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9 Jan 2003 : Column 369—continued
3.41 pm
Mr. Wiggin: The Bill will, sensibly, retain CHCs for Wales. It is a disgrace that English CHCs have not been preserved in the same way. While I am happy to work in the House for what is best for the Welsh people, it is fair to point out that Labour Members have a responsibility to look after the whole of the UK and that the Bill will therefore stand in the statute book as a monument to new Labour's double standards.
What is good for the goose is good for the gander—and my entry in the Register of Members' Interests shows that I have some expertise on geese. We know that CHCs are a good thing, as does the National Assembly for Wales. What a shame that nobody told the Executive of this Government, as was shown when my hon. Friend the Member for Surrey Heath (Mr. Hawkins) asked the Prime Minister this question:
- XFollowing the Government's humiliating defeat in another place last night, will the Prime Minister finally agree with the views of medical charities, the British Medical Association and the Opposition and withdraw his mad plans to abolish community health councils?"
- XNo, we will not, because the replacement of community health councils by patient forums and patient councils is, we believe, and as the College of Health made clear earlier, a better way to make sure that patients' interests are represented. There has been a debate about community health councils for many years, but patient forums"—[Official Report, 25 April 2002; Vol. 376, c. 305.]—
Mr. Wiggin: On a point of order, Mr. Deputy Speaker. May I ask you for some guidance? I was
quoting those remarks because the retention of CHCs is the sole purpose of the first part of the Bill. That is why I was making such comparisons. Am I out of order in that respect?
Mr. Deputy Speaker: I can allow the hon. Gentleman to allude to the fact that a different policy is being pursued in England, but that is outwith the scope of the Bill. On Third Reading, a much more restrictive approach is taken than on Second Reading, when hon. Members can speak about what they would like a Bill to deal with and make complaints in that regard. On Third Reading, it is not in order to talk about matters that lie outside the Bill.
Mr. Wiggin: I am grateful for your guidance, Mr. Deputy Speaker, but I remain a little muddled about the matter. However, I shall cease quoting the Prime Minister, although it is fair that hon. Members have a good idea of the double standards.
Mr. Deputy Speaker: Order. I could clear up the muddle more drastically for the hon. Member.
Mr. Wiggin: I hope that you will not feel that that is necessary, Mr. Deputy Speaker.
Let me deal with the aspects of the Bill that cover the National Assembly. Until your recent intervention, Mr. Deputy Speaker, I had not witnessed such pathological delight by Labour Members as that shown in their eagerness to hand over opportunities to the National Assembly to exercise powers such as those in the Bill. I am worried about the autonomy of Health Professions Wales and the Wales centre for health as well as Welsh CHCs when the National Assembly can exercise almost unlimited power over them.
I am also worried about the Bill's ambiguity on the co-ordination of the activities of the Wales centre for health and Health Professions Wales with those in rest of the United Kingdom. For example, there is the bureaucracy involving Welsh patients who seek medical treatment in England or vice versa. I support the Conservative view that a strong, independent body separate from the Welsh Assembly needs to be created to support CHCs. We were dismayed that none of the amendments that we tabled in Committee in favour of the independence of Welsh CHCs was accepted.
Let me give an example of imbalance. The Bill gives highly centralised powers to the National Assembly for Wales to abolish or alter the CHCs, to abolish or assume the functions of the Wales centre for health as well as to appoint its members and chairman, and to abolish Health Professions Wales. Although I am sure that it is possible for the Government to know and agree with the intentions of the current Welsh Assembly Administration, it is impossible to know the type of Administration that will exist in future.
I have always believed that, when making law, we should take the longer-term view and attempt to prevent as many unknown eventualities as possible, thus ensuring that the powers in the Bill will not have to be redistributed yet again. I am not against its concepts, but I am increasingly saddened by the short-term approach that it exemplifies.
Foundation hospitals constitute another missed opportunity. We have all expressed anxiety that there are no plans to create foundation hospitals in Wales. An article in the Daily Post on 12 December confirmed that there are no plans for such hospitals. The Secretary of State for Wales endorsed the views of the First Minister, Rhodri Morgan, that foundation hospitals are not an option for Wales. He effectively endorsed Mr. Morgan's criticisms of the Prime Minister's national health and social policies on the development of foundation hospitals.
Although I appreciate that some may describe Rhodri Morgan as a dinosaur with extreme socialist views who is stuck in a prehistoric shell and refuses to accept that we have moved on from the 1940s, the First Minister is more than entitled to his views. However, the Secretary of State deserves criticism for endorsing those seriously outdated views. Despite criticising the two-tier health service, the Government are trying to construct a similar division.
Mr. Touhig: The Secretary of State made it clear in his comments that we are a partnership. The Government here and the Government in the Assembly have the same objectives, which we shall follow by different routes. However, the objectives are the same, and the Secretary of State emphasised that.
Mr. Wiggin: I am grateful for the Minister's intervention.
I am also worried about the excessive bureaucracy that the Bill will add to the already horrific amount in the NHS in Wales. Health spending in Wales is significantly higher than in England, yet Wales has worse health outcomes. The Labour-Liberal Democrat Welsh Assembly Government have failed to meet their targets for waiting lists, which continue to increase. Welsh consultants rejected the Government's offer of a new contract because they were worried that the waiting list targets distorted clinical priorities.
