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11 Dec 2002 : Column 282—continued
Mr. Milburn: No, it is already being top-sliced and then we will distribute it to social services. On paying fines, if I know local government and social services—at least this is what they tell me and I believe them—they want to spend extra money. The whole case that they have been making is about building capacity, particularly in elderly care services. We have just provided an extra #100 million so that they can do so. I know that that does not always happen in Liberal Democrat councils, particularly ones such as Liverpool, which talk the talk but then fail to walk the walk by cutting back on social services.
Clive Efford (Eltham): Will my right hon. Friend say whether he intends that people from local communities who represent their communities on foundation trusts will be better known to those communities than, say, local councillors or even local MPs? How are they going to be representative of the views of those local communities, and how are they going to stay in touch with them?
Mr. Milburn: I suspect that those people will be better known than the current non-executive directors of NHS trusts. I may ask my hon. Friend later in private to name the five non-executive directors in his own NHS trust. I bet that he would struggle, and I would too. I believe that this is an imperfect form of governance. It is a public service and it should have greater public input—not just a community input but a staff input. We have important traditions, at least on this side of the House, not just of community ownership but of industrial democracy. We believe that services are better if local people and local staff are involved with them. I do not believe that the current governance structures in the NHS facilitate the involvement of either local staff or members of the local community.
Andy Burnham (Leigh): Communities in Leigh and across Greater Manchester will today celebrate the passing of a funding formula that has left a legacy of entrenched ill health across the county and a deficit this financial year of about #55 million. I congratulate my right hon. Friend on introducing a formula that better reflects our health needs, but, to ensure that the resources have maximum effect, I ask him to give our PCTs perhaps the full three years to balance their books.
Mr. Milburn: I place on record my thanks to my hon. Friend because, perhaps above all others from his area, he has argued assiduously for a change in the formula and made an extremely reasoned case. Some PCTs have inherited deficits. It is important that those deficits are managed out as quickly as possible, because we must get
services on to the front line to improve services for patients. However, three-year budgets give an opportunity to smooth those deficits out over a period of time if that is what is necessary.
Dr. Brian Iddon (Bolton, South-East): Authorities such as mine have bumped along at the bottom of the health provision league for many years far away from target. Can my right hon. Friend say following this welcome announcement that we will be levelled up with PCTs with similar health need?
Mr. Milburn: Yes, I can confirm that. I do not know whether my hon. Friend has been able to see the figures yet, but the total percentage cash increase for the Bolton PCT is in the order of 31.8 per cent., which is well above the national average and recognises the problems of deprivation and poverty that have caused such pressures on the local national health service. It will still take time to meet the targets, but we have an opportunity now, with a better, fairer formula, to ensure that we get the maximum resources into the areas of greatest health need, including his constituency.
Mrs. Gwyneth Dunwoody (Crewe and Nantwich): Is my right hon. Friend aware that elitism has been the curse of the national health service for the 50 years since its creation, and that he now appears to be setting up precisely the kind of division that will encourage that? Will he please accept that there is no legal way in which he can bind those trusts, and make it clear that creating such foundation hospitals will not only damage the interests of patients but will, in the final analysis, create a machinery that any incoming Conservative Government would use to privatise hospitals?
Mr. Milburn: I have a lot of respect for my hon. Friend, but she has been in this place long enough to realise that any incoming Government can do whatever they like in terms of new legislation. If we genuinely want to protect the public benefit purpose of the national health service from future encroachments by any Conservative Government, however far away that might be, the best way of doing so is surely to lodge ownership in the public, among members of the local community. That is one of the main purposes of NHS foundation trusts. Then the Conservatives would not only have to pass a law but actively to take power, resources and assets away from local communities.
Mr. Jon Owen Jones (Cardiff, Central): I welcome the experiment of foundation hospitals, but can the Secretary of State reassure me that the criteria used to judge the success of the experiment will be whether it delivers more efficient patient care and more choice for patients, rather than the ideological purity of the mechanisms used?
