| Previous Section | Index | Home Page |
Mr. Jack: I am glad that there is so much support. Having had a modicum of responsibility for operation of the PFI, I can tell hon. Members that, if we do not very carefully define our terms and criteria, not only will those who are trying to do business under the PFI not know where they are going, but the NHS will not be able to achieve its objectives. I therefore look forward to the Minister shedding some light on the issue.
Mr. Simon Hughes: I shall speak briefly to amendment No. 7 and the question of an Audit Commission report, but I must tell the right hon. Member for Fylde (Mr. Jack) that neither my hon. Friend the Member for Richmond Park (Dr. Tonge) nor I dissent from the proposition that we need to know what the criteria are to be--my hon. Friend was simply suggesting that the Conservative spokesman had made his case adequately on that point.
The important point about amendment No. 7, which is not dissimilar to amendment No. 2 tabled by the hon. Member for Stratford-on-Avon (Mr. Maples), is that the report should be public and published and that, given criteria that we all understand, the value-for-money assessment should be considered regularly by the body which does the assessment throughout the whole procedure. The Minister might come back to us and say that he has something else in mind, or the review may show that another body could do the job--that is fine, but one of the things that the health service desperately lacks is independent, objective, consistent accountability. We have to build that in, because I am never prepared to trust any Government with the statistics and the assessment of what goes on in the health service, and I do not think that the public are, either.
Mr. Milburn:
I pay tribute to the right hon. Member for Fylde (Mr. Jack), who has great knowledge of and expertise in these matters. He made some extremely important points about affordability, risk transfer and value for money. Those matters are currently dealt with by the PFI process, as he knows. However--I say this advisedly--the right hon. Gentleman is in some danger of putting the cart before the horse. I remind him that the purpose of the Bill is to get existing PFI deals delivered.
The first stage in the process of getting new capital development under way in the national health service is to get the Bill on the statute book, to get deals delivered and then to move on. We shall certainly be looking at different forms of public-private partnership and at ways to improve the PFI as one form of that partnership. The right hon. Member for Fylde asked me for details on how we might do that. We shall be considering a number of issues in our PFI review.
We shall try to ensure that we no longer go through the endless process of reinventing the wheel when it comes to PFI documentation. One of the real boons of recent years is that because of the steep learning curve that I described earlier, a mass of information and expertise is now locked in the system, and it is important to take advantage of it so that NHS trusts no longer have to reinvent the wheel for every PFI they enter into. That is why standardisation of documents and contracts will form such an important part of the process in future.
Similarly, I should like improved competition in the PFI and more bidders in place for longer during the PFI process. Such competition might help to improve value for money from the point of view of the public sector and from that of the taxpayer. These will be the subject of detailed further consideration when we undertake our PFI review. I repeat the invitation that I issued earlier: I am happy to receive representations from right hon. and hon. Members of all parties and, indeed, from my right hon. and hon. Friends to ensure that there is a full consultation exercise that takes account of as many views as possible from the House and from the public and private sectors.
The right hon. Member for Fylde went into detail about the criteria that had been used for the initial prioritisation exercise. The criteria may not apply as fully and in the same detail to the next round of prioritisation. It is important for him to understand that at the outset.
The right hon. Gentleman asked for transparency. He has a bit of a cheek, given the lack of transparency from the previous Government on the private finance initiative, most notably their failure even to publish the number of PFI deals under consideration, the number in the pipeline and their assumed capital value. We have put that right and we shall ensure more openness and transparency in future. In that spirit, I assure the right hon. Gentleman that there will be criteria, appropriate weighting and a proper process for future prioritisation exercises. I shall ensure that those criteria are made fully available so that the public can see that the assessments undertaken by the region and the capital prioritisation group in the NHS executive are done fairly and objectively.
Mr. Jack:
I am grateful to the Minister for his kindness in answering one half of the range of questions that I asked. One of our amendments deals with the National Audit Office. I understand the Minister's reluctance to go all the way, but can he assure me that the National Audit
Mr. Milburn:
If the right hon. Gentleman gives me a moment or two, I shall come to the point about the NAO and the Audit Commission when I deal with the amendments individually.
The right hon. Gentleman referred to the north-east schemes. It is important to set the record straight. He knows full well that the decisions on Northern and Yorkshire schemes were taken by my right hon. Friend the Secretary of State. I absented myself from those decisions, for reasons that are crystal clear. It was important that I should do that. All the schemes that the right hon. Gentleman highlighted--south Tees, north Durham and Bishop Auckland--had been well highlighted for many years as front runners for the PFI. I do not believe that there were any surprises there, although if the right hon. Gentleman has information to the contrary I should be happy for him to share it with me.
