:00:01. > :00:07.the beginning of this crisis. I would like to see the moderate
:00:07. > :00:12.members of the regime to do so again. Interest has exceededlet the
:00:12. > :00:15.time available. We must on. Urgent question Mr Jamie Reid. Thank you,
:00:15. > :00:25.Mr Speaker. Can I ask the Secretary of State to update the House on the
:00:25. > :00:30.government review of waste policy in England. Mr Speaker, I have laid
:00:30. > :00:34.in the library copies of the waste review to which we received 1800
:00:34. > :00:39.responses. The government's waste review looked at all aspect of
:00:39. > :00:44.waste policy and delivery in England. We want to make it yesier
:00:44. > :00:49.for people to do the right thing and recycle more. Today's are you
:00:49. > :00:55.view is good news. We will make it easier for people to recycle and
:00:55. > :00:59.tackle measures introduced by the last government, which encourage
:00:59. > :01:04.councils specifically to cut the scope of collections. We will
:01:04. > :01:11.remove the criminal sanctions applying to householders so that
:01:11. > :01:17.households aren't menaced for simple mistakes. We also propose to
:01:17. > :01:22.introduce a harm to local amenity to tackle neighbours from hell,
:01:22. > :01:28.ensuring enforcement is targeted at those who deliberately break youth
:01:28. > :01:37.law. The review is good for business. We are abolishing lotts
:01:37. > :01:46.because they offer certainty about landfill tack tax. The escalator
:01:46. > :01:50.will move from �8 to �0. We are announcing a voluntary agreement so
:01:50. > :01:55.that recycling services can be better exercised. Energy from waste
:01:55. > :02:00.will be a key technology in the future. Today's review is good for
:02:00. > :02:06.the environment. It will start consulting on restricting wood
:02:06. > :02:12.waste from landfill and go on to review the feasibility of bands on
:02:12. > :02:17.metal, textiles and biodegradable wastes. The review changes the way
:02:17. > :02:22.we look at waste by unlocking the economic opportunities of
:02:22. > :02:31.transforming waste to resource. We have set out a clear direction for
:02:31. > :02:35.cutting landfill, preventing waste and increasing recycling. It's
:02:35. > :02:39.barely credible, no wonder DEFRA is seen as the political equivalent as
:02:39. > :02:43.the mad woman in the attic. Today's announcement has been spun to the
:02:43. > :02:48.media before it has been led before Parliament. Amongst the spin was
:02:48. > :02:51.another broken promise, this time on weekly bin collections. Both the
:02:51. > :02:54.Secretary of State for DEFRA spent their time in opposition promising
:02:55. > :02:59.the public that weekly bin collections would be introduced.
:02:59. > :03:03.Today, we discovered this is not the case. Before the election the
:03:03. > :03:08.Secretary of State for Communities and Local Government said, to much
:03:08. > :03:13.acclaim, amongst his own party, "it's a basic right for every
:03:13. > :03:16.Englishman and woman to be able to put the remnants of their chicken
:03:16. > :03:21.teebg ta masala in their bin without having to wait for two
:03:21. > :03:25.weeks for to be it to be collected". Why is it that the government's
:03:25. > :03:29.position has changed? Can she also explain to the House today, is she
:03:29. > :03:34.happy that this waste review contains no recycling targets at
:03:34. > :03:38.all for England. The UK's recycling comind under the European Union are
:03:38. > :03:43.going to be met on the backs of recycling targets in Wales,
:03:43. > :03:46.Northern Ireland and Scotland, is that right? Can she also tell us
:03:46. > :03:49.why it is that she choose, on becoming Secretary of State, to
:03:49. > :03:53.abandon the last Labour government's consultation on
:03:53. > :04:00.stopping wood going to land fill, to waste a year and today
:04:00. > :04:04.reintroduce it? Instead of taking the chance to reduce recycling and
:04:04. > :04:10.reduesz waste this government aband Bann on the other hand's Labour's
:04:10. > :04:20.target. There is more to do. Today's announcement fails to
:04:20. > :04:23.
:04:23. > :04:27.establish a frame work for the green world that this country needs.
:04:27. > :04:31.The Secretary of State should today explain why it took so long and
:04:31. > :04:35.looks set to deliver so little. Speaker, first of all, I would like
:04:35. > :04:39.to make it clear that the written ministerial statement was available
:04:39. > :04:43.to members of the House before I spoke to the chartered institute of
:04:43. > :04:47.waste management. Of course, the government will work with all
:04:47. > :04:52.parties to increase recycling rates. The recycling target is a European
:04:52. > :04:56.target of reducing by 50% by 2020. I'm confident we are on target.
:04:56. > :05:01.This is a devolved matter also for the other nations. Mr Speaker, it's
:05:01. > :05:05.a bit rich coming from the opposition, who had 13 years, to
:05:05. > :05:11.get to grips with landfill. It could, if he had so wand wanted,
:05:11. > :05:15.got on and banned wood and materials and textiles and metal fs
:05:15. > :05:20.it had so choosen to do. I fear the opposition is in denial about the
:05:20. > :05:26.dreadful economic legacy it has left to the government. Mr Speaker,
:05:26. > :05:28.he asks about green growth. Mr Speaker, I have just spoken to the
:05:28. > :05:35.chartered institute of waste management and shared with them the
:05:35. > :05:37.fact we estimate that there will be a growth of 34 to 4% per annum in
:05:37. > :05:43.green jobs through the waste industry because of the positive
:05:43. > :05:52.frame work we are setting out to help people do what they want to do,
:05:52. > :05:57.the right thing, waste less and recycle more. That the Secretary of
:05:57. > :06:00.State laid before the House today, may I share with the Secretary of
:06:00. > :06:06.State that the district council serving my part of North Yorkshire
:06:06. > :06:09.will be on their way to making the target she has set. There will be
:06:09. > :06:18.preverse implications of abolishing the LAX because rural communities
:06:18. > :06:22.have done well out of. That could I ask the Secretary of State on
:06:22. > :06:27.anarobic digestion, it is welcome it will be increased. It deals with
:06:27. > :06:32.waste food, what are the implications from other energy -
:06:32. > :06:36.from waste facilities going forward in the next few years? Well, Mr
:06:36. > :06:39.THE SPEAKER:Er, I would like to thank the Chairman of the Select
:06:39. > :06:45.Committee Warm Welcome to the government's waste review and the
:06:45. > :06:49.recognition, I think, that LATS fulfiled a role. The landfill tax
:06:49. > :06:56.has largely overtaken its impact in helping us reduce the amount that
:06:56. > :07:03.goes to land fill. At the same time as publishing the waste review, I
:07:03. > :07:06.have published the government's's die gection strategy. It's very
:07:06. > :07:11.important. The Select Committee Chairman makes an important point.
