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Compulsory Competitive Tendering
4. Mr. Swayne: To ask the Secretary of State for Health what estimate he has made of the financial impact of the abolition of compulsory competitive tendering in the national health service. [7945]
Mr. Milburn: There is no compulsory competitive tendering in the national health service. The Government are, however, examining market testing policy, in particular the current requirement to market-test catering, cleaning and laundry services. Whatever the outcome of the review, we are committed to best value in terms of both cost and quality of service for all NHS patients.
Mr. Swayne: I thank the hon. Gentleman for that excellent reply. Does he agree with the Secretary of State--[Hon. Members: "Reading."] I shall quote if I may--who, in 1995, said that the benefits from compulsory competitive tendering had been made
- "at the expense of blue collar workers"
Mr. Milburn: Five marks for artistic impression, none for substance. The hon. Gentleman is obviously unaware not just of the concerns of NHS staff and managers about compulsory market testing but of the concerns of commercial contractors. He might know of the Business Services Association, which represents leading-edge cleaning and catering companies. Its director general said recently:
- "Our most urgent task is to convince the public sector that we genuinely want a partnership based on mutually compatible objectives. The confrontational approach of CCT and market-testing must be transformed into a system of co-operation between public and private sectors."
Mrs. Dunwoody: Will my hon. Friend explain to the hon. Member for New Forest, West (Mr. Swayne) that no hospital service survives in a clean and secure state if it
is run by low-paid, disaffected and unhappy people such as the low-paid workers who provide the profits for unscrupulous private contractors?
Mr. Milburn: My hon. Friend is absolutely right. Catering, cleaning and portering staff deliver part of the family of services provided under the umbrella of the NHS. They play an important role in hospitals and other settings in the NHS. The Government value and respect their contribution and we want value for money and quality of provision to go hand in glove in the future.
Mr. Maples: Is the Minister aware that an estimate produced by his Department at the end of the last Parliament suggested that the savings made for the NHS by competitive tendering were about £90 million a year? If that is added to the cost of the minimum wage that the Government propose to introduce and to the impact of inflation next year, how much of the additional £1 billion that his Department obtained in the Budget will be available for patient care?
Mr. Milburn: I have a fairly simple view about statistics produced under the previous Administration--they are wrong.
Tobacco
5. Ms Stuart: To ask the Secretary of State for Health what action the Government are taking to reduce tobacco consumption. [7946]
7. Dr. Iddon:
To ask the Secretary of State for Health what action the Government are taking to reduce tobacco advertising. [7948]
The Minister for Public Health (Ms Tessa Jowell):
The Government are fully committed to banning tobacco advertising as part of a comprehensive strategy to reduce the 120,000 deaths every year caused by smoking or smoking-related illnesses. We made clear our intention to do this in our manifesto. A summit of national and international experts was held on 14 July to examine options for reducing smoking and controlling tobacco consumption. It is essential that we get the right combination of measures rather than rely on any single measure. The results of the summit will help inform Government policy and we will set out our strategy to reduce smoking prevalence and tobacco consumption, including our plans for legislation, in a White Paper to be published later in the year.
Ms Stuart:
Is my hon. Friend aware of just how badly the previous Government's strategy to control smoking among 11 to 15-year-olds failed? I am particularly concerned about young girls. Ten years ago, one in five girls aged 15 smoked--now, one in three smoke. What are the Government doing to improve that appalling statistic and to protect children from the dangers of tobacco?
Ms Jowell:
The first step is to realise that young people--young women in particular--are susceptible to the influence of direct tobacco advertising and indirect advertising through sport and other sponsorship. My hon. Friend is right. If we are not successful in reducing
Dr. Iddon:
I am sure that my hon. Friend is aware that smoking kills 120,000 people every year. That is equivalent to six jumbo jets crashing every week with total loss of life. If that happened, there would be public outrage and calls for action. What package of measures is my hon. Friend therefore proposing to adopt to tackle one of the nation's most deadly killers?
Ms Jowell:
I should make it clear that the purpose of the anti-smoking summit held on 14 July was precisely to get the best possible advice about the range of measures that should be included in the White Paper that will frame the legislation to ban tobacco advertising, which will be published later this year. There is no single measure that will enable us to make an impact on those wasted deaths. We realise that it is through a combination of measures that we will achieve that end; that is why we have sought the advice of experts from around the world to ensure that we have a policy that works.
Mr. Peter Bottomley:
The hon. Lady is right to say that a combination of pressures is needed to stop 5,000 teenagers a week taking up smoking. Is it possible to learn some lessons from the continuing campaign to end drink-driving? Can she try to give more emphasis to the points that she used to make on radio, with some effect--if people around smokers disapprove, those smokers are far less likely to continue to smoke and if people smoke in front of those who are younger than them, the young are far more likely to copy them?
Ms Jowell:
The Government will examine a range of evidence when drawing up their programme of anti-smoking measures. It is quite clear that children who are brought up in households where the parents smoke are more likely to smoke. That significant fact explains why it is also important that, through good health education in schools, we ensure that children are aware of the risks of smoking and seek to influence the behaviour of their parents.
Mr. Forth:
Does the Minister propose to replace the current health warnings that appear in advertising and, if so, what is her estimate of the cost of that?
Ms Jowell:
I repeat that last week's summit examined a range of measures. We will consider where we need to take further steps to alert the public to the risks of smoking. We will bring forward our proposals in the autumn.
6. Mr. Goggins:
To ask the Secretary of State for Health what action he proposes to take to speed up the national health service private finance initiative. [7947]
Mr. Dobson:
We have already speeded up the NHS private finance initiative. We have given the go-ahead for 14 major hospital projects and passed the first Act of this new Parliament to clear up the law on the operation of the PFI in the NHS.
Mr. Goggins:
Does my right hon. Friend agree that the best way to speed up implementation of the PFI in the
Mr. Dobson:
I confirm that we will keep a close eye on the 14 projects to ensure that they get on with the job and stick to the agreed price and time scale. I am extremely glad that the go-ahead has been given for the south Manchester hospital at Wythenshawe in my hon. Friend's constituency.
Mr. Paice:
I am sure that the Secretary of State agrees that private finance has existed in the NHS through general practitioner services because, over the years, they have invested in their premises to develop a modern and sophisticated service. Is he aware that in rural areas many of those GPs' private investments to enhance the services that they give their patients would be threatened if they lost the opportunity to dispense drugs to their patients because a pharmacy moved into the village? Many such places are at risk, including a major practice in my constituency which is under threat because a pharmacy has moved to the village. The practice could be made bankrupt as a result. Does the right hon. Gentleman agree that there is an urgent need for a review, and action, on the disparity of dispensing rules in rural areas?
Mr. Dobson:
I am not sure that that issue relates to the private finance initiative, but I share the hon. Gentleman's concern. We have to ensure that the health service is designed to provide the services people need in each particular locality and that we do not try to force a particular model on every part of the country.
Mr. Richard Allan:
While I accept that the fast-tracking process is a vast improvement on the PFI mess created by the previous Government, will the Secretary of State say how much public capital is to be made available to help to pick up badly needed projects, such as the proposed women's hospital in my constituency, which were not selected for the fast track?
Mr. Dobson:
There are two points to make. We fast-tracked 14 new hospitals, so we managed to achieve in 11 weeks what the Tory party had failed to do in the five-year period since adopting the PFI approach, spending £30 million of taxpayers' money in the process. Because a scheme was not one of the first 14 chosen does not necessarily mean that it will not go ahead under the PFI. In any case, as we have made clear, more than £1 billion a year from the public sector will be available for national health service capital costs.
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