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'(aa) an NHS community trust;'.

Amendment No. 208, in page 60, leave out line 24.

Amendment No. 93, in page 60, line 24, at end insert

'all or most of whose hospitals, establishments or facilities are situated in England'.

Amendment No. 209, in page 60, leave out line 47.

Amendment No. 94, in page 61, line 17, at end insert—

'(bb) an NHS foundation trust all or most of whose hospitals, establishments or facilities are situated in Wales;'.

Amendment No. 219, in schedule 10, page 135, line 30, leave out sub-subparagraph (a).

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Amendment No. 220, in page 135, line 35, leave out 'an NHS foundation trust'.

Amendment No. 221, in page 143, line 29, leave out sub-subparagraph (a).

Amendment No. 222, in page 143, line 35, leave out 'NHS foundation trust or'.

Amendment No. 223, in page 144, line 2, leave out 'or NHS foundation trust'.

Amendment No. 224, in page 144, leave out line 20.

Amendment No. 210, in clause 141, page 62, line 36, leave out paragraph (b).

Government amendment No. 252.

Amendment No. 211, in clause 151, page 73, line 29, leave out subparagraph (ii).

Amendment No. 212, in clause 153, page 75, line 34, leave out subparagraph (ii).

Amendment No. 213, in clause 156, page 77, line 29, at end insert 'or'.

Amendment No. 214, in page 77, line 31, leave out from 'Act' to end of line 32.

Amendment No. 215, in clause 175, page 94, leave out line 6.

Amendment No. 216, in page 95 leave out line 31.

Amendment No. 217, in clause 184, page 96, line 13, leave out '1' and insert '2'.

Amendment No. 218, in page 96, line 18, leave out paragraph (a).

Amendment No. 95, in page 96, line 18, leave out from 'Part 1' to end of line 19 and insert—

'(i) for sections 2, 29 and 30, the Secretary of State;
(ii) for section [Community Health Councils and NHS foundation trusts in Wales], the Assembly; and
(iii) for the other provisions of the Part, and section 182 and Schedule 13 so far as relating to those provisions—
(a) in relation to England, the Secretary of State; and
(b) in relation to Wales, the Assembly;'.

Amendment No. 225, in schedule 13, page 151, leave out lines 3 to 26.

Mr. Hinchliffe: The purpose of the amendments tabled by my hon. Friends and I is to delete the foundation trust proposals from the Bill. I certainly support most of the remainder the Bill. It could be carried forward without part 1, which is the controversial element that many Labour Members oppose.

There are three key reasons why I am a member of the Labour party: my party has traditionally stood for redistribution of wealth and a fairer society; it has traditionally stood for comprehensive education and equal opportunities; and it introduced a national health service based on sound socialist principles. I emphasise the word "national" in national health service because the concept of the national health service is fundamental to the debate.

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There was no national system before 1948. It was hit and miss as to whether local provision existed. There was a geographical lottery and people sometimes suffered as a direct consequence of that. Such a diversity of provision seems to be the aim now and I am worried that it will hit at the heart of much of what my party has achieved by bringing about the national health service.

The current Government have a proud record on health. I pay tribute to my right hon. Friend the Member for Holborn and St. Pancras (Mr. Dobson) and the Health Ministers who are in the Chamber. I also pay tribute to my right hon. Friend the Member for Darlington (Mr. Milburn), who is not in the Chamber, for his contribution to many of the Government's health achievements.

There is record investment in the national health service and record staff recruitment and training. We have a record capital programme to address hospitals that have been falling down for years and that suffered from gross under-investment. Pinderfields hospital, which is in my constituency, is such a hospital, and I am proud that we will soon have a new hospital. I am proud of the quality measures that the Government have introduced for our health care system. I am especially proud that we ended the Conservative internal market because my area experienced the two-tier system that was at the heart of our concerns about that. People living in the same street had different access to key health services, as I have said on many occasions in the House. I am proud that we set about getting rid of competition in a service that is essentially based on collectivism and co-operation.

1.45 pm

Angela Eagle (Wallasey): I am looking in astonishment at the Conservative Benches, which are completely devoid of any Back Benchers except for one high-quality Member. The Labour Benches are packed with people who will debate passionately the future of our health service. Is that not the most telling thing that we have seen today?

Mr. Hinchliffe: In defence of the hon. Member for South Cambridgeshire (Mr. Lansley), who is sitting on the Conservative Benches, he probably knows more about the health service than the rest of his colleagues put together.

For the first time in the history of the health service, we have a Government who are committed to the empowerment of primary care. That is probably the most crucial policy development that they have achieved. The history of the health service has been dominated by the concerns of the acute hospital sector and by hospital consultants. We have never before exploited the potential of primary care, but primary care trusts are starting to achieve that. I strongly commend the steps that the Government have taken.

Dr. Howard Stoate (Dartford): Does my hon. Friend agree that the ballot of general practitioners in which 80 per cent. voted in favour of the new GP contract shows that primary care physicians are committed to leading the NHS toward the modernisation that we so richly deserve in this century?

Mr. Hinchliffe: I was delighted by the result of the GP ballot. It is also worth placing on record that the Royal

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College of General Practitioners, which represents GPs, including my hon. Friend, has come out strongly against foundation hospitals. No doubt he will take note of that point.

I shall outline the key concerns that many of us have. One lesson that I learned through my work on the Select Committee on Health is that the last thing that our health care system needs is further restructuring and change, especially ill-considered change that has not had its potential consequences worked through. As I said on Second Reading, there have been 18 significant restructurings of our health care system during the past 20 years. People ask me where all the money has gone—it has gone on many of those restructurings.

I have examined redundancy costs of staff who have gone down the road and early retirement costs. It is worth considering the possible salaries of the people who will be chief executives of the new foundation trusts. Some are campaigning enthusiastically for foundation status in the full knowledge that they are guaranteed to receive a huge salary hike. When we consider the use of scarce resources, we should be aware of how resources that should be used for patient care are being used—they are being used for ill-thought-out restructurings. I bet that there will be at least three more restructurings before the end of the proposed five-year roll-out of foundation hospitals. We should listen carefully to the many in the health service who say, "Enough is enough." We should let reforms bed down and let investment take effect so that we deliver on patient care.

I mentioned my pride that the Labour Government have moved away from the internal market that the Tories introduced. One of my central worries about the principles that underpin foundation status is that the policy will mark a return to a market-oriented approach to health care. It will undoubtedly restore a competitive ethos, putting hospital against hospital and doctor against doctor. I know from talking to managers that they are looking over their shoulders at their rivals in their localities and elsewhere in the regions in which they are based.

The policy is about winners and losers. It is clear from the Government's response to the Health Committee report on foundation trusts that capital spend by foundations will have an impact on the wider NHS. So when I talk to colleagues about their position on the issue and they say to me, "David, I'm going to have a foundation hospital in my constituency", I say, "That's all well and good, but have you thought about the impact on your neighbours?" There will be a foundation hospital near my constituency and I am aware of the serious impact that it will have on the health economy elsewhere in the west Yorkshire area. We have to consider that issue because it is fundamental to concerns about foundation status.

Mrs. Louise Ellman (Liverpool, Riverside): Does my hon. Friend share my concerns that the new system could lead to fragmentation and competing trading organisations—some in the public sector, some in the private sector—without us fully debating the implications of that concept in the Chamber?

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