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12.59 pm
Mr. Peter Hardy (Wentworth): I make no apology for raising this matter, as experience suggests that hon. Members have an obligation to maintain an interest in agencies and local organisations that serve their constituencies. National health service trusts and other bodies that administer the health service are extremely important in their regions and nationally. Their duties are vital. The funding for which they are responsible is large and needs to be larger. As the taxpayer provides those funds, the Member of Parliament, the taxpayer's representative, is entitled to maintain an interest--indeed, it may be an obligation.
That interest may not always be convenient to, or welcomed by, those bodies, but they need to appreciate that national health service trusts owe their position to the Minister. They are not directly democratically based or clearly representative in their nature--Members of Parliament are. I make the point because, on two or three occasions over the years, my relationship with bodies serving my constituency has not always been smooth and easy. It has usually been cordial, and I have great respect for the people who serve on those bodies. Some years ago, however, one chief officer imagined that he could refuse to meet local Members of Parliament: the Minister will appreciate that the meeting did take place.
Two or three years ago, hon. Members had cause for concern when a project of major importance was not drawn to their attention at a reasonably early stage and the trust's initial response to the public's growing concern was less than sensible. In another matter, I expressed serious concern about the fact that my constituency provided no lay member to serve on Rotherham health authority, an authority of considerable quality, which serves three constituencies: Rother Valley, Rotherham and my own. That was a serious omission. It led me to see the then Health Minister--the present Secretary of State for Health-- who, unfortunately, was ill-informed about the position as he said that my constituency did not provide the authority with a lay member before it was reorganised. I was able to give him the relevant names and addresses.
Lest it be suggested that I am wholly critical, I make it clear that I recognise the fact that many of my constituents are justifiably grateful for, and appreciate, the services and help that they have received from the national health service in Rotherham, and that I share their view that the medical, nursing and caring staff at the hospital and in the service generally maintain high standards and show a commendable dedication to their work, which should be consistently recognised. Their position led me to seek this debate. I am not sure that the people responsible for the leadership of the service have adequately recognised their obligation to consider staff and to give proper regard to their views.
I accept that smoking is bad for health--that is beyond dispute. I agree that people, especially the young, should not be encouraged to smoke. I do not quarrel with the efforts of public bodies such as health trusts to discourage smoking and to take steps to protect others from the effects of smoking. Nor do I object to the Department of Health's advice on that matter--that point needs to be made clear from the outset. In effect, this debate is about not smoking, but the conduct of public business and Rotherham trust's approach.
The trust decided to introduce a complete ban on smoking, phasing it in until full implementation on 1 April 1995. That met the wish of Rotherham health authority, which, in compliance with its obligation to the Department, required its providers to operate an anti-smoking policy within Government guidelines. Just before the complete ban came into effect, constituents expressed their concern to me that they were to be prevented from smoking, not only in the hospital but within its grounds and in the car park, including in their motor cars.
On 28 March 1995, I wrote to the trust to express concern about the absolute nature of the ban. The acting chief executive responded promptly to say that the trust had unanimously approved the decision, and he informed me that that was in accordance with Department of Health guidelines. Constituents then said to me that they had been told that the ban had been introduced on the Minister's advice or instructions, so I wrote to the Minister involved--the noble Lady Cumberlege--who replied on 22 April. Her letter referred to the setting aside of a limited number of smoking rooms for staff. That position was significantly different from that of the trust.
National health service guidelines cover the point. They say specifically that a limited number of smoking rooms are to be set aside for members of staff who cannot give up smoking. They assume that all members of staff wish to give up smoking. The Minister who is to reply will accept that not all of them do--it is a free society. The Department asked district health authorities to implement the anti-smoking policy and specific reference was made in the guidelines to the provision of separate smoking rooms for patients and visitors. Rotherham appears to have disregarded that.
Many staff were unhappy about that absolute approach. I understand that the hospital administration department was unhelpful in the drawing up of a petition. The Minister will be aware that more than 500 members of staff at the hospital--500 dedicated and hard-working people--signed a petition seeking the provision of a smoking room. The petition was submitted to the trust and rejected, despite the fact that the Department's guidelines provided for that facility.
Following receipt of the noble Lady's letter, I wrote to the trust and said that the position was anomalous. The noble Lady had advised me that patients could be allowed to smoke if the clinician approved and if the arrangements to allow that had been put in place, and that the facility would be only for patients and not for staff, visitors or anyone else. However, given the number of patients who gather around to smoke outside the hospital, it is peculiar that the trust tells me that facilities have been provided for patients to smoke. If they had, they would not be standing by the hospital doorways in wet and cold weather indulging in the habit.
