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[Part II]

Part of Health and Social Care (Community Health and Standards) Bill – in a Public Bill Committee at 5:58 pm on 20th May 2003.

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Photo of Andrew Lansley Andrew Lansley Conservative, South Cambridgeshire 5:58 pm, 20th May 2003

I confess that I am not fond of vetoes and do not subscribe to them. I note that the hon. Gentleman's amendment No. 246 reflects the same groups of people that paragraph 7.11 of the guide to NHS foundation trusts foresees as having to show that they had undertaken a consultation. I am sure that if the consultation uncovered strongly held objections of substance, the independent regulator would have to have regard to them and could not ignore them.

I am not fond of the concept of vetoes, but I accept the case for a veto for the Secretary of State. It is difficult to contemplate substantial institutions in the NHS no longer being under the control of the Secretary of State, as that would be directly contrary to his valid objections. The objections must be valid, but under the clause, the Secretary of State would control and choke off applications in the first instance.

Who decides who will become an NHS foundation trust? [Interruption.] The hon. Member for Oxford, West and Abingdon gives the correct answer from a sedentary position: the Secretary of State decides. Ministers may have us believe that it is the independent regulator, but I do not believe that. The Bill sets out that the independent regulator determines the nature of the authorisation for who becomes an NHS foundation trust.

My evidence for that proposition is not merely an interpretation of the Bill: the Government have given us the evidence because only the other week on 14 May the Secretary of State for Health unveiled the foundation trust shortlist. He told us which trusts would be permitted to become first-wave applicants. That is fine. I had understood that and it is consistent

with the Bill that the Secretary of State waves people through. In this instance, he waved through 29 trusts. However, I then read the extract on the No. 10 Downing street website. The second paragraph says,

''The trusts will submit their applications by autumn 2003.''

The timetable in paragraph 7.5 of the guide is presumably the September 2003 closing date for second stage applications. I note that the shortlisted applicants were supposed to have been announced in March 2003, but were announced in May. The closing date for second stage applications seems to have been foreshortened by two months to make life easier for the applicant trusts.

The second paragraph of the website says,

''The trusts will submit their applications by autumn 2003. Ministers will then decide which applicants will become NHS Foundation Trusts in April 2004.''

It does not say anything about a regulator. I searched to the end of the column, but it did not appear to say anything about a regulator at all. So, who knows? One finds a reference in the guide to the independent regulator after the second stage applications—the establishment phase—but so far as I can tell the decision is the Secretary of State's, which the Government acknowledge. Ministers will decide who becomes an NHS foundation trust and all the details of how that will be implemented will be left to the independent regulator. That does not seem to be what we are setting out to do, which is one reason why I support amendment No. 75, as others do. My hon. Friend the Member for Epsom and Ewell (Chris Grayling) was right to move it.

Let us get things into proportion. If we are making this a trust-led operation, the trusts should be able to apply. If their applications are being independently scrutinised, let us take the Secretary of State out of the process and make the regulator the person who takes those decisions.