:07:11. > :07:16.Not just food waste that can be used as a feed stock, we must be
:07:16. > :07:24.careful that food crops are not caught in as feed stock. We should
:07:24. > :07:31.be using waste. Thank you Mr Speaker. I expect the Communities
:07:31. > :07:38.Secretary eats more chicken tikkamasala than the DEFRA
:07:38. > :07:43.secretary. Does she agree with me, however, that the chicken tikka
:07:43. > :07:49.masala remains would be much better put into a food collection than
:07:49. > :07:53.into a sack. Will she made progress on further recycling and what does
:07:53. > :07:59.she think of the Friends of the Earth target, which I very much
:07:59. > :08:08.support of, of halving black sack waste by 2020? I can tell the House
:08:09. > :08:13.I have to feed the teenageres who are partial to chip chicken tikka
:08:13. > :08:18.masala, there is very little left at the end of the day. We will make
:08:18. > :08:22.it easier to make recycle and tackle measures which encourage
:08:22. > :08:27.councils to cut the scope of collections and support them where
:08:27. > :08:33.they wish to provide a weekly collection for smelly waste.
:08:33. > :08:38.welcome the publication of the review today. Does my right
:08:38. > :08:43.honourable friend agree with me, if we address the challenge of the
:08:43. > :08:47.regularity of waste collection we need to, particularly look at pages
:08:47. > :08:52.5 on wards of the report in relation to the management of food
:08:52. > :08:58.waste. What will the government be doing to reassure people that, in
:08:58. > :09:00.fact, we will meet targets to reduce food waste going into the
:09:00. > :09:04.chain? THE SPEAKER: There is a lot of
:09:04. > :09:08.interest, and little time. Speaker, I thank my honourable
:09:08. > :09:14.friend for a question which shows he read the review. He will know it
:09:14. > :09:19.contain as startling fact we currently waste �12 billion of food
:09:19. > :09:23.waste. Something we can ill afford to do. We need to work with all of
:09:23. > :09:33.those involved in food production and packaging to try and minimise
:09:33. > :09:34.
:09:34. > :09:41.the amount of food waste. Why is she sparing the Community
:09:41. > :09:49.Secretaries blushs wasn't it a nonsense to force local authorities
:09:49. > :09:53.to re-introduce weekly collections. Would she confirm there a strong
:09:53. > :09:59.core laition between high recycling rates and alternative weekly
:09:59. > :10:04.collections? It's important we encourage councils to response to
:10:04. > :10:07.what local people want and need. That is the very essence of
:10:07. > :10:11.localism. Therefore, we will be proceeding with a new commitment
:10:11. > :10:20.from councils to redouble their efforts to listen and respond to
:10:20. > :10:24.the wishes of their residents in the matter of refuge collection.
:10:24. > :10:30.is unacceptable to have rotting food waste hanging around for two
:10:30. > :10:33.weeks in bins bins. Will she tell councils she would hope they would
:10:33. > :10:39.have weekly collections so we don't have the danger and risk of that
:10:40. > :10:43.situation? I said in response to an earlier question from the honably
:10:43. > :10:48.lady we believe it's important to support local authorities that want
:10:48. > :10:56.to provide a weekly collection of the smelly parts of the waste. And,
:10:56. > :11:01.DEFRA will make available �10 million to assist them in that.
:11:01. > :11:04.Secretary of State is adept at U- turns why is she hanging on to this
:11:04. > :11:09.U-turn which she could have left the Communities Secretary have his
:11:09. > :11:17.very own U-turn today? I might remind the honourable gentleman we
:11:17. > :11:26.are a coalition government. A government of two parties and...
:11:26. > :11:31.And he might... And he might like to read the coalition
:11:31. > :11:35.agreementments commitment is that the government would work towards a
:11:35. > :11:42.zero waste economy and encourage councils to pay people to recycle
:11:42. > :11:49.and reduce littering and measures to produce a huge increase of
:11:49. > :11:55.energy through waste, as set out out in our review today. I think
:11:55. > :11:59.her for the flexibility, in contrast to my honourable friend
:11:59. > :12:04.ahead of me. My local authority works with the private sector. They
:12:04. > :12:07.provide a two-weekly service but a weekly food waste. The key factor
:12:07. > :12:11.has been the flexibility of a good contract with the private sector.
:12:11. > :12:14.Would she not agree that those local authorities who have been
:12:14. > :12:24.dogmattic about not using competitive tendering should think
:12:24. > :12:27.I agree that waste services are a matter for local authorities. The
:12:28. > :12:31.Government believes that better procurement and joint working can
:12:31. > :12:34.improve the efficiency of collections while improving the
:12:34. > :12:42.front line services for the public in an affordable and practical
:12:43. > :12:49.manner. Five years ago, the Conservatives in Newcastle and line
:12:49. > :12:52.made the same promise then promptly broke it. Then they spend �2.5
:12:52. > :12:56.million of their Liberal Democrat friends on a complicated recycling
:12:57. > :13:01.scheme with 10 different bins, boxes and bags which has turned
:13:01. > :13:09.Newcastle into a curiosity. We could not now afford to reinstate
:13:09. > :13:19.that collections. Order! I did appeal for short questions. Isn't
:13:19. > :13:22.the Government's pickle over this reflective... Mr Speaker, I think
:13:22. > :13:27.the most important message is that the Government is trying to make it
:13:27. > :13:32.easier for people to do the right thing, so whether you are at home
:13:32. > :13:38.trying to do with your household refuse, at work, or on the go, we
:13:38. > :13:43.need to make it easier for people to waste less and recycle more.
:13:43. > :13:47.Does the Minister accept that developing technologies can turn
:13:47. > :13:54.waste into bile fields and chemicals? Was she encourage such
:13:54. > :13:59.plans and will she support those currently being put forward to?
:13:59. > :14:04.am not aware of the specific technology being developed, but I
:14:04. > :14:07.would be delighted to learn more about it. It is important that we
:14:08. > :14:12.embrace all new technologies. I have mentioned anaerobic digestion
:14:12. > :14:18.for which I have set out a strategy, but there are new technologies
:14:18. > :14:22.coming out all the time to turn waste into resource. It is all very
:14:22. > :14:26.well hiding behind the language of local choices, her government
:14:26. > :14:32.promised they would bring back weakly been collections across that
:14:32. > :14:39.country. Will she apologised to families who have been led up the
:14:39. > :14:43.garden path by what she has said? made it clear that the coalition
:14:43. > :14:47.consists of two parties who struck an agreement. This includes
:14:47. > :14:54.provisions regarding a waste which we are fulfilling two days. I said
:14:54. > :15:00.that out very clearly. In contrast to the strong-arm tactics of the
:15:00. > :15:05.last government, in what way it do we have incentives to drive up
:15:05. > :15:09.recycling rates? This is such an important point. The last
:15:10. > :15:14.Government, with its punitive approach, lost the confidence of
:15:14. > :15:18.the public by punishing a little old lady for making a genuine
:15:18. > :15:23.mistake by putting it the wrong containers in a recycling bins.
:15:23. > :15:33.Today, we restore a proportionate response to the penalties that
:15:33. > :15:33.
:15:33. > :15:36.should apply, going after the rail waste criminals. There is not a
:15:36. > :15:40.Liberal Democrat available to act as a human shield for the Secretary
:15:40. > :15:47.of State! Can I ask the honourable lady what are the key issues at
:15:47. > :15:57.local levels for Caen tonight for containment of -- for containment
:15:57. > :15:58.
:15:58. > :16:08.of waste. Also, what do Sucha -- what does she suggest to a council
:16:08. > :16:09.
