Community health councils should be informed, responsible and responsive local forums for discussions of local health services, but I do not see them as the only means of public participation.
Is my right hon. Friend aware that the Bromley area health authority has recently refused to meet the Orpington Nurses and Citizens Association, which is the only local body taking a professional interest in the Orpington hospital, on the ground that the community health council is the only appropriate body for public participation in local Health Service matters?
Having regard to the fact that the association has been denied membership of the community health council, is that not the sort of bureaucratic tyranny which public participation in the NHS was designed to prevent?
There should be room for flexibility in the arrangements and we certainly do not regard community health councils as the only channel of communication. At the same time, we have to take a responsible and realistic view of the options facing area health authorities.
In the case to which my hon. Friend has drawn attention, the community health council felt that there was no way that it could find an alternative to the proposals being put forward. The Orpington Nurses and Citizens Association did not offer any alternative to the proposal recommended to the area health authority and it may have been that, in those circumstances, the area authority felt that no useful purpose would be served by a meeting.
Is my right hon. Friend aware that there are a large number of people in communities throughout the country who would like to participate in the well-being of their local hospitals by raising funds for them and offering voluntary services? Will he do everything he can to encourage that healthy trend?
That is indeed the policy of the Government, as indicated by the proposals that we announced shortly after the election for saving the Elizabeth Garrett Anderson hospital.
If all the community health councils in the Lambeth, Lewisham and Southwark area health authority district meet the right hon. Gentleman and tell him that any cuts over and above the arrangements made with the authority by the previous Administration would so damage its service as to make it unworkable, will he guarantee that there will be no such further cuts?
The hon. Gentleman must know that I could not conceivably give such a guarantee. The role of community health councils is to represent local people in the delivery of local health care services. Their representations should be made, therefore, to the local area health authority. The CHCs have a statutory power to object to specific proposals, such as hospital closures, and to require that I should consider closures before they take place.