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18 Mar 2003 : Column 746—continued

Foundation Hospitals

7. Mr. Andrew Mackay (Bracknell): If he will make a statement on foundation hospitals. [103199]

The Secretary of State for Health (Mr. Alan Milburn): The Health and Social Care (Community Health and Standards) Bill published on 13 March sets out our legislative proposals for NHS foundation trusts. Subject

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to Parliament, I expect that, in four to five years, every NHS hospital will have the opportunity of becoming an NHS foundation hospital.

Mr. Mackay : As the Secretary of State will be aware, Conservative Members strongly support foundation hospitals, so we were concerned to note that at least 115 of his Back-Bench colleagues have signed an early-day motion criticising them. Will he explain to the House why he has so singularly failed to sell his policy to them?

Mr. Milburn: I suppose that I should say that I am grateful to the right hon. Gentleman for his support. However, there is a small matter of difference between him and me on foundation hospitals, as he calls them: I believe that those hospitals should be part of the NHS. They should have greater freedom, greater local control and greater local accountability, but none the less they should be subject to national inspection systems and, most importantly, to national standards. Indeed, what is very obvious every time Conservative Members talk about foundation hospitals is that they use those two words, but they fail to mention the three words that are important: national health service.

Mr. Lindsay Hoyle (Chorley): Obviously, as a person who has been treated by an NHS hospital—I received remarkable treatment at St. Thomas's—I can only congratulate the NHS on the service that it provides, and that is without foundation hospital status. If my right hon. Friend pursues the foundation hospitals policy, will he ensure that all hospitals can apply for that status and that real consultation will take place with the staff, patients and trade unions before we venture down that road?

Mr. Milburn: My hon. Friend is absolutely right. Incidentally, I wish him well and I hope that the other knee survives. When he reads the Bill he will see that we set out the process of consultation in it. If proposals are to come forward from NHS trusts that want to become NHS foundation trusts, they must have the local community on board. Clearly, it will be important to consult local Members of Parliament and elected local councillors, but equally, it will be important to consult local staff and other parts of the local health community: most notably, primary care trusts.

I can give my hon. Friend the undertaking that he seeks: our ambition has always been to try to raise standards of care in every single NHS hospital. We do not want a two-tier service, and we certainly do not want to pursue a sink-or-swim policy. That is why I believe that it is necessary to provide extra help and support so that every hospital, over a four-to-five-year period, has the opportunity to become an NHS foundation hospital.

Mr. Peter Lilley (Hitchin and Harpenden): Will foundation hospitals be subject to the remorseless process of centralisation, mergers and closures being carried out by strategic health authorities across the country?

Mr. Milburn: Strategic health authorities, under the proposals contained in the Bill, as the right hon. Gentleman will see when he reads it, lose their powers of

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direction—effectively, my powers of direction—over NHS hospitals. I believe that that is right. Although it is absolutely necessary, for equity purposes, to ensure that appropriate standards in the system apply in all parts of the country, ultimately, health care is delivered locally, not nationally. If we are to have better local health services capable of dealing with specific local problems in local communities and tackling some of the appalling local health inequalities that exist in our country, and which have been widening for decades, it is necessary to put local staff and local communities in charge of the hospitals that serve them.

Mr. David Hinchliffe (Wakefield): In evaluating the expressions of interest in foundation status that have been received so far, what steps have been taken by the Government to establish whether there is genuine local community support at this stage for foundation trust status beyond a handful of very ambitious NHS managers?

Mr. Milburn: We will do precisely that. To continue the conversation that my hon. Friend and I had in the Health Committee a week or so ago, it will be extremely important, when I assess the proposals that come forward from NHS trusts that want to become NHS foundation trusts, that they genuinely demonstrate that they have support, not just in the local hospital but in the local community, too. That will be important because, ultimately, those hospitals will become owned and controlled by the local community. I want to ensure that as wide a range of stakeholders, and as many people in the local community and among local staff as possible, are involved in this process from the outset.

Dr. Liam Fox (Woodspring): In the Prime Minister's speech and subsequent article, "Where the Third Way Goes from Here", he says that we must

Does that mean that in foundation hospitals and elsewhere in the NHS, the Government are considering co-payment?

Mr. Milburn: No, that is the hon. Gentleman's policy, not mine.

