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Mr. Dobson: That would not be a sensible way of approaching matters. The point that I made at Question Time was that we want to encourage mergers between trust and trust and health authority and health authority which appear to make sense to people in the locality. We do not want to lay down the law; we want to encourage them.
More than 50-odd trusts are involved in merger talks about which the public know. I do not think that any virtue would be served in going back on our recent decision to agree to the merger in Derby, or holding back our examination of the proposal which I understand will be coming from Leeds to merge the two acute trusts there.
I do not accept the hon. Gentleman's point. In certain particular circumstances, it might be wise to hold off certain mergers, but that should, generally speaking, be a matter for those in the locality concerned.
Mr. Ivan Lewis (Bury, South):
Will my right hon. Friend confirm that the only basis for the competition in the health service under the previous Government was that they were preparing it for privatisation? Does he acknowledge that people will welcome the White Paper because it proves that, without privatising the NHS or encouraging competition, it can be modernised by encouraging collaboration and all the values which were the basis of the health service when it was created?
Mr. Dobson:
I entirely agree with my hon. Friend.
Mr. Roger Gale (North Thanet):
The right hon. Gentleman has stressed the need for the health service to reflect patients' needs. That is a view which I share entirely. What safeguards does he intend to build into his system to ensure that medical freemasonry and cosy relationships between some GPs and some consultants do not militate against patients' interests and choice?
Mr. Michael Fabricant (Lichfield):
That is a googly.
Mr. Dobson:
No, it is not a googly. We have to work on the assumption that the bulk of the medical profession
I very much welcome the fairly recent decision of the General Medical Council to address the question of doctor performance and people who are not living up to professional standards of patient treatment. Although self-regulation is not right in other areas, I strongly believe that it is appropriate for the medical and nursing professions. However, it is up to them to demonstrate to their colleagues and the public that self-regulation works. We want to encourage them to do so.
Mr. Dennis Skinner (Bolsover):
Is my right hon. Friend aware that the reason why he is able to make today's statement is that the British people woke up in time? They realised earlier this year--and perhaps a bit before--that the national health service was on its way to the hands of insurance companies and other speculators, which would probably create a service costing twice as much and similar to that in America?
Blessed with this good fortune, I hope that my right hon. Friend will realise that he will have to fight for every penny with the Chancellor of the Exchequer--£10 billion extra already collected in taxes--due to the advance of medical science. He will always have to remember this: the NHS is not just a service; it is a cause worth fighting for.
Mr. Dobson:
I certainly agree with the last point that my hon. Friend makes. The national health service is popular with people in this country, partly because it provides them with such a good service when they and their families are in need, and partly because of the principles on which it is based. When I am doing okay,
People believe, because of that principle, that the national health service does not just bind the nation's wounds: it helps to bind the nation together. That is why the people treasure it.
Mr. Eric Forth (Bromley and Chislehurst):
The Secretary of State referred to quality standards and targets. Is there any contradiction between those and the reference he also made to long-term agreements? If too many institutions are committed to long-term agreements and fail to meet the quality standards or targets, insufficient flexibility may exist to enable the institutions to improve to meet the targets.
Mr. Dobson:
We live in a world of dilemmas, and the right hon. Gentleman's point contains some truth. Therefore, we will have to try to ensure that the problem does not arise.
It is not a question of the local primary care group making an agreement with its local hospital on how many services will be provided and to what standard and price they will be delivered. I expect that arrangements will be made so that, if standards are not met, either improvements can be enforced or the institutions can break out of the contract.
We do not want the ultimate weapon to be used, but it may need to be available in the negotiations to give weight to the demands of the primary care group. Primary care groups and their patients do not wish to be forced to transfer their trade to another hospital 20 miles away. That is why, in parallel with the pressures that the primary care group will be able to apply locally, we will introduce national measures to drive up standards and to ensure that they are maintained.
Madam Speaker:
Thank you, Mr. Dobson. Go and rest your voice.
Sir Patrick Cormack (South Staffordshire):
On a point of order, Madam Speaker. I am sorry to have to ask you for a ruling, but this morning, from the news bulletins, and especially from the "Today" programme, one would have gathered that we would have two statements in the House this afternoon, not one. We were told in some detail what the Government will propose in a White Paper on freedom of information.
As soon as I got to my office, I rang the Chancellor of the Duchy's office; asked whether there would be a statement, and was told that there would not; and asked whether a White Paper would be published today, and was told that it would not be published. Again, we have government by leak and innuendo. I put it to you that it is intolerable that we should hear on the radio what purports to be an accurate account of an important item of Government policy, instead of hearing it in the House. I should be grateful for your guidance.
Several hon. Members:
On a point of order.
Madam Speaker:
Order. Hon. Members must wait for my answer, and not be so impatient.
The Chancellor of the Duchy of Lancaster (Dr. David Clark):
Further to that point of order, Madam Speaker. I should like to apologise most sincerely to you and to the whole House for what appears to have been a premature disclosure of some features of the freedom of information White Paper which I hoped to present to the House this Thursday. I should like to assure you that I myself had no part in this, and no knowledge of it. No one is more annoyed than I that these details should have emerged, and I believe that it is a disservice to the House.
Although it could be informed speculation, we cannot discount the possibility that it may have been premature disclosure from within Government. Therefore, I am taking this matter very seriously, and I have set in train the task of looking further into the circumstances surrounding the reports.
Madam Speaker:
I am grateful to the Minister.
Madam Speaker:
Could we have sensible points of order, please?
Mrs. Margaret Ewing (Moray):
This is a genuine point of order, Madam Speaker. We have listened to
The Secretary of State for Scotland and the Minister responsible for health in Scotland have been briefing the press all day, yet Scottish Members have not had an opportunity to question the issues contained in the document. It almost seems as if the Scottish Office has published a document which should be called "Designed to Ignore Scottish Members of Parliament".
Madam Speaker:
The hon. Lady appears to be asking me whether I have heard from the Secretary of State for Scotland whether he is seeking to make a statement on the document to which she has referred. I have not heard that a statement is to be made, but I am sure that those on the Front Bench will have noticed what she has said.
4.27 pm
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