Examination of Witnesses (Questions 40-59)
20 MAY 2004
RT HON
JOHN HUTTON
MP, MR JOHN
BACON, MS
ANN STEPHENSON
AND MR
GORDON HEXTALL
CB
Q40 Chairman: Do not imply what my assumptions
are. Actually I am very happy for the public to be engaged with
the Health Service. What I am wondering, in light of the experiences
we have had, is whether within the department we have got the
model right in view of concerns that there must be about the low
level of engagement in certain areas. I accept you have given
me Gloucester, but there are other examples where people have
done better. In looking at future waves, are the models you put
forward the right models for engagement with the public and getting
them involved? I think we are agreed upon the principle and I
entirely support the principle.
Mr Hutton: Certainly I apologise
if I am implying something you are not saying. Let me just come
back to the point. I agree with you that we need to do more on
membership; this is a common position and there is no problem
on that. Some trusts are doing a really brilliant job and some
foundation trusts need to recruit new members and I am sure they
will be trying to do that. In relation to the members they have
recruited, turnout rates in the election have been quite high
and compared much more favourably than turnout rates in local
government elections. It would be quite wrong to make the sort
of judgments which have been offered today. I am not going to
make those judgments. We need to do more, we need to encourage
higher turnout. The other thing I would say is that it is wrong
to suggest that there is a model here: there is not. The legislation
allows foundation trusts themselves to tailor their local governance
arrangements to suit the needs of their own local communities
and that is why we specifically did not put them all into one
straitjacket.
Q41 Chairman: The point I am making is
that as you have such an interesting difference in the success
or otherwise of the membership drives, are you looking at the
models used by those who are more successful and possibly going
to encourage that as an approach by future foundation trust applicants?
Mr Hutton: Yes.
Q42 Dr Taylor: One of the worries expressed
to us was that even though the turnout is quite low in elections
to boards, they would be flooded by particular pressure groups
which had got their members together and therefore were trying
to take over the board. Is there any evidence of that sort of
thing happening or is it too early to say?
Mr Hutton: There is no evidence
of it happening.
Q43 Mr Burns: Without going into the
pros and cons of the principle of foundation hospitals, no doubt
you would accept, particularly as we discovered as the legislation
was going through Standing Committee that the area is a very complex
one to the average man or woman in the street. Would you accept
that?
Mr Hutton: The issues around foundation
trusts?
Q44 Mr Burns: Yes. They are fairly complex
to your average man or woman in the street.
Mr Hutton: No, I do not think
so.
Q45 Mr Burns: Right. Okay. I am surprised
by that. I think most people would think the governance, the actual
responsibilities below the headline principle of foundation hospitals
is quite a complex issue if one looks into it properly for your
average man or woman in the street, more or less. We do not need
a long answer on this. I was hoping you were going to concede
the principle.
Mr Hutton: I think the basic principle
behind foundation trusts is a very simple one.
Q46 Mr Burns: The principle, but the
mechanisms.
Mr Hutton: I agree that local
governance arrangements are not going to be everyone's cup of
tea.
Q47 Mr Burns: Forget the pros and cons.
I am trying to get you to accept the principle that they are slightly
complex for your average man or woman in the street.
Mr Hutton: Governance arrangements,
yes.
Q48 Mr Burns: As you will appreciate,
in this country at local elections, general elections, European
elections, the age by which citizens can vote is 18 years and
the Electoral Commission recently has said they are not in favour
of reducing it to 16. Right?
Mr Hutton: Yes.
Q49 Mr Burns: Why is it then that to
be able and eligible to be registered as a member of these trusts
you only have to be 12 years' old?
Mr Hutton: I am not familiar with
that.
Q50 Mr Burns: Anyone over the age of
12 living in Essex can become a member. I know people in Essex
are intelligent, but it must be uniform across the country. Twelve
seems a rather young age to allow people to register.
Mr Hutton: The legislation does
not specify 12 as the statutory age at which people become eligible
for membership. That will be a decision which the applicant for
foundation trust status has made locally.
Q51 Mr Burns: Yes, but do you not think
it is slightly odd? Basildon and Thurrock University hospitals
registered 3,204 public members from a catchment population of
310,000. The voter base is potentially even larger. Anyone over
the age of 12 living in Essex can become a member. It just seems
to me slightly odd that a 12- or 13-, 14-, 15-, 16-year-old can
be considered competent enough to understand the issues to register.
It just seems weird to me.
Mr Hutton: This is ultimately
one of those issues which need to be resolved in the consultation
process locally. If people really have very strong concerns about
that, that is the right place and time to do it.
Q52 Mr Burns: Do you think it is satisfactory?
Do you think people of that age are qualified and responsible
enough to be able to be part of this process?
Mr Hutton: It is not for me.
Q53 Mr Burns: You are an Essex boy, so
you know what we are like.
Mr Hutton: Essex boys are obviously
different from the rest of the country. I am sure 12 is fine for
us.
Q54 Mr Burns: So you think it is a rational
thing.
Mr Hutton: These are decisions
ultimately on which people locally must come to a view. My views
on this matter are neither relevant nor appropriate.
Q55 Mr Burns: Interesting though.
Mr Hutton: This is an issue for
people locally to sort out and for the regulator ultimately to
pass judgment on. He is the person this House has decided should
make a judgment on these matters and I am happy for him to do
it.
Q56 John Austin: The Chairman stressed
the importance of openness, ownership and involvement. When a
person is elected to the board of governors of a foundation trust
will their name be announced or will they be allowed to remain
anonymous?
Mr Hutton: If they are a member
of the board of governors?
Q57 John Austin: Yes.
Mr Hutton: That will have to be
publicly available.
Q58 John Austin: May I relate to another
part of the Health Service in terms of patient and public involvement
and that is the patients' forums. I have been told by the Commission
for Patient and Public Involvement that they cannot disclose the
names of patient representatives on the patients' forums under
the Data Protection Act unless the person agrees to have their
name released. Could you ensure that anyone who goes for public
office, whether it is a patients' forum, a board of governors
or anywhere else is obliged to have their name publicly known?
Mr Hutton: I think that is bonkers
myself, if you ask me for my personal view about that. We should
just bear in mind that members of patients' forums are not holding
public office. Boards of governors of NHS foundation trusts discharge
statutory functions.
Q59 John Austin: But they are elected
or appointed in order to represent the interests of patients and
surely patients should know who their representatives are.
Mr Hutton: As I understood it,
patients' forums' members are appointed by the Commission for
Patient and Public Involvement.
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