| Home Page |
Column 135
House of Commons
Tuesday 14 May 1991
The House met at half-past Two o'clock
PRAYERS
[Mr. Speaker-- in the Chair ]
PRIVATE BUSINESS
Llanelli Borough Council (Dafen Estuary) Bill
[Lords] Read a Second time, and committed.
Oral Answers to Questions
HEALTH
Health Plans
1. Mr. Carrington : To ask the Secretary of State for Health if he will make a statement on the progress of health plans to meet health needs in regional health authorities.
The Secretary of State for Health (Mr. William Waldegrave) : Every regional health authority has submitted to my Department a plan for 1991-92 putting forward its key objectives and setting out levels of activity to be purchased to meet the health needs of its population. Regions are also developing strategies to improve health based on health needs identified in director of public health reports, which are published annually.
Mr. Carrington : My right hon. Friend will be aware that inner London is facing considerable problems in adjusting to the new structures of the national health service because of the high cost of London teaching hospitals. Will he reassure my constituents that the availability and quality of their health care will be assured under the new contracts?
Mr. Waldegrave : It is not fair to say that the problems facing London derive from the reforms. Everyone concerned with the national health service knows that there have been long-postponed issues to do with the division of NHS resources between London and the rest of the country, to which the reforms are indeed drawing attention. The regions and districts, together with the Department of Education and Science and those who have responsibility with us for teaching, must steer London carefully through the reform process.
Mr. Salmond : If the Minister is so confident that the planning and changes that he is introducing into the NHS have support, why are the Government so intent on appointing so many card-carrying members of the Tory party to positions of responsibility in the NHS? Are the members whom he is appointing a greater or smaller
Column 136
proportion than the extraordinary number of Tories who have been appointed to positions of responsibility in Scotland?Mr. Waldegrave : I am not particularly interested in the party affiliations of those whom we appoint. We have appointed a good many people from other parties, although not, the hon. Gentleman will understand, within my responsibility, from his party.
Dame Elaine Kellett-Bowman : Is my right hon. Friend aware--I gather from his answer to my hon. Friend the Member for Fulham (Mr. Carrington) that he is--that in my part of the world, in Lancaster and the north-west, we are glad that resources are at last being channelled to our area? We run our affairs prudently and are not short of staff or laying off staff.
Mr. Waldegrave : My hon. Friend is right, and I do not think that, fundamentally, there is any division between the two sides of the House on the issue. There needs to be a fairer distribution of health resources across the country. The reforms are clearly resulting in our making decisions in London that have been long deferred by both parties. We must do that, but we must do it skilfully.
Mr. Campbell-Savours : Why will not the Secretary of State publish all the business plans of all the trusts and all the documents that have been submitted by those organisations to his Department? The public should know the truth now. The debate in recent weeks has been about that, so let us see the documents and let the public know the truth.
Mr. Waldegrave : The hon. Gentleman is wrong. The debate has not been quite about that. There are a variety of management documents for directly managed hospitals and trusts that have not been prepared for publication. Many trusts are perfectly prepared to publish the documents, and why should they not do so if they choose? But it would be unfair on them to change the goalposts half way through and ask them to publish internal management documents that were not prepared for publication.
Child Abuse
2. Mr. Day : To ask the Secretary of State for Health what assessment he has made of the impact of the Children Act 1989 on the handling of child abuse cases.
The Minister for Health (Mrs. Virginia Bottomley) : The Children Act 1989 will have a major impact when it is introduced five months from now, in October. It provides a proper framework to safeguard the child as well as the parents and will promote firm action to protect the child when necessary.
Mr. Day : Does my hon. Friend agree that the Children Act recognises fully the importance of the role of parents?
Mrs. Bottomley : The Children Act redresses the imbalance in terms of recognising the on-going responsibility of parents. Two new orders are the emergency protection order, which enables parents to return to court after 72 hours to put their case, and the child assessment order, which means that the child can be assessed without removing parental rights.
