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8 Jan 2003 : Column 224—continued

Mr. Page: The hon. Gentleman must stop writing the script for the Labour party and stop starting to believe it. I shall deal with his point in a moment.

I welcome the concept of foundation hospitals. They could be a means of improving the health care of my constituents, but what of the hundreds of other hospitals that are not given foundation status and foundation opportunities? What will happen to the Hemel Hempsteads and the Watfords of this world? The hon. Gentleman speaks of money. The Government muddle up money and management. My hon. Friend the Member for Woodspring (Dr. Fox)—I hope that he will shortly be my right hon. Friend—commented that more than 20 per cent. more money went in, but there was only a 1.6 per cent. increase in treatment.

I have to smile when I find that there is agreement between my right hon. Friend the Member for Wokingham (Mr. Redwood) and the right hon. Member for Makerfield (Mr. McCartney)—a sort of

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unholy alliance—when they ask how the Government's scheme is to be rolled out for the rest of the acute hospitals. There is a huge gap between the cost and the achievement, as the hon. Member for Cardiff, Central (Mr. Jones) pointed out. How true that is. We must examine more effectively the level of efficiency that is being achieved. The Government think that if they throw money at a problem, it will go away. I remind them of their experience with the dome. How many hundred millions of public money were thrown at the dome, and what do we have? A tatty example, instead of a shining example, of what Britain is really like.

Nothing brings things home to people more than personal experience. Just over a couple of years ago, one of my larger four-footed friends deposited me on the ground at a fairly high rate of knots. Being old and unfit and not bouncing like I used to, I hit the ground more with a splat than with the youthful enthusiasm that I had in the past. The ambulance arrived and the staff did their job remarkably effectively. I was taken to a hospital, but the process turned out to be almost an Ealing-type comedy. My total treatment time was about 20 minutes, but I was at the hospital for more than 10 hours.

I had heard that there were now more administrators than beds in the health service, but I did not see my personal administrator standing beside my bed to look after my needs. When one is lying in pain, feeling waves of pain washing over, one is not that interested in the technicalities of funding national health provision or in whether it is private or public or whether the nurses are regular nurses or agency ones. One is looking only for treatment. The staff discovered that I had broken a shoulder, my collarbone and rib or two, and I can tell hon. Members—I can see concern in every face—that I have made a full and happy recovery.

I came away thinking, XSurely we can run our national health service better than this?" I waited 10 hours for 20 minutes' treatment. I cannot see that we will achieve anything else by conducting review upon review and counter-review. In my constituency, shortly before the general election, we had another review of the Watford and Hemel Hempstead general hospitals. Surprise, surprise: the decision was made to keep them both open. Immediately after the election, however, the Government announced the decision to close Harefield and the reviews started again. Interestingly, the decision to close Harefield, a well-known international heart hospital, was made even before planning permission was gained for the move down to the Paddington basin. A leaked report completed a few months ago asked for about #5 million or #6 million more to be spent on Harefield to keep it going for another five years, so some more operations could be carried out there, as delays were occurring in Paddington. I have encountered such trouble in my constituency, where we have spent more and more money on project after project and building after building, only for the projects to be reversed and the buildings knocked down, so that we have to start again.

The hon. Member for Dartford (Dr. Stoate) commented on Conservative party policy, as did the Secretary of State, who also wrote the policy according to his own lights. I share the view of my right hon. Friend the Member for Wokingham, as I would be appalled if we cut the money that is currently going into our national health service, but I would like us to

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achieve a higher rate of efficiency. The money should not be wasted and we should not spend 20 per cent. more to achieve only a 1.6 per cent. increase in clinical episodes.

Although the Opposition have been accused of confusion, it is not unknown in the Labour party. I was greatly impressed by the comments of right the hon. Member for Makerfield in The Guardian on 2 December. He argued that the creation of foundation trusts represented an example of the Xrebirth of popular socialism"—a contradiction in terms if ever I heard one. He had obviously not been listening to the right hon. Member for Holborn and St. Pancras (Mr. Dobson), who I thought spoke sensibly and eloquently in this debate. I disagreed with him, but I thought that he made a logical point. He went on record in The Guardian of 5 November last year as describing the proposals for creating foundation hospitals as an attempt to Xestablish . . . a Tory consensus". The hon. Member for Crewe and Nantwich (Mrs. Dunwoody) expressed her belief that the plans


It is transparently clear from the fact that 100-plus Members have signed the early-day motion on foundation hospitals that there is deep concern that we are creating a two-tier system.

