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Mr. Hughes: The hon. Gentleman would think that.
Mr. Horam: Although it prevents me watching on television the last night of the Royal Opera house, Covent Garden, which I very much regret, it is sensible for the Bill to complete all its stages in one evening, because it is the type of simple Bill, with all-party support, broadly speaking, which should be pushed through quickly. It is totally different from the Finance Bill, which my right hon. and hon. Friends on the Opposition Front Bench rightly made a lot of fuss about earlier. The Bill is needed--[Interruption.] I have provoked an intervention. I knew that I should never have departed from the path. The Bill is simple, clear and has broad all-party support, so it should pass quickly.
Mr. Hughes: If, as the former Minister rightly says, the Bill was on the shelf when he left the Department of Health, why did not the Government introduce it weeks ago, instead of waiting for the last few days before the summer recess and then being obliged to rush it through the House? He must agree that there would have been a better way.
Mr. Horam: There it is; harmony has been restored. I have no doubt that the Government could have passed the Bill more quickly and with greater scrutiny if they had so wished, but they did not do so.
This support may be unwelcome to the Government. Let me point out that the reason for the Bill is Labour's habitual financial incontinence. The banks have gradually become extremely suspicious about lending to organisations that are not wholly part of central Government--local authorities, trusts or whatever. They have become suspicious, because there is a long history of the usual improvident loony Labour councils getting into financial difficulties and trying to borrow money at great length from City bankers and so on.
One thinks especially of the swap arrangements entered into by the London borough of Hammersmith and Fulham--an incident that is embedded in the memory of all City bankers because, in the end, the court decided that it was ultra vires for the borough to engage in such practices. That was another example of an improvident loony Labour council doing things that were crackers, causing the City to become very leery of lending to bona fide organisations such as health trusts and local authorities, because it could no longer trust Labour. I believe that it is now discovering that it can no longer trust Labour in national Government, never mind local government, as a result of the events of the past few weeks, but that is a party political point.
There is another reason why I am glad that the Bill has been introduced. As my hon. Friend the Member for Stratford-on-Avon (Mr. Maples) said, it is, we hope, the final full conversion of the Labour party to the private finance initiative process. As has been said, for many years Labour opposed the PFI, and those of us who were Health Ministers in the previous Government remember a constant stream of shadow Health Ministers--I hope that Labour has a better record in government than in opposition--inveighing against the PFI process as creeping privatisation, totally unacceptable, ideologically unsound and so on.
I hope that the Minister of State, who has persuaded the Government that the PFI is sensible, can bring the trade unions with him. The House will remember the Unison advertisement--in the Manchester Evening News, I believe--which said that the PFI was so unacceptable that it was the worst thing to happen to the national health service since 1947. The advertisement appeared in connection with the South Manchester University Hospitals NHS trust scheme--one of the 14 schemes that the Minister of State has prioritised. I hope, therefore, that the Government will bring the trade unions with them.
When we were in government and the Opposition were opposing our proposals, we had to put up with the criticism that the implementation of the PFI was a mess and that it was going too slowly. Astonishingly and amusingly, within weeks of a Labour Government being elected, two huge schemes are given the go-ahead. How could that have happened if all the underlying work had not been thoroughly done? Within a few weeks of that, another dozen schemes are out into the open, which can proceed within the next 18 months. That could not have happened if all the groundwork had not been done.
The Minister of State has walked into a rich inheritance. When he opened the doors of Richmond house, he could not have conceived that such a cornucopia of schemes was waiting for him to pick up and advance. Indeed, as Lord Jenkin of Roding said in another place, Labour took
over at an extremely fortunate moment in the history of the private finance initiative, and I am interested to see that the Government are advancing it.
I shall risk another intervention from the hon. Member for Southwark, North and Bermondsey by saying that we are used to the Liberal Democrats taking credit for things that other people do. Hon. Members will know those little leaflets that come through letter-boxes when a Labour council has done something and the Liberal Democrats claim credit for it, or when a Conservative council does something and the Liberal Democrats are very sharp to claim credit for it immediately. They may have voted against it in some cases--
Dr. Brand:
We deliver leaflets.