Column 137
Mr. Hinchliffe : Is the Minister aware that there appears to be a deliberate campaign of misinformation in certain sections of the press about the role of social workers in child abuse cases? Will he take the opportunity of the implementation of the Act in October to launch a public information campaign, setting out the rights and duties of parents under the legislation and also the rights, responsibilities and duties of local authorities and the social workers whom they employ?Mrs. Bottomley : I certainly endorse the hon. Gentleman's point. However, the decisions that social workers must make are enormously complex. If social workers remove a child needlessly, they are castigated ; but if they do not remove a child and it is abused, they are also castigated. Sometimes it appears that there is a ritual abuse of social workers.
In implementing the Act we are determined to clarify the rights of parents. The Family Rights Group, for example, has been working on a handbook for that purpose. We are also determined to clarify the role and responsibility of social workers. If they can remember that their prime duty is the welfare of the child and the need to have clear evidence, they may be able to avoid some of the pitfalls that have occurred in recent cases.
Miss Emma Nicholson : Will my hon. Friend consider, when looking at the aftermath of child sex abuse cases in the past two years, giving child psychotherapists a primary responsibility for identifying whether a child should be taken into care? I ask that because, as my hon. Friend knows, the modern social worker is a generic animal and does not have the specific child care knowledge that the old-style children's officer used to have.
Mrs. Bottomley : Skilled and professional workers should also know the limit of their knowledge and there are clearly times when they need to seek further expertise and advice. Our major implementation programme for the Children Act is unprecedented in child care. I recently announced a further package of initiatives, amounting to £1 million, to deal with various aspects of child abuse. One of those involves the treatment of victims of child abuse. The aspect that my hon. Friend indentifies is part and parcel of the matters on which we hope to make further progress.
Mr. Rooker : I think that the Minister appreciates that there is a good deal more common ground on that issue than on many that come before the House. What action is being taken to remedy the acute shortage of qualified social workers to implement the most significant piece of child care legislation for the past 100 years? If 50 per cent. of local authorities are to implement the Act on the financial basis of cuts or no growth, how will they meet the strict new timetables laid down by the courts for the detailed and rigid assessments required, given that shortage? How will the social service departments avoid families becoming child abuse statistics if they do not have the resources to operate what must be the ultimate user-friendly service?
Mrs. Bottomley : I endorse the hon. Gentleman's point about the spirit of co-operation that underlies the implementation of the Act. Because of the resource implications, this year local authorities, in their personal social services standard spending assessments, have seen an increase of 23.5 per cent., which is the biggest increase
Column 138
in money going into social services for 15 years. Moreover, there has been a 40 per cent. increase for social worker training, amounting to £50 million.I recently hosted a meeting with local authority representatives, social services inspectors and directors of social services and talked about how we could secure the commitment of long-term social workers to the service. We considered manpower, training and deployment issues. Many local authorities could do better in deploying their existing work force. We have more social workers and more of them are well qualified, and we must use them as effectively as we can in implementing this important Act.
Mr. Holt : My hon. Friend will know that the Children Act arose as a direct result of the Cleveland child sex abuse scandal. How does she react to the fact that my constituents who were caught up in that scandal are still, seven months later, waiting for compensation? It should have been paid to them, but is being held up because of the solicitor acting on behalf of the local authority and the doctors involved, who caused the scandal in the first place.
Mrs. Bottomley : My hon. Friend played a major role in drawing attention to the situation in Cleveland and championing the cause of his constituents. I am happy to report that when the social services inspectorate went back to Cleveland relatively recently, it was most impressed by the way in which lessons had been learned and the new procedures implemented. I have no information available on my hon. Friend's specific worry, but I shall take up the matter on his behalf.
Mental Health Foundation (Mid-Staffordshire)
3. Mrs. Heal : To ask the Secretary of State for Health if he will make a statement on the future of the Mental Health Foundation of Mid Staffordshire national health service trust.