:16:09. > :16:16.for this? There were incentives in the previous government, but it
:16:16. > :16:22.actually deterred people. People will be we incentive rise to as
:16:22. > :16:28.well councils, we want to help make it easier for small and medium-
:16:29. > :16:36.sized enterprises to benefit. contrast to Cumbria's recycling
:16:36. > :16:40.rate of 37%, Suffolk has over 60%, no doubt helped by regular weekly
:16:40. > :16:47.collections of food. We are giving money to anaerobic digestion, will
:16:47. > :16:51.she worked with me to make sure that more is available across the
:16:51. > :16:56.country's? It is right to applaud householders in how they have
:16:56. > :17:01.actively got involved in increasing recycling rates. That is what
:17:01. > :17:06.people want to do. The Government's job is to make it easier for them.
:17:06. > :17:13.That includes a collection for food waste. If that is what local people
:17:13. > :17:16.want, we will support local authorities that do that. If the
:17:16. > :17:24.cuts mean that councils cannot collect rubbish once a week, what
:17:24. > :17:27.chance is there for the NHS or other services? I am not the
:17:27. > :17:31.Secretary of State for Health, but I think the honourable gentleman,
:17:31. > :17:38.just like everyone in his party, is in a complete state of denial about
:17:38. > :17:43.the mess they left the nation's finances ins. I welcome the fact
:17:43. > :17:49.that small businesses can now have the waste collected a, would she
:17:49. > :17:52.therefore lobby her friends and hopefully introduce a renewable
:17:52. > :18:02.obligation services Certificate for recycled kicking a which could be
:18:02. > :18:09.used as a bio fuel. I will of course to discuss that possibility,
:18:09. > :18:19.we work very closely together to draw together this review. I have
:18:19. > :18:26.the largest incinerator in the country in my constituency. Which
:18:26. > :18:31.reaches the end of its useful life in 2014. The replacement, and a row
:18:31. > :18:35.about digest and it was cancelled because of PFI credits were
:18:35. > :18:39.withdrawn. What reassurance can the honourable lady give my
:18:39. > :18:48.constituents that your strategy will lead to the ending of
:18:48. > :18:52.incineration in my constituency? have made it clear that energy from
:18:52. > :18:56.waste has its place in turning waste into resource, but also I
:18:56. > :19:00.made it clear today that the Government is committed to helping
:19:00. > :19:06.local authorities that want to use anaerobic digestion and will make
:19:07. > :19:11.funds available to achieve that. The Secretary of State, will she
:19:11. > :19:17.congratulate Malvern Hills District Council and which he then District
:19:17. > :19:23.Council, the former kept weekly been collections and the latter
:19:23. > :19:28.moved to fortnightly collections. Both were recently elected for a
:19:28. > :19:32.fourth term. That demonstrates that good local authorities that respond
:19:32. > :19:36.to the wishes and needs of their resident, and supply refuse
:19:36. > :19:43.collection services of good quality and sufficient frequency receive
:19:43. > :19:47.their reward through the ballot box and I returned to it office. In the
:19:47. > :19:52.Secretary of State's opinion, does the Prime Minister require a weekly
:19:52. > :19:58.been collection to dump at the rubbish policies like the NHL's --
:19:58. > :20:03.NHS reforms? I do not think that is it proper question with regard to
:20:03. > :20:09.the waste review. The Prime Minister enjoys a very good refuse
:20:09. > :20:12.collection service in his Oxfordshire constituency. The will
:20:12. > :20:17.the Secretary of State explain why, if she wants to meet her waist
:20:17. > :20:27.targets, the availability of feeding carrots have been reduced.
:20:27. > :20:32.
:20:32. > :20:42.Why has she done that? That is more accurately a question for a
:20:42. > :20:48.
:20:48. > :20:51.Government Minister from DC. With permission, Mr Speaker, and further
:20:51. > :20:56.to the statement I made in the House earlier today, a wish to make
:20:56. > :21:01.a statement on the Government's response to the NHS future forum.
:21:01. > :21:05.We established it on sixth April under the chairmanship of Professor
:21:05. > :21:12.Stephen Field to look at our proposals on them modernisation of
:21:12. > :21:17.the NHS. Yesterday it published its proposals. I would like to thank
:21:17. > :21:22.everyone who worked so hard these past eight weeks. I would also like
:21:22. > :21:29.to thank more than 8,000 members of the public, health professionals
:21:29. > :21:33.and representatives from some of 250,000 organisations. Also, the
:21:33. > :21:38.thousands of people who wrote to us with their views. I would like to
:21:38. > :21:42.thank the many officials in my department who supported this
:21:42. > :21:47.unprecedented engagement across the country. I said two months ago to
:21:47. > :21:51.the House that we would pause, listen reflect and improve our
:21:51. > :21:58.plans. Our commitment to engage and improve the Bill has been genuine
:21:58. > :22:03.and has been rewarded with an independent expert and valuable
:22:03. > :22:10.recommendations from the future forum. We have allowed this for him
:22:10. > :22:16.to continue its work, including implementing proposals on education
:22:16. > :22:20.and training and public health. In the report, the NHS must change if
:22:20. > :22:25.it is to respond to challenges and realise the opportunities of more
:22:25. > :22:30.preventative, personalise and effective care. They said the
:22:30. > :22:35.principles to NHS modernisation was to put patients at the heart of
:22:35. > :22:39.care and to give clear initial -- clinicians a central role in
:22:39. > :22:44.commissioning health services. In the form's work they set out to
:22:44. > :22:48.make proposals for improving the Bill. To provide reassurance and
:22:48. > :22:54.safeguards and to recommend changes when needed. As Professor Field put
:22:54. > :22:57.it, they did it to embrace change guided by the values of the NHS and
:22:57. > :23:06.their relentless focus on the provision of high-quality care and
:23:06. > :23:11.improved outcomes for patientss. We will make significant changes to
:23:11. > :23:15.implement those recommendations, and in some cases, offer for the
:23:15. > :23:19.specific assurances which we know have been sold. There are many
:23:19. > :23:23.proposed changes and we will publish are more detailed response
:23:23. > :23:28.shortly. I would now like to tell the House for some of the main
:23:28. > :23:33.changes we will make. The Bill will make clear that the Secretary of
:23:33. > :23:38.State will have a duty to promote a comprehensive health service as in
:23:38. > :23:41.the 1946 Act and be accountable for securing its provision and for the
:23:41. > :23:45.oversight of the national bodies charged with doing so. We will
:23:45. > :23:48.place duties on the Secretary of State to maintain a system of
:23:48. > :23:53.professional education and training within the health service and a
:23:53. > :23:57.duty to promote research. One of the most vital areas of
:23:57. > :24:00.modernisation to get right is the commissioning of local services. It
:24:00. > :24:07.must draw upon a wide range of the people when designing those
:24:07. > :24:16.services, including clinicians, patience and patient groups, carers
:24:16. > :24:21.and charities. Everybody will have two members, one body focusing on
:24:21. > :24:25.the public and one focusing on key elements of government, such as
:24:25. > :24:29.ordered, managing conflicts of interest. While we shall not
:24:29. > :24:34.centrally prescribed the make-up of the Government body, it will need
:24:34. > :24:38.to include at least one registered nurse and one register specialist
:24:38. > :24:43.care doctor. To avoid conflict of interest, neither should be
:24:43. > :24:47.employed by a local health provider. These governing bodies will meet in
:24:48. > :24:52.public, and publish their minutes. Clinical commissioning groups will
:24:52. > :24:56.need to publish details of all contracts they have with health
:24:56. > :25:00.service providers. To support commissioning, the Independent NHS
:25:00. > :25:04.commissioning Board will host commissioning senates providing
:25:04. > :25:09.advice on that shape and fitness of health care across a wider area of
:25:09. > :25:13.the country. They will develop existing clinical networks who will
:25:13. > :25:17.advise on how specific services like cancer, mental health or
:25:17. > :25:21.stroke can be better designed to provide integrated and effective
:25:21. > :25:25.care. Building on this multi- professional involvement, clinical
:25:25. > :25:29.commissioning groups will have a duty to promote integrated health
:25:29. > :25:32.and social care around the needs of their users. To encourage greater
:25:32. > :25:38.integration with social care and public health, the boundaries of
:25:38. > :25:41.these groups should not cross the Borders of local authorities. If
:25:41. > :25:45.they do so, the groups will need to demonstrate to the NHS
:25:45. > :25:50.commissioning Board a clear rationale with regards to the
:25:50. > :25:58.benefit of patients. I have always said that I do not want there to be
:25:58. > :26:08.no decision without me about need for patience when it comes to their
:26:08. > :26:12.
