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Mr. Deputy Speaker: Order. Before the right hon. Lady continues her speech, I should like to tell the
hon. Gentleman that he has now seen a demonstration of how easy it is to intervene properly, and not from a sedentary position.
Mrs. Bottomley: The hon. Gentleman has also intervened as I thought that he might. He might like to read Lord Nolan's report. Lord Nolan said that there was no evidence of widespread political appointments--[Interruption.] Is the hon. Gentleman saying that he was a member of a health authority or trust?
Mr. King: I do wish that the right hon. Lady would come to Rugby, where I live, because it was rife with Tory placepeople. When the trust was established, every single person who was not a Tory placeperson was immediately dismissed from the trust--or proposed trust. The fiasco ended with the trust crumbling, just before the general election. The chairman, chief executive and everyone else resigned, because they had let the people down. The situation was totally unviable.
Mr. Deputy Speaker: Order. The hon. Gentleman has already heard my statements on the need for brevity in interventions on an hon. Member who has the Floor. The right hon. Lady has perhaps seen how awkward it can sometimes be to give way.
Mrs. Bottomley: I have learned my lesson, Mr. Deputy Speaker. As I said, however, I am trying a more emollient style, and I thought that it was only courteous to give way.
I cannot comment on the example given by the hon. Member for Rugby and Kenilworth because I do not know of its veracity. I know what Lord Nolan said. He dismissed ideas that there were widespread political appointments, and he not only commended the changes that have been introduced but proposed changes to make the matter even more open.
I can tell both the hon. Member for Rugby and Kenilworth and Liberal Democrat Members that people such as Baroness Jay, Baroness Hayman, Baroness Dean, Baroness Neuberger and Baroness Thomas all served in NHS appointments. I do not know whether, under the previous Government, serving on the board of an NHS trust or health authority was a prerequisite to becoming a life peeress. It is extremely important, however, for the Secretary of State urgently to examine the matter of appointments.
The Secretary of State will know that his predecessor, the late Lord Ennals, dismissed about 150 health authority leaders when he came to office. It would be a grave error and misjudgment if the Secretary of State were to behave in a similar manner.
Currently, the despair is that nothing is known about appointments. It was said, for example, that anyone who used private health care would not be appointed to an NHS trust or authority. Labour Members are nodding and showing their approval of such statements. It makes one wonder why Greg Dyke was appointed as the guru of the patients charter. Although I greatly applaud Greg Dyke's activities in the media world, it seems as if the Labour party believes that a media guru is the answer to every
problem. The millennium company has been filled with media gurus, and Greg Dyke--excellent man though he is--has been put in charge of the patients charter. Labour Members have not said much about that appointment.
I urge the Secretary of State to respond at the earliest opportunity to people's concerns over appointments.
Mr. Dobson:
Mr. Greg Dyke was appointed because the Government wanted someone to take a fresh look at the matter. Last week, he had a day-long meeting with people who work in the health service, people from community health councils and people who advise on producing better health service publications. So far as I know, all those who turned up--there were about 30 of them--thought that it was a most excellent start to Mr. Dyke's review. We need someone who takes a fresh look. We cannot keep going to the usual suspects, as the previous Government did.
Mrs. Bottomley:
If his job is to examine NHS communications and publications, I am sure that he will do a better job than Mr. Joe McCrea. Providing authoritative information for people in the NHS and for those using it is certainly a laudable goal, but it is not one in which the Secretary of State has given people much confidence so far. My point was that, if the use of private care was a disqualification, the Secretary of State must have had great difficulty with the man who was, presumably, imposed on him to take responsibility for the patients charter, excellent man though he is.
Mr. Gareth R. Thomas (Harrow, West):
The right hon. Lady is in danger of straying from her new emollient style. That would be a tragedy because she was doing so well in praising my right hon. Friend the Secretary of State for Health for a number of initiatives. Perhaps I might suggest a new emollient track for her. Will she apologise to the House for failing to open up NHS trust boards and for allowing some of the people she appointed to take decisions on NHS matters behind closed doors?
Mrs. Bottomley:
Whether NHS trusts should sit in public is a vexed and difficult question because confidential matters need to be debated privately by a small group of people. The danger of trust boards meeting in public is that such meetings could become artificial--controversial or ambiguous information is kept separately, and boards or authorities might have separate meetings to deal with it.
Having said that, in many cases it will essentially be a matter of evolution. My personal view is that the NHS should be as open as possible, subject to the fact that patient material is confidential. Staff issues are often highly sensitive and confidential, too. I do not really take issue with the hon. Member for Harrow, West (Mr. Thomas) on that matter, but I believe that public meetings may lead to a certain artificiality. There are other ways to communicate with the public, and communication should be the aim.
Valerie Davey (Bristol, West):
Might I suggest that it is the financial aspects of health authority trusts that have been kept most secret? Indeed, it is the competitiveness between the trusts that has caused the difficulty. Surely
Mrs. Bottomley:
It is a great shame that neither the Secretary of State nor the Liberal Democrat spokesman dealt with precisely that issue. Many commentators have described GP fundholding as the real engine for change and innovation in the NHS. It is important that all GPs should have the opportunity to become fundholders, but the current worry is that the Secretary of State's soundbites give the impression of levelling down, just as with Labour's plans to get rid of assisted places in schools.
One of the challenges in the public services has been to allow diversity and to allow people to improve, innovate and change. Fundholders who were able to spend their money more cautiously and then invest in various services found that there was a virtuous cycle of reward, instead of the vicious cycle of disincentives which was so pervasive in the past. We are all looking forward to hearing from the Secretary of State whether he is introducing change for change's sake in a service that has seen great improvements. Is he suggesting talking shops? There have been leaks in the press about the changes but, as is typical of the Labour party, the right hon. Gentleman does not inform the House. The press are informed first, and the House is told only in the fulness of time. We are all getting used to his doing business that way.
Mr. Dobson:
I deplore the leak of an early draft of our White Paper on the NHS, which is why I have ordered a full leak inquiry with the support of the head of the civil service. I hope that the log showing every telephone call made from the Department of Health will be examined in an effort to track down the people responsible. I believe that the House has a right to hear about things first--I believed that in opposition and I believe it now that we are in government.
Mrs. Bottomley:
Once again, the Secretary of State has a very different way of doing business from No. 10, but I appreciate his point. Nevertheless, the House wishes to hear his thoughts. It is important to know whether there is simply going to be a talking shop with more layers of bureaucracy and consensus management whereby difficult decisions are never taken.
It is clear that the challenges facing our education service, health service and other public services are linked not only to the volume of resources and the interests of those who work within them, important though they are. Those services have to go through further changes to deliver a better quality of care and research excellence and to meet the needs of an aging population with increasingly high expectations.
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