The Parliamentary Under-Secretary of State for Health (Mr. Stephen Dorrell) : We have every confidence that this trust will continue toraise the quality of care available to its NHS patients.
Mrs. Heal : Does the Minister agree that the only way to guarantee the highest quality of standards and services for people with mental illness is to ensure that the mental health services stay as an integral part of health and social care? We must not allow them to opt out, operate separately and sell their services to general practitioners and hospitals, thus providing a fragmented service that will allow patients to fall through the net.
Mr. Dorrell : I entirely agree with the hon. Lady that mental health services must be an integrated part of the national health service, which is where they remain when they are run by NHS trusts. I hoped that the hon. Lady would use the opportunity of her question this afternoon to welcome the fact that the trust has already employed 20 additional staff in the mental health services of Staffordshire since 1 April and is committed to a further 20 staff before the end of this year. I hoped that she might also welcome the commitment to quality of service by the trust which is shown by the introduction of patient questionnaires, regular surveys of long-stay patients and a medical audit, the setting of standards and by the facts that 90 per cent. of all staff have attended training on quality
Column 139
and public meetings are being held every two months. I should have thought that the hon. Lady would welcome at least some of those facts.Guy's and Lewisham NHS Trust
4. Ms. Ruddock : To ask the Secretary of State for Health if he will make a statement on the future of the Guy's and Lewisham national health service trust.
Mr. Waldegrave : The long-term future of the Guy's and Lewisham national health service trust will ultimately be determined by the willingness of districts and GP's to send patients there. I am confident that the managers and clinicians at Guy's and Lewisham will continue to ensure that high-quality, cost-effective patient care is provided to meet the needs both of local people and of patients from further afield.
Ms. Ruddock : Will the Secretary of State guarantee that no two-tier service will develop in Lewisham ? Is he aware that the two fund-holding general practitioners from Bromley have applied to the trust for a contract that not only asks for accelerated waiting times but demands that all their patients are seen by locum consultants and senior registrars ? Will he instruct the trust not to accept that contract, or does he believe that my constituents deserve a second-rate service ?
Mr. Waldegrave : I should have thought that the hon. Lady might welcome the new and better services that many of her constituents are receiving and would turn to the districts and say that they should match that performance in their contracts. It is a pity that she did not mention, for example, the new children's unit that is to be opened at Lewisham hospital this week to replace the 119-year-old unit at Sydenham hospital-- perhaps she will be at its opening.
Mr. Hayes : Does my right hon. Friend agree that it is dangerous, cynical, electioneering nonsense to talk about a two-tier system ? Will my right hon. Friend make it 100 per cent. and unequivocally clear that the health service trusts are not opting out of the health service and are beholden not to big business, property developers or shareholders but to the best possible care of patients ?
Mr. Waldegrave : As my right hon. Friend the Prime Minister said, if they are opting out of anything, it is bureaucracy. As every doctor must have been trained in an independent, board-run hospital, it strikes me as ironic that so many of them seem to find the idea surprising.
Ms. Harman : Will the Secretary of State answer the question of my right hon. Friend the Member for Lewisham, Deptford (Ms. Ruddock)? Will there be queue-jumping at Guy's and Lewisham, which will mean that, instead of patients being treated according to clinical need, some patients will have to wait longer and be treated by more junior members of staff because a minority will be able to jump the queue? Is that the system that we shall see at Guy's and Lewisham?
Mr. Waldegrave : The hon. Lady is confused. It is for Guy's and Lewisham, as a hospital trust, to set its proper priorities for clinical care. Those who are seeking better
Column 140
treatment for patients, whether they are districts or GP fund holders, are doing their best for their patients and should be encouraged to do so.Severely Disabled People
5. Mr. Hannam : To ask the Secretary of State for Health what arrangements will ensure severely disabled people have control over their own personal assistance arrangements under the community care proposals.
Mrs. Virginia Bottomley : Our guidance to local authorities emphasises that service users, including severely disabled people and their carers, should be involved as closely as possible in decisions about what services should be provided to them individually. Section 46 of the National Health Service and Community Care Act 1990 also requires that local authorities consult representatives of users and carers in preparing their community care plans.
