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8 Jan 2003 : Column 228—continued

Mr. Kevan Jones: Will my hon. Friend explain this example to me? My constituency is in the north-east. If Sunderland general hospital, which is a three-star trust, goes down the foundation route and attracts better staff and if people feel that it is better than the excellent University Hospital of North Durham, how could North Durham and neighbouring hospitals not be affected by that?

Siobhain McDonagh: People already have a perception of which they believe to be the better hospital. My constituency is served by St. Helier, which is a local district hospital that I mentioned earlier, and St. George's, which is a teaching hospital. People already have perceptions. They do not need the word Xfoundation" to be included to make them have certain feelings about those hospitals.

Equally, it is patently not the case that there are not already different incentives for staff to work in certain hospitals. Staff at St. Helier get outer-London weighting while those at St. George's get inner-London weighting. Those hospitals are a mile and a half apart. Staff at St. Helier get a really good crêche for their children while that is not the case at other hospitals. There are already incentives built into the system to attract staff. I understand the concerns expressed by my hon. Friend the Member for North Durham (Mr. Jones), but we do not perceive the NHS as our constituents already perceive it.

The proposal is not about assisting a few; it is for the many. The document suggests that every hospital, should it achieve three-star status, will have the opportunity to go for foundation status. That is the key. What we are discussing is not like grant-maintained status for schools, which could only ever be accessed by a few. Foundation status is a possibility for all those hospitals.

Mr. Simmonds: Will the hon. Lady consider the possibility of a hospital that has achieved two-star status being given foundation status as a way to raise its standards and achieve three stars?

Siobhain McDonagh: It seems reasonable that the best standard—three stars—should be achieved before that freedom is given. I cannot understand why no-star or one-star hospitals should have the prospect of more freedom when they are clearly unable to address some of their basic problems. The logic of that is there for me.

The proposal is not about recreating an internal market, because it is clear that different hospitals will not offer different prices for different operations when the NHS reference costs are introduced. I know that there are difficulties there, because the reference costs are quite bizarre at the moment, but if we can get to a stage at which we know the cost of an operation in a particular region we shall achieve much more clarity and openness over contracts with the PCT.

I firmly believe that the NHS is under threat in the long term not from Labour Members or people of my age and older, but because younger people—those in

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their 20s and early 30s—will not put up with the system as it is, even when we get the full benefits of the investment. They live in a society and a world in which they enjoy international access within seconds. They want treatment now, and they want to be involved in a system that allows them some control over the services provided for them.

I completely understand why people are concerned about change to a system that we cherish desperately. However, we must ask whether we cherish it because of the way that it is currently structured, or because, based on everything that made us become members of the Labour party and stand for election, we believe that people should have the very best treatment when they need it, at no cost. That is our fundamental belief, and if we need to change the system in some way to ensure that that the wider community continues to cherish that goal, we should consider doing so.

3.45 pm

Mr. David Tredinnick (Bosworth): During his first Parliament as Secretary of State for Health, the right hon. Gentleman was obsessed by central control and central planning, and ran the health service in an almost Stalinist style. Some way into his second Parliament as Secretary of State, he is finally taking on board some of the policies of choice and diversity that are truly Conservative ones. According to the leaked memo that is doing the rounds of the newspapers, we hear that extra billions may not sort out the NHS. In other words, throwing money at the problem will not necessarily lead to a solution.

In one particular way—it has already been touched on—the proposal for foundation hospitals is unbelievably divisive. As it stands, it excludes all hospitals in Leicestershire because all of them have two-star status. In other words, the great Leicester royal infirmary, Glenfield hospital and others will be excluded. There is a very strong case for using this proposal as an incentive, certainly in a county such as mine, where not a single hospital has three-star status.

It is perhaps no surprise that more than 100 Labour Members have signed an early-day motion that opposes these proposals. In fact, they are founded on Conservative policies and derive from the National Health Service and Community Care Act 1990. As originally passed, that Act gave NHS trusts the freedom to determine staff terms and conditions. Furthermore, the notion of some financial control independent of Government was proposed by my right hon. and learned Friend the Member for Rushcliffe (Mr. Clarke) when he was Secretary of State for Health. No financial control was given—[Interruption.] The right hon. Member for Holborn and St. Pancras (Mr. Dobson) seems to be trying to intervene—I hope that he is agreeing with me. He is beyond the white lines, so he is out of court and cannot speak. The fact is that my right hon. and learned Friend's proposals did not get past the then Chancellor because the then Opposition complained that they were all about privatisation. So this really is a case of the pot calling the kettle black.

