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1 May 2007 : Column 396WH—continued
I shall now address the issues that the hon. Member for Ruislip-Northwood put before us. The vital context of today’s debate is specialist services and the extent to which we enhance and improve them. Ara Darzi discusses his reasons for change and devotes the body of the document to the need for more specialised care. I hope that the hon. Gentleman is encouraged by that. Ara Darzi makes his assessment of health care needs in London in that context. If I were the hon. Gentleman, I would take considerable comfort from that, having raised two issues relating to institutions today. What is important is improving the excellence in the west London health economy.
I turn to the specific issues raised by the hon. Gentleman. I, too, enjoyed our meeting last year to discuss the Royal Brompton and Harefield NHS Trust, and I, too, pay tribute to Jean Brett, who has done a superb job of raising the profile of the trust and the arguments that it wants to advance in this debate. The hon. Gentleman and I are absolutely at one on that. I would go further and say something else, which I probably said at the meeting, which the hon. Member for Uxbridge also attended. I argue that the foundation trust model does provide an answer.
We had a huge and impassioned debate in the House, particularly on the Labour side, about whether the foundation trust model was right. I am trying to remember, but I think that the Liberal Democrats opposed the model. I remember debating with the hon. Member for South Cambridgeshire (Mr. Lansley) at the time, and I do not think that we disagreed. I remember that he supported the principles of the foundation trust model. For me, it is the natural fit for a trust such as the Royal Brompton and Harefield NHS Trust. I fully endorse the trust’s efforts to realise its aspiration to achieve foundation status.
The hon. Member for Ruislip-Northwood used a phrase to the effect that it was Monitor’s intention to block the application, but that is a misrepresentation of the current position. As I said, the application went forward to Monitor with the Secretary of State’s support. That brings me to the role of Monitor. First, let me say what its job is. Its job is to make a hard-headed assessment, without fear of unpopularity, of the business case that underpins foundation status.
My local trust—Wrightington, Wigan and Leigh NHS Trust, which includes a specialist hospital in Wrightington hospital—went through the process too. Monitor found out things about the trust’s financial rigour and framework that have been helpful to its planning for the future. All of us at different times call for that rigour in the finances of the national health service. If the hon. Gentleman’s call was for leniency and for us to get all the trusts through the process, that would be wrong and would not serve his constituents’ interests or the health service in general. As anybody who has been through it will testify, the process is rigorous.
Mr. Randall: Does the Minister consider that some trusts that have not been given foundation trust status would have been given it had the information about what the Government intended to do with research and development funds been available at the time?
Andy Burnham:
Monitor should always base its judgment on the information available at the time. That
is what it does—it takes the trusts through the process and alerts them to potential risks that it may feel have not been adequately addressed in the trust’s business plan.
The hon. Member for Ruislip-Northwood used what we might call an anonymous quote to the effect that the trust has no future as a stand-alone trust. Let me say it clearly: that is not the view of the strategic health authority, NHS London. I put it clearly on the record that NHS London says that it thoroughly supports the trust’s foundation trust application and, provided that it can work through the problems raised by the reduced R and D funding, the trust has a positive future. The Government very much share that view.
It is not for Ministers in any such situation to say, “This trust can go forward and that one can’t,” and it is not the role of Monitor to say what is the right configuration in any one area. That is properly the responsibility of the strategic health authority and local commissioners. Let us be absolutely clear about the strategic health authority’s view. I hope that we can have a period of intensive discussion about some of the potential problems that have been highlighted and then get the application back on track so that it can be considered again shortly.
The hon. Gentleman talked about the three-year phase-out of transitional funding under the new arrangements for R and D funding. It is worth putting on record that in the last financial year, the trust received £28.6 million as part of that funding. This year, it will receive £24.6 million and in 2008-09, we expect it to receive something in the region of £4.8 million, although that has yet to be fully confirmed. That transitional timetable is not to be reviewed and is set in stone. That is a fair basis on which trusts can plan for the new world of R and D funding.
A number of hon. Members commented on the R and D funding regime. It is important to say that the NHS budget for research and development for this financial year is £776 million. I hope that hon. Members accept that the Government have made a significant contribution and commitment to research and development. As in other parts of the national health service, under the new regime people will no longer be paid for historical reasons or for what they have always done. The new regime is about being transparent so that people can bid for funding on the basis of the quality of what they do. I expect an organisation of the quality of the Royal Brompton and Harefield NHS Trust to benefit under the regime like any other such trust.
Andy Burnham: I shall give way only briefly, as I want to address points made by my hon. Friend the Member for Ealing, Acton and Shepherd's Bush.
Mr. Hurd: I should be grateful if the Minister explained why the phasing arrangements are set in stone, given the evidence that they are destabilising prestigious institutions such as the Royal Brompton and Harefield NHS Trust and Great Ormond Street hospital.