During the previous 17 years, from 1980 to 1997, just two new hospitals were built in north-eastern England. I am pleased about my right hon. Friend's decision, because it means that the region, together with others, will catch up. We shall provide long-overdue facilities not just in my part of the world but in communities up and down the country.
Some of the issues that the right hon. Gentleman has highlighted may appear in another guise, but that is a subject for further consideration. I assure him that our criteria will be made publicly available.
I shall now deal with each amendment in turn, starting with amendment No. 6. We can sign up to the fair distribution of revenue and capital. As the hon. Member for Southwark, North and Bermondsey (Mr. Hughes) is well aware, we want to ensure a fairer distribution of NHS resources. In particular, we want to ensure that NHS need is properly taken into account in the allocation of resources for secondary and primary care services. I shall make a further announcement about that in due course.
However, I am afraid that there are fundamental problems with the amendment. The first concerns its drafting. It refers to the need to ensure that the agreement is
Mr. Simon Hughes:
I declare my interest as someone who trained and practised as a lawyer. The Minister cannot have it both ways; one cannot have plain English on the one hand yet reject things that are drafted to be absolutely plain. The Minister must certify that any agreement is fair, within a regional strategic framework and compatible. If he cannot do that, it is his problem, not ours. We think that the amendment is clear.
Mr. Milburn:
I am sure that the hon. Gentleman thinks that it is clear, but I am afraid that it does not stack up.
It is by no means clear whether the amendment--I am happy to be advised on it--contemplates simply ensuring equality between trusts within each region or more general equality between all trusts by using a regional strategic framework. I am unclear; I guess that NHS trusts would be unclear, and certainly the private sector would be unclear. The only people who would be making business from that lack of clarity would be the aforementioned lawyers.
We can be quite sure that the Bill is not the means by which to address such issues. As I said recently, in future we will prioritise capital schemes. In doing so, we will take health service need as the driving force. We want a well-thought-out and rational capital expenditure policy that covers PFI schemes and publicly funded schemes. Above all, any consideration of the proper allocation of resources to trusts needs to take place long before the agreement is submitted to the Secretary of State for certification.
The amendment does nothing to improve the fair distribution of resources, however the hon. Gentleman defines fair. I am afraid that it suffers from being hopelessly imprecise. I know that the intentions behind it are good, but I am afraid that when it comes to defining words on the statute book, good intent is not quite good enough. It would introduce a further element of uncertainty into a Bill that is designed to end that. I therefore ask the hon. Member for Isle of Wight (Dr. Brand) to withdraw the amendment. If he will not do so, I invite the Committee to reject it.
Amendment No. 7 refers to the assessment by the Audit Commission. The Secretary of State's certification identifies that an agreement is an externally financed development agreement, an EFDA, under the terms of the Bill. That certification will usually take place when the contract is signed between the NHS trust and the private sector. For that reason, the Audit Commission cannot assess the value for money of an agreement in advance of its certification since there will be no legally binding agreement for it to assess.
The hon. Member for Southwark, North and Bermondsey will be aware that the Audit Commission's main task is to audit expenditure already incurred and decisions already taken, not to provide a form of guarantee in advance that a particular proposal represents value for money.
The right hon. Member for Fylde asked about the National Audit Office. It will not examine an agreement retrospectively to assess its value for money. I am more than happy for either the Audit Commission or the NAO to consider PFI deals for value for money. I positively invite them to do so. We have nothing to hide.
We believe that if a PFI deal has been certified, by definition it gives improved value for money and improved risk transfer for the public purse. If the right hon. Gentleman and the hon. Member for Southwark, North and Bermondsey are seeking further assurance about the role of the NAO and the Audit Commission, I am more than happy to invite them to scour each PFI deal to which we give the go-ahead to re-establish that confidence in the process about which I spoke earlier.
"compatible with the fair distribution of capital and revenue spending within a regional . . . framework."
I am afraid that terms such as "compatible", "fair distribution" and "regional framework" are very imprecise. Frankly, it is that lack of precision, aside from any other factor, which makes it impossible to accept the amendments. The PFI has already been lawyer-fest and they have done very well out it. The last thing that I intend to do is to give lawyers yet more business. That is why I am determined that the Bill should be properly and precisely drafted.
| Next Section
| Index | Home Page |