:26:12. > :26:15.care. -- patients. We will further clarify the duties on the NHS
:26:15. > :26:19.commissioning Board and clinical commissioning groups to involve
:26:19. > :26:24.patientss, carers and the public's. Commissioning groups will have to
:26:24. > :26:30.consult the public and involve them on any changes which will affect
:26:30. > :26:34.patient services. One of the main ways patients can influence the NHS
:26:34. > :26:39.is by choice. The Bill will emphasise commissioners duty to
:26:39. > :26:45.promote patient of toys. Choice of any qualified provider will be
:26:45. > :26:50.limited to those areas where there is a national or local tariffs.
:26:50. > :26:56.This tariff development, alongside a best value approach, will
:26:56. > :27:01.safeguard against cherry picking. Monitor's core duty will be to
:27:01. > :27:06.protect the interests of patients. We will remove its duty to promote
:27:06. > :27:09.competition, instead it will be under a duty to support services
:27:10. > :27:15.integrated around the needs of patients and the improvement of
:27:15. > :27:19.quality. It will have power to tackle specific abuses and
:27:19. > :27:24.restrictions of competition which act against patient interests.
:27:24. > :27:30.Competition will be a means to buy high NHS commissions can improve
:27:30. > :27:40.the quality of service. We will keep the existing competition rules
:27:40. > :27:41.
:27:41. > :27:44.introduced by the last Government, the principles and rules for co-
:27:44. > :27:49.operation and competition and give them a firmer statutory
:27:49. > :27:59.underpinning. The corporation and competition panel will transfer to
:27:59. > :28:02.
:28:02. > :28:06.Monitor and retain its distinct There must ab level playing field.
:28:06. > :28:11.We will strengthen the role of health and wellbeing boards in
:28:11. > :28:14.local councils making sure they will involved throughout the
:28:14. > :28:19.kerbing process and local health service plans are aligned with
:28:19. > :28:23.health and wellbeing strategies. We will make 9 timetable for change
:28:23. > :28:26.more flexible to ensure no-one is forced to take on new
:28:26. > :28:31.responsibilities before they are readying while enabling those who
:28:31. > :28:37.are ready to make faster progress. If any of the remaining NHS Trust
:28:37. > :28:41.ks not meet foundation trust criteria by 2014 we will support
:28:41. > :28:45.them to achieve it subsequently. All NHS Trust will be required to
:28:45. > :28:51.become foundation trusts as soon as feasible with an agreed deadline
:28:51. > :28:54.for each trust. We will ensure a safe and robust transition. It's
:28:54. > :29:00.vital change is introduced carefully and without creating
:29:00. > :29:05.instability. We will take the time to get it right as the future forum
:29:05. > :29:09.has recommended. We will give them a clear home within the NHS family.
:29:09. > :29:14.On any qualified provider its extension will be phased carefully
:29:14. > :29:18.to reflect and support the viability of choice for patients.
:29:18. > :29:24.Strategic Health Authorities and Primary Care Trust also crease to
:29:24. > :29:29.exist in April 2013. By April 2013 all GP practices will be members of
:29:29. > :29:35.either a fully or partly authorised commissioning group or one in
:29:35. > :29:38.shadow form. There will be no two tier NHS. However, individual
:29:38. > :29:44.clinical commissioning groups will not be authorised to take over any
:29:44. > :29:47.part of the commissioning budget until they are ready to do so.
:29:47. > :29:52.Individual GPs need not take managerial responsibility in a
:29:52. > :29:55.commissioning group if they don't want to April 2013 will not ab drop
:29:55. > :29:59.dead date for the new commissioners. Where a clinical commissioning
:29:59. > :30:03.group is not able to take on some or all aspects of commissioning,
:30:03. > :30:08.the local arms of the NHS Commissioning Board will commission
:30:08. > :30:11.on its baf. Those groups keen to press on will not in anyway be
:30:11. > :30:16.prevented from becoming fully authorised as soon as they are
:30:16. > :30:19.ready. Mr Speaker, I also told the House on 4th April that we would
:30:19. > :30:23.secure proper scrutiny for any changes we made to the Bill. In
:30:23. > :30:27.order to do this, and without trespassing on the House's time to
:30:27. > :30:31.review the Bill as a whole at report, we will ask the House to
:30:31. > :30:35.recommit the relevant parts of the Bill to a public Bill committee
:30:35. > :30:39.shortly. Mr Speaker, through the recommendations to the NHS future
:30:39. > :30:49.forum and our response, we have demonstrated our willingness to
:30:49. > :30:51.
:30:51. > :30:55.listen and to improve our plans. To make... To make big changes, not to
:30:55. > :30:59.abandon the principles of reform, which the forum them sestselves
:30:59. > :31:03.said were supported across the service, to be clear the NHS is too
:31:03. > :31:10.important and modernisation too vital for us not to be sure of
:31:10. > :31:13.getting the legislation right. The service can adapt and improve as we
:31:13. > :31:17.modernise and change, the legislation cannot be continuously
:31:17. > :31:23.changed. On the contrary, it must be an enduring structure and
:31:23. > :31:26.statement. So, it must reflect our commitment to the NHS constitution
:31:26. > :31:30.and values. It must incorporate the safeguards and accountabilities
:31:30. > :31:34.which we require. It must protect and enhance patients rights and
:31:34. > :31:40.services. It must be crystal clear about the duties and priorities
:31:40. > :31:45.which we will expect of all NHS bodies and in local government for
:31:45. > :31:49.the future. Professor Field's report says it's time for the pause
:31:49. > :31:53.to end. Strengthened now by the forum's report and recommendations,
:31:53. > :31:57.we will now ask the House to reengage with delivering the
:31:57. > :32:07.changes and the modernisation the NHS needs. I commend this statement
:32:07. > :32:08.