I wrote to the trust after I had received the noble Lady's letter and waited for a reply. Unfortunately, none came. At a function, I saw the chairman of the trust, a local and distinguished citizen whom I view highly and have known a long time. We still have a cordial relationship. I said that I had not received a reply to my letter. He assured me that the contents of my letter were being taken seriously, but I still did not get a reply.
Like other hon. Members, during recesses I make a number of visits and hold a number of meetings to fulfil my constituency obligations. Following usual practice,
a meeting with the trust was arranged for 12 September last year, which my hon. Friend the Member for Rother Valley (Mr. Barron) and I attended. As soon as the meeting began, I drew attention to the fact that I had not received a reply to my letter and the chairman unhesitatingly offered a full apology. We discussed the problem of the smoking ban in detail. I hoped that, following that meeting, a rather more sensitive approach would be taken. However, within a short time I learnt that the trust had endorsed its existing policy in every particular and again claimed that it was complying with Department of Health policy--which it clearly was not.
I wrote to Baroness Cumberlege again, but I received a reply that I thought was inconsistent with her previous letter. The Minister may disagree about that. Baroness Cumberlege said that she stood by everything that she had stated in her previous letter about the provision of smoking rooms, but she then expressed total support for the trust's decision. I am sure that the Minister has seen the correspondence.
Baroness Cumberlege also referred to the claim that the vast majority of patients, staff and visitors wholeheartedly supported the trust's policy. I have very real doubts about that--514 members of staff requesting a different arrangement can hardly be described as overwhelming support. As far as I know, the trust has made no attempt to discover whether it actually does have the overwhelming support of the community, patients and visitors. Indeed, as far as I am aware, the only exercise to establish that was carried out by members of staff. It revealed that the majority of people who do not smoke as well as the overwhelming majority of people who do smoke disagreed with the trust's policy. That clearly shows that the trust's claim that its policy enjoys overwhelming support is not well founded.
I am concerned about people who visit the hospital and use their own cars. Despite the enormous successes of hospitals in modern times, they remain places of stress. To add additional stress by refusing to allow any opportunity to smoke is not necessarily wise. It is also rather oppressive to tell people that they cannot smoke in their own cars. I pointed out to the trust last September that it would face wholesale disregard of its ban. South Yorkshire is not the sort of area where big brother immediately and automatically commands obedience and respect. I told the trust that docile, obedient, responsible citizens would obey the ban, but a very large number of people would not, which would make those who respected the ban feel somewhat angry and embittered. The ban does not help to foster good relationships. It is much too oppressive to tell people that they cannot smoke in their own cars.
There has been a slight advance because the chairman has now told me that the trust will not enforce the ban. I am not happy about that because I believe that regulations should be sensible and enforceable. If they are not, they should not have been made. I hope that there will be a different approach.
The Department of Health is responsible for the trust and it appoints its members. It has issued guidance to which I do not object and nor do the majority of people and the staff of Rotherham hospital. However, the trust, which does not have a democratic mandate, has chosen to disregard the staff and impose a ban. That places a burden
on staff, one of whom is a constituent of mine who has not had a day off work for health reasons in 20 years. She is now told that she cannot smoke within the precincts of the hospital.
The trust feels entitled to disregard the Department's advice on the provision of smoking rooms. It is distasteful that the trust, having decided to differ from the Department's advice, has not acknowledged that difference but instead claimed, both before and after the ban and during our meeting, that its action was in accordance with departmental advice. Will the Minister make it clear to the trust that it should not say that it is following ministerial instructions when it is not?
We are concerned here not with the merits or demerits of smoking but with the proper conduct of public business. Perhaps it would be appropriate for the Minister to confirm that trusts should always be willing to meet Members of Parliament and that they should never mislead them. Hon. Members are entitled to be, and must be, given accurate information by all the public bodies that serve their constituents. In this case, I do not think that I was given accurate information. Neither do I think that the trust recognised its obligations to the community and to its parliamentary representatives.
The dedicated and caring staff of Rotherham hospital should have received adequate information. I am not sure whether it is correct, but I have been told by several members of staff that they were not properly consulted. The Minister will acknowledge that departmental advice makes it absolutely clear that staff should be consulted. In this case, I have a real suspicion that they were not. I hope that there will not again be the same insensitive disregard of the views of staff that has clearly been the case until now. I hope that there will be an understanding that sometimes a draconian attitude can be counter-productive.
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