Tuesday 25 January 2011: Commons Health Questions, January 2011 edition - missed targets and Burns Night
VERDICT: Not much heat, and even less light.
There were a few good questions, from Ben Bradshaw on waiting times and Margot James on CQC-damned care homes reopening under a new name (hint: get a named individuals licensing system, including directors, and keep public record of miscreants). A howl of old Labour rage from the Beast of Bolsover.
But in general, that was not adequate holding of the Government to account.
John Healey is likely to be underwhelmed by SOS Lansley's decision to quote out of context Healey's "consistent, coherent and comprehensive" line from his Kings Fund speech - and do so repeatedly. Which could be to the good. Shorter and more aggressive questions, on a single subject, might be more effective.
The lines taken on NHS privatisation need a bit more priming of public opinion to become effective. True, the required anal, micro-level policy attacks on the Bill's various incoherences might bore Parliamentary sketchwriters (though we also have Simon Burns for that), but such a strategy could pave the way to establish a more effective critical story.
Because Labour need to remember that in some places, parts of the reforms are going to work quite well, and improve existing services. So if that happens, and is consistently called 'privatisation', there is a loop to complete that is probably not Healey and co's intention
Of the written questions, SOS Lansley took questions 1, 3, 6, 8 and 11 together: almost a lottery number set (appropriately enough). He then took a quiver of supportive soft questions from backbenchers on consortia pathfinders.
Challenged on potential tensions between GP's role as patients' clinical advocates and rationers, SOS Lansley insisted that "there is no conflict", and that the Bill emphasises the duty to commission for quality rather than cost. Curious, when his explicit plan is to allow price competition.
On the ability of consortia to pay quality bonuses to practices (which remains superbly unclear, including whether individual profits can be made and taken), The Liberator suggested that it was the same as QOF payments. Or perhaps not: QOF was specific bribes to GPs to do and systematically record things they should already have been doing. Nurses did it; GP principals shared the profits.
Healey's main point was that the Bill opens the NHS up to the private sector. That is true, but so did Labour's concordat, PFI, ISTCs and any willing provider policy - and SOS Lansley duly, predictably retorted in kind. Healey came back with the White Paper's 57 pages having just 3 references to the market, and accusing the Bill of being an iceberg, whose "substantial ideological bulk is out of private view".
Lansley's promise in response was that "we will not rig the market as Labour did, overpaying the private sector", which is not what Table B in the Impact Assessment seems to say (thank you Richard Blogger) - it implies a potential 14% private premium.
Liz Kendall raised the question of the danger that the reforms distract attention in the system at a time of needing to save £4 billion a year over four successive year, stressing pressures already apparent. The Liberator ignored the substantial point, accusing Leicester Liz of "attacking the NHS".
Paul Burstow gamely trying to sell the "real-terms funding increase" line, in the face of rising inflation and economic flatlining.
Stephen Dorrell looking appallingly bored. Understandably.
Ah, Simon Burns.
How do we love him? Let us count the ways.
1. He has a Prescott-esque facility with the English language, which he enunciates sounding like Dale Winton recorded at 45rpm and played back at 33rpm (ask your grandparents). Burns' Dale Winton-alikeness was spotted by Sarah Wild of Independent Nurse.
2. No doubt wholly inadvertently, he wholly misled the House answering a question on the perceived threat to Conservative MP Patrick Mercer's local hospital, answering that "the local GP consortia will be able to strengthen and tailor the hospital's offer to meet the needs of people in Newark". Er, no. The consortia absolutely won't be able to do that.
3. Answering Diane Abbott's steely question on the health select committee commissioning report being "surprised"("surprised" being Parli-speak for 'what the fuck are you doing?') about the top-down NHS reorganisation following hard on the Coalition Agreement's promise of no such thing. Burns attempted the 'in our manifestos' guff, and was roundly heckled - some of which was not from the opposition benches.
4. The plot was roundly lost when, asked about his confidence that waiting times could be kept down, Burns babbled about "quality and outcomes ... and quality times". WTF?
Topical, I guess - it is Burns Night tonight.