---

Mr. Ronnie Campbell: I thank the hon. Gentleman for giving way. I am very interested in what he is saying, as it would surely be a good case to take to the parliamentary ombudsman so that she can investigate it.

Mr. Yeo: I am grateful to the hon. Gentleman for that helpful suggestion. I had not previously thought of doing that but I shall give it consideration. I am sorry that I did not give way to the hon. Gentleman earlier on—[Interruption.] It was a good suggestion and he is being very helpful.

The doctors and nurses who work in the hospitals that were downgraded from three to two stars and the patients whom those hospitals serve may conclude that if they had been lucky enough to have one of Tony's cronies as their Member of Parliament they, too, would have enjoyed in 2002 the benefits that three-star status bestows.

Mrs. Gillian Shephard (South-West Norfolk) (Con): My hon. Friend is describing a series of rather murky events, as he puts it, but will he tell the House if the same star-rating system applies to hospitals in Scotland, and whether the current Secretary of State will be protected from the same problems as have apparently affected his colleagues?

Mr. Yeo: My right hon. Friend raises a very intriguing issue. Of course we all know that the current Secretary of State will answer today for what went on in northern England, in this case, in a way that he cannot answer for what goes on in Scotland. From what we read in some of the public prints, the waters in Scotland are at least as murky as those in South Durham.

One of the benefits of three-star status was described by the Health Service Journal in the same issue, which said that it bestowed

"a place on the starting grid once the race to form the first wave of foundation trusts got under way. Anybody who remembers the formation of the first NHS trusts in the early 90s will understand how valuable being in the vanguard can be."

We must remember that, back in July 2002, the then Secretary of State advocated a foundation trust model that was a great deal more robust, independent and exciting than the one that the Government, in the face of widespread rebellion from their own Back Benchers, introduced last November. The right hon. Member for Darlington would correctly have judged in July 2002 that the opportunity to be in the first wave of foundation trusts would be a great deal more valuable and advantageous than it eventually turned out to be.

Mr. David Hinchliffe (Wakefield) (Lab): I appreciate that the hon. Gentleman is developing his argument, and I am listening carefully to what he is saying. I have also studied in detail the Health Service Journal piece,

7 Jan 2004 : Column 267

which deals with the previous Secretary of State's intervention in respect of a trust in Basildon. Does the hon. Gentleman intend to develop his argument and set out why the Secretary of State also intervened in respect of Basildon, which does not seem to have a connection with himself or the Prime Minister?

Mr. Yeo: The answer is that the same article in the Health Service Journal did indeed raise the issue of Basildon, but because I am concerned about the role of Downing street, as well as that of the Secretary of State, I am concentrating on what seems to be the particularly scandalous example of South Durham.

The Secretary of State for Health (Dr. John Reid): Can we take it that that is why the hon. Gentleman has not referred to the other seven trusts that have nothing to do with No. 10?

Mr. Yeo: I am perfectly happy if, when the Secretary of State answers, he deals with the one trust with which I am particularly concerned, and we will take his answer as a proxy for how he might have answered on the other trusts that I could have mentioned. Indeed, if he is unable to answer in detail on South Durham, we have to assume that the waters are as murky in the case of all the others as well.

The Secretary of State has a clear choice this afternoon. He can opt—as I fear he may, given the tone of his interventions—for the cover-up route. He can bluster about how the system has been changed since 2002, how the role of the new Commission for Healthcare Audit and Inspection has been strengthened and how the Department of Health's involvement in awarding star ratings has been reduced, but none of that will alter the facts of the episode that I have just described. The words of the note sent by Mr. Wilmore to the Secretary of State on 16 July 2002 are the smoking gun. Mr. Wilmore had clearly received a request from the Secretary of State—a request that, doubtless, the right hon. Gentleman assumed would never become known to the public, but a request made in an e-mail seen by the Prime Minister's own top health adviser in Downing street.

Sir Nicholas Winterton (Macclesfield) (Con): Does my hon. Friend accept that what is not important is whether or not the Prime Minister or the Secretary of State made representations in connection with a particular trust? What is important is whether, if other hon. Members had made similar representations to the Secretary of State or the Department of Health, they would have received the same sympathetic acknowledgement of those representations and whether the decision made would be transparent in every way and be justifiable?

