Clive Efford

I rise to speak to amendment 97 in my name, which would remove clause 10 from the Bill. Clause 10 gives powers to the Secretary of State to vary the proportion of public and private provision of health services if they consider that to do so is in the interests of the health service. In evidence to the Health and Social Care Committee, the chief executive of the Nuffield Trust said that clause 10 “seems to make it more possible for the Secretary of State to explicitly set out to increase private or public provision.” Why does the Secretary of State need this power? Introducing an extra level of nuance now, as clause 10 will do, has the potential to raise fears within the NHS that it could be abused in future. The clause has the potential to create unintended consequences. The explanatory notes for the Bill say that this new flexibility is necessary “where there may otherwise be a breakdown in provision of a health service.” Can we imagine a situation where the Secretary of State has concerns about a health service and that an approach to assist a local provider would be rebuffed? It is hardly likely to happen. The explanatory notes suggest that, in such circumstances, the Secretary of State needs the power to direct local decisions, rather than to work with local health service providers to resolve any difficulties. How does the power to influence the proportion of public and private provision help in resolving a breakdown in service? Labour’s 2024 plan to make work pay set out a welcome desire to bring more essential services back into public control—something that is welcomed by health workers across the country, because so far the “biggest wave of insourcing in a generation”, as was promised, has felt more like a trickle when it comes to the NHS. The new Prime Minister and new Secretary of State have inherited the Health Bill from their predecessors, so hopefully they will be able to stamp their own mark on it before it becomes law. Removing clause 10 would be one way of making that mark. The concern for those who work for the NHS and those who support it is that the clause has the potential to be exploited in future by those who would seek to move away from the public provision of healthcare. There are ample powers to enable the Secretary of State to intervene and resolve breakdowns in the provision of a health service. On clause 10, we must balance what it adds in those situations against its potential misuse by an ideologically driven Government that are determined to privatise our NHS. To remove any ambiguity and to protect the NHS from the possibility of the clause being abused by a future Secretary of State, I urge that it is dropped from the Bill.