Self-governing Hospitals

Oral Answers to Questions — Health – in the House of Commons at 12:00 am on 18th December 1990.

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Photo of David Winnick David Winnick , Walsall North 12:00 am, 18th December 1990

To ask the Secretary of State for Health what further representations he has received over self-governing hospitals.

Photo of Mr William Waldegrave Mr William Waldegrave , Bristol West

I have received many representations about national health service trusts.

Photo of David Winnick David Winnick , Walsall North

I can well imagine it. Is it of no concern to the Government that there is no public support for these substantial changes? For example, in my borough, at the district general hospital, there is overwhelming opposition to what is being proposed. Why are the Government pursuing this path of Thatcherite dogma, instead of dealing with the financial crisis in the health service? It would be far better to deal with the financial crisis, which is due to underfunding, than to gamble with people's health by making unnecessary changes.

Photo of Mr William Waldegrave Mr William Waldegrave , Bristol West

I spent a large part of yesterday at the Royal Free hospital, where I met many people—doctors, nurses and health service workers—who are strongly in favour of the changes. They may all have been passionate Thatcherites, but I am not sure that they were. Some may even have voted for the Labour party. I think that the hon. Gentleman will find that there is growing support. One should consider the hon. Gentleman's area, where the National Union of Public Employees sent out 2,700 ballot forms. Four hundred came back and 100 were actually in favour of the trust—I suppose that they went to the wrong people. It is really not very serious.

Photo of Nicholas Winterton Nicholas Winterton , Macclesfield

When considering the representations made to him by hospitals or authorities that want to opt out and become self-governing trusts within the national health service, does my right hon. Friend give more weight to the views of members of the area health authorities, consultants and other doctors, nurses, paramedics, other staff and patients, or to those of the rather remote chairmen of the regional health authorities?

Photo of Mr William Waldegrave Mr William Waldegrave , Bristol West

I should probably attach the most weight to the quality of the submission made by the hospital or other unit in question. Those are the people who know most about a hospital and whose future rests with it. If they present good proposals—as they did this year—it is principally to those proposals that we respond, although we also take advice from the districts and regions.

Photo of Mr Joe Ashton Mr Joe Ashton , Bassetlaw

Although the Secretary of State keeps saying that there will be consultation, he never announces what sort of consultation it will be and with whom it will take place. Who will he consult before the trusts are set up—the patients, the staff or the public? If he is not satisfied with the NUPE ballot, why does not he organise a ballot himself? Is he aware that no consultation has taken place with Bassetlaw hospital, except that which I have tried to organise, with no help at all?

Photo of Mr William Waldegrave Mr William Waldegrave , Bristol West

Ballots are not at all the right way to improve the system of management in a great service such as the national health service. We have been trying to carry out the statutory duties imposed on us by the Act that was passed earlier this year and, above all—as I said to my hon. Friend the Member for Macclesfield (Mr. Winterton)—to study the representations made to us by the hospitals themselves.

Photo of James Paice James Paice , South East Cambridgeshire

Following the undoubted success of hospital trusts, will my right hon. Friend find a mechanism whereby hospitals that are not currently part of the NHS—for instance, former military hospitals such as the one in my constituency from which the RAF is to withdraw—can become independent trusts within the NHS and thus build on the success of this initiative?

Photo of Mr William Waldegrave Mr William Waldegrave , Bristol West

I know the hospital to which my hon. Friend refers very well; indeed, I talked about it to the regional chairman and officers when I was in Cambridge last Friday. I am not sure that the establishment of a trust is the most likely solution in that instance, but the regional authority is willing to consider any financial proposals that make sense and could save the hospital.

Photo of Robin Cook Robin Cook , Livingston

Can we tempt the Secretary of State to tell us something about the independent representations that he commissioned from Coopers and Lybrand Deloitte? Can he confirm that that organisation concluded that only 14 of the 56 applications that he approved were financially sound? If that was not its conclusion, why does the right hon. Gentleman keep refusing to publish its report? Should not the public have the right to know the figures and should not Parliament have the right to debate them?

Photo of Mr William Waldegrave Mr William Waldegrave , Bristol West

The hon. Gentleman has misunderstood the nature of the process. During the summer, Coopers and Lybrand Deloitte and many other advisers produced a variety of advice, much of which was passed back to the trust units and altered in the course of dialogue with them. It is as futile to ask for that particular piece of paper as it is to ask for thousands of others that were made available to me.