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Mr. Patrick Thompson (Norwich, North): Will the hon. Gentleman give way?
Mr. Barron: The hon. Gentleman has just dropped down out of the Gallery.
Ministers will be exposing us to a possible £5 billion worth of debt, over which the Secretary of State will have no control at all.
Mr. Thompson:
I am conscious of the fact that I have not been present through all the debate, but references to Norwich should be accurate. The long delays in the Norwich hospital have been due to changes of mind on the siting of the hospital and have nothing to do with the PFI. I hope that the hon. Gentleman will persuade members of the Labour party to stop campaigning for alternative sites, because that will cause further delay. He should concentrate on matters that he knows something about.
Mr. Barron:
I am pleased that I gave way to the hon. Gentleman, because he is using the same logic as that used by the hon. Member for Worcester (Mr. Luff), who argued that the Worcester hospital has been delayed for the past two years because of our amendment.
The hon. Member for Norwich, North (Mr. Thompson) should have been here earlier to hear my hon. Friend the Member for Peckham read out a press release that was produced by the Department of Health in 1990. The then Secretary of State read out the press release and spoke of the great things that were to happen involving the new hospital in Norwich. It is a pity that the hon. Gentleman was not here to hear that.
Many people are concerned that the PFI is nothing more than a ramp for privatisation, and those concerns are heightened by the overarching secrecy that surrounds the PFI. The Secretary of State smiles, but many clinicians inside the NHS fear that the decisions that they take now will not be taken if other people, who put the concrete in the hospitals, also run and manage the services. The Secretary of State knows that that is the case because it is well documented. That is why the right hon. Gentleman says that the Government will never do anything unless clinicians say that it is all right to do so. He knows that he ignored those same clinicians when they wrote to him to say that he should not reorganise the National Blood Authority.
The Bill commits the House to supporting debt resulting from contractual obligations about which we can discover nothing. Secrecy and mystery surround every turn of the PFI process. When I recently received some information from one hospital trust about the PFI, the paper came in marked "confidential" and its recipients were sworn to secrecy about its contents. The document contained nothing more exciting than a budget for running the PFI process. That budget is commonly acknowledged to be in the region of £1 million a time.
The greatest secrecy surrounding PFI is that nobody knows where the boundaries are. At last month's health questions I asked the Secretary of State to tell the House which services were clinical services--and therefore need not go out to PFI--and which were clinical support services. He said that the clinical and clinical support services were
He should remember that occasion as I wrote to him two days later and asked him to define the terms. I thought that the House would appreciate a list stating which
services were clinical and which were not. In view of what he had said, I thought that my request was reasonable, but one month has passed and my postbag remains singularly empty of correspondence on that matter from the Secretary of State. Perhaps he will answer the letter and tell me exactly what he means when he talks about PFI in the health service.
Is it true that nothing is outside the scope of the PFI and literally everything is up for grabs? If so, I believe that the House will take a dim view of the privatisation of clinical services with a cast-iron guarantee of return from the Government. Clinicians are already worried that their service will be privatised and the Bill will not ease their concerns.
Contractors are worried that they will not get paid if the Secretary of State does not change more NHS regulations. The Bill is designed to make them feel better. Contractors and private sector consortiums fear that they are being asked to sign agreements with weak and insubstantial NHS trusts.
The Government's health service reforms have created organisations that the Secretary of State can dissolve almost at will; they lack accountability to their communities and to Parliament. The reforms have created trusts that operate without effective forms of control; they are able to borrow without the statutory approval of the Secretary of State. The private sector fears that the agreements entered into with the trusts will not be safe. Banks fear losses and the insecurity caused by the continual upheaval in the NHS brought about by the internal market.
There are also Government fears: Ministers fear that their reforms have created a monster that they cannot control. They fear that they have built a system that stands permanently on the point of collapse, which is exactly what they have done. The Government fear the electoral annihilation that awaits them and Ministers fear voters far more than any concerns about the massive increase in public borrowing that the Bill could bring about.
The Labour party cares about the public purse and public borrowing, which is why we shall vote for our reasoned amendment. As my hon. Friend the Member for Peckham said earlier, we cannot support the Second Reading of the Bill because it commits the taxpayer to signing a blank cheque for as much as £5 billion over which the Secretary of State has no control. It is a badly thought-out Bill that is being rushed through the House by a scared Government who are unable to cope with the chaos that they have created in the national health service.
It is inconceivable that the so-called anomaly has only now come to the Department's attention. Newchurch and Co.--the official guardians of the PFI in the health service--recognised in autumn 1994 the problems created by the Government's haphazard and incoherent trust system. It questioned the implications of the dissolution of a trust and said:
It is quite clear that the Government have resisted changing the law at least since 1994. One might think that the issue was not keeping the Secretary of State awake at night until two weeks ago when he telephoned my hon. Friend the Member for Peckham. The Government have known about the anomaly for a long time and their best
effort ignores their own logic. Newchurch consultants have long recognised--as they say in their "Guide to the PFI"--that
The Secretary of State has admitted that it is perfectly true that capital always costs more in the private sector than it does in the public sector. In his speech to the Royal College of Physicians, he said:
We agree entirely with best value, but we remain unconvinced that worst value can be underwritten by the Bill and that the Department of Health does not have to take a decision about it.
We tabled the amendment because we are concerned about the state of the national health service. We do not believe that the PFI is any substitute for the public investment that was cut by 17 per cent. in the last Budget. If the PFI is to apply to the health service, it should be on the basis that it is additional and that it will do what it is supposed to do. Dozens of hospitals that should have been built--some of them years ago--remain on the architects' drawings boards because of the Government's belief that the private sector is always the way to go. We do not believe that that is correct in all circumstances. [Interruption.]
The Parliamentary Under-Secretary of State for Health (Mr. John Horam):
I am somewhat disappointed by the efforts of Opposition Front-Bench Members in the debate. I am aware that the hon. Member for Peckham (Ms Harman), following the rumpus surrounding her decision to send her son to an excellent school in my constituency--I have not had the opportunity to congratulate her on her excellent choice; Bromley is renowned for its hospitals as well as its education facilities--
Mr. Deputy Speaker (Sir Geoffrey Lofthouse):
Order. The Bill is about the Health Service and not schools.
Mr. Horam:
I congratulate the hon. Lady, and I know that she will accept it in good heart. Following the rumpus surrounding her decision, she no doubt wanted to show her mettle and prove that she is not a liability to the Opposition Front Bench.
"both well-known terms of art within the health service. The scope of those terms is well defined."--[Official Report, 13 February 1996; Vol. 271, c. 794.]
"The rights of contractors in the event of default by an NHS trust is an issue of concern to many."
"In all but the most exceptional circumstances, capital sourced from the private sector is going to be more expensive than money provided by Her Majesty's Treasury".
"I am strongly in favour of testing public and private sector solutions and adopting the approach which offers best value".
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