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27 Nov 2002 : Column 370—continued
6.32 pm
Lembit Öpik (Montgomeryshire): The Secretary of State correctly said that many hon. Members would welcome this Second Reading debate. It is always pleasing to see people from all over the world celebrating our deliberations on what I like to think is, by and large, a Bill arrived at by consensus. As the hon. Member for Clwyd, South (Mr. Jones) said, it is a credit to the pre-legislative scrutiny that so many people have been involved—Members of this House, Members of the Assembly and health professionals. In the past, we have not always realised the importance of working closely with the Assembly. Let us hope that this useful precedent will lead us towards more effective representation of the people of Wales in the future.
The Secretary of State also said that the Bill is about patient power. Actually, I think that it is about patient health. We must make sure that we do not become obsessed with process. All four parties present want to ensure that we maximise the effectiveness and value for money that the public get from the system. In that sense, the consultation process has, one hopes, been all to the good, because it has made stakeholders out of individuals who are on the front line trying to deliver the service.
I was, as ever, entertained by, and delighted to listen to, the hon. Member for Ribble Valley (Mr. Evans). Most Welsh Liberal Democrats were grateful that he did not put all the blame on us for the problems of the health service. He is a very nice man—most Liberal Democrats think that, with the possible exception of Michael Carr. The hon. Gentleman got some considerable heat for the 18 years of underfunding which many believe were instrumental in causing the problems in the run-up to 1997. I noticed the relief on his face when Madam Deputy Speaker intervened to protect him, giving him a lucky escape, lest people were reminded of the 70 closed hospitals and the 8,000 lost beds. I agree that the hon. Gentleman's swingeing attack on the Government had about as much relevance to this debate as improving standards in the Estonian health service. In fact, those improvements are impressive and I would recommend that hon. Members go to Estonia to see how it is dealing with its outstanding health problems.
Mr. Wiggin : Is the hon. Gentleman proud of the current state of the NHS in Wales?
Lembit Öpik: I can honestly say that I am. I think that the health service does a damn good job. I shall return to that matter in a moment. We must all celebrate the
fact that the United Kingdom is extremely fortunate that, despite all the issues, we still enjoy some of the highest health standards enjoyed by any society at any time in the history of the planet.
Huw Irranca-Davies : I would join the hon. Gentleman in celebrating the standards in the national health service. When my mother was taken into Morriston hospital in an emergency last weekend, the quality of care that she received was first class. She spent two days there and now, thank goodness, she is back home. That was not the first time that she had been taken into hospital; it was the third occasion. Each time, she has been dealt with admirably, so let us not slate health service in the way that it is so often slated.
Mr. Deputy Speaker (Sir Michael Lord): Order. Before the hon. Member for Montgomeryshire (Lembit Öpik) responds to that, may I say that this is not a general debate about the health service in England or Wales, and I should be grateful if hon. Members would confine their remarks specifically to the Bill before the House.
Lembit Öpik: I certainly will, Mr. Deputy Speaker, and I apologise for bringing Estonia into the debate as well.
As I listened to the hon. Member for Ribble Valley discussing the Bill, I became increasingly nervous because I simply did not know whether the Conservatives were supporting the Bill tonight. At one point, I almost intervened on a point of order to ask whether it was in order for the hon. Gentleman to expose us to such stress. In waiting for the answer, we may have developed some stress-related disorders.
The hon. Gentleman explained on behalf of the Conservatives where the money should come from to improve the health service. In answer to my question to him, we received only one figure: he would save £14,000 by abandoning the logo project. That would pay for almost a year's worth of nursing—[Interruption.]
Mr. Evans: Will the hon. Gentleman give way?
Lembit Öpik: I believe that my point is almost in order, Mr. Deputy Speaker, so on that basis I shall give way.
Mr. Evans: I said that £14,000 was being wasted on the logo. I could have gone on to give a whole list of ways in which the Welsh Assembly is mis-spending the money, including the new Assembly building, but I did not mention that in case Madam Deputy Speaker ruled me out of order.
Mr. Deputy Speaker: Order. I fear that hon. Members are starting to stray again and I must insist that they do not.
Lembit Öpik: The point just made by the hon. Member for Ribble Valley brings me right back to the research paper published on 20 November to explain various aspects of the Bill. It says on page 16:
- XThe draft Regulatory Impact Assessment, published by the Wales Office to accompany the draft NHS (Wales) Bill, estimated that CHCs' enhanced visiting rights would cost around £100
- million a year across Wales, while the enhanced advocacy role would cost £480 million per year. The cost of putting the AWCHC on a statutory footing and increasing its responsibility and powers was estimated at £10 million per year in additional rates and rents and £70 million a year in additional staffing."
We did some investigation in the House, however, and it transpired that it comes to £660,000 a year, so in one fell swoop the Welsh Liberal Democrats have saved Wales £659,340,000 already, while the Conservatives could come up with only £14,000.
Mr. Wayne David (Caerphilly): Does the hon. Gentleman therefore welcome the fact that the National Assembly Government have already publicly announced an extra allocation of £550,000 for the enhanced role of CHCs in Wales?