The shortage of funding for Welsh patients who seek treatment in England has threatened the principle of treating patients according to clinical priority. Shortages of care home places and delayed discharge are also significant problems in Wales. There are also many GP vacancies. A truly Welsh health Bill would deal with those matters and strengthen the excellent work of the staff, doctors, nurses and managers who work in Wales. A Welsh health Bill of which we could all be proud would put patients first.
3.49 pm
Hywel Williams: I am sure that hon. Members will be gratified to learn that I intend to be brief. [Hon. Members: XSit down, then!"] I shall in a moment, if hon. Members contain themselves.
I welcome this, the first all-Wales Bill since devolution. It is the product of extensive preparation and discussion. The proposals that have been fashioned are extremely appropriate for Wales and do not preclude co-operation between the health service in Wales and that in England, Scotland or any other country. The Bill contains valuable proposals for the
Wales centre for health, which will have a vital job in promoting public health. I also welcome the establishment of Health Professions Wales, and the strengthening of the CHCs, including, I hope, their all-Wales body.I would like to look at the process by which we have reached this point. It has involved an extensive process of consultation, consideration and discussion involving the National Assembly for Wales and its committees, the public, the Welsh Affairs Committee, the Welsh Grand Committee, followed by the Bill's Second Reading, the Standing Committee, Report and Third Reading—nine steps, so far. The interpretation of this process will, no doubt, be varied and could form the subject of much discussion in Wales in political and academic circles. I look forward to that discussion, as I think that we need to develop our understanding of Welsh political processes through as wide a discussion as possible. Bearing in mind those nine steps, however, I conclude by commending to hon. Members—and, incidentally, to Lord Richard—the good business principle of cutting out the middle man.
3.51 pm
Mr. Touhig: With the leave of the House, Mr. Deputy Speaker, I should like to say that we have had another good debate on the Health (Wales) Bill this afternoon, and we have again explored in fine detail some of its provisions. The outcome has confirmed that the pre-legislative scrutiny that preceded the Bill's introduction was successful, and proceedings in the Standing Committee and here today have further assisted in providing a thorough understanding and appreciation of the Bill and the policies that it seeks to implement.
The hon. Member for Ribble Valley (Mr. Evans) gave the Bill a welcome but then, as usual, dwelt on some of the problems that we have had with the health service in Wales. We recognise that there are problems, but I hope that he will also recognise that the legacy of his party's time in government was closed hospitals, fewer doctors and nurses, and fewer hospital beds. One wonders where the Conservatives' present proposal for a 20 per cent. cut in public expenditure would leave the health service in Wales, if ever they were in power and able to do anything so drastic and insane.
The hon. Member for Brecon and Radnorshire (Mr. Williams) welcomed the Bill. He referred to some of the problems that we face in Wales, in terms of the legacy of ill-health and inequality. He also touched on the worries about orthopaedics. I can tell him that, in Gwent, where there has been a problem with the delivery of orthopaedic services, the health expert Professor Brian Edwards will carry out a review of orthopaedics in the area of the Gwent NHS trust, and produce a report on ways in which waiting times can be reduced. We all look forward to that.
The hon. Member for Leominster (Mr. Wiggin) highlighted the different approaches in Wales and England, so far as giving patients a clear voice is concerned. That is devolution, and this Labour Government, working in partnership with the Labour-led Assembly, share the same objectives, although we may well follow different routes to achieve them. That is perfectly valid within the context of the devolution settlement in Britain. He also mentioned waiting lists.
As I said earlier, there have been significant improvements in reducing waiting lists in Wales. Money is being put in to tackle the problem, reforms are being put in place, and the taskforce headed by the Assembly's deputy Health Minister is now monitoring progress to see how quickly we can reduce waiting lists across a range of areas in Wales.The hon. Member for Caernarfon (Hywel Williams) welcomed the Bill, but also spoke about the processes by which we brought it here. No doubt we shall continue to evaluate how successful they have been. I am sure that there will be Wales-only legislation further down the line and that we shall examine how we should consult, in a pre-legislative sense, before it comes before the House.
The Bill contains three key elements that have been extensively considered and welcomed. The first is the retention and reform of community health councils, which has been widely welcomed. The second is the welcome from stakeholders for the establishment of the Wales centre for health, which was conceived back in 1998 in the days of the old Welsh Office before devolution and taken on as a result of the commitment of the Cardiff Assembly. That means that we shall strengthen public health capability and capacity in Wales. The third is the creation of Health Professions Wales—a body to perform the functions of the former Welsh National Board for Nursing, Midwifery and Health Visiting and to support post-registration education and training of health care professionals.
Proceedings in Standing Committee improved Members' understanding and knowledge of the Bill, which have also been enhanced this afternoon. I am grateful for all contributions made by Members throughout the pre-legislative process and in Committee as well as on Report and Third Reading. We have done a good job of work between us and I am very pleased. I have every confidence in commending the Bill to the House.
Bill accordingly read the Third time, and passed.
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