At the risk of being parochial, there is the strange coincidence that the hospital in my Liberal Democrat-held constituency closed so that a new one could be built in the neighbouring Labour-controlled constituency. We need to know that the difficult decisions that have to be made are being made on clinical grounds. All too often, it seems blindingly obvious that other factors, shall we say, come into play.
The Government and the health service must treat the public as adults and give them the necessary information and the opportunity not to be consulted and ignored, but consulted and listened to and for their views to be acted upon. I have discovered a new word in the English language—it is sham-consultation. We cannot have the word "consultation" any more without the adjective "sham" in front of it. Throughout the country when I, like the Secretary of State, visit local people, they say, "Yes, we went to endless consultation meetings, we had engagement, then consultation, then review, and then all the rest, but in the end they did what they were always going to do."
If people are making decisions against the will of the local people, they should be people whom local people can get rid of. How can it be right that decisions affecting hon. Members' health services are made by people whom they never elected, whom they can never get rid of, and whose only right of appeal is to the Secretary of State—who has total discretion to ignore the appeal and, if she hears the appeal, can refer it to a quango, which we also did not elect? Where is the democratic accountability in that?
I have some sympathy with the idea of getting rid of centralised meddling, so to that extent I am with the Conservatives on the idea of independence, but it falls down because there is no democratic accountability, particularly at the local level. Local communities are frustrated because they feel that the decisions are being made for them, rather than with them. Lots of meetings take place, but how often do they change anything? That is one of the things in the health service that must be changed.
The Secretary of State met the press this morning. She is anticipating whatever the Healthcare Commission might find tomorrow about the health service's performance. She said that we need action plans. In other words, where PCTs are found to be weak we urgently need action plans to start within a month. That typifies the Government's mismanagement of the NHS. She does not say that we need long-term strategic thinking for efficiency over a period of years or that we need deep-seated financial problems sorted out in the medium term, but that we anticipate a bad headline tomorrow, so we need an action plan and we have a month—a month—to do things that presumably have not been done for the last nine years. Is that a month to put long-term plans in place; a month to consult and listen and refine? No, just a month to get them out of the mess they are in this month.
What is happening with NHS finances is that problems that have built up over years, decades in some cases, have to be sorted out by Wednesday week. How can that be a rational way to run the health service? We have huge financial instability. The Secretary of State complained that the Tories wanted to spend taxpayers' money subsidising the private sector. The words "pot", "kettle" and "black" spring to mind. Independent sector treatment centres are being given better prices than the NHS, guaranteed volumes of delivery, the chance to cherry-pick the easy hips, cataracts and scans, but at the expense of what? She mentioned the ISCT at Shepton Mallet, but that has resulted in job cuts at the Royal United hospital in Bath just up the road. Frenshay hospital will virtually close and the chances are that an ISTC will be built on the site, so the same people will be having the same procedures on the same site but done by the private sector instead of the public sector, probably at greater cost—and that is not privatising the NHS? I wonder what would be.