Burns Night

The vote on the second reading of the Health and Social Care Bill last night was not unexpected, the coalition has a majority, after all. As always the speeches in the Chamber were a mixed bunch from both sides. Some were tribal, some showed intellect and research, and some were downright silly. For example, this rather dim question from Jesse Norman solicited a suitable put down by John Healey (Hansard 31 Jan 2011 : Column 625):

Jesse Norman (Hereford and South Herefordshire) (Con): I note that the right hon. Gentleman failed to answer the question about the rate of increase in the number of managers. When I last checked, the NHS had 1.3 million employees, of whom almost exactly half were administrators and half were on the front line. Is he really willing to defend such an extraordinary level of overstaffing in management?

John Healey: Oh dear, the hon. Gentleman really has to get a better briefing from his Whips than that.

Either Norman has never visited a single hospital in his constituency (in which case sack him, electors, he's not doing his job correctly!) or he cannot count. If he walked through any hospital he would be able to see that it is not the case of every other person is an administrator.

Norman's question was not the only daft statement said during that debate. I really do despair that our Parliament seems to be populated mostly by such second class politicians.

Anyway after quite a depressing performance from the government benches, with many of the speakers saying how they thought the NHS should be run, rather than saying how it actually will be run under the new policy and hence wasting time by talking about things that are completely irrelevant, it rested upon the government to wind up the debate with a final speech by Simon Burnzzzzz the Minister of State for Health.

The Conservatives avoided any discussion about the NHS during the election last year (and readers of this blog will remember my frustration over this), and have been accused of misleading the public. So now the government is attempting to say that they were completely open and everyone knew what their plans were (although, no one can actually remember being told!
). Simon Burns used his closing speech to tell us that they had not misled the public, but sadly the rather dimwitted and bumbling minister did not check the references that his speech writer had provided (Hansard 31 Jan 2011 : Column 698):

Hon. Members might find it helpful if I debunk a few of the myths that have sprung up about our plans to modernise the NHS. The first, and perhaps the most insidious, is that they were kept secret and hidden from the electorate. Quite frankly, that is palpable nonsense. In June 2007, my right hon. Friends the Secretary of State and the Prime Minister, when in opposition, published the Conservative party's white paper, "NHS Autonomy and Accountability". It laid out our clear intentions, which we reiterated on pages 45 and 46 of our election manifesto.

This is right. The "NHS Autonomy and Accountability" white paper outlined many of the policies that are in the Health Bill, and likewise so did the Conservative manifesto. (My take on this white paper is here.) The problem is that Burns shows that he has not actually read that document, because if he had he would know that it contradicts government policy in two important areas. These two policies were the ones that were discussed the most during the debate, so if I had been him, I would not have mentioned that policy document. However, Burns, being one step behind everyone else chose to read out what he had been told to read.

The "NHS Autonomy and Accountability" white paper section 4.25, 4.26 say:

4.25 As part of our commitment to avoid organisational
upheaval, we will retain England’s ten SHAs, which will
report to the NHS Board.

4.26 SHAs will be the NHS Board’s regional presence, and will
help to performance-manage Primary Care Trusts in the delivery
of the NHS Board’s commissioning objectives.

Notice that? The "clear intentions" mentioned by Burns were not to abolish SHAs in an attempt to avoid organisational upheaval! Further:

4.28 PCTs will remain local commissioning bodies.

4.30 PCTs will also remain, as now, the areas to which NHS resources are allocated, although almost all of these resources will be cascaded down by the PCT to its primary care commissioners.

Oh dear, oh dear. The policy document also said that PCTs would be retained.

So what has changed, why is it now considered so important for the NHS to suffer organisational upheaval? Are Lansley's new plans designed to fail? We can only wait and see.