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27 Nov 2002 : Column 354—continued
Peter Hain: I welcome the hon. Gentleman's support for the stance adopted by Derek Wanless. It was on the back of his report to the Chancellor that we as a Government made a clear decision earlier this year that we would go for increased publicly funded health investment—
Peter Hain: It is good to know that, for once, the nationalists voted for a socialist measure. The more that happens, the better for us—if not for them.
Returning to the Wanless report and the application to Wales of foundation hospitals, the National Assembly has made it clear that it sees Wales' needs as being completely different from those elsewhere in the United Kingdom; therefore it will not introduce foundation hospitals. I support the National Assembly in that decision. That is precisely what devolution is about—it was so that different decisions could be made according to different circumstances and different needs that we established the National Assembly for Wales, and a far better model for decision making it is than an independent Wales, which the hon. Gentleman's party supports. An independent Wales under the nationalists—Mr. Speaker, I will not go too far down this road—would be stricken with poverty, and there would be health service cuts as well as all the other difficulties that the nationalists would bring to Wales.
The Wanless report that the Assembly will commission will both help to guide the reform and modernisation agenda for the NHS in Wales, and provide valuable evidence in allocating resources beyond the end of the next financial year. There are now clear dividing lines between the Government and the Opposition, between Labour and the Conservatives, on health. Labour stands for investment and reform, the Conservatives for cuts and privatisation. Earlier this year the Opposition voted against the Budget that released the extra resources that the Assembly is now investing in the health service in Wales. They toured the world in search of a policy on the health service, only to come up with the same old Conservative nostrums of privatisation, making patients pay for their own health care, and subsiding those who are able to pay for treatment.
As for Plaid Cymru, it would not introduce the necessary reform and it could not afford the necessary investment. I make no apology for again asking the question that Plaid Cymru Members never want to answer: in an independent or self-governing Wales, how would they finance the record levels of public investment in the national health service that we are delivering? The answer is they would not, because an independent Wales could not.
Mrs. Jackie Lawrence (Preseli Pembrokeshire): Does my right hon. Friend agree that the nationalists have never satisfactorily answered this question about separatism: where would the money come from, bearing in mind that there is a significant difference between
taxes raised in Wales and public spending in Wales—a difference that could mean a 30 per cent. cut in public services, or a 50 per cent. tax increase?
Peter Hain: My hon. Friend makes a valid and wholly convincing argument. If the nationalists ever got their way, health services in Wales would be cut and hospitals would be closed, because they do not have the ability to finance the health investment that we are providing in record amounts, which the Bill is designed to underpin.
Part of the Bill can be traced back to the policy document XBetter Health—Better Wales" issued by the Welsh Office in 1998, under the leadership of the then Welsh health Minister, my hon. Friend the Member for Bridgend (Mr. Griffiths), and to the Assembly's ambitious and wide-ranging national plan XImproving Health in Wales—A Plan for the NHS with its partners", which was issued in 2001 and which set out a 10-year programme of renewal.
Last year, we announced our intention to introduce legislation to reform the provision of health services in Wales by establishing local health boards, strategic health partnerships, the Wales Centre for Health and Health Professions Wales. I am pleased that we have been able to establish local health boards and strategic partnerships through the National Health Service Reform and Health Care Professions Act 2002, which went on the statute book on 25 June this year. That Act is important, as it provides the Assembly with a foundation on which to begin delivering the reform agenda that it and the Government want to carry through.
However, we still needed to reform and strengthen community health councils and establish the Wales Centre for Health and Health Professions Wales. We therefore published the draft National Health Service (Wales) Bill—now called the Health (Wales) Bill, which we are considering this evening—on 17 May this year, to include those remaining three elements. Publication of the draft Bill signalled the beginning of an intense three-part scrutiny—by Parliament, the National Assembly for Wales and the public and those with a direct professional interest in the Bill. Pre-legislative scrutiny is an innovation introduced by the Government to elevate the quality of draft Bills, obtain greater involvement by people likely to be affected by proposed legislation, and improve the planning of the legislative process. The Health (Wales) Bill is one of the first measures to benefit from that innovation, and has been much improved and refined by the valuable contributions of a range of institutions, professional bodies and individuals. I pay special tribute to the Select Committee on Welsh Affairs and its Chairman, my hon. Friend the Member for Clwyd, South (Mr. Jones), for their contribution, and to hon. Members from all parties, but especially my own, representing Welsh constituencies.
Peter Hain: I am not sure that the hon. Gentleman made a valuable contribution, but as I am a generous soul, I will take it on trust.
So thorough was the process of refinement that not even the title of the Bill remained untouched. We therefore have before us today not the National Health Service (Wales) Bill but the Health (Wales) Bill. Pre-legislative scrutiny involved three parallel activities. Parliamentary scrutiny in the House was conducted by the Welsh Affairs Committee, and its report was debated by the Welsh Grand Committee. In the other place, Members were briefed on the Bill by both Government and Assembly Ministers and invited to register any concerns. The Assembly's Health and Social Services Committee undertook scrutiny of the draft Bill on behalf of the Assembly and there was also a public consultation.
It is a testament to the robustness of the original policy that the draft Bill attracted widespread support. Indeed, the process of pre-legislative scrutiny revealed no significant concerns about the policy. In all, 45 recommendations for change to the draft Bill were made—some to remedy omissions, some to clarify the powers both of bodies dealt with in the Bill and the Welsh Assembly, and others to extend its scope. We decided to consider 17 recommendations further. In only one instance did we find that there were legal or technical reasons why it was not necessary or possible to amend the Bill as suggested. In the remaining 16 instances, it was appropriate to amend the draft Bill to achieve what was intended, and we did so.
The changes have definitely improved the Bill. Some acknowledged omissions have been rectified and the powers and independence of community health councils, to which my right hon. Friend the Member for Newport, East (Alan Howarth) referred, the Wales Centre for Health and Health Professions Wales have been clarified. By retaining CHCs and making their membership a better reflection of the people whom they represent, by providing complaints advocacy services independent of the NHS in Wales, and by giving CHCs powers to inspect premises providing NHS services, we will build on the strong local relationships, which already exist within the health service in Wales. By establishing a statutory association of Welsh CHCs that will not only advise and assist CHCs but have a performance management role, we will guarantee the people of Wales a consistent service of the highest standard across Wales.
By establishing the Wales Centre for Health as an independent body, we shall ensure that the people of Wales have the best multidisciplinary advice on health hazards, that risks to health are properly assessed and that research and other evidence is made available to support effective policy making and decision taking. By establishing Health Professions Wales as an Assembly-sponsored public body, we shall provide quality assurance for the training and education of those in the health care professions in Wales. Its remit will be extended to cover not just nurses, midwives and health visitors, but allied health professionals and clinical scientists.
By 2004, there will be more than 4,300 nurses in training in Wales. That is more than double the number in 1997, when 2,029 were in training. The annual allied health professions training intake has been increased from 494 in 1999–2000 to 649 in 2001–02, and will have been increased by a further 681 by 2003–04. Among the increases in recent years, the occupational therapy
intake has risen from 161 when we came to office in 1997 to 219 this year. In physiotherapy, there has been a rise from 168 in 1997, when the Conservatives left office, to 288 this year.
Mr. Elfyn Llwyd (Meirionnydd Nant Conwy): The right hon. Gentleman is right to say that there has been an increase in the number of occupational therapists, but unfortunately, it is not sufficient. Will he please look again at the provision of bilingual occupational therapists, which is important in relation to speech therapy and so on? Furthermore, what will the Bill do about the dental crisis in Wales?
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