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Mr. John Gunnell (Morley and Rothwell): Will the hon. Gentleman give way?
Mr. Maples: No, I would like to make a little progress. I have given way an awful lot.
The document also shows how far Labour is willing to take the policy. It was described to us as commercialisation of the health service, but it appears that the Secretary of State plans the ultimate in commercialisation, although he may choose to deny it. According to the 9 July issue ofBMA News Review, as part of the celebrations of the50th anniversary of the NHS,
Let me now turn to the policy that is under discussion. Let us look at the Conservative record on that policy. Notwithstanding what the Minister said, it is fair to remind the House that it was invented by a Conservative Government, who had two aims: first, to relieve pressure on public spending, which, as we all know and as the Labour Government are discovering, is infinite and difficult to meet, and to achieve better solutions. Our second purpose, which should not be ignored, was to find local, entrepreneurial, imaginative solutions to local problems, to encourage local trust managers to come up with those solutions, to--if I may use the jargon--let a thousand flowers bloom.
Mr. Stevenson:
Will the hon. Gentleman give way?
That was based on the realisation that central planning from the top in Whitehall has not worked in the health service. The man in Richmond house does not know best. He cannot know the best way to run pathology services in Nottingham, and canteens and car parks in Chester; but there is a good chance that local managers in those areas do, and may have some original ideas. There is a possibility of better, more efficient solutions, not just financial but medical.
Mr. Stevenson:
Will the hon. Gentleman give way?
Mr. Maples:
I would like to get this section of my speech out of the way. I have given way an awful lot so far.
There is a possibility of such novel, imaginative local solutions to problems large and small, from building car parks to building hospitals. The NHS executive guidance published in 1993--shortly after the PFI became an option for the NHS--stated:
Mr. Gunnell:
Will the hon. Gentleman give way?
Mr. Maples:
I want to finish this section of my speech.
An answer to a parliamentary question reveals that, by January this year, 32 PFI schemes worth over £1 million each had been completed and put into operation. By June this year--according to a parliamentary answer given by the Minister himself, obviously referring to the years before he was responsible for policy--61 projects worth over £1 million had full business case approval, to a total value of £800 million, and 151 had outline business case approval, to a total value of nearly £3 billion. Twenty-five PFI schemes for new hospitals had reached preferred bidder stage, five had full business case approval and one had been signed in November 1996.
When Labour rubbishes our record and talks about five years of indecision, let us remember the truth. This is our policy. It was, I remind the House, introduced in the teeth of Labour opposition. Many projects had already been
successfully completed, and many more were in the pipeline. The Minister was able to give the go-ahead to 14 projects two weeks ago because we got the projects to that stage. If it were not for us, there would be no private finance initiative and no new hospitals being built in Norwich or Dartford.
Mr. Gunnell:
Would the hon. Gentleman like to comment on the grand announcement made on 29 January last year by the then Minister, the hon. Member for Orpington (Mr. Horam), of a £50 million scheme atSt. James's hospital in Leeds? Not surprisingly, the scheme has not been approved as one of the 14 that can go ahead. People at the hospital accept that the scheme cannot go ahead. Despite all the trumpeting, the scheme cannot go ahead. I was told that the hospital would present a better scheme than the one that was announced so grandly. The Conservative Administration's PFI mechanisms were ineffective and did not result in the major developments that they wanted. There was a residual liabilities measure to clear up the mess, but my right hon. Friend the Minister had to introduce another Bill to make it clear that companies should adhere to their agreements.
Mr. Deputy Speaker:
Order. Interventions should not be speeches.
Mr. Maples:
Hon. Members seem to want to make bits of their speeches in the middle of mine. Perhaps they would do me the courtesy of waiting.
I have given the figures on our achievements under the PFI. It has been said that there is a steep learning curve for such new approaches. I gather that there were particular and specific problems with the Leeds project. No doubt the hon. Gentleman is making representations to the Minister about it and I am glad that he is able to do that.
Mr. David Rendel (Newbury):
The hon. Gentleman seems to think that that is a specific case. Will he comment on the Royal Berkshire trust and the priority care trust in Newbury, both of which were ready to go ahead with new hospital buildings before the PFI scheme started? Both were delayed under the PFI scheme and neither has gone ahead. The Royal Berkshire has now decided that it cannot proceed under the private finance initiative.
Mr. Maples:
I do not know the details of that scheme and cannot comment on it. In case it has escaped the hon. Gentleman's notice, perhaps I should tell him that I am the Opposition spokesman on this subject and not the Minister who answers questions about it.
I am delighted that Labour has converted to the PFI and that 14 schemes will proceed. Of course, two of those were signed by us and several of the others have full business case approval. The Minister spoke about a £1.3 billion scheme, but there is no guarantee that the 12 projects or the two that have been signed for will be built. He spoke about work being under way on them by the end of the decade. Therefore, there is still a period of uncertainty.
The Minister heralded the hospital building programme as the biggest ever announced, but it is the biggest cancellation of such a programme that has ever been
announced because 23 schemes were cancelled. The Minister's stance has changed somewhat, because on 10 June he said that schemes that failed to make the list, for whatever reason, would be invited to stop any further work, decline any tenders they had and stand down preferred partners. The projects would then be considered nationally alongside schemes that were competing for limited public sector capital.
In his announcement, the Minister hinted that successful schemes either would go forward in the second wave of new model PFI projects or would compete for public sector capital. Today, he went further and said that he had invited comments on the projects and was considering specifically whether they could be taken forward in a new wave of PFI projects next year. I shall be delighted if that proves possible. There is no need to stand all these projects down just because they have not made the cut on his first assessment and first decision. If they stand down their proposals and partners and stop work, it will be extremely difficult to get them going again. I am prepared to bet that they would be unlikely to start again and if they are stood down, even temporarily, those 23 places will not get new hospitals under Labour.
The redevelopment of Walsgrave hospital in Coventry is one of the 23 schemes. It serves my constituency and is an important acute hospital and a regional tertiary referral centre. It is important to us that the project should be allowed to see whether it can reach the criteria.
Labour's view of the PFI is rather like its view of the management of the health service, and that is where it differs so much from us. Labour sees the health service being run from the top down rather than from the bottom up. It is not interested in local solutions or local entrepreneurship. The advice to those who run trusts is, "Do not bother thinking up original ways to do things because if they do not fit Ministers' concepts of health service need, you can forget it." Matters are dictated by Ministers' views of health service need, which is an appalling way to attempt to motivate local trusts and health authorities. [Interruption.]
The evidence lies in what the Minister said. He said that matters were prioritised solely on the basis of health service need and that that would be his criterion for the future. That is not the way to motivate local trusts and health authorities to come up with solutions to local problems. Apparently, health service need will be determined in Richmond house and not in Camden, Darlington or Warwick. That is a mistake, but it is symptomatic of the Government's approach.
"Supermarkets will be allowed to print the NHS logo on carrier bags under government plans".
"Expressions of interest" have been invited
"from Safeway, Kwik Save, Boots"--
[Interruption.] It is from BMA News Review. I do not know whether it is true, but if it is, we will take no more lectures on commercialisation or privatisation from Labour Members.
"The additional scope for using private capital in the NHS will mean additional resources for health care. We must aim to use the new arrangements to benefit patients to the greatest extent, either through provision of services to patients or by finding more efficient ways of providing support services."
It was never a leasing arrangement; it was never just a piece of financial engineering. It was about efficiency and effectiveness in the provision of services.
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