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Mr. Nigel Evans (Ribble Valley): The hon. Gentleman and I both represent north-west constituencies, and he will undoubtedly be very interested to know what the CHCs in that area have to say on the issues that he has raised. Has he consulted with anyone in the CHCs in his own area who believe that CHCs should be abolished?
Andy Burnham: I am not talking about abolition of CHCs; at the moment, I am talking about resources for primary care trusts. I have spoken widely to people working in the NHS—
Mr. Evans: Come on, answer the question.
Andy Burnham: I am not talking about the CHCs, and I shall crack on with my speech, if the hon. Gentleman does not mind.
Mr. Evans: Have you spoken to the CHCs?
Mr. Deputy Speaker: Order. The hon. Gentleman must not keep interrupting from a sedentary position. He intervened and he has received a response. He must not continue intervening from a sedentary position.
Andy Burnham: If the hon. Member for Ribble Valley (Mr. Evans) is less well refreshed the next time he comes in the Chamber, perhaps he will allow hon. Members to get on with their speeches.
I hope that Ministers will also take the opportunity to deal with the NHS's long-standing weakness in taking public opinion seriously. There has been a tendency to disregard public opinion, especially in areas that have had a fierce debate about the reconfiguration of local services. It is when people's concerns are borne out by their experience of the service after the reconfiguration that their trust in the NHS is really undermined. We had a classic example in Leigh. The accident and emergency department was closed in the early 1990s. The claim was that it was being closed to improve the delivery of
services to local people, but that was fiercely contested by the Leigh community, and today 99 per cent. would say that they have been proved right. While we cannot turn the clock back on that decision, the proposals in the Bill may help the NHS to be better at listening to and understanding public opinion.The third opportunity is the chance to break the historical hold that acute hospital services have over the health service and the preoccupation with their needs and services. Primary care trusts should focus on the renewal of the physical fabric of the NHS at primary care level at an early opportunity. That, after all, is where most people have their week-to-week contact with the service. For too long, primary care facilities have been organised and developed in a piecemeal fashion, partly because of the status of primary care professionals as independent contractors. That system has not led to the development of high-quality facilities—in Leigh, we know that more than anyone.
Primary care trusts are well placed to tackle that historical problem and provide the catalyst for better primary care facilities. In Leigh, we have the proposals for the Leigh health park. It is envisaged that it will be a PFI scheme, and I know that the Government are still piloting the LIFT scheme—the local improvement finance trust—for primary care. The provision of primary care facilities is a far less complicated exercise than the commissioning of acute hospitals, but the danger is that time and resources are expended on secondary and tertiary PFI schemes, because of their demands, instead of making quick progress in the primary care sector.
I urge the Government to roll out the LIFT scheme to all areas as quickly as possible, so that from the very beginning primary care trusts will have that option in their efforts to improve local facilities. It could also help to solve the problems of GP recruitment by providing attractive surroundings to work in, without individuals having to take a financial stake.
Some critics have attacked the PFI as a waste of taxpayers' money, but they miss a crucial point. However healthy the economy and public finances, there will always have to be a limit placed on the NHS capital budget. Throughout the history of the NHS, building projects and refurbishments have been prioritised and queues formed. Every town could not have a new hospital or clinic at the same time. People had to be patient—in some cases, heroically so. The old capital funding system may have pleased public sector purists, but it did not give the public modern, well maintained NHS facilities and it has bequeathed an NHS estate to this generation that is simply not up to the job. By contrast, the PFI lifts the limit from NHS capital spending and means that more towns and people can have their new hospitals and clinics now. While the cost to the NHS of PFI projects over their lifetime is disputed, there has to be a value in giving the local population access to a modern health care facility that they might not otherwise have had for 10, 15 or 20 years.
The Government are giving local communities a better NHS and the Bill will take forward that process. It will put power where it belongs, at the bottom of the system, and will throw open historic opportunities to create the modern service that we on this side of the House desperately want to see.
9.18 pm
Laura Moffatt (Crawley): On Friday, together with staff from Crawley hospital, I abseiled down the side of the hospital building. We did that to raise cash for Children in Need. However, we had another reason. We wanted to communicate to the people of Crawley that we are not so totally consumed by the health service that we cannot think about anything else. We are able to go and do exciting things, raise cash and enjoy ourselves at the same time. The view that the NHS is on its knees and cannot raise its head above the parapet because it is so bogged down with work is completely untrue, and I want the House to know that.
I shall be brief to ensure that all our colleagues who wish to speak in the debate can do so, and I shall concentrate on the Commission for Health Improvement and its work on quality. That work is crucial, and the Government have ensured that it runs as a thread through all their new legislation. It is essential in the partnership between our communities and the health service, because—let us be under no illusions—the NHS has not been good at talking with people. It has been good at talking at people and telling them what it thinks they need, but the relationship has been lacking. The quality of the relationship should lie in the way the NHS communicates with people as well as in the way it does its job.
I have little doubt that we have a first-class service, but one of my constituents attended an accident and emergency department in my area with an injury that was not major yet he found that he had to wait for four hours. He had been seen by the triage nurse, but no one thought to explain that the people waiting would have to hang on because the department was looking after others who were seriously ill.
We can improve our performance in circumstances such as that. Relationships can be improved by involving local people more, and I have no doubt that the new patient advocacy and liaison service will contribute to that. Its staff will be on site, with the result that matters such as I described can be dealt with in a way that will be of great value.
I turn now to the role of local authorities. My local authority has been invigorated by its new role. It now has a say in what is going on my area, and its role in oversight and scrutiny has made it feel part of the community. The authority believes that it has a mandate that allows it to contribute.
The concern that I share with my local authority is how to ensure that the Commission for Patient and Public Involvement in Health will not usurp local authorities' role. The tremendous health service review that we have just undergone has been a fantastic experience. I could not have said that in the House two years ago. I have no idea what the outcome of the review will be, but the process of getting our community involved is not one that I shall forget. People who marched in the streets and demanded that I be taken from the House and hanged in Whitehall are now saying that the review was good. They felt that they had been asked about what they wanted in their services. I hope that a similar process will be undertaken with the proposals under consideration today.
When we look at our health services, we must talk to our local communities and find the people who are able to contribute and who want to do so. We must go beyond the usual suspects in such matters, who come to the fore
and say that they are good at articulating problems. We need to find the people in our communities who want to contribute to the process. They are there, they want to take part and they can have confidence in what we are doing. The review of our hospital services is one of the very good things that the Government have undertaken. They have trusted local people to contribute to the service.I shall say a brief word about strategic and specialist commissioning, especially in respect of issues that can be difficult. We rightly allow those in the front line in the health service to decide what is to happen, but we must ensure that matters such as HIV remain to the fore. Although they are difficult matters to get to grips with, they must be included in the commissioning strategy. I want to ensure that the Herpes Viruses Association can batter down the door of our PCT just as the Alzheimer's Association can.
The hon. Member for Westbury (Dr. Murrison) is not in his place now, but he talked earlier about the poodles in the community who will say anything to suit the Secretary of State. I have to tell him that in Crawley we do not have poodles; we have Jack Russells.
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