NHS Trusts

Part of the debate – in the House of Commons at 3:32 pm on 29th April 1991.

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Photo of Robin Cook Robin Cook , Livingston 3:32 pm, 29th April 1991

The Secretary of State's assurance that health authorities are happy with the cuts would carry more weight if those health authorities represented anybody in the community for whom they now administer the health service.

Will the Secretary of State explain to the House how he reconciles his many statements over the weekend and his statement today to the House that there will be no cuts in patient care with the financial memorandum of Guy's, which was leaked today to my hon. Friend the Member for Peckham (Ms. Harman), and which states that managers recognise that in acute services there will be inevitable reductions in direct patient care and that in mental health services, which are local services, there will be "substantial reductions in service"? After those internal statements by the management of Guy's itself, should not the Secretary of State apologise for all those misleading statements?

If the business plans are to assist the Government in monitoring the progress of the trusts, why cannot those business plans be published so that we can all assist in the monitoring? What is in those business plans that needs to be hidden? How many more of those business plans contain cuts similar to those that we have heard about at Guy's this past weekend?

Will the Secretary of State publish the report on trusts from Coopers and Lybrand? Will he now tell the House what he has already told journalists—that last November Coopers and Lybrand found that only 12 of the 57 trusts had plans with which there were no financial difficulties? If that is true, was it not totally irresponsible of the right hon. Gentleman to go ahead with all 57 trusts? How did he keep a straight face when he told the House on 4 December that, in deciding which hospitals should opt out, the key criterion was financial viability?

Will the right hon. Gentleman also explain how Guy's can be so much in debt and yet can afford to pay its chief executive the highest salary in the entire NHS? Is he aware that, in the past year, Guy's has advertised 44 new management posts at a total cost of £1·3 million—one quarter of its deficit? Will he explain how it can be value for money to hire more managers on bigger salaries to run a reduced service?

Finally, after this weekend, does not the Secretary of State realise that leaving hospitals to sink or swim in the marketplace is regarded by the public as a wholly unacceptable way of running their health service? Will he now accept that he cannot plough ahead with the second wave of opt-outs while hospitals in the first wave are foundering?

May I give you and the House notice, Mr. Speaker, that the Opposition will return to this matter until we get an assurance from the Secretary of State that he will not take any more decisions on opt-out until the people of Britain have had their say in a general election about the health service they want?