Mr. Hannam : Does my hon. Friend accept that when local authorities cannot provide the personal assistance that severely disabled people need if they are to live independent lives in the community, the present practice is that those local authorities can make cash payments to allow disabled people to buy in those services--and that that should be allowed to continue? Does she recall that she and other Ministers and the Audit Commission supported that idea in principle, and will she look for a way of putting it on a statutory basis?
Mrs. Bottomley : As my hon. Friend is well aware, it has not been possible to find a way to break the long-standing tradition in which local authority social service departments provide services and social security departments provide financial resources. As my hon. Friend knows, I am most sympathetic to the approach that says that those who are severely disabled should feel as far as possible in control of their destiny and of the care that they receive. In our practice guidance we shall emphasise that as strongly as we can.
Mr. Wigley : Does the hon. Lady accept that for such disabled people to have a real choice they need consultation and representation of the sort embodied in the Disabled Persons (Services, Consultation and Representation) Act 1986 ? The section to which she referred does not go anything like as far as that Act in ensuring that disabled people's voices are adequately heard so as to ensure valid choice for them.
Mrs. Bottomley : I do not accept that. I refer the hon. Gentleman to the debate initiated by the hon. Member for Monklands, West (Mr. Clarke) in which many of these issues were discussed. Since the passage of the Disabled Persons (Services, Consultation and Representation) Act, care for and understanding of disabled people have moved forward at a great pace and the philosophy of "Does he take sugar ?" is, I hope, a thing of the past. The National Health Service and Community Care Act overtakes the Disabled Persons (Services, Consultation and Representation) Act ; but we shall of course keep the matter under review once the formal requirements to consult the users and the carers on plans and assessments have been implemented. The local authority associations have been given a clear commitment, as have others
Column 141
concerned with the disabled, that we shall continue to review the matter once community care is fully implemented.Mr. Alfred Morris : Is the hon. Lady aware that the fundamental issue here is one of human dignity and independent living for disabled people ? How does she respond to the letter in The Times from her hon. Friend the Member for Mid-Kent (Mr. Rowe), published last Thursday, about the need to end the legal impasse ? Is she aware of the widely held view among disabled people, as reported by the Spinal Injuries Association, that the Government's attitude on this issue is "patronising and ill conceived" ? Will she act now to give them both choice and the fullest possible control over their own lives ?
Mrs. Bottomley : I very much hope that all the energy and commitment of the many organisations concerned with disabled people will be transformed into working with local authorities and their community care plans. Local authorities must have those plans drawn up within the year. They have to consult users and carers in that work, and I believe that the special protected position of disabled people under the Act should be broadened to ensure that community care moves forward as fast as possible.
Waiting Lists
6. Mr. David Marshall : To ask the Secretary of State for Health what research has been conducted on the relationship between the length of national health service waiting lists and the availability of private practice.
12. Mr. Patchett : To ask the Secretary of State for Health if he will initiate a study into the effects of the availability of private practice on national health service waiting lists.
Mr. Waldegrave : We have not conducted, nor do we plan to conduct, any research into the relationship between private practice and national health service waiting lists. However, we are determined to tackle long waiting times for NHS treatment. The NHS management executive is agreeing tough targets with all 14 regional health authorities for substantial reductions, by March 1992, in the numbers waiting over one year for treatment.
Mr. Marshall : Is not it a disgrace that, three months after John Yates, the Government's former waiting list expert, drew attention to the fact that private practice by national health service consultants may be leading to longer waiting lists for NHS patients, the Government have done nothing about it? The Secretary of State's reply is just not good enough. Will he assure the House that an immediate investigation will be carried out into this matter, or does he simply intend to expand his party's two- tier health service, which means priority for private patients and longer waiting lists for national health service patients?
