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Health and Education

I am grateful to the hon. Gentleman for that. Legislative hyper-activity and lack of delivery are the story of this Government—I am now waiting for another ““Hear, hear”” from the hon. Gentleman—but if the Government propose legislation, one would at least expect that it might be original, purposeful and substantive. On health, the Government's approach is none of those. It is certainly not original. Almost three years ago, my right hon. Friend the Member for Witney (Mr. Cameron) and I called for an NHS constitution to be established in primary legislation, and the Government are now following our lead, but do their plans have the necessary purpose? The Government's plan is to construct an NHS constitution that, by their own admission, does not extend new legal rights to NHS services. That is astonishing; their consultation states to the public that they are not setting out to create any new legal rights. All the rights or pledges could be provided under existing powers. Even the much-vaunted new legal right to choose can be, and indeed probably will be, established by a direction issued by the Secretary of State under existing legislation. NHS bodies can already be required by direction under existing legislation to comply with any of these rights or pledges, and certainly to have regard to them. So what does the Government's proposal—the centrepiece of the Queen's Speech so far as health is concerned—achieve? It achieves this: the Prime Minister said he wanted a constitution, so he has to have one. I wonder whether Ministers are even aware of how meaningless their response to the prime ministerial commitment has become. However, I think the public and the people who work in the NHS do know. The consultation issued this summer on the NHS constitution resulted in 1,008 replies to the Department of Health, including just 178 from NHS staff. That is not even one response for each NHS hospital; not even one in 5,000 NHS staff could be bothered to reply. No doubt Ministers think that silence betokens consent. I do not think so; I think silence means contempt—contempt for the Government, where NHS staff feel that responding to the Government is pointless because they do not listen. In a top-down culture, what price consultation? When gimmicks abound, why should NHS staff have given this particular Government proposal any more credence? We will see whether Ministers listen to consultation. Three weeks ago, another consultation on the pharmacy White Paper ended, with 80,000 responses received. If consultation means anything, the Secretary of State will say this afternoon that the Government will make no changes to the existing GP dispensing arrangements because he has listened to the results of that consultation. I challenge him to do so.