Mr. Yeo: My hon. Friend is right. Of course any hon. Member on either side of the House is right to make representations about how their local NHS is treated. As my hon. Friend suggests, it is likely that representations from some hon. Members will receive more careful consideration than others. However, the circumstances in this case are indeed very much worse than in the situation that he implies. The Secretary of State and his senior officials were in possession of information about the conclusions arrived at by the

7 Jan 2004 : Column 268

methodology already agreed with the commission, and it pointed out that a hospital in which the Prime Minister and the Secretary of State had a direct interest had been downgraded. They chose to use that information in a manner that is wholly lacking in transparency to have those ratings reconsidered—I would say manipulated—to secure advantages for that local NHS trust that are denied to the trusts operating in the constituencies of many other hon. Members.

As I say, the Secretary of State has a choice today. He can become an accomplice of his predecessor. He can make himself complicit in this tale of ministerial interference, this case where the demands of low politics were put before the needs of patients and professionals. If he chooses that route, he will further undermine the integrity of the whole performance management process in the NHS because, if the people at the very top of the NHS, at the highest level in the Government, cannot be trusted to operate the system objectively, responsively and ethically, the public will have little confidence in the judgments that are reached.

I urge the Secretary of State therefore to take the alternative route: to announce today that all the relevant documents, e-mails, correspondence and other material will be made public immediately and to welcome any further investigation—whether by the parliamentary ombudsman, as the hon. Member for Blyth Valley (Mr. Campbell) so helpfully suggested, by the Health Committee, which may like to consider the matter, by the Public Accounts Committee or by any other body that decides to inquire into the matter, perhaps including the Health Service Journal. If the publication of that material indicates any wrongdoing or improper interference—either by No. 10 Downing street or by anyone at the Department of Health, including the Secretary of State's predecessor—he should establish a proper, independent inquiry into the whole matter that can be conducted swiftly and report to the House on what actually happened in July 2002.

Mr. Christopher Chope (Christchurch) (Con): Will my hon. Friend go further and say that hospitals, such as the Royal Bournemouth and Christchurch hospitals, that suffered as a result of the arbitrary action by Ministers should be compensated for the loss that they suffered?

Mr. Yeo: My hon. Friend raises a very important issue on behalf of his local hospitals and his constituents. It is perfectly true that, if it appears that that trust suffered as a result of the manipulation of the ratings for political purposes, there is indeed a powerful case for saying that it should be compensated for those losses.

Mr. Henry Bellingham (North-West Norfolk) (Con): The local hospital in my constituency—the Queen Elizabeth hospital—has two stars. As my hon. Friend rightly points out, there are consequences for not getting

7 Jan 2004 : Column 269

the third star, but surely, given all the obsession with targets, stars and ministerial control from the centre, what we need is more local autonomy.

Mr. Yeo: My hon. Friend is absolutely right. Of course local autonomy is a key element in our policies to improve the NHS and the lot of patients throughout the country.

Andy Burnham (Leigh) (Lab): Will the hon. Gentleman give way?

Mr. Yeo: No, I must conclude, I am afraid.

If the Secretary of State goes down the route that I propose, he will take the first step to redressing some of the damage that this rather shabby episode has inflicted. Opening up the circumstances that led to the re-rating of South Durham is necessary if public confidence is to be restored. I salute the work of Health Service Journal in bringing those facts into the public domain and the courage of those individuals who may have co-operated to help it do so.

In conclusion, let me remind the House that it is not only the Conservative Opposition who regard the star-rating system as deeply flawed. Jim Johnson, the chairman of the British Medical Association commented last July:

"Nobody should use star ratings to judge how well a hospital is doing. They measure little more than hospitals' ability to meet political targets and take inadequate account of clinical care or factors such as social deprivation. It is grossly unfair on staff working in low-rated trusts that public confidence in them is being undermined".

Imagine how the staff felt in the trusts whose ratings went down from three to two stars as a result of the exercise.

The Conservative party believes that the whole star-rating system should be scrapped. Its effect can be demoralising for staff and it does not provide valuable information for patients. It fails to acknowledge the complexity of the activities performed by the hospitals that it purports to judge. We shall return to the question of why the system is seriously flawed on another occasion. Today, however, we focus on one set of ratings that was unveiled 18 months ago and that has now been exposed as the victim of meddling by a Minister, which was perhaps carried out to curry favour with the Prime Minister—perhaps done even with the connivance or encouragement of No. 10 Downing street itself. I urge the Secretary of State to come clean on behalf of the Government, to publish all the documents that we need in full and to allow an inquiry to be conducted. I commend the motion to the House.

---