Mr. Waldegrave : I do not think that the hon. Gentleman has exactly and correctly reported Mr. Yates's views. If the hon. Gentleman will produce evidence to back what he says, I shall look into it. The hon. Gentleman presents yet a further argument in favour of national health service trusts. Those trusts will hold the contracts
Column 142
for their consultants, and it will be open to them to negotiate with their consultants if they wish to see them carrying out more national health service work.Mr. Patchett : Given the evidence of Mr. John Yates to the Select Committee, does not the Minister recognise the need for a study of this matter and the possible dire consequences to the health service if it is ignored?
Mr. Waldegrave : I think that my previous reply answers the hon. Gentleman's question. If the baying of Opposition Members over the issue of independent practice by doctors were drawn to the attention of the British Medical Association, it might dampen the association's enthusiasm for anything that might lead to a Labour Government.
Mr. Michael Morris : Is my right hon. Friend aware that whenever the Public Accounts Committee has looked at any alleged negative relationship it has found none? Will my right hon. Friend ensure that the whole issue of waiting lists is simplifed so that health authorities who remove people from the waiting lists are paid after they have performed the required service?
Mr. Waldegrave : I confirm that my hon. Friend is right. There has never been any evidence to show what has been alleged. There is unfair reporting of the matter. One of the newspapers that supports the Opposition, the Daily Mirror, reports another of Mr. Yates's ideas, which is to give incentives to doctors who do well in reducing waiting lists. However, the Daily Mirror reports that in most unfair terms as being a dreadful thing to do. I am not sure whether the Labour party is in favour of Mr. Yates or against him.
Mrs. Peacock : Will my right hon. Friend not be drawn along lines that confuse the issue but confirm that the national health service is what it says it is, what it has always been and what it always will be--a service that is available when needed and free at the point of need?
Mr. Waldegrave : I have no difficulty in fully endorsing that. In response to these questions, I re-endorse an element of the policy of the national health service's founding Minister, Mr. Aneurin Bevan, who made a historic compromise with consultants when he allowed them independent practice in NHS hospitals.
Mrs. Dunwoody : Is the Secretary of State aware that the BMA does not represent consultants? If he wants to know what consultants think, he should talk to their representative groups. Would he ask them to explain why, over a recent holiday weekend, the trust in my area simply stopped taking in patients because it did not have a senior registrar available to do the work?
Mr. Waldegrave : I think that Mr. John Chawner would be confused to be described as not representing consultants. He regards that as his job and he certainly represented them when he saw me a few days ago. I am willing to admit that, in the few weeks in which they have been in existence, the trusts have not solved all the problems of the national health service. There are still problems, but I assure the hon. Lady that the management delivered by her NHS trust will be much better than the traditional management, which created these problems in the first place.
Column 143
NHS Funding
7. Mr. Robert B. Jones : To ask the Secretary of State for Health what has been the real growth in capital spending in the national health service since 1979.
Mr. Dorrell : Gross capital expenditure in the national health service in England has grown by 62 per cent. in real terms since 1978-79.
Mr. Jones : I am grateful to my hon. Friend for that answer. Will he confirm that it includes more than £40 million-worth of new capital investment in the North Hertfordshire district health authority area? Those projects are well appreciated by those who live in the areas concerned, especially as the projects were cancelled by the Labour Government.
Mr. Dorrell : My hon. Friend is right in his figures and in drawing a favourable comparison between our record and that of our predecessors. In the past 12 years, capital investment has increased by 62 per cent. in real terms while under the Labour Government it decreased by 16 per cent. in five years.
Mr. Bermingham : Does the Minister agree, that as he knows all too well, in the St. Helen's and Knowsley hospitals area investigations show that capital and other funding has always been undercut? Now that we have hospital trusts--both hospitals have opted out--are we to understand that the hospitals will get no more capital and that there is no hope of our ever having the capital that we should have had over the past 15 years?
Mr. Dorrell : The hon. Gentleman has not quite caught up with the Leader of the Opposition. The funding argument is over. The Labour party is clearly on the record as saying that an incoming Labour Government would have no new money for the national health service. The question that the hon. Gentleman asked me is one that he should put equally to the Opposition Front Bench.