Mr. Horam:
Yes, the Liberal Democrats do deliver leaflets. They endlessly deliver leaflets. They do not canvass, but they deliver leaflets.
Even by comparison with the Liberal Democrats, who have a tendency to take credit for things that they have not done, the Minister's announcement the other day was astonishing. However, as has been said, it was not an announcement of progress on schemes, but a cancellation announcement. Apart from the 14 schemes that were going ahead anyway, 23 had been cancelled or delayed, or whatever phrase one may choose. I feel sorry for the new Labour Members--
Mr. Milburn:
As the hon. Gentleman is so confident about all those schemes, on what time scale does he think that they would have gone ahead? Will he remind us how many successes there were under the "let a thousand flowers bloom" philosophy? How many hospitals were built?
Mr. Horam:
The schemes would have gone ahead more quickly than under a Labour Government, because we would not have stopped for innumerable reviews. Thirty-eight reviews are now being conducted--indeed, they overlap. The hon. Gentleman had to exclude some hospitals from the PFI scheme, because the London review does not report until later in the year. He is therefore not on to a good point.
New Labour Members representing Gloucester, Peterborough, Leeds, Rochdale and elsewhere can simply thank the Government for the fact that the schemes that were going ahead under the Conservatives have now been delayed, cancelled or are otherwise a problem. As my hon. Friend the Member for Stratford-on-Avon said in his opening remarks, the hon. Gentleman is imposing central planning. We are now moving back to the cosy Stalinism that the health service knew for so long, but from which, under the regime that we put in place, it was gradually escaping. We deliberately motivated people and gave them the power to make decisions.
An important issue over the years to come will be the difference between the two sides of the House: the Conservative party believes in local decision making, whereas the Labour party believes in central planning. The Labour party believes that Richmond house and Quarry house know best; we believe that local managers have their ears to the ground and know how to do the job.
We believe that that is the way forward on the vexed issue of clinical support services, which the Liberal Democrats also raised. Why do we need to define clinical
support services? Why must we constantly invent things that are out and things that are in? Why not simply let local clinicians decide whether radiology or pathology are now out? Why debate the matter here? Local people can decide in the light of their experience what works in their area. That is wholly consistent with the Conservative and Liberal Democrat view. I am sorry that the Government have gone to so much trouble to come up with a definition of what is right for clinical support services. It is totally unnecessary. When one hears the British Medical Association say that there must be a clear definition of a clinical support service, one's suspicions that that is the wrong track to go down prove to be well founded. It is an unnecessary ideological battle that need not be fought.
I welcome the Bill but stress that, although the centre has a role, it is not the heavy-handed central planning role that the Government envisage. I make two recommendations. First, the Government should take more care about the outline business case. In my experience, too many unsatisfactory schemes surmounted that hurdle too quickly. If the Government were much tougher at the outline business case stage of a scheme, it would benefit the whole process. I am sure that that will be taken into account in the years to come.
Secondly, a point that has not been raised during the debate is the quality of buildings, particularly design quality. Evidence now shows that people's health improves more quickly in the right surroundings, and hospital staff are better motivated if their surroundings are pleasant and they have an input on them. The great danger with the PFI is that it becomes a design-and-build process, in which the architect is employed by the consortium building the hospital and the input from consultants and others involved in the hospital is too little. The danger is that financial and planning considerations simply outweigh concerns of quality, functionality and ability to produce a satisfactory health solution.
The Minister of State may be aware that, as Minister, I established a committee to examine design quality. The Minister for Arts is also concerned about that issue, and we have addressed a joint conference about the quality of hospital buildings. The Minister of State will know from his own experience that the NHS has a poor record when it comes to quality buildings. For example, St. Thomas's hospital, which was bombed during the war, retains its original Florence Nightingale-influenced design. There is an interesting building next to the hospital, but a very unsatisfactory office block behind it. Those three totally different buildings create an architectural mess that Members of Parliament must look at every day when we stand on the Terrace.
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