Clause 10 - Register of NHS foundation trusts
Health and Social Care (Community Health and Standards) Bill
10:15 am
Mr Adrian Bailey (West Bromwich West, Labour/Co-operative)
These are probing amendments. They seek to explore ministerial thinking on the role that the foundation trusts will have in promoting involvement in the local community. The amendments are based on my experience in the co-operative movement. In my previous employment I dealt with a vast range of co-operative and mutual organisations. Their rules were based on a standard template, but there were amazing variations in the ways in which they were interpreted and in the levels of public involvement that arose from them.
Some co-operative societies took their membership role seriously and were very active in promoting community participation over a range of activities. By and large, there was a relationship between the success of each society and the level of member involvement. Others allowed their membership involvement to atrophy and, to a certain extent, were run by what I can only describe as self-perpetuating oligarchies.
It is obvious that the Government do not want the latter to happen. It would interest me to know exactly how they will obtain the maximum level of participation, which is essential to success.
Inner-city areas have their own problems. My constituency, which is probably quite similar to that represented by the Under-Secretary, is characterised by an unusually high percentage of relatively low-income and elderly people, and an unusually low level of car ownership and mobility. These are obvious issues in terms of foundation hospital trust involvement with the local community. This group has a potentially high level of need, but is potentially inaccessible to the various mechanisms that the
hospital trusts will need to operate to promote membership involvement.
Similarly, 15 per cent. of my constituency comprises ethnic minority communities of varying origin. Many of them are elderly, first-generation immigrants with a lower than usual level of literacy. There are obvious barriers to communication between them and the hospital trust, although their need as a group may well be far higher than that of others in the community.
We have already discussed entryism and the running of these trusts by '' the sharp-elbowed middle classes''.
The most effective way of countering this is for hospital trusts to have a policy and to develop relationships with genuinely representative groups in the community that will promote membership from as wide a range as possible. I look forward to the Minister telling us what exactly will be expected of trusts in those areas.
Amendment No. 217 also draws on my experience in the co-operative movement, and on my personal experience. The hon. Member for Westbury (Dr. Murrison) spoke about district hospitals being at the glamorous end of the service. I am sure that the professionals involved believe that to be true; however, for a humble layperson such as I, hospitals can be quite frightening. I must confess that I have always regarded them as a rather uncomfortable reminder of my own mortality and have tried whenever possible to avoid using their services. I confine my involvement with them to that which is commensurate with my professional responsibilities.
Last year, however, I had to bow to the inevitable and go to my local district hospital at Sandwell—it was subsequently declared a three-star hospital, although it is not in the first wave of applications—for major hip surgery. I assure hon. Members that as one lies on one's bed, nuzzling one's oxygen mask and caressing one's morphine drip, one has time to reflect on the benefits of the NHS. One also marvels at the huge range of professional skills that are needed for an effective hospital service. If one is not directly involved, one tends to think solely of doctors and nurses. Of course, many other skilled professionals are involved; radiologists, anaesthetists, physiotherapists and many others.
Many nationalities are involved in running the health service; I counted eight different ethnic origins. It struck me that people knew very little about their local district hospital unless they were involved either as a patient or as a professional. The new foundation hospital trusts could provide a valuable educational role in disseminating such information.
There must also be a means of monitoring how well hospitals are working with primary care trusts. Every area has its own health needs. In my area, low birth weight is a concern, as is the higher than normal incidence of early death from cancer and from heart disease, which is typical of inner-city post-industrial areas. In the first instance, that should be dealt with by primary care trusts, but services must be dovetailed with local foundation hospitals. Providing information on how that is to be done is essential in formulating a
comprehensive, effective health-care policy in the community.
The amendments are designed to promote the involvement of everybody so that health-care policies are truly reflective of the local community.