. You may not care about the NHS but, on these Benches, we do. When the medical professions and nurses say that the Government should think again, it would be wise for the Government to do so. My question is whether the noble Earl will ask his colleagues to do so, and whether we can then move together, with consensus, as my right honourable friend Andy Burnham has now twice asked the Secretary of State to do.

My Lords, I understand that the noble Baroness is asking me to deliver a certain message to my right honourable friend. I am not quite sure what that message was, but if it is to do with the Health and Social Care Bill, I have to say that we need that Bill. We believe that reform of the NHS is essential if it is to be sustainable in the future. Every penny saved from this reform will be reinvested in front-line patient care. The previous Government had, as we do, an ambition to save £20 billion—the so-called Nicholson challenge—over the next three or four years. This reorganisation will enable us to contribute to that total. The modernisation will also move the NHS to a much more patient-centred system where good providers are rewarded for high-quality services. We are spending money on redundancy now to gain in the future.

My Lords, will the Minister tell us whether the report in this morning’s Guardian that the NHS regulator is proposing that a hospital should be credit-rated is correct? If it is correct, why are the Government pursuing this commercialisation of our hospitals? They are not supermarkets; they are places of care.

My Lords, I have not seen that report, but clearly there is concern, following Southern Cross, as to whether difficulties such as those should be predictable in some way. I am sure that a lot of thought is being devoted to trying to avert such crises in the future. I will look at that report and write to the noble Lord with any comments.

The Bill is called the Health and Social Care Bill. If the recommendations of the Dilnot commission for social care are implemented speedily with cross-party support there will be a huge saving to the NHS, where many frail and vulnerable people are inappropriately treated because the impending crisis in social care has not been addressed. Does the noble Earl agree that that is the case?

I strongly agree. The noble Baroness will know that running right the way through the Bill are duties around the integration of services between health and social care and indeed between different aspects of healthcare. By giving clinicians greater autonomy to decide what good care looks like for their patients in an area, I am confident that we will see fewer unplanned admissions to hospital, which cost a great deal of money, and much better preventive care for patients delivered by healthcare and social care professionals.

My Lords, has my noble friend noticed that this upsurge in criticism of his proposed reforms in the health service has coincided with an upsurge in the demands for more pay by some of the people who are making the criticisms? Perhaps if they were a little more modest in their demands, there might be a little more money for patients.

My noble friend makes a good point. Of course we wish to see professionals properly rewarded, but it behoves everyone in the public services to bear in mind the difficult economic circumstances in which we currently live. Many public servants, I am pleased to say, are responding to that call.

Is the Minister aware that his message about the imperatives of health service reform does not appear to have reached the Royal College of Nursing and the Royal College of Midwives, based on statements that they made yesterday? Does he share the view of his right honourable friend the Secretary of State in another place, who has stated that these are not disputes about the health service but politically motivated strikes?

I do think that the objections that the Royal College of Nursing has raised have very little to do with the Health and Social Care Bill. They are much more about what may or may not be happening in certain hospital trusts, which are matters that, in general, the Bill does not affect.

My Lords, health reforms rarely come at low cost. Can the Minister tell the House how much the previous Government’s health reforms cost between 1997 and 2010?

My noble friend is right to remind the House of the repeated reforms of the health service made under the previous Administration. I do not have a figure for how much they cumulatively cost the taxpayer, but it was clearly a great deal and I recall that one of the reforms took place over the course of the summer without any reporting to Parliament at all. The contrast between those reforms and this one is marked. We are doing this to get better care for patients. The previous Government were really only doing it to rearrange the deckchairs.

Does the noble Earl agree that, contrary to my noble friend’s comments, there is a real regret in the health service that our excellence awards—as you know my trust in Chase Farm has received one—have been done away with by the Government with the CQC. I do not know what the Guardian article said and I do not know what it means by “credit”, but getting credit for good services and proper care is something that everyone in the health service would welcome. The focus for us in the health service is indeed to join social care and healthcare. Can any emphasis that can be given by the noble Earl or the Department of Health come as quickly as possible please?

The noble Baroness was absolutely right in what she said in the last part of her question. I apologise to the House if I misunderstood the previous question about credit ratings, which I took to mean something to do with finance rather than gold stars, which I think the noble Baroness was talking about. I will try to clarify that in a letter.