:32:08. > :32:14.to the House. Spl speaker, can I thank the Secretary of State for
:32:14. > :32:16.the copy of his statement before. Although I must say, I learnt more
:32:16. > :32:22.before hand from the press kefrpbgs conference press did from the
:32:22. > :32:29.statement this afternoon. Humilitating. The Health Secretary
:32:29. > :32:32.has had health policy taken out of his hands. He spent the last nine
:32:32. > :32:38.months telling anyone who criticised the government's health
:32:38. > :32:44.plans that they were wrong, and that they didn't understand. Today,
:32:44. > :32:51.he admits he's wrong. How can he argue for this latest blue plipbt
:32:51. > :32:56.for the biggest reorganisation in NHS history? With any credibility
:32:56. > :33:04.or integrity? The man who messed up so badly last year, telling us how
:33:04. > :33:10.he's going to mess up next year too. Why no apology to NHS patients and
:33:10. > :33:17.staff for the wasted year of chaos, confusion and incompetence? Why not
:33:17. > :33:20.apology for breaking the coalition agreement to stop top down
:33:20. > :33:25.reorganisations? Why no apology to patients who are already starting
:33:25. > :33:30.to see the NHS go backwards again because of this reorganisation?
:33:30. > :33:36.More than one in ten people now waiting 18 weeks for operations.
:33:36. > :33:43.Three times the number of patients waiting over six weeks for tests.
:33:43. > :33:47.Casualty waits at a six year high. Mr Speaker, this is the first Prime
:33:47. > :33:56.Minister forced to ask 45 experts for a roar report on how to protect
:33:56. > :33:59.the NHS from his own government policies. Now, he's reorganising
:33:59. > :34:04.his reorganisation. The future forum report yesterday was a
:34:04. > :34:08.demolition job on the government's misjudgements and mishandling of
:34:08. > :34:12.the health service. Why is he wasting �800 million on redundancy
:34:12. > :34:17.payments when some of the same people will be rehired to do the
:34:17. > :34:23.same job? Why is he holding back �2 billion, promised for patient care,
:34:23. > :34:28.when it could fund 55,000 nurses? Why is he ploughing on with the
:34:28. > :34:32.Health Bill when what he announced today could largely be done without
:34:32. > :34:37.legislation and without the risk and cost of the biggest
:34:38. > :34:42.reorganisation in NHS history? Mr Speaker, this is a political fix,
:34:42. > :34:46.not a proper plan for improving care for patients, or for a better
:34:47. > :34:52.or more efficient NHS, which is able to meet the big challenges it
:34:52. > :34:57.must face for the future. Make no mistake, these plans today will
:34:57. > :35:05.mean the NHS mired in more complex bureaucracy, more confusion, and
:35:05. > :35:09.more wasted cost in the years to come. In the battle of spin, with
:35:09. > :35:16.all parts of the divided government claiming a win, the big losers will
:35:16. > :35:22.be the NHS patients. We will judge and the public will judge the
:35:22. > :35:28.government on what they do, not on what they say. You know, I lost
:35:28. > :35:34.track of the bureaucracy that he announced in his statement today.
:35:35. > :35:39.Will he admit that this reorganisation creates five new
:35:39. > :35:44.national quangos, set to spend tens of billions of pounds? Will he
:35:44. > :35:47.admit this reorganisation replaces one local body, the Primary Care
:35:47. > :35:51.Trust, with at least five others all playing a part in
:35:51. > :35:56.commissioning? Will he admit the plans still cut hospitals loose
:35:56. > :36:01.from the NHS with no limits on treating private patients while NHS
:36:01. > :36:05.patients wait longer no. Support from the NHS if they run into
:36:05. > :36:10.financial trouble. No longer with the protection as a public service
:36:10. > :36:16.from the full force of competition law? Mr Speaker, what was a very
:36:16. > :36:21.bad Bill will still be a bad Bill. This House should be allowed to do
:36:21. > :36:27.its proper democratic job, as the only elected House, and scrutinise,
:36:27. > :36:33.in full, in committee the whole Bill. At its heart will still be
:36:33. > :36:40.the Tory long-term plan to see the NHS set up as a full-scale market.
:36:40. > :36:44.And the NHS broken up as a national public service, so patients will
:36:44. > :36:50.increasingly see the services they depend on, the Lottery of where
:36:50. > :36:55.they live. The public, Mr Speaker, have rumbled the Prime Minister.
:36:55. > :37:00.They know they can't trust him with the NHS. Fewer than one in four now
:37:00. > :37:04.trust him to keep his NHS promises, over half believe the Conservative
:37:04. > :37:11.Party's plans for the NHS are just a way to privatise the health
:37:11. > :37:16.service. Today, the government have recycled their plans for the NHS
:37:16. > :37:26.with should have been scrapped. People are right to conclude they
:37:26. > :37:26.
:37:26. > :37:30.can't trust the Tories with our NHS. Well, Mr Speaker, when we got
:37:31. > :37:35.passed the abuse I was hoping at some point he would actually tell
:37:35. > :37:39.us whether he agreed with the NHS future forum or not? He didn't
:37:39. > :37:44.mention it. He welcomed the exercise in listening and
:37:44. > :37:47.engagement he announced. He said it would be the right thing. He said
:37:47. > :37:51.it would be good government to do it. When an independent group of
:37:51. > :37:55.experts report and make recommendations he ignores them and
:37:55. > :37:59.says he will oppose the Bill regardless much he didn't listen to
:37:59. > :38:02.what the people in the NHS were saying. It's's shameful he
:38:02. > :38:07.dismissed everything that happened over the last year as if it didn't
:38:07. > :38:11.happen at all. A year in which we, in this coalition government, said
:38:11. > :38:16.we would increase resources to the NHS, and we have done that. We are
:38:16. > :38:20.committing to �11.5 billion extra to the NHS over the next four years.
:38:20. > :38:26.Money which we will continue to remind the British public, money
:38:26. > :38:33.that the Labour Labour Party told us we should not give to the NHS.
:38:33. > :38:37.And, this is a coalition government which, in the last year, and in the
:38:38. > :38:41.NHS across the country which implemented a cancer drug trust
:38:41. > :38:44.with 2,500 patients benefiting from that. Which cut in the last four
:38:45. > :38:52.months the breaches of the single sex rules by three quarters in four
:38:52. > :38:58.months. Which has cut the number of hospital infected by 22%, and CJD
:38:58. > :39:03.infections by 15%. Three quarters of a million more people accessing
:39:03. > :39:07.dentistry. Where the waiting times for people waiting to go into
:39:07. > :39:13.hospital compared to March 2010 have gone down. Where we said we
:39:13. > :39:16.would reduce management costs, and we will do so, we have taken 3,800
:39:16. > :39:23.managers out of the NHS since the election, while the number of
:39:23. > :39:29.doctors has gone up. The right honourable gentleman six months ago
:39:29. > :39:34.said he supported the principles of the reform and the Bill. All he
:39:34. > :39:38.said today is sheer opportunism but it will come back to haunt him
:39:38. > :39:42.because the NHS is going to benefit from the changes that we are
:39:42. > :39:47.proposing today. The NHS is going to take ownership of its own
:39:47. > :39:52.service to a greater extent, patients will be empourered.
