Health and Social Care (Community Health and Standards) Bill

Part of the debate – in the House of Lords at 8:45 pm on 13th October 2003.

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Photo of Lord Clement-Jones Lord Clement-Jones Liberal Democrat 8:45 pm, 13th October 2003

The amendment seeks to introduce pilot schemes for the first seven NHS foundation trusts. The policy for foundation hospitals has been developed without trial or public consultations, as the Government themselves will admit. They pray in aid the Spanish model as a precedent but, as is now commonly recognised, that is very different.

The Government claim that foundation hospitals will improve local accountability and allow more scope for staff to innovate and improve services. However, no one has been able to show convincingly that that will be the case and that there will not be adverse impacts such as the poaching of staff and the emergence of a two-tier health service. The noble Lord, Lord Warner, used the phrase that reformers always have to demonstrate a negative. In fact, they have to demonstrate a positive—that is the minimum expected of them—that foundation hospitals will have the desired effect.

In their 1999 White Paper, Modernising Government, the Government stated,

"we must make more use of pilot schemes to encourage innovations and test whether they will work".

Well, amen to that. A number of recent Government initiatives have been piloted, including children's trusts, the savings gateway scheme and the new adult learning gateway grant. Furthermore, the Government recently conceded that they should have piloted the A2 examination, the second half of the new A-level curriculum, whose introduction caused chaos last year.

What happened to evidence-based policy in the Department of Health? We on these Benches believe, as does a very wide coalition of interests and organisations, that before any decision is taken to introduce foundation trusts, they, too, should be piloted, and their impact evaluated.

Amendment No. 143 would designate the first seven foundation trusts authorised as "NHS foundation trust pilots" and would require their impact to be evaluated before any further foundation trusts could be authorised. I beg to move.