I find myself on the horns of a dilemma. I want to see these foundation hospitals up and running; they seem to be the way to go. The new system will retain them within the national health service while giving them greater freedom for individual expressions of management and control. But what about the hundreds of other hospitals that will be left outside, unable to catch up? The Labour party said that there were 24 hours to save the NHS. Suddenly that became 10 years. When did that 10 years start? Was it in 1997? Did it start a year or so ago? Has it started now? When is this 10-year plan going to come to fruition? When will the hospitals in Hertfordshire—in Hemel Hempstead and Watford, and at Mount Vernon—have the chance to take advantage of the opportunities that are being given to the foundation hospitals? When will my constituents have the chance to obtain a better level of service? I have already outlined my concerns about the quality of service being given to my constituents, and I could spend hours going through them, time and again, to the House. We have all had experience of cases in our surgeries; every one of us has a tale of horror burned into us.

We must ensure that we improve our national health service. While supporting the move towards foundation hospitals, I would like to hear from the Minister what is to happen to all the other hospitals that are going to be left out in the cold. What about the Watfords, the Hemel Hempsteads and the Mount Vernons of our society?

3.36 pm

Siobhain McDonagh (Mitcham and Morden): I welcome the debate about foundation hospitals. Perhaps because some part of me is a latent Trotskyist, I believe that every public organisation—including the one that we hold most dear—has to be subject to considerations of how it should be organised and structured. When we are in a position to put large amounts of money into the national health service over the next 10 years, we must consider how best that money should be spent and in which ways.

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I am encouraged by this debate because these measures are about increasing public involvement in our cherished institution, and anyone here who has ever been in a constituency in which a hospital is threatened knows just how fervent the support for the NHS is. Anyone who has ever attempted to get a petition together in such circumstances knows how easy it is to get members of the public to sign it and become involved in their local NHS.

There will be an opportunity within foundation hospitals to allow them more clearly to reflect the needs of the community in which they are based. Uniformity does not guarantee equality. We have a multi-layered and multi-standard NHS. All our constituents know how good or bad their local hospitals are. There is already competition between the teaching hospital and the local district general, for example. Where do people want to go if they have a complicated ailment? There is also competition in terms of how we view hospitals with old or new buildings. The idea that we all believe that everything is equal and the same across the NHS is simply not true. Our constituents do not believe that to be the case either.

I find the idea of diversity exciting. It offers the prospect of real innovation. My feelings about diversity and the opportunities that it presents stem from my experience in my work before I came to the House. I worked in the most exciting, vibrant and innovative part of the voluntary sector in the country: I worked for a housing association. In fact, I worked for both a local authority housing department and a housing association. If people really want to provide more, better housing in exciting ways, housing associations are the place to be. They have core principles, just like the NHS. One core principle is to house those in need, but they do it in many different ways depending on which part of the country they are based in. They represent different ethnic groups and they are formed out of the needs of the local community.

I have read the Department of Health briefing document on foundation hospitals and, for me, it reflects what could be and what is good in housing associations as well as how that might be introduced to the NHS. Housing associations, not local authority housing departments, are at the cutting edge of providing services for the most vulnerable and the most difficult to house. Due to their freedom, housing associations can consider and tackle the needs of groups that local authorities often shy away from.

I understand and fully appreciate why people are concerned about changes in structure, because, for 17 years under the Conservative Government, we fought for the continued existence of the NHS. Any threat or any change to that institution makes us concerned that perhaps it is being undermined, but diversity is not about sacrificing standards, and the Commission for Health Improvement and the National Institute for Clinical Excellence are fundamental in ensuring that we have national standards, although those could be provided in different ways across the country.

Giving foundation status to some will not impoverish the rest. The proposal will provide an opportunity as well as an expression of how and why we can improve.

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It is not about money, as the Liberal spokesperson suggested. It is about the room to manoeuvre as well as the room to have a good idea and seeing it happen.


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