:39:52. > :39:54.Clinicians will be empowered. They will deliver better outcomes for
:39:54. > :39:58.patients. When that happens, we will be able to say the Labour
:39:58. > :40:01.Party would have denied the NHS the resources and they would have
:40:01. > :40:11.denied the NHS the freedom and responsibility to deliver those
:40:11. > :40:16.better outcomes. Is not the key challenge facing the NHS today the
:40:16. > :40:23.need to reverse a decade of declining productivity which was
:40:23. > :40:28.left to us by the party opposite? Does my honourable friend agree
:40:28. > :40:33.that his statement today provides the basis for us to do that, based
:40:33. > :40:37.on the evolution of effective commissioning engaging the entire
:40:37. > :40:40.clinical community, which will address the fragmentation of
:40:40. > :40:49.service and progress the intergration of service around the
:40:49. > :40:55.needs of individual patients? I agree with my honourable friend.
:40:55. > :40:59.It's that process of now engaging clinicians coming together to
:40:59. > :41:03.design services around around the needs of patients which delivers
:41:03. > :41:07.improving quality of services for patients that is at the heart of
:41:07. > :41:12.the shift from Primary Care Trust and Strategic Health Authorities.
:41:12. > :41:16.The Labour Party spent a decade presiding over declining
:41:16. > :41:21.productivity, over declining productivity while the cost of
:41:21. > :41:27.bureaucracy and management in the NHS doubled. We are going to be
:41:27. > :41:31.embow -- empowered people in the NHS to deliver improving services
:41:31. > :41:36.and reduce bureaucracy. THE SPEAKER: The opposition front
:41:36. > :41:41.bench shouldn't be yelling at the Secretary of State. Order on both
:41:41. > :41:51.sides. Whatever the passions you need feel, you need to simmer down
:41:51. > :41:52.
:41:52. > :41:54.a little. A fine example of that calm can now be provided by the
:41:54. > :41:57.honourable gentleman. Does the Secretary of State Iraq recognise
:41:57. > :42:04.that enforcing the NHS to start implementing his changes, before
:42:04. > :42:10.the law had been changed, has reresulted in vast expense to the
:42:10. > :42:18.NHS, chaos in the services and to diverting the NHS staff from
:42:18. > :42:21.treating patients? Does he also recognise that just cobbling
:42:21. > :42:27.together a few amendments to this Bill will not make things better,
:42:27. > :42:37.but make things worse? Won't he recognise...
:42:37. > :42:38.
:42:38. > :42:42.THE SPEAKER: Last sentence, we must press on. Does the
:42:42. > :42:47.THE SPEAKER: Order. I will have the question finished I don't require
:42:47. > :42:54.any help from any member. Doesn't the Secretary of State recognise
:42:54. > :43:04.that by pretending to produce a collaborative silk purse out of
:43:04. > :43:06.competitive pig's ear will not It is slightly confusing because
:43:06. > :43:11.his right honourable friend on the front bench was telling us we could
:43:11. > :43:16.have done this without legislation. Now he is accusing us of proceeding
:43:16. > :43:23.without legislation. It is not true. We're doing things that are
:43:23. > :43:28.essential. To sustain the structure we inherited from the Labour Party
:43:28. > :43:34.in terms of all of these Primary Care Trusts and strategic help the
:43:34. > :43:39.authorities, it could never have happened. -- Strategic Health
:43:39. > :43:42.Authorities. We had to empower clinicians in the service. We are
:43:42. > :43:51.doing it now regardless of whether the legislation has made progress
:43:51. > :43:57.or not. I welcome the statement. I have a list here of government
:43:57. > :44:01.responses. It is seemingly not enough. It cannot be enough because
:44:01. > :44:06.ironically it is a list of amendments tabled by the Labour
:44:06. > :44:13.Party during the committee stage. Why does he think it is so hard to
:44:13. > :44:18.build consensus? Why are the Labour Party being so pointlessly
:44:18. > :44:23.churlish? I have to tell my honourable friend there are many
:44:23. > :44:30.things that are beyond many of us to understand. One of them is the
:44:30. > :44:37.Labour Party and the way in which they put policy. The fact is, the
:44:37. > :44:43.Labour Party have no policy. They simply had opposition of four
:44:43. > :44:48.opposition's sake. They just want is a two things. Questions and
:44:48. > :44:55.answers must focus on the policy of the Government. That is the
:44:55. > :45:00.Parliamentary position. Secondly, I want to a comedy at the level of
:45:00. > :45:10.interest in the statement, but members must help me to help them
:45:10. > :45:12.
:45:12. > :45:17.by being brief. -- I want to accommodate. The last Labour
:45:17. > :45:22.Government left dissatisfaction with the NHS. How much has this
:45:22. > :45:28.year's shambles cost the NHS and how much has it damaged patient
:45:28. > :45:38.care? It has not damaged patient care. The right honourable
:45:38. > :45:40.
:45:40. > :45:47.gentleman, he should not denigrate the NHS. In May 2010 at the last
:45:47. > :45:55.election, patients waiting to be admitted for hospital waited 8.4
:45:55. > :46:01.weeks. On the latest figures that went down to 7.9 weeks. May 2010,
:46:01. > :46:11.it went down to 3.7 weeks, and that is in the midst of rising demand on
:46:11. > :46:19.
:46:19. > :46:25.the NHS. This is clear evidence of a listening government. Does the
:46:25. > :46:29.Secretary of State agree with me that what the NHS now needs is
:46:29. > :46:33.consensus across all political parties and for everybody to put
:46:33. > :46:40.their money where their mouth is and support the NHS and these
:46:40. > :46:46.changes as we move forward? It I am grateful to my honourable friend.
:46:46. > :46:49.The future forum itself made to the point that across the NHS what they
:46:49. > :46:58.want it is for the certainty of knowing what the policy is and of
:46:58. > :47:03.moving forward in making that happen. In view of the NHS Future
:47:03. > :47:08.Forum's comments, and I quote, the importance and relevance of the NHS
:47:08. > :47:11.constitution were in guiding their work. Does he accept that the
:47:11. > :47:15.principles set out in the constitution were more effective in
:47:15. > :47:23.protecting the NHS from a hostile government than the Prime
:47:23. > :47:26.Minister's five pledges? No, I do not accept that. I think the Prime
:47:26. > :47:32.Minister's commitments are absolutely what the public and
:47:32. > :47:36.people working in the NHS expect and wish to see. I think they are
:47:36. > :47:39.vital ones and ones which would not have been true under a Labour
:47:39. > :47:45.government. He Labour government would not have increased resources
:47:45. > :47:48.for the NHS and we can see, we can see the only part of the United
:47:48. > :47:57.Kingdom further is now a Labour government is in Wales, and in
:47:57. > :48:01.Wales, resources for the NHS are being cut this year by 5%. When I
:48:01. > :48:06.went to North Wales during the midst of the recess, there was the
:48:06. > :48:12.front page of the Liverpool Daily Post saying the number of patients
:48:12. > :48:21.waiting for their operation was more than 36 weeks. It had gone
:48:21. > :48:24.from a 16 to 989. I welcome these proposals, but could the Secretary
:48:24. > :48:30.of State to detail the safeguards against it cherry-picking of the
:48:30. > :48:36.kind which, if unchecked, could fatally undermine rural district
:48:36. > :48:41.hospitals like the West Suffolk in my constituency. In order to be
:48:41. > :48:46.brief, it essentially comes down to we have to make sure that
:48:46. > :48:51.commissioners are increasingly able to use a tariff, and established
:48:51. > :48:54.national or local price in order to determine the service that they
:48:54. > :48:58.commissions. And that that it therefore does not allow the
:48:58. > :49:03.private sector to come in and cherry-pick services by
:49:03. > :49:08.undercutting on price. We also have to make sure that that price
:49:08. > :49:12.reflects the cost of that condition to be treated, including complex
:49:12. > :49:19.conditions. This is why we are committed to work with the Royal
:49:19. > :49:25.Colleges in developing tariffs to make sure that is true. I welcome
:49:25. > :49:30.the statement, not least because it pays tribute to the future
:49:30. > :49:38.commitment -- future commission. Could the Secretary of State tell
:49:39. > :49:42.me what he thinks the future of there Healthcare Commission is?
