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Mr. Milburn: I assure the hon. Member for Sheffield, Hallam (Mr. Allan) that I understand the very real concerns in his city that the project did not get the
go-ahead in the first wave. I can also tell him that it is recognised that the project has a high strategic health need. It will be considered with other schemes for possible prioritisation in the future. The whole idea behind the prioritisation process is to do just what the hon. Gentleman wants--to bring clarity where it has been lacking, to sort out the confusion and to bring certainty to the national health service and the private sector.
In future, schemes across the country that are regarded as having the highest strategic health service need will be chosen and prioritised and then driven through the PFI. In future, the PFI process will really deliver the goods. The problem, as we heard earlier, was that too many projects were in the pipeline. The previous Government simply were not able to deliver them all. One of the most telling speeches in our earlier debate was made by the hon. Member for Orpington (Mr. Horam), who urged me to be more robust and to prioritise. That is precisely what we have done. I am convinced that, in future, there will be much greater clarity, and as a consequence we shall get more hospitals built.
Mr. Simon Hughes:
Does the Minister accept, then, that there must be a regional element in strategic planning? If he is holding to his view of a fortnight ago, that there will not be any re-creation of democratic regional authorities, how is there regional strategic assessment involving the public and not just the bureaucrats in the regional outposts?
Mr. Milburn:
Just on a small point of detail, there were never democratic regional health authorities. It is certainly not our intention to re-create the regional health authority structure, but we shall ask the regional offices of the national health service to undertake a full, impartial, fair and objective assessment of capital development schemes in their areas. When they have assessed where the highest strategic need is in their regions, those schemes will be submitted for prioritisation nationally. Once they have been prioritised nationally, we shall seek to make progress on them.
To overcome the problems that the hon. Gentleman addressed earlier, on public consultation, I reiterate that we shall expect any major NHS changes to be subject to full, public consultation at the appropriate point. It is pointless doing that before prioritisation, because if a scheme is not to be prioritised, there is no point in consulting on it. If it is to be prioritised, there is, of course, a need to ensure that the scheme has backing not only from the national health service and the private sector, but, most important, from the local community. I can give the hon. Gentleman the assurance that I think he seeks.
Mr. Milburn:
Obviously, not quite.
Mr. Hughes:
That was a fair and straight answer, but does it mean that, at regional level, at the appropriate stage--I use the example of my hon. Friend the Member for Sheffield, Hallam (Mr. Allan)--my hon. Friend would be able to know what the region was thinking and have some input into the regional process, and that it would not happen in secret, behind closed doors and involve only those who work for the NHS?
Mr. Milburn:
That access to information will not be at regional level. It will be at trust level and health
Dr. Brand:
Does the Minister recognise that there are some services of concern to the public that go wider than the area covered by one health authority or trust? I am thinking about radiotherapy services, which are both vital and capital intensive. Access to them is extremely important to people throughout a region. I hope that we shall see something more proactive from the Minister's Administration than we saw from the previous bunch of Ministers.
When the regional outpost was pushed to give a lead on where it would like to see investment in a new site, for example, it washed its hands of the matter and said, "This is a matter for local trusts and districts to negotiate." That is clearly not a satisfactory way of establishing a vital service. Members of the public should have a say on whether the facility is to be based in a part of the region that is accessible and to which they can relate.
Mr. Milburn:
If there are services that cross trust and health authority boundaries and which impact substantially upon the make-up of local NHS services, consultation should take place as a matter of course. That should be happening already as a matter of course. I shall, of course, consider the specific matter that the hon. Gentleman has raised with me.
I hope that I have satisfied some of the concerns that have been expressed from the Liberal Democrat Benches. I shall now take up the matters raised by the official Opposition. I appreciate the concern of the right hon. Member for Fylde (Mr. Jack) to ensure that the Secretary of State does not certify what might be described as a dud contract. Legally, however, the amendment does not achieve anything.
Part of the amendment would require the Secretary of State to be satisfied that the terms of the agreement had been finalised. In law, that is approaching gobbledegook, and I shall explain why. Certification is precisely that which confirms that an agreement is an externally financed agreement for the purposes of the Bill. Until then, there is no agreement within the terms of the Bill. The Secretary of State may reasonably be expected to ensure that the commercial contract for a PFI deal has been signed before he certifies that contract as an externally financed development agreement--for short, an EFDA--and he will do that in any event.
I shall move on further down the PFI process to explain how the amendment would be inoperable, for it would require the Secretary of State to satisfy himself that the necessary finance had been committed. It is a point that the right hon. Member for Fylde was keen to stress. That
would have to be done before the Secretary of State certified an agreement. That requirement would again be legal gobbledegook.
I know that the right hon. Gentleman recognises that the purpose of the Bill is to reassure bankers who are considering putting up capital for private finance schemes in the NHS. Bankers will be willing to put up capital once an agreement has been certified, but not before. The amendment would merely serve to ensure that bankers refused to finance NHS schemes, thus undermining the purpose behind the Bill.
The rest of the amendment is beside the point. It states that no certificate, once given, could be withdrawn. I am advised that once an agreement has been certified, it is once and for all an externally financed development agreement. If the certificate were withdrawn, it would have no effect, as the original act of certification would have conferred permanent validity on the agreement.
Mr. Jack:
The Minister has just said something intriguing. He said that there may be circumstances under which part of an arrangement could be subject to recertification, but that no legal mechanism is required to enable that to occur. Would he be kind enough to describe a circumstance in which such a process would operate, and to tell me how the Secretary of State would address the problem?
Mr. Milburn:
The obvious example is when one of the facility providers in a PFI deal either withdraws or is unable to fulfil its part of the contract, for whatever reason. The EFDA will have been given against a whole PFI deal, but will inevitably cover specific parts of it, so if an element comes adrift for whatever reason, recertification may be necessary. The original certification would have been given for a PFI deal, part of which was no longer operable. Those are the circumstances that I envisage, but frankly it is a pretty minor point.
Mr. Jack:
May I press the Minister on that point? He is giving the impression that deals can be subdivided. It was my understanding that a certificate was granted in respect of bankers, who may be external to any service provision in which other parts of the consortium providing the PFI may be involved. The bankers provide the money. If two bankers were involved and one of them ran into a problem and was unable to provide the money, would the mechanism that the Minister has just described work?
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