It emerged this morning that Labour MPs took the extraordinary step of blocking the publication of the Health Select Committee report into the NHS – because the conclusions backed up government reforms. I have just been handed details of this report, and it’s clear why Labour wanted it suppressed: it contradicts the party’s attack message. Here are the main points:
- No sweeping privatisations: there has been little increase in private sector providers since 2010.
- Nor has there been an extension of charges or top-ups during the current parliament, and that these are not planned.
- Less red tape: a general trend of declining administration costs in the NHS.
- No evidence that the Transatlantic Trade and Investment Partnership poses a threat to the NHS.
The Labour members of the committee tabled 52 amendments either objecting to the way the report was worded as well as edits to punctuation and spelling. The majority of these came from Valerie Vaz, who refused to sign up to the report as drafted.
So why was there a row? I understand that Vaz objected to lines in the report that she felt said private provision of healthcare was acceptable, and that appeared to suggest that changes to the Health and Social Care Act as implemented would be disruptive for the sector (though the committee has not been at all supportive of that legislation as a whole). She also objected to over reliance on evidence from NHS England (and former Labour adviser) chief Simon Stevens, and threatened that unless the report was ‘radically rewritten’, the committee would have to produce a minority report that would make clear the split between the parties over its conclusions. When asked to provide evidence that contradicted the particular points in the report that she took issue with, Vaz responded that she didn’t have time to do that and it wasn’t her job.
In response, Vaz told Coffee House:‘This was a private meeting and I am disappointed a colleague has publicised their version of what was said. It is for the clerk as it always has been to draft reports with the Chair and we amend it on the basis of our discussions. The report in my view did not make full use of the evidence. At a different point in the parliamentary cycle I am sure there would have been time to redraft the report as we have done previously.’
The Tory committee members say they asked Labour members to come up with evidence that they felt contradicted the evidence in the report, and also claim that at no stage during the Inquiry, which was announced in September, did Labour object to those who were giving evidence or suggest others who should be included. Robert Jenrick, one of the Conservatives on the committee, said:
‘I was dismayed that Opposition members of the committee voted against even attempting to agree a cross-party report, which brings select committees and parliament into disrepute. Opposition Members could have suggested alternative witnesses to those we heard from, but they didn’t and now appear to want to bury the report and the key facts, presumably because they don’t like the evidence we received.’
The dossier of evidence, which would have been included in the report, goes through the contentious areas that Labour MPs objected to. It has been compiled by Conservative MPs Robert Jenrick, Charlotte Leslie and Andrew Percy.
On charges, it says:
‘No evidence given to the committee could be found suggesting that since 2010 there either had been, or would be additional charges or top-ups to the NHS in the future, and all witnesses said this was undesirable.’
The Five Year Forward View says:
‘…nothing in the analysis (above) suggests that continuing with a comprehensive tax-funded NHS is intrinsically undoable – instead it suggests that there are viable options for sustaining and improving the NHS over the next five years, provided that the NHS does its part, together with the support of Government’ (p38).’
On private providers, it found that ‘evidence submitted to the committee demonstrated that private provision in the NHS has increased, but the increase is modest and has slowed since 2010.’
The dossier says the key points were that ‘independent provider admissions has increased by 0.57% in all admissions, and by 0.9% in elective admissions since the introduction of the Health and Social Care Act’ and that ‘the percentage of Foundation trust income from private patients as a percentage of the total has fallen from 1.5% in 2005/6 to 0.9% in 2013/14’. It includes the following charts and graphs to illustrate this point:
On administration costs, the committee found that expenditure on administration as a percentage of total spend has fallen from 5.1% in 2009/10 to 2.7% in 2015/16 and actual expenditure has fallen from £5.57bn to £3.08bn.
A letter from Jean-Luc Demarty, the European Commission’s Director General for Trade, said that ‘all publicly-funded public health services are protected in EU trade agreements, and this approach will not change for TTIP’. The Labour allegation has been that the NHS is vulnerable under TTIP to takeovers from foreign corporations.
The dossier concludes that ‘the authors regret the necessity of this report and believe that politics should be removed from the NHS funding debate. We very much hope that in future an open, evidence-based and honest conversation can be held about the NHS and its funding, as befits Members of Parliament, and Health Select Committee members, performing their public duty to be honest with the electorate’.
A Labour source said:
‘Labour MPs wanted the report to reflect what’s happening in the NHS but the final draft ignored all concerns on privatisation and funding shortages. The Tory MPs didn’t want to admit to what their Government has done and should be ashamed that there’s now no report at all.’
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