:49:42. > :49:47.if I may interpret and relation to the NHS Future Forum, I freely
:49:47. > :49:52.acknowledge that I wish we had instituted the NHS Future Forum
:49:52. > :49:56.after the publication of the white paper last year. Although we had a
:49:56. > :50:00.full and formal consultation process, I think the character of
:50:00. > :50:05.the engagement that has been agreed over these last two months had been
:50:05. > :50:09.superlative. As we make further progress, for example in relation
:50:09. > :50:14.to education and training and the development of training proposals,
:50:14. > :50:18.I want to ask the NHS Future Forum in that and other areas to continue
:50:18. > :50:22.that process of engagement across the servers. I have a great deal of
:50:22. > :50:27.time for most GPs, in particular the one sitting in front of me.
:50:27. > :50:36.What part of this Bill will allow communities to rid themselves of
:50:36. > :50:41.underperforming GP practices? answer to my honourable friend's
:50:41. > :50:46.question is for it in order for that to happen, it is something
:50:46. > :50:49.that would need to be initiated by the NHS commissioning Board. BNH is
:50:49. > :50:54.commissioning Board would respond to their health and well-being
:50:54. > :50:59.board of its local authority. Or indeed to the local clerical
:50:59. > :51:02.commissioning group. My noble friend will have, in his area,
:51:02. > :51:10.through the Health and well-being board the new and powerful means
:51:10. > :51:13.from which the voice of the public can be heard. Can I just remind the
:51:13. > :51:20.House that members who came into the chamber after the Secretary of
:51:20. > :51:23.State began his statement, should not expect to be called.
:51:23. > :51:26.Secretary of State must know that the bigger threat to the
:51:26. > :51:32.destabilisation of the National Health Service is the introduction
:51:32. > :51:36.of competition lot of clinical services. Will the clause that says
:51:36. > :51:42.the mergers of NHS trusts are a matter for the office of Fair
:51:42. > :51:47.Trading and competition be removed from the Bill? I think the right
:51:47. > :51:51.honourable gentleman should be aware that the future forum has
:51:51. > :51:56.recommended that those powers that are held by the office of Fair
:51:56. > :52:00.Trading -- Trading and the Competition Commission should be
:52:00. > :52:05.done because they believe it is in the interest of the NHS for those
:52:05. > :52:12.powers to be exercised by a health service specific regulator,
:52:12. > :52:15.sympathetic and understanding to NHS interests. Primary Care Trusts
:52:15. > :52:21.and Strategic Health Authorities are part of a management structure
:52:21. > :52:24.which led to waste and bureaucracy. Can my right honourable friend
:52:24. > :52:30.reconfirm there will be abolished and the �5 billion they will save
:52:30. > :52:35.will be ploughed back into his phone line medical services? I am
:52:35. > :52:40.grateful to my honourable friend, I can do that. It is essential we
:52:40. > :52:45.moved to a world weary reduce administration costs, where we have
:52:45. > :52:50.relieved bureaucracy in the service, where we provide resources to
:52:50. > :52:58.deliver improving care without the burden of bureaucracy, cost and
:52:58. > :53:01.waste which was inflicted on them by a Labour government. Doesn't the
:53:01. > :53:06.Secretary of State understand that when the Labour government was in
:53:06. > :53:15.power, it increased the money from 33 billion to 111 billion in one
:53:15. > :53:25.decade and now we are witnessing a new Frankenstein monster all to
:53:25. > :53:25.
:53:25. > :53:33.pacify these tinpot liberals! have a mission for the honourable
:53:33. > :53:36.gentleman, I think he should head to Wales. In England, this
:53:36. > :53:42.coalition government has committed to increase NHS budget in real
:53:42. > :53:47.terms in the life of this Parliament. In Wales, a Labour
:53:47. > :53:53.Government is intending to reduce the NHS budget by over eight
:53:53. > :53:58.present. I believe the very act of listening to patientss and the
:53:58. > :54:03.public will have done a lot to improve these proposals. Once the
:54:03. > :54:07.dust has settled, it will have done good for at the Health Secretary's
:54:07. > :54:11.reputation as well. Given the requirement for greater local
:54:11. > :54:16.accountability, would he make the same recommendation to local,
:54:16. > :54:26.clinical commissioners in the changes they are yet to make for
:54:26. > :54:27.
:54:27. > :54:31.health services in their area? grateful for four and his kind
:54:31. > :54:36.remarks, I have to tell him, I do not think I am looking to achieve
:54:36. > :54:42.anything in terms of reputation. I just want a positive outcome for
:54:42. > :54:52.the NHS. I have said to the House before, it is about achieving for
:54:52. > :54:52.
:54:52. > :54:56.the NHS, the opportunity to deliver better services for patients. This
:54:56. > :55:01.point illustrates what it is we needed to do, and will now do in
:55:01. > :55:06.response to the future form. Many people wanted to see, set out in
:55:06. > :55:13.detail in the legislation, high patient and public will work in
:55:13. > :55:16.these respective bodies. There is always a balance to be struck
:55:16. > :55:24.between the degree of prescription any legislation and the degree of
:55:24. > :55:28.freedom. Clearly, we now half the approval for putting a much more of
:55:28. > :55:35.this detail into the Bill because they are clear they will engage the
:55:35. > :55:42.patients and the public's. welcome the changes, most of the
:55:42. > :55:46.changes that have been announced today. Could I just ask one point,
:55:46. > :55:49.I am very concerned that the bureaucracy that is going to be
:55:49. > :55:54.around after all these changes go through could actually be worse
:55:54. > :56:04.than what we have got at the moment. I genuinely would like to be
:56:04. > :56:07.