Dr. Fox: How very interesting, because in the next paragraph of the article, the Prime Minister says:

Does that not entirely torpedo what the Secretary of State has just said?

Mr. Milburn: No, because, unlike the hon. Gentleman, I have read the whole article, not one section of it, and what the Prime Minister was clearly talking about was our proposals in relation to tuition fees. It is the hon. Gentleman who is making proposals for co-payment. Just this weekend, he went out of his way to suggest that the future of Conservative party policy on health care is clear. He wants

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School Pupils

8. Bob Russell (Colchester): When he last met the Secretary of State for Education and Skills to discuss the health of school pupils. [103200]

The Parliamentary Under-Secretary of State for Health (Ms Hazel Blears): My right hon. Friends the Secretary for State for Health and the Secretary of State for Education and Skills last met on 12 March 2003 and discussed a range of issues about the health, social care and education of children. They propose to meet regularly to continue their discussions on these issues.

Bob Russell : Will the Minister accept that obesity among school pupils is now running at record levels and increasing year by year? Does she accept that a major reason for that is 20 years of attacks by the educational establishment on physical education and sport in schools, with the result that today's young people are less fit than their parents and grandparents were at their age? Unless urgent action is taken to make young people fitter and healthier, they will have serious mobility, breathing and heart problems at a much earlier age, which will put an extra major pressure on the national health service.

Ms Blears: I share the hon. Gentleman's concerns, which is why physical activity is a crucial factor in the NHS plan, the cancer plan and the coronary heart disease and diabetes national service frameworks. It is also why we are working closely with the Department for Culture, Media and Sport on its £459 million programme to enhance school sport and club links. The New Opportunities Fund programme is providing £581 million to enhance school sports facilities. The issue is extremely important for the Department of Health because obesity leads to perhaps 9,000 premature deaths in this country every year.

Mr. Barry Sheerman (Huddersfield): Will my hon. Friend take more action with the Department for Education and Skills? Does she remember that my Committee, the Select Committee on Education and Skills, examined school meals only two years ago? We made some strong recommendations because it is a catastrophic situation when our children's diet and lack of exercise causes such concern. There are action points and we have done a lot of the work, but instead of merely discussing the problem, will the Minister meet her opposite number in the DFES to produce an action programme?

Ms Blears: I assure my hon. Friend that regular meetings are held between the Department for Culture, Media and Sport, the Department for Education and Skills and the Department of Health—that really is joined-up government. He will be aware of the food-in-schools programme. We are rolling out the national school fruit scheme so that by the end of the year, about 1 million children will receive a free piece of fruit in school every day. It is a high priority to extend the

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healthy schools programme to school meals, tuck shops and vending machines, and to ensure that fresh water is available in schools.

Ann Winterton (Congleton): It could be said that many school children are the equivalent of couch potatoes, which hints at a lack of exercise and obesity. However, there is activity on the equivalent of the couch because the level of sexually transmitted diseases is rising at almost epidemic proportions among under-age children in certain areas of the country. It is said that there are not adequate resources to deal with the problem. Will the Minister comment on that?

Ms Blears: The hon. Lady will know that this country has a sexual health strategy for the first time. That is backed up by £47 million of extra investment and £5 million has been invested this year in genito-urinary services to try to halt the rise of disease and to ensure that people with sexually transmitted infections receive swift treatment. She will also know about the major media campaign that was launched to try to persuade young people to change their behaviour and adopt safe-sex practices in future. That is an attempt to halt the rise of infections such as chlamydia, which are of great concern to many people in this country.

Mr. Andy Reed (Loughborough): My hon. Friend is right to point out the extra investment in schools, and especially the money for school sports co-ordinators. Is she aware that, in reality, many people who did sport at school drop it after they reach 16 or 17? Obesity costs the country, and especially the health service, £2 billion. Will she ensure that her Department plays its part with Sport England, lottery money and the Department for Education and Skills to invest in the long-term future of our people by ensuring that we reduce people's obesity not only when they are at school, but throughout their lives?

Ms Blears: My hon. Friend makes an important point and I am delighted to tell him that the Department of Health will fund nine local exercise action pilots—LEAP projects—to encourage more forms of exercise among groups ranging from older people to young parents to schoolchildren. We realise that enabling people to access sport and physical activity throughout their whole lives is key to ensuring that we reduce levels of coronary heart disease, cancer, strokes and diabetes.

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