| Previous Section | Index | Home Page |
Dame Jill Knight: On a point of order, Mr. Morris. For 30 years I have been proud to be a loyal Back Bencher, but the vote that has just been taken is unprecedented, as is the fact that, earlier this evening, no fewer than 112 Conservative Members voted, including 11 Ministers and five Whips. Note should be taken of this extraordinary vote.
The Chairman: The hon. Lady is an important constituent of mine, but nevertheless I must tell her that that was not a valid point of order.
Mr. Patten: Further to that point of order, Mr. Morris.
The Chairman: There cannot possibly be anything to add to that point, even by the right hon. Gentleman.
Mr. Patten: On a separate point of order, Mr. Morris.
The Chairman: Order. That is a remarkable change in so few seconds.
Mr. Patten: It is a new point of order. Would it be in order for the Lord President and Leader of the House to approach you tonight if he wished to make a statement on Government business in light of this evening's vote, and the fact that an overwhelming majority--
The Chairman: Order. The Chairman does not anticipate anything that is likely to happen later.
Bill (Clauses 5 and 7), as amended, to be reported.
Mr. Kevin Barron (Rother Valley):
I beg to move, That the clause be read a Second time.
New clause 1 is about giving back to Parliament the right to scrutinise and monitor decisions relating to the national health service, as they might mean a call on the public purse. It would ensure that the Executive, in the form of the Secretary of State for Health, and the Exchequer must approve the borrowing. It would also provide that the House be informed that new liabilities have been approved and will be incurred. Neither of those checks applies to existing liabilities; the new clause seeks to place them on any future liabilities below the sum of £5 million. It is constructive and designed to strengthen the Bill.
Hon. Members who missed the Bill's Second Reading might wonder why we have tabled the new clause. We believe that it is not right or proper that the Executive should effectively let people in various outposts of the now fragmented national health service take decisions about public borrowing that has been okayed neither by the Executive in Whitehall nor by the House.
Our case is that, currently, anything up to £5 billion could be borrowed by a national health service trust without statutory protection and without any proper Executive approval or parliamentary scrutiny. It is a unique condition that public liabilities are incurred entirely without public approval or knowledge. We want that changed.
The new clause would guarantee parliamentary scrutiny and ensure that borrowing by NHS bodies was approved in advance by the Secretary of State. It is a straightforward measure that the Government should have thought of but, instead of considering carefully what the Bill proposed, Ministers have stumbled blindly to this point. They have been blinded by their desperate desire to revive the private finance initiative in the health service, which is in a state of chaos.
Mr. Mike Gapes (Ilford, South):
Is my hon. Friend aware of concerns expressed to me only last week by my local health authority about the implications of the private finance initiative for the long-term status of health authorities? Can he assure us that, when there is a change of Government, steps will be taken to resolve the problem?
Mr. Barron:
We are prepared to give the assurance that the private finance initiative will not take over clinical practice in the national health service or influence decisions that should be taken by clinicians who are in the NHS for the public good rather than for other purposes, as the PFI players will be.
The whole purpose of the Bill is to gold-plate the private finance initiative in the health service. Since their opening remarks on Second Reading, Ministers have stopped pretending that the Bill has any other purpose than effectively to underwrite liabilities that we thought were quite the right type of risk to go with the benefits that the private sector receives. Our new clause would bring back what the Government are intent on giving away. It would ensure that the Secretary of State holds himself accountable for his current manipulation of the PFI rules and the constant change that is taking place under them.
It cannot be right that health service bodies can borrow against a blanket guarantee from the Secretary of State without the Secretary of State's having to approve such liabilities as and when they are incurred. It also cannot be right that no Minister will be responsible to Parliament for sanctioning such borrowing as and when it occurs, and that the Treasury will be left paying the private sector's bills without ever having agreed to do so.
The Under-Secretary of State for Health, the hon. Member for Orpington (Mr. Horam), tried to claim in Committee that, by approving external financing limits, Ministers will approve new liabilities. It is our contention that that is wrong. What the Under-Secretary claims counts as proper parliamentary accountability is in fact some vague approval of health service bodies' hypothetical ability to consider using borrowed money. They are hardly the tightly defined measures that our new clause proposes.
It is equally important that the Under-Secretary's alternative does not represent proper parliamentary scrutiny. It certainly does not offer the openness and accountability that we want. The Under-Secretary has an obligation to explain where that openness and accountability will be found in his PFI support system. When and through what mechanisms can Parliament scrutinise the cheques that will be written to PFI contractors? How can Parliament hold the Secretary of State to account for agreeing to underwrite private contractors' returns for, in some instances, as much as 60 or 70 years into the future?
As we understand it, contracts of that length are running at the moment. What does that mean for change in the health service, as has occurred in the past 20 or 30 years, new medical practice and new science that is now taken on board practically every day? We are not too sure whether we are disagreeing with a straitjacket not only on public liability but on the flexibility that the health service needs to be able to change and to deliver increasingly better health care for years to come.
What is the device for limiting the level of exposure of the public purse to those gold-plated risks in the health PFI? We recognise that the Government have made a mess of investment in the national health service owing to their incompetent handling of the PFI, but is it right that they should ask Parliament to dig them out of the mire by passing the Bill and, in doing so, keep all of us in Parliament, including Conservative Members, in the dark about decisions that will be taken on our local health services in years to come?
We want parliamentary scrutiny of the private sector's involvement in the national health service. We want the secret system surrounding health service borrowing from the private sector--including the amounts of money, the terms of repayment, and the lengths of deals--made much more transparent than it is in the current chaos. Our new clause delivers scrutiny, accountability and openness, and I commend it to the House.
The Parliamentary Under-Secretary of State for Health (Mr. John Horam):
The new clause returns to the issue that we discussed at some length in Committee and relates to the scrutiny and control of hospital trust borrowing and liabilities by the Government and the House. The hon. Member for Rother Valley (Mr. Barron) will recall that he tabled an amendment in Committee to increase scrutiny and control by the procedures that are repeated in the new clause. He will recall that my objection to his amendment in Committee was that it would bring about a huge increase in bureaucracy.
| Next Section
| Index | Home Page |