Mr. Milburn: I very much agree with my hon. Friend about choice in our health care system. Of course, there always has been choice in it—provided that people have had the wherewithal to opt out and pay for their health care. Most of us on the Government side—indeed, all of us—believe in choice being available on the national
health service. Why? Because we believe that health care should be available according to the scale of a person's need, not the size of their wallet.
Mr. Paul Marsden (Shrewsbury and Atcham): I welcome the increase, but is not the reality—
Mr. Gordon Prentice (Pendle): The hon. Gentleman was not in the Chamber for the statement.
Mr. Speaker: Order. The hon. Gentleman should not shout at me that the hon. Member for Shrewsbury and Atcham (Mr. Marsden) was not in for the statement. The hon. Gentleman came to the Chair and gave assurances that he was in for the statement. He is an honourable Member, and he is telling the truth.
Mr. Marsden: Thank you, Mr. Speaker.
As I was saying, I welcome the real-terms increase, but the reality is that for Shropshire, for instance, there will be only slightly more money than there has been in the previous five years. Who will appoint the independent regulator for foundation hospitals, and how independent will that person or body really be? How free will they be from Whitehall constraints?
Mr. Milburn: The hon. Gentleman's muddle on figures is rather like his muddle on politics. The allocation per weighted head in his area in 1997–98 was #438. As a result of the changes that I have announced today, and the extra resources for his primary care trust area, that sum will rise to #1,090. By any measure, that is a huge and handsome increase in resources for his local primary care trust. I will appoint the independent regulator, but he, like the regulators of other parts of the public services, will be independent and report independently to Parliament.
BILLS PRESENTED
Co-Operatives And Community Benefit Societies
Mr. Mark Todd, supported by Mr. John McWilliam, Dr. Vincent Cable, Mr. Simon Thomas, Linda Gilroy, Ms Meg Munn, David Taylor, Mr. Adrian Bailey, Mr. Andrew Love, Mr. Tom Watson, Mr. Gareth Thomas and Mr. Dennis Turner presented a Bill to enable the law relating co-operatives and community benefit societies registered under the Industrial and Provident Societies Act 1965 to companies; to permit a registered society whose business is conducted for the benefit be amended so as to bring it into conformity with certain aspects of the law relating to of the community to provide that its assets are dedicated permanently for that purpose; and for connected purposes. And the same was read the First time; and ordered to be read a Second time on Friday 31 January, and to be printed [Bill 15].
Sunday Working (Scotland)
David Cairns, supported by Mr. Malcolm Savidge, Sir Nicholas Winterton, Miss Anne Begg, Jim Sheridan, Angus Robertson, Anne Picking, Mr. Tom Clarke, John Robertson, Sir Robert Smith, Ann McKechin and Mr. Edward Leigh, presented a Bill to make provision as to the rights of shop workers and betting workers under the law of Scotland in relation to Sunday
working; and for connected purposes: And the same was read the First time; and ordered to be read a Second time on Friday 7 February, and to be printed [Bill 16].Fireworks
Mr. Bill Tynan, supported by Mr. Edward Davey, Mrs. Cheryl Gillan, Linda Gilroy, Mr. Jimmy Hood, Mr. Lindsay Hoyle, Shona McIsaac, John Robertson, Mr. John Randall, Mr. Paul Tyler, Mr. Michael Weir and Brian White, presented a Bill: And the same was read the First time; and ordered to be read a Second time on Friday 28 February, and to be printed [Bill 17].
Retirement Income Reform
Mr. Edward Garnier, supported by Mr. Michael Howard, Mr. David Curry, Mr. Frank Field, Mr. John Butterfill, Mr. Steve Webb, Mr. Richard Allan, Mr. David Willetts and Mr. Charles Hendry, presented a Bill to amend the law relating to the provision of retirement income in respect of private and personal pensions, annuities and defined and additional voluntary contribution pension schemes: And the same was read the First time; and ordered to be read a Second time on Friday 7 March, and to be printed [Bill 18].
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