:56:07. > :56:13.I'm am grateful to the honourable lady. The bureaucracy will reduce
:56:13. > :56:16.in the NHS as a result of all this because we are shifting the
:56:16. > :56:21.ownership of commissioning and the responsibility for the design and
:56:21. > :56:25.delivery of services from what is essentially a distant, managerial
:56:25. > :56:29.organisation into one that is locked into clinical decision-
:56:29. > :56:33.making of doctors and nurses across the service. This is about
:56:33. > :56:42.delivering benefits to patientss by empowering the doctors and nurses
:56:42. > :56:46.to care for them. Can the Secretary of State confirm that the
:56:46. > :56:52.Government has no plans to decrease the Budget on the NHS, unlike the
:56:52. > :56:56.plans of the party opposite to slash it by �30 billion.
:56:56. > :57:00.honourable friend makes an important point, because if we had
:57:00. > :57:05.listened to the Labour Party we would have cut the NHS and not
:57:05. > :57:10.increased resources. The 20 billion power and efficiency savings that
:57:10. > :57:14.is required for the NHS in order to respond to demand and cost would
:57:14. > :57:20.have been a �30 billion. It would have been an unsupportable degree
:57:20. > :57:24.of pressure on the NHS. We're giving the NHS, not only resources,
:57:24. > :57:30.but the opportunity to deliver better care. After the white paper
:57:30. > :57:32.was published in July, there were 6,000 representations from health
:57:32. > :57:36.select committee reports and professionals asking the Secretary
:57:37. > :57:40.of State to think again about breaking up the NHS. This listening
:57:40. > :57:50.exercise is a waste of public money. I know the Secretary of State was
:57:50. > :57:52.
:57:52. > :57:58.That was nonsense. We spnded postively to the consultation and
:57:58. > :58:02.made changes then. What is clear, as the details of the Bill have
:58:02. > :58:06.been coming forward, people are working out how they would make it
:58:06. > :58:10.work in the future. They have been saying, we want to set out in the
:58:10. > :58:14.legislation how it will work. There is no better way of making that
:58:14. > :58:19.effective than to talk to people and engage gauge with people in the
:58:19. > :58:23.NHS, listen to them and implement those changes. I'm sure the
:58:23. > :58:27.Secretary of State will agree with me that the single biggest
:58:27. > :58:31.challenging facing healthcare in the United Kingdom is dealing with
:58:31. > :58:37.the health economic and human challenge, looking after our ageing
:58:37. > :58:39.population. The key to this is better intergrating healthcare
:58:40. > :58:43.services, better intergration hospital services with community
:58:43. > :58:47.and social services these reforms are a good way of going about that?
:58:47. > :58:52.Yes, I would very much do so. I think the future forum in the
:58:52. > :58:56.report, particularly on clinical advice and leadership, is giving us
:58:56. > :59:01.a robust structure for engaging across the range of professions
:59:01. > :59:04.that are capable of deliver that more joined up and effective care.
:59:04. > :59:10.Can the Secretary of State reassure us that no services or hospitals
:59:10. > :59:13.will be taken over by the private sector? There are no plans in the
:59:13. > :59:19.legislation or indeed in the future forums recommendations that would
:59:19. > :59:23.lead to that. In particular, if I might just tell the lady, she will
:59:23. > :59:28.see in the detail, published with the written ministerial statement,
:59:28. > :59:32.we are proposing there should be no power in particular for Monitor,
:59:32. > :59:39.for reasons of competition to allow the private sector to have access
:59:39. > :59:44.to NHS facilities and taking those away from NHS providers. Mr Speaker,
:59:44. > :59:48.we have a Prime Minister who loves the NHS. A Secretary of State who
:59:48. > :59:52.is the most experienced member in this House. We have a coalition
:59:52. > :00:00.government that has done something that the Labour government never
:00:00. > :00:03.did, it listen and was willing to improve its Bill. It is a great day
:00:03. > :00:06.for democracy. I congratulate the Secretary of State and for
:00:06. > :00:13.referring it back to committee. If he is looking for volunteers for
:00:13. > :00:16.the committee, I'm available. grateful. From my point of view, it
:00:16. > :00:20.is because I believe in the NHS, also because I believe in the
:00:20. > :00:24.people who work in the NHS, that I believe it's right to listen and to
:00:24. > :00:29.engage. And, it's right to give them a much greater control of the
:00:29. > :00:33.service they provide for patients. Mr Speaker, what can we conclude
:00:33. > :00:40.from the fact that the Prime Minister isn't here with us this
:00:41. > :00:46.afternoon, supporting the Secretary of State, who is involved in a PR
:00:46. > :00:50.stunt at St Thomas's and Guys Hospital. Isn't it true, the reason,
:00:50. > :00:55.is as was said across the Atlantic, you could put lipstick on a pig, at
:00:56. > :01:00.the end of the day, it's Stig a pig. Isn't that the truth of the NHS
:01:00. > :01:07.Bill? I'm starting to get into matter perhaps not of order, but of
:01:07. > :01:13.any rate of taste. If you will forgive me, Mr Speaker, I don't
:01:13. > :01:17.think I will gratify that question with an answer. Will he expand on
:01:17. > :01:22.the report that organisations such as the Spinal Injuries Association
:01:22. > :01:27.can expect through specialised commissioning? Yes. I believe that
:01:27. > :01:33.the NHS Commissioning Board, under our proposals, will be aib to able
:01:33. > :01:38.to give greater consistent cyst si to specialised commissioning. I
:01:38. > :01:42.hope it will be true for people with spinal injuries. I know the
:01:42. > :01:46.Association well. They have done terrific work. We have worked
:01:46. > :01:53.closely with them to improve commissioning and services for
:01:53. > :01:58.those injured with spinal injuries. It is disgraceful to see Lib Dems
:01:58. > :02:01.and Tories scrapping to claim credit for this alleged listening
:02:01. > :02:08.exercise. Will the Secretary of State come to the dispatch box and
:02:08. > :02:16.apologise to me and my colleagues for not listening to us during the
:02:16. > :02:20.Bill Committee? Mr Speaker, I give credit in relation to the changes
:02:20. > :02:23.that we are now bringing forward. Yes, indeed, to some of my
:02:23. > :02:26.colleagues, very much so, also to the Prime Minister, the Deputy
:02:26. > :02:31.Prime Minister for their time and trouble they have taken in relation
:02:31. > :02:36.to. This they have spent a great deal of time listening and engaging
:02:36. > :02:40.with people across the health service. And, we will give credit
:02:40. > :02:44.to the NHS future forum and to the thousands of people across the NHS
:02:44. > :02:50.who have made their contribution now to the NHS's future. I think
:02:50. > :02:54.they will be very disappointed to hear members opposite who just want
:02:54. > :03:00.to denigrate that and make political capital out of it rather
:03:00. > :03:04.than supporting the NHS in it is future objectives. Collectively
:03:04. > :03:10.throughout Oxfordshire told the Field Commission they wanted to get
:03:10. > :03:13.on with GP commissioning. They were committed to GP commissioning they
:03:13. > :03:21.believed they could be better designed NHS services for local
:03:21. > :03:24.people. When are GPS in Oxfordshire going to be able to get on with GP
:03:24. > :03:27.commissioning? I can assure my honourable friend, I know his GPS
:03:27. > :03:30.locally. They want to work with their colleagues, professionally,
:03:31. > :03:34.across their area. They want to be able to get on with that now.