Sir Anthony Grant : Does my hon. Friend agree that while, we welcome the additional resources that have been made available in the eastern region, in formulating hospital policy big is not necessarily beautiful? I cite, for example, the unsatisfactory proposal to move the world famous Papworth hospital into the already over-large Addenbrooke's hospital.
Mr. Dorrell : I entirely agree with my hon. Friend that big is not necessarily beautiful. In designing future NHS provision, it is important to ensure that it meets the identified needs of patients. That is the priority that we have established through the establishment of the purchaser-provider split. We have ensured that it is the principal responsibility of the new health authorities.
NHS and Community Care Act
8. Mrs. Fyfe : To ask the Secretary of State for Health when he last met representatives of local authorities to discuss the implementation of the National Health Service and Community Care Act 1990.
Mrs. Virginia Bottomley : Ministers regularly meet representatives of local authority associations to discuss a range of matters, including community care implementation. They last met them on 16 April.
Column 144
Mrs. Fyfe : Does the Minister recall telling the Leonard Cheshire Foundation conference recently that caring and costing are related? If so, what has she told local authorities about community care? More than half the local authorities are having to make cuts in their community service provision and in their grants to voluntary bodies. Those cuts are necessary if authorities are to fulfil their statutory obligation to implement their part of the care in the community policy.
Mrs. Bottomley : I was honoured to speak at the annual general meeting of the Leonard Cheshire Foundation, which provided an excellent example of care in the community. Perhaps those who were wasting money on the £1.5 million National and Local Government Officers Association's advertisement last week should have paid attention to it. In talking with local authority associations, we are discussing the 23.5 per cent. increase for social services this year, which is in part the result of phase 1 of the community care programme. We have taken the unprecedented step of providing specific grants for voluntary organisations which provide drug and alcohol support as well as introducing a specific grant for the mentally ill. In short, the meetings with local authority associations integrate caring and costing. We make it clear that the Government will support community care and we look to local authorities diligently to implement the policy.
Mr. Robin Cook : Has the Minister grasped the sharp increase in charges that social services authorities are having to make for disabled and elderly people? Is he aware that the average rise in charges for home helps is one third, which is four times the rate of inflation? How many elderly people does the Minister know whose benefit has increased by a third in the past year? Does it not make a mockery of care in the community if elderly and disabled people have to pay for the care that they need?
Mrs. Bottomley : What is clear is that local authorities need to think through their charging policies. As hon. Members will know, Derbyshire, for instance, provides one in three of its elderly residents with a home help, and charges nothing. There has been a dramatic expansion in community services, with an increase of 30 per cent. in the number of day centres for the elderly, an increase of 25 per cent. in the meals on wheels service and a 27 per cent. increase in the number of home helps.
As local authorities implement the community care policies, it is essential that they manage their resources effectively and well. The spending of social services departments has risen by 52 per cent. in the past 11 years. We are already clearly identifying the cost of implementing community care and, in turning that policy into practice, local authorities must ensure that they achieve good value for money.
Mr. Kennedy : When the Minister comes out with statements like that about the reality of community care, she seems to pay no attention to the findings of the Radio 4 programme "You and Yours", on which she was interviewed last week. The programme carried out an in-depth analysis of the subject, across the whole country. Does the Minister accept that-- according to the clear evidence that emerged from that process, and the direct feedback from those who were involved and consulted, community care is in a catastrophic state because of underfunding and because of the delays to which it has
Column 145
been subjected? Anyone who has talked to those in the local social services departments will inform hon. Members on both sides of the House of that.Mrs. Bottomley : As I hope that all hon. Members will agree, the key issue is that the challenge of caring in the community affects all our constituents as demographic factors change and expectations rise. We must harness the good will of the community to meet those care needs, to provide carers with practical support and to ensure that our provision is truly user-led rather than producer-driven. Local authorities, health authorities, voluntary organisations and the private sector certainly need the two years that it will take them to phase in community care. We have already made a start with the mental illness and drug and alcohol treatment facilities, the training and the complaints procedure. We look to local authorities to work with us in a constructive partnership to implement what is a popular and very important policy.