Lembit Öpik: Indeed, that shows that we are quite close to the estimate within the research document.
The Bill has attracted an encouraging degree of consensus in the Chamber, because much of it has been fashioned on a cross-party basis. Crucially, it has been fashioned with outcomes in mind. The proof of the pudding will be in how it is implemented but in my judgment this is an evolutionary step. Those who were in favour of devolution wanted the Assembly to have greater autonomy in defining how the many different elements of health were provided in Wales.
One of the Bill's crucial elements is the Wales Centre for Health. If it is handled correctly, it could provide a powerful strategic drive to the work and thinking of the Assembly in defining what the Secretary of State said he wanted: a health service specifically tailored to Wales. He mentioned plans for thousands of extra nurses and hundreds of other staff in the health service in Wales, which is to be welcomed. It is a credit to the Welsh Liberal Democrat-led coalition with Labour in the Cardiff Assembly that so much has been achieved.
Mr. Jon Owen Jones: Will the hon. Gentleman give way?
Lembit Öpik: I knew I would not get away with that.
Mr. Jones: If the Liberal Democrats claim so much credit for leading the Welsh Assembly on so much, why is it that the Welsh Assembly intends to renege on a commitment to rebuild Cardiff royal infirmary in my constituency and that of the former deputy leader of the Welsh Assembly, Jenny Randerson? Although Ms Randerson, the Member for Cardiff, Central in the Assembly, has condemned that decision, she apparently is powerless to do anything about it. The Liberal Democrats cannot have it both ways.
Lembit Öpik: I shall save you the bother, Mr. Deputy Speaker, of ruling me out of order for attempting to reply to that intervention. I will be happy to discuss that matter with the hon. Gentleman later. I assure him that, as the Secretary of State said—I think that it was a sincerely held point, made in the spirit of the debate—there are still lots of problems in the health service in Wales.
To be a little more serious about the coalition, what is interesting is that the Welsh Liberal Democrat-Labour coalition is working hard to achieve the consensus out of which this Bill has been born. What is even more interesting is that there has been constructive input on the Bill from four parties. As I have said—I will not dwell on it particularly—the kind of new politics that we promised a few years ago when we were campaigning for a Welsh Assembly has probably led to a Bill of this sort coming before us now. I am greatly encouraged by that.
There is one risk associated with the Wales Centre for Health. If, in working and offering guidance to the Welsh Assembly, it becomes the strategic driving force that I believe it can be, it is likely that there will be increasing divergence between what happens in Westminster for the English health service and what happens in Wales. That would be a healthy development for Wales but I imagine that it could cause strains between what we discuss here for England and what is discussed in the Assembly for Wales. I hope that the potential resistance of the Government in Westminster, who could be uncomfortable about the guidance given by the centre, will not come about.
For that part of the Bill to work, there must be some tolerance in terms of the divergence, which could put a strain on other health-related debates here. There must be an acceptance that we are trying to find, to use the sort of language that the Secretary of State used before he left the Chamber, Welsh solutions to Welsh health issues.
If the Wales Centre for Health does its job well enough, current best practice could be imported from Wales to England. Again, it requires a new kind of politics, enabling Ministers to take the opportunity, without loss of face, to look at the devolved institutions and to say that the Westminster Government can learn something useful from what has happened elsewhere.
The issue of foundation hospitals and whether they should have been included in the Bill is a good example of divergence. I am not convinced by some of the statements by the Government for England with regard to health provision. I agree with what the hon. Member for Ribble Valley said about divergence.
The Government's language on the health service now seems to include creeping terminology about failing institutions. That sort of psychology has done a lot of damage in the education sector. The Bill may help to protect us from the same danger creeping into Wales.
Certain specific points relate to cardiac and orthopaedic services. While I am very happy with the service that I and my mother, who has had various health problems, have received, again, the strategic approach that the Wales Centre for Health and the community health councils could provide across Wales could deal with the issues that we are all concerned about. Waiting lists concern me—I think that they concern us all—but by working together we can perhaps get those down.
I was heartened by the fact that the Conservatives have travelled around various parts of Europe to see best practice. It is ironic that they are so pro Europe in that respect but not quite so keen on other aspects of harmonisation.
On the question whether the Bill can save money, we need to be honest. It is very difficult to save money in the health service because, ultimately, when people feel
better, they live longer. The quality of life improves but the health bill does not reduce. The NHS was originally set up in the belief that it would save money for the Government by reducing illness. It has improved life expectancy and the quality of life of individuals but that has come with a large price tag, not least because technology costs a lot more. Often, technology costs increase at a higher rate than the underlying inflation rate in the health service. This is not the place to discuss that but we should not pretend to anyone that by supporting and passing the Bill anyone will save a significant amount of money in the health service.The hon. Member for Cardiff, Central (Mr. Jones) said, with insight, that he did not believe Labour would always be in power. How right he is. He knows that the Liberal Democrat Government are just round the corner and already operating effectively in Wales.
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