The proposals put much store on governance arrangements giving local stakeholders, patients and people in the local community far greater control. There will be real opportunities for local people through the

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management proposals, and I certainly welcome that because it is in line with our party's policy. During yesterday's debate in Westminster Hall, the Under-Secretary of State for Health, the hon. Member for Salford (Ms Blears) said that we want are new ways of doing things and new governance arrangements. Indeed, according to a press release from the Under-Secretary of State for Health, the hon. Member for Tottenham (Mr. Lammy), there will be a

He said that the Commission for Patient and Public Involvement in Health will not just promote but

Well, that is great news, because one question that the Government must address is what these new people—the local people who will get control, not the apparatchiks or central control freaks from Richmond house—will ask for. What will they ask for? They will ask for services that many already use.

Andy Burnham (Leigh): Complementary medicine.

Mr. Tredinnick: The hon. Gentleman has it in one. He should be promoted.

The Minister of State, Department of Health (Jacqui Smith) indicated assent.

Mr. Tredinnick: The Minister clearly agrees. Foundation hospitals should be required to move to an integrated delivery of service, which should include the main complementary therapies—osteopathy, chiropractic, homeopathy, acupuncture and herbal medicine. I served on the Standing Committees scrutinising the Bills in the 1987 and 1992 Parliaments that put provision of chiropractic and osteopathy on the statute book; then many doctors still considered them to be beyond the pale. The fact that they are pretty much mainstream now is to be welcomed.

I have always believed that I represent two constituencies in the House. I have been lucky enough to represent Bosworth, a constituency in the middle of England, for 15 years. I have also tried to represent the interests of minority groups who practise complementary and alternative medicine for about 14 years. In that time, there has been a sea change in the House's approach to such matters.

In Bosworth, I have 80,000 constituents. My other constituency consists of 10 million people—the number of people using complementary and alternative medicines every year. Recent surveys report that 4.5 million people see a complementary therapist every year. A BBC poll in August 1999 estimated that 20 per cent. of the public used complementary therapies, double the number of 10 years earlier. I shall not bore the House with statistics, but it also showed that 80 per cent. were satisfied with the treatment that they received.

I checked the Library this morning and found that the country now has a population of 59.1 million. Of that total, between 25 to 35 per cent. of people now buy remedies, such as simple homeopathic preparations, from chemists. The market is expanding exponentially, as is interest. Whenever I ask colleagues in the House to sign a motion, they always tell me—although they sometimes ask me not to quote them by name—that

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they have, for example, relatives who take various remedies for their ills. In fact, the Minister of State, Department of Health, the right hon. Member for Barrow and Furness (Mr. Hutton), went on the record in a debate on complementary medicines in the summer as saying that he used, I think it was, reflexology.

The Government have been on the road to Damascus and now want people to have more choice. They have a wonderful opportunity. In 1981, there were only 13,500 therapists in the complementary sector, but there are now 40,000. That is because of a rise in demand for their services. However, those services are not supplied through NHS hospitals very much. The complementary sector remains the preserve of the middle classes. If the Minister wants a social cause to promote, she should get the range of treatments on offer firmly embedded in the public sector.

Many people come to me on these matters, and I shall cite some reasons why the NHS should embrace complementary therapies. For people undergoing chemotherapy for prostate cancer and other problems, an amazingly effective treatment is the use of Chinese herbs and acupuncture. The chemotherapy is rendered much less painful, and recovery periods are much reduced.

A year or so ago, I was giving awards at the Royal Free hospital to doctors who had studied complementary medicine. A nurse told me that she was not allowed to use acupuncture on transplant patients, even though fewer transplanted organs would be lost if she were given the opportunity to change patients' energy meridians. I do not want to alarm the hon. Member for Richmond Park (Dr. Tonge), but powerful steroids are used to treat skin conditions, when there are many ways to treat those conditions with homeopathic or herbal medicine techniques. Simple problems such as tinnitus or the difficulties currently treated with grommets are also susceptible to that approach.

There is phenomenal, exponential demand in the health service for such therapies, yet many people do not have the opportunity for treatment. The Minister of State, the right hon. Member for Barrow and Furness, has done quite a lot of work on this and the Government are coming round to the view that these therapies should be incorporated in the health service. I pay tribute to them for getting Professor Pitillo to work on regulating herbal medicine and Professor Chan on acupuncture. These disciplines will soon be regulated; they will have the stamps in the passport that the doctors want. The march of integrated health care will not be stopped. The Minister of State, the hon. Member for Redditch (Jacqui Smith), should grasp the nettle now.

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