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19 Nov 2002 : Column 571—continued

7.21 pm

Dr. Richard Taylor (Wyre Forest): It is an honour to follow the many illustrious Members who have spoken. Although I cannot manage without notes I will not be reading my speech, because my writing, like that of many members of my profession, is not particularly legible.

I could not attend the health day debate because, along with other Members, I was visiting the north of England, so I shall devote some of my precious time to health issues. First, however—at the risk of sounding a fearfully discordant note on both sides of the House—I want to say a word about hunting. My constituency, which is split between a rural area and several urban areas, contains three groups: those who are ardently in favour of hunting, those who are ardently against it, and what I consider to be the large majority who wonder what the fuss is all about. I cannot summarise that better than by quoting a columnist who recently described the hunting Bill, in one of the broadsheets, as

I think everyone will welcome the establishment of the railway accident investigation branch, but my constituents will want more. They will want measures to improve railway services. When I travel down to London, it is very common for one or other train to be delayed, and the excuses given are farcical—congestion, for instance, on a line that is lucky to carry two trains a day. Surely the Government could do something about at least one cause of delay. It is inexcusable not to provide a spare guard or driver in order to prevent trains from being delayed owing to the lack of a crew member: that should be illegal.

Few people in my part of north-west Worcestershire support the development of regional governance. I remind the Government of what was said by Lord Falkland, a loyal royalist who tried to moderate Charles

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I—obviously without much success—and whom I consider to have originated the saying XIf it ain't broke don't fix it". What he actually said was

Raising the subject of local government allows me to turn to that of health. I feel that only one part of the system is being blamed for the imposition of charges on social services departments for delayed discharges. The national health service may be at fault, and indeed is at fault on many occasions. I know of an 81-year-old lady who went into hospital. Although her treatment finished after five days, she was in hospital for three weeks and two days because no effort was made to engage in discharge planning. I could also give examples of inappropriate admissions that could have been avoided. Patients themselves have wondered why they have been kept in hospital. The situation has not been helped by inappropriate hospital reconfigurations, and I think that the failure to develop intermediate care services is the fault of the NHS rather than that of social services departments. The charges drive a wedge between social services and health departments, which are bound to compete in passing charges from one side to the other. We should be aiming for closer partnerships.

Let me make two general points about the NHS. First, like most people, I support the Government's extra funding coupled with reforms, but I do not think it profitable for the Government to dwell on the official Opposition's failure to support extra health spending. That, in my view, has devalued questions to the Prime Minister and other Ministers. Secondly, the public know that vast sums are being poured into the NHS and are tremendously pleased about it, but they expect instant improvement. Last week, the Secretary of State himself said

I wish, in a way, that he had been even more open, admitted to the huge deficit mentioned in the Wanless report, and conceded that initially extra money would be devoted to paying existing debts.

My local primary care trust is battling to manage debts and elements of inflation—in particular, a 15 per cent. rise in prescribing costs. By the end of the current financial year, the three primary care trusts in my county will have a deficit of some #8 million. That is a relatively small proportion of their total budget, but when primary care trusts—as health authorities were—are already being violently squeezed by economies, it is impossible for them to produce the improvements that people expect. I would have liked the Government to explain that money is being spent, that the backlog is being attacked, but that there will not be improvements just yet.

The nationwide debt arouses several suspicions. There is, for instance, the suspicion that extra sums that should have been earmarked for such purposes as the cancer plan are simply being swallowed up by debt. There is the suspicion that emphases on national service framework are penalising conditions to which no such framework applies. There is the suspicion that drugs and treatments approved by the National Institute for Clinical Excellence are leading to a reduction in resources for other well-established, standard treatments.

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I will not mention all the aspects of foundation hospitals that worry Members who fear that they will turn the NHS into a two-tier system, because they have been emphasised enough already. It is too early to be over-critical of the proposals, because we are waiting for a detailed prospectus. I welcomed devolution to primary care trusts, so in principle I welcome the devolution of powers to local people, allowing them to own and manage their hospitals; but a criticism of which we have not heard much so far is that foundation hospitals could well drive a wedge between primary and secondary care.

My criticism of primary care trusts is that there is relatively little consultant input; my criticism of foundation hospitals is that there is likely to be very little GP input. I would have liked to think that hospitals and primary care could be welded together somehow, as that would enable more treatments to take place in primary care and fewer in hospitals.

Another fear about foundation hospitals that has not been properly addressed concerns emergency care. It will be easy for foundation hospitals to cope with elective work. Will they also be able to cope—

Mr. Deputy Speaker: Order. The hon. Gentleman has had his time.

7.30 pm

Mr. Neil Turner (Wigan): I welcome much of what is in the Queen's Speech, in particular the opportunity that it gives us finally to decide on hunting with dogs. That issue has dragged on for far too long. Many Labour Members at least will welcome that opportunity.

I want to address my remarks to regional government and local government and the Bills on those. I particularly welcome the opportunity that people throughout the country will have to vote on regional government. Our country is diverse: it has many different cultures, needs and resources. One needs to consider only one aspect, housing, and compare the north-west with the south-east to see how diverse the cultures and needs of two regions can be. Far too much of the governing of this country is centrally controlled, with Whitehall, which in effect means civil servants, taking decisions that should be taken at a much more local level.

Opposition Members who oppose that have tried to portray the issue as being about local identity. That is nonsense. It is not about local identity—the people of Scotland and the people of Wales had clear identities long before they had their Parliament and Assembly. It is about a constitutional settlement and about bringing the governing and governance of our country much closer to people in their particular regions.

Government offices were set up by the Conservative party when it was in power. I went to the Government office for the north-east when I was on the Public Administration Committee. The offices do an excellent job but see themselves as representing the Government in the regions, not as the region's voice in Government. They see themselves as being answerable to Whitehall and central Government, not to the people in the regions whom they are meant to serve.

The offices are not accountable to those regional bodies. They make decisions about resources and where they will go in the regions, yet the people in the regions

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cannot hold them to account; the democratic ability to achieve accountability is not there. Regional government is important.

Mr. Syms: When England play football, my constituents cheer them and I am sure the hon. Gentleman's constituents do, because we are English; there is a bond there—rather more of a bond than most of my constituents feel for the south-west or, I suspect, some of his constituents feel for the north-west.

Mr. Turner: I am not sure what that means. We do not have a north-west football team or a south-west football team, but when Lancashire plays Yorkshire in rugby league the people of Lancashire and the north-west support the red jerseys of Lancashire, as opposed to the white jerseys of Yorkshire. There is that regional identity in rugby league. Of course, Lancashire always wins, which is even better.

Mr. Gary Streeter (South-West Devon): The hon. Gentleman mentioned that civil servants were not the region's voice in Government, but what does he think Members of Parliament are elected to be; and does he not think that civil servants are accountable—they are accountable to their Ministers and then Ministers are accountable to the House?

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