NHS Doctors
9. Mr. Barry Field : To ask the Secretary of State for Health how many doctors were working in the national health service in 1979 and in 1990.
Mr. Waldegrave : The number of doctors in the national health service in England has risen from 61,554 in 1979 to 72,446 in 1989.
Mr. Field : I thank my right hon. Friend for that reply. Does he agree that it represents a record of achievement, under a Conservative Government, of which we should be proud? More doctors are spending more time with their patients, and there are fewer of those patients.
Will my right hon. Friend reassure the House, however, that the taxpayer's pocket is not being misused to allow a tiny minority of doctors to practice politics rather than patient care?
Mr. Waldegrave : My hon. Friend is right to pay tribute to the Government for the major increase in the number of medical and clinical personnel in the NHS. That is reflected in the many more treatments that have been afforded to our people.
On the Isle of Wight, my hon. Friend may have come across one general practitioner who seems able to spend a great deal of time outside his surgery.
Mr. Madden : Does the Secretary of State accept that members of the British Medical Association in Bradford voted by a large majority against the establishment of the Bradford health trust? Does he agree that the cuts announced so far--a £7 million cut and 300 redundancies--have done nothing to allay those doctors' anxiety? Will the right hon. Gentleman now agree to open the books? Will he allow the publication of the business plan and the Coopers and Lybrand Deloitte financial report, and will he allow the Select Committee on Health, which is to interview the chief executive and the chairman next week, to question both officials fully and thoroughly about evidence that is published and available to them?
Mr. Waldegrave : The Select Committee needs no encouragement from me to carry out its questioning, and I am sure that it will do so excellently.
Column 146
The hon. Gentleman is wrong to say that there will be 300 redundancies in the trust. There is no question of that. The underlying problems of that hospital, which go back many years, are now being tackled by much better management, and the hon. Gentleman will soon see a hospital with a secure and successful future.Mr. Dykes : Does my right hon. Friend agree that, under the old arrangements, a significant and regrettable minority of GPs treated their patients with less than the full care that we would expect and that the current much more positive response from GPs is already being manifested under our new arrangements?
Mr. Waldegrave : I think that they were always a very small minority. The new GP contract, which is delivering major improvements in services to all our patients in this country, shows that GPs are providing ever better service. It is characteristic of the Labour party, I am afraid, to oppose the new GP contract.
NHS Trusts
10. Ms. Armstrong : To ask the Secretary of State for Health what advice he is giving the Northern region health authority in respect of future applications for national health service trust status.
Mr. Dorrell : We have made it clear that trust status is our management model of choice throughout the NHS.
Ms. Armstrong : Is the Minister aware that there is deep resentment and anxiety in the Northern region about the Government's pushing hospitals to go for opted-out status ? I am particularly concerned about the financial viability of the north-west Durham health application. Will he guarantee today that the business plans in connection with that application and others will be published so that people who now feel anxiety will be able to see for themselves precisely what the future offers ?
Mr. Dorrell : My right hon. Friend the Secretary of State has already dealt with the question of the publication of business plans. I remind the hon. Lady that NHS trusts have an obligation to publish reports to the local public. That obligation is entirely new--it was never in the traditional model of management of the national health service.
Mr. Devlin : Is not the situation in inner London rather different from that in the Northern region ? In inner London there are 82 consultants and 420 beds per 100,000 population, whereas in the Northern region there are only 26 consultants and 260 beds per 100, 000. Does that not show that in the past 10 years the Government, through the 39 major capital schemes in our region, have shown an unequalled commitment to the improvement of the health service in the Northern region, which is now being demonstrated by the number of local hospitals that wish to take on trust status so as better to serve their local population ?
| Next Section
| Home Page |