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Health and Education

This has been a rambunctious debate and, in view of some of the misunderstandings at its beginning and for the avoidance of doubt, I should put it on the record and make it clear to the House that the Opposition indicated last Wednesday the order in which their Front-Bench spokesmen would speak. We then made it clear what our order would be and I am sorry if there was any misunderstanding particularly between those on the two Front Benches. Having made that clear—[Interruption.] I wish I had not bothered now. [Hon. Members: ““Try again.””] I think I will pass on that. The two Front-Bench spokesmen for the Conservatives, the hon. Members for South Cambridgeshire (Mr. Lansley) and for Surrey Heath (Michael Gove), are both pleasant and affable people and they are reasonably bright, but something comes over them when they get behind that Dispatch Box. I remember when I was a kid seeing an old Walt Disney film in which a very timid husband says goodbye to his wife, walks out downtrodden, gets into his car, closes the door, switches on the ignition and suddenly horns come out of his head. His character changes completely. Something like that comes over the hon. Members for South Cambridgeshire and for Surrey Heath. They get this preening self-regard. In Scotland, they say that if they were chocolate, they would lick themselves. That is great in whatever debating society they come from, but I do not think it really does justice to the debate that we have had in the House on the Queen's Speech. We have been debating the two most important issues for the public in terms of the services that are provided in this country. We have Bills on health and social care, a human fertilisation and embryology Bill, Bills on education and skills and on children and young persons, and the sale of student loans Bill. Admirable justice was done to them in the long debate and in the important contributions that I shall come to in a moment. I say to the hon. Member for South Cambridgeshire that the right hon. and learned Member for Rushcliffe (Mr. Clarke), who has just taken his seat, pointed out that the policy differences between us on health—and I believe in the health Bills that will come before Parliament—are very slim if, indeed, they exist at all. It was remarkable that when the Conservative party's policy arrived on my desk with a dull thud—the dull was more than the thud—it was a thoughtful exposition on how we could move forward. I think that the hon. Member for South Cambridgeshire will agree that I am doing him justice when I say that the thing about the Conservatives' health policy on which to remark is that it explicitly endorses the broad shape of the Government's reform programme. The policy agrees with the 10 reform principles set out in the NHS plan. The patient passport policy has disappeared and there is now a policy of commitment to the NHS. There are commitments to practice-based commissioning, payment by results, local involvement networks—they are an important development for patient and public involvement—foundation trusts, primary care trusts, local area agreements, patient choice, strategic health authorities and the National Institute for Health and Clinical Excellence. That is a remarkable indication of how the Government have moved the centre ground to the left and the Conservative party is trying to occupy that ground. Let me give the hon. Gentleman a word of advice about his policy. It is completely wrong—the hon. Member for North Norfolk (Norman Lamb) also pointed this out—to suggest that we should introduce the monolithic, top-down, unaccountable organisation that the Conservatives are putting forward. For a start, that would mean structural reform. The Conservatives say that they want structural stability, but they also propose the biggest structural reform that the NHS would have ever seen. If the hon. Gentleman will not take my word for that, he should listen to the NHS Confederation, which is clear in its views on the Conservatives' proposal. It says:"““the problems of the NHS are not just about political interference. And it would be odd for politicians not to take an interest in an organisation spending almost £100 billion of tax payers' money””." It also says:"““Autonomy and independence are more to do with the nature of relationships in the system than the structures. If the relationships are not clearly defined, then no amount of structural change will protect frontline organisations.””" There is no difference between us on the need to ensure that we have a clinically led, locally driven NHS. However, the Conservatives' policy solution is badly thought out and would fail.