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[Part II]

Part of Health and Social Care (Community Health and Standards) Bill – in a Public Bill Committee at 6:30 pm on 20th May 2003.

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Photo of Chris Grayling Chris Grayling Shadow Minister (Education) 6:30 pm, 20th May 2003

I accept the Minister's explanation, but the provisions create an anomalous situation. Let the Minister think through what he said in the context of the Epsom and St. Helier NHS trust, which is my local trust. If that trust decides to become a foundation hospital, it will put forward an application to the Secretary of State and there will be various stages of deliberation in the Department as to whether it is eligible. Let us suppose that the Secretary of State then says, ''Fine, it can go forward.'' The trust then has to advertise in the community for members. There will be a big recruitment push, quite a lot of expenditure on advertising and a lot community-based, because that will be when the real drive for recruitment and involvement in that local hospital will take place. There will be a big push to secure members, who will then be invited to vote in an election for the shadow governing body of the hospital. That will again require considerable expense, a high profile campaign and a lot of visibility in the local community, especially in the earlier stages if that trust is one of the first to apply. There will be an election for positions on the governing body of the trust. That election will be completed and those people will take office on the shadow governing body. Theoretically, the regulator can then turn round and say, ''We don't accept your application. It's not up to scratch and the financial side doesn't add up. Other aspects of the proposals don't add up either, so we don't accept your application. Go back to being a normal NHS trust.'' What message would that send to the community in my area or any other area affected by such a situation?

The proposals are absurd. I understand the Minister's rationale, but the risks are enormous. The process of setting up foundation hospitals would be undermined in an entire region of the country because such a failure as I have described would undoubtedly be enormously newsworthy. The existing, appointed board takes the strategic decision to apply for foundation status and does much of the work to push forward to foundation status. Why is it not then possible for that board to see through the process of establishing foundation status and then have a window in which to complete a full election to the governing body of the trust? Surely that would be more sensible than for there to be the possibility of holding a high-profile local election with lots of candidates and lots people signed up to be participants in their local hospital yet then seeing the whole thing collapse like a pack of cards. Surely the Minister can see that our proposals are a smarter way of doing things and would

remove of a major embarrassment to the Government's programme.