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9.37 pm
Mr. Milburn: I am grateful to the right hon. Member for Fylde (Mr. Jack) for his support for the Bill and to hon. Members in all parts of the House who have taken part in this wide-ranging debate. I remind the House that the Bill is a simple, short and effective measure with a single purpose--to get new hospitals built. It is intended to unlock the PFI gridlock that has built up in recent years in the NHS.
The Bill's secondary purpose is to re-establish the confidence that has been so badly dented in the NHS and in the private sector in the ability of public-private partnerships to work for the benefit of patients. The Bill is not the final word on the PFI or on the future of public-private partnerships in the NHS. The aim of the review is to get such issues right in future. I assure the hon. Member for Isle of Wight (Dr. Brand) that we shall return to this issue. I am happy to receive views from hon. Members on both sides of the House about how we can take such partnerships forward.
The hon. Member for Southwark, North and Bermondsey (Mr. Hughes) complained that the Bill was progressing too quickly and accused the Government of arrogance in trying to get the Bill through this evening. Where has he been for the past 18 years? Has he visited some of the communities that have been waiting for these hospitals, which are long overdue, much needed and now have the chance of going ahead? We need to get on with it. Without the Bill, there is a simple alternative: those hospitals in Norwich, Dartford and elsewhere would not be built. It is as simple as that.
Mr. Milburn:
I know that the hon. Gentleman wants to speak later, so, if he can just contain himself, I will continue.
Some hon. Members referred to specific projects in their constituencies. The right hon. Member for South Norfolk (Mr. MacGregor) talked about the important Norfolk and Norwich hospital. He said that the endless arguments in the local community are the reason for the delay. The reason for the delay has nothing to do with endless arguments in the community. It is about the need to tie up the technical, legal and financial niceties and the Bill is an important step in that direction.
My hon. Friend the Member for Norwich, South (Mr. Clarke) made some important points about the process leading up to where we are now in relation to Norfolk and Norwich hospital. I understand some of the concerns in the community, particularly in the city of Norwich, about the location of Colney hospital and about the process surrounding the PFI. We are seeking to address those concerns, but there is a simple alternative for the people of Norwich and of Norfolk: either to go ahead with the Colney PFI or not to have a new hospital.
Whatever reservations and concerns they may have about the process, above all, people in Norfolk and in Norwich want their new hospital. Of course we will try to co-operate with the city council and with others in trying to address the concerns to which my hon. Friend the Member for Norwich, South alluded about the future of primary care and about proper access to the site, but it is time to look to the future rather than harking back to the past.
Dr. Ian Gibson (Norwich, North):
Does my hon. Friend agree that, besides giving first-class care to the people of Norfolk and Norwich, the localisation of the hospital on the research park will attract world-class research institutes and perhaps even a postgraduate medical school, which will provide badly needed jobs for the people of Norfolk and Norwich?
Mr. Milburn:
My hon. Friend is right. The Norfolk and Norwich PFI deal will not just improve the quality of patient care in Norfolk and Norwich, but provide economic regeneration opportunities. I look forward to that added value developing in the next few months and years.
Mr. MacGregor:
I agree with that. When I was talking about delays, I was looking back over many years and it was the siting that caused those delays. We must above all avoid that happening again, so will the Minister confirm that the meeting that I referred to, which gave the impression that the siting was being reconsidered, is wrong and that there is no question but that the site should be at Colney?
Mr. Milburn:
I confirm two things. First, there is a simple choice: Colney or bust. The people of Norfolk and Norwich want Colney--they want a new hospital. Secondly, frankly, it is extremely important that any Government address community concerns. I am intent on doing that. I want to open up the PFI process, and we will come to that when we discuss some of the amendments. It is important that we re-establish the confidence not just of the private sector and the NHS in the PFI, but of the community--the public--because we are talking about their hospitals and their health service. I hope that I can be helpful in dealing with some of the concerns expressed by my hon. Friends and others in Norwich.
My hon. Friend the Member for Norwich, South raised some general concerns about the need to be open and accountable in relation to the PFI. Our review of the PFI and future partnerships between the public and private sectors will include that point. Environmental considerations are important and they will be properly taken into account.
My hon. Friend the Member for Wakefield(Mr. Hinchliffe) referred to the danger of becoming locked into outdated forms of care if we go down the PFI route. That is a real concern on both sides of the House. However, whether a hospital is provided through the PFI or through the public sector, there is a danger of getting locked into inappropriate forms of care. That is whyit is important, as the hon. Member for Orpington(Mr. Horam) said, that we design buildings, especially hospitals, in a more flexible way so that they can have a variety of purposes and be geared accordingly.
We need only look back over the past 30 or 40 years to see the changes in the nature of health care in this country. If we look forward 30 or 40 years, the possibilities are endless--but so are the dangers. That is why flexibility in building design will be extremely important.
My hon. Friend the Member for Dartford (Dr. Stoate) invited me to a sod-cutting ceremony--if that is the right phrase--and I would be delighted to cut a sod with him in Dartford. He expressed concern about the future of staff interests, as did my hon. Friend the Member for Wakefield. He referred to some of the services that, potentially, could be transferred to the private sector under PFI deals.
As I have already made clear, we have ruled out any clinical services being part of a PFI deal. We have ruled out radiology and pathology being any part of a PFI deal. We have also said this evening that there will be a proper review of other services in order to produce a definitive dividing line between clinical and non-clinical services. That is extremely important and it will help to deal with a number of concerns.
The hon. Member for Orpington railed against prioritisation and accused us of cancelling a whole host of hospital projects for which he had responsibility when he was a Health Minister. He told the House, and me in particular, that we needed to be more rigorous about rooting out poor PFI projects. He is right--we do need to be more rigorous. We need to ensure that if public money is going into the health service through any sort of capital development, it goes to the projects that are most needed. That is why we will prioritise projects on the basis of NHS need, not on the whim of the market and not on the basis of a consortium and trust cobbling together a deal that manages to pass a number of Treasury hurdles. We will prioritise on the basis of clinical, patient and strategic need. I hope that the hon. Gentleman will welcome that and stop carping about the prioritisation exercise.
The hon. Member for Stratford-on-Avon (Mr. Maples) produced a long litany of quotations from former Labour spokesmen about the PFI. The one thing that he did not quote was Labour's manifesto at the general election. It is important, so I will remind him of what it said about the PFI:
The hon. Member for Stratford-on-Avon and the right hon. Member for Fylde talked about the success story of the previous Administration's hospital building programme. If they will take a bit of advice from me, I suggest that a bit of humility would not come amiss. In the past five or six years, using the public sector route, the previous Administration managed to build only two major hospitals. Moreover, under the previous Government, not a single new hospital was built using the PFI route--although an endless raft of self-congratulatory
press releases was issued by Richmond house. I am interested not in issuing press releases or in making promises or talking about building hospitals but in building hospitals and in delivering the goods, for the good of patients.
"The Tory attempt to use private money to build hospitals has failed to deliver. Labour will overcome the problems that have plagued the Private Finance Initiative, end the delays, sort out the confusion and develop new forms of public private partnership that work better and protect the interests of the NHS."
The hon. Member for Stratford-on-Avon may have difficulty with the concept, but we believe in keeping our promises. We are keeping our promises: we are unlocking the PFI gridlock, we will end the uncertainty, we will build hospitals and we will develop new forms of public-private partnership.
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