Part of Prayers – in the House of Commons at 12:30 pm on 19th March 1997.
First, I must say how pleased I am to see the Minister of State for the Scottish Office, the right hon. and learned Member for Edinburgh, West (Lord James Douglas-Hamilton) here to answer the debate. I must take this opportunity to thank him for his unfailing personal courtesy to me and, I believe, to other Scottish Members, during his term of office. We have been grateful for that.
I regret to say, however, that the story of the proposed East Ayrshire hospital is a saga of Government delay and ineptitude, and of the Conservatives putting political dogma ahead of health care. As far back as 1993, which is four years ago, the South Ayrshire Hospitals national health service trust had planned to replace the Ballochmyle hospital at Mauchlin with a new purpose-built community hospital for East Ayrshire on the same site at Ballochmyle. That meant that the land was in NHS ownership, ready for the building to go ahead.
The Government had earmarked £13 million in the capital budget. If construction of the hospital had started as planned and been funded as originally intended, it would be open now, and the urgent needs of the people of East Ayrshire would be being provided for at this minute. Instead, we have had a catalogue of dithering, delay, political interference and, I am afraid to say, chicanery.
First, the then Health Minister, Lord Fraser, threw a spanner in the works when he announced that, rather than proceed as planned, two NHS trusts would have to compete for the right to build and run the hospital. That is a prime example of the way in which unnecessary competition and rivalry have replaced planned provision in the NHS, setting trust against trust.
Instead of providing immediately for the health needs of the area, there was a long and often acrimonious debate about which trust should run the hospital, and whether it should be at Ballochmyle, as originally planned by the South Ayrshire Hospitals trust, or on a new site at Cumnock, where the Ayrshire and Arran Community Healthcare trust preferred it to be.
That long-drawn-out consultation eventually finished in June 1995, but, regrettably, the dithering of the Ayrshire and Arran health board added further to the delay, when it failed to decide at its board meeting in July as it had planned to do. The board left the decision until the end of September and opted for the community trust—not the trust that had originally intended to build the hospital— and for building the hospital on the Cumnock site. Incidentally, that site is not in NHS ownership, so the decision added planning and acquisition problems.
I regret to say that that was not the end of the catalogue of delay and interference. Ministers intervened again to insist that the option of a private finance initiative should be considered alongside that of public funding, which had been the original intention and for which the money had been earmarked. The public funding option had not been questioned, either by the board or the trust, until the Government interfered. That political interference was unnecessary, as public funding had been earmarked for the hospital, and it has been the cause of even more unnecessary and unwelcome delay.
Nearly 18 months after the health board's decision, not a brick has been laid. There is not even an agreed contract, unless the Minister tells me otherwise today—but I doubt it, for reasons that I will come to. On 17 November 1995, however, the chairman of the health board, Jim Donaldson, wrote to me giving the timetable, promising that the first patients would be treated in the day hospital by November 1996. That date has passed, and not a brick has been laid or a contract signed. He also promised that the out-patients and general practitioner unit would be operating in October 1997, and the continuing care facilities by April 1998. There is no hope of any of that now.
In his letter, Mr. Donaldson said:
The Board and the Community Trust have made a clear public commitment to delivering the new Community Hospital within the time scale outlined above … It is the responsibility of the Board to ensure that the timetable is achieved.
It is evident that it has failed in that responsibility; and who are the losers? None other than the people of East Ayrshire, who are waiting for much-needed, long-overdue healthcare facilities.
Although the Ayrshire and Arran health board has manifestly failed, I argue that the Government are the principle cause of that failure. The board is responsible to the Minister—it is appointed by him and under his direction. It reports to the management executive, to Mr. Geoff Scaife and, through him, to the Minister regularly. It is the dithering, the interference and, frankly, the dubious practices of Scottish Office Ministers that have caused the delay.
First, the Government's insistence on the PFI option meant a delay while the preferred bidder was chosen. We had to go through all the procedure of considering potential bidders and choosing one. Ultimately, the community trust chose G. A. Construction Ltd.—formerly Gilbert Ash Ltd., I think.
The first delay was in coming to a decision about the preferred bidder, but eventually, on 2 September last year, the trust submitted the PFI bid, together with the public funding option as an alternative. That option is still there. That is the benchmark for considering whether the hospital should be constructed through the PFI.
I presume that the benchmark must be at or near—I hope that the Minister will confirm this—the £8 million that was the original figure with which the community trust won the competition with the South Ayrshire Hospitals trust. The right hon. and learned Gentleman will know that the South Ayrshire Hospitals trust bid was about £11.5 million.
What happened? I understand that this is happening not merely in East Ayrshire but in other parts of Scotland and the United Kingdom. It would appear that the PFI bid was not merely much more expensive than the £8 million benchmark—in other words, PFIs are much more expensive than funding by the traditional public method— but it is rumoured that it was even higher than the South Ayrshire Hospitals trust figure. It might even have been as high as £12 million.
What happened then? This is the interesting thing, as Ministers received the details of the PFI bid and the benchmark figure, but then told the community trust that they would give the preferred bidder time "to revise the bid". The Minister used that phrase in a parliamentary answer to me.
That was very fishy: why was extra time given to revise the bid? What fiddling of the figures was needed behind the scenes? Were the specifications reduced in an attempt to get the PFI bid down to the benchmark figure or below? The Minister has so far refused all the opportunities that I have given him to answer those questions. I hope that he will take the opportunity to answer today, to the House and to me, but above all to the people of East Ayrshire.
I regret to say that there is more to the story: 1 November passed and there was still no announcement, and on 4 November I tabled another parliamentary question, to be told by the Minister that he would announce the decision "shortly"; but still there is no decision. I can see that my hon. Friend the Member for Cumbernauld and Kilsyth (Mr. Hogg) agrees that that is stretching the English language a little too far. It is stretching the patience of the long-suffering people of East Ayrshire even further, particularly as the closure of wards in Ballochmyle continues relentlessly. Health care in East Ayrshire is deteriorating rather than improving as was intended.
The suspicion that something fishy was going on behind the scenes was increased with the revelation that a second revised PFI bid had to be submitted two weeks ago today. I understand that it is still on the Minister's desk, being considered. Why was that further revision necessary? I hope that the Minister will answer that question today. Have there been further changes in the specification? Are corners being cut? Will we get a second-rate hospital because the Minister and the management executive are insisting that the trust should try to find reductions in the PFI bid?
Over the past few months, I have asked question after question in the House and in the Scottish Grand Committee, and still delays continue as Ministers try to get the answer they want rather than the best answer for the national health service and for the people of East Ayrshire.
I hope that the Minister will confirm today that the facilities to be provided in the East Ayrshire hospital have not been cut back, that they are still as outlined in his written answer to me of 6 February, and that there is still money in the capital pool to fund the hospital publicly. I believe that that is the better option.
Will the Minister say whether the report in yesterday'sFinancial Timesis correct, which said that banks will not support PFI schemes for hospitals, because any trust signing a deal with a private consortium would be acting ultra vires under current legislation? Will he stop trying to fiddle the figures to favour the PFI option? Why does not he give the go-ahead for the long overdue and much-needed hospital, funded with public money?
I have spoken to my hon. Friend the Member for Hamilton (Mr. Robertson), and I can assure the Minister in this changeover period that my hon. Friend would support the course of action that I advocate. Parliament is to be prorogued on Friday, and the Minister has the opportunity to finish his ministerial career with one act of sense and courage; I urge him to do so.