Andy Burnham: I do not believe that that is the case. A three-year funding phase has been agreed and, as I say, there is the opportunity to bid for new funds under the new regime.
Let me address the question of the academic health science centre. I confirm to my hon. Friend the Member for Ealing, Acton and Shepherd's Bush that today the strategic health authority has initiated a consultation on whether the three confirmed organisations will be able to go forward to create the UK’s first academic health science centre. It could be an incredibly exciting proposal and vision for health services in west London, and my hon. Friend will agree that as the clinical research translates into NHS services the benefits to his constituents could be huge. I am pleased to hear that at this stage, knowing what he does, my hon. Friend is supporting the proposal.
The hon. Member for South Cambridgeshire was right to say that the issue should not become wrapped up in debates about reconfiguration. The proposal should stand on its own merits and go forward with cross-party support so that we can see whether we can create an institution that would begin to rival the academic and health service institutions that are seen in the United States. Obviously, I encourage my hon. Friend to play a full part in the consultation. We will see whether we can turn the vision of Professors Sir Ara Darzi and Steve Smith into reality. I pay tribute to them for their personal commitment.
In the time that I have, I want to mention Mount Vernon hospital. I hope that the hon. Members for Ruislip-Northwood and for Uxbridge accept that there has been recent investment in the improvement of cancer services at Mount Vernon hospital. No one can ever say that something could never be reviewed or changed, but we should look at the reality on the ground. As a result, we see a trust whose services are being invested in and improved. That is the important thing that matters to local people.
The hon. Member for Uxbridge raised the issue of Hillingdon hospital. I believe that an outline business case is about to be put to the strategic health authority, and I hope that it will reach me soon.
Scotland and the Union
11 am
Jim Sheridan (Paisley and Renfrewshire, North) (Lab): I am delighted to have secured this debate, particularly at a time when the future of the United Kingdom is at stake because of the forthcoming elections in Scotland. It might be appropriate to remind colleagues that this Labour Government’s policy on Scotland and the Union delivered the settled will of the Scottish people through the devolution of a range of important issues to the newly constructed Scottish Parliament. I shall return to that issue later. That Parliament has delivered on its promises and introduced progressive policies that have enhanced the quality of life for the vast majority of its people. So successful has it been that even those who wish to break up the UK are reluctant to debate the issues that are relevant to that Parliament.
Scotland is stronger because of the Union and the Union is stronger because of Scotland—not because of North sea oil, but because the Government believe that, by focusing on the future and not reliving old battles and prejudices, we can all make progress and, together, face up to the challenges of an ever competitive global economy.
Today’s UK is a democratic country that is the envy of the world. That hard-fought tradition should not be destroyed by short-term separatism. That is a probability that even the London leader of the Scottish National party has acknowledged. He suggests that Scotland should vote in the forthcoming elections in the knowledge that, if it does not work out, we will just regroup and move on. Such deceitful politics is dangerous and irresponsible. It takes for granted the views of the other countries that make up the UK, surmising that they will just wait around for the self-indulgent activities of the SNP.
The vast majority of the Scottish people—and the rest of the UK—do not want to break up Britain. I would liken such an act to a student sabbatical, but one where the student does not want to give up their room. The financial costs of breaking up the UK would soar into billions of pounds. Likewise, if we were to regroup—provided the rest of the UK wanted us—those billions of pounds could and should have been spent on improving the lives of all our constituents. Constitutional wrangling would sever the relationship between Holyrood and Westminster, which would generate a blame culture that would foster nothing but hostility and conflict. Exploiting people’s prejudices, especially anti-Englishness, lies at the heart of the SNP, despite its national leader’s attempt to downplay that. There are historic examples worldwide of similar nationalism that has led to unnecessary conflict and irreparable damage. Some would argue that that might be an exaggerated risk, but is it a risk worth taking?
I turn now to the defence of the UK and, in particular, the valuable jobs associated with the defence industry. As an island, we are heavily dependent on securing our shores, whether from those who wish to harm our people, to enter the country illegally, to exploit our shores or to carry out organised crime involving drug or human trafficking. Our service
personnel work tirelessly to protect us, coupled with the other agencies that work together to collect and share information and surveillance. We owe them all a great deal of gratitude. That would be put at risk if we were to break up the partnership. Investment could be affected and jobs could be lost. Paradoxically, some areas in Scotland are heavily dependent on a UK defence presence yet choose to elect people who would, if they come to power, put that investment at risk.
Mr. Ian Liddell-Grainger (Bridgwater) (Con): The hon. Gentleman is absolutely right. Is it not the envy of the world that the British military is the best we can have? It is British. Does the hon. Gentleman agree that if the Union were to break, we would have an English army, a Scottish army and whatever else, and that that would be a disaster for the United Kingdom?
Jim Sheridan: The hon. Gentleman makes a valid point. If that were to happen, we would have no more than some sort of “Dad’s Army”, which would be absolutely no use in the modern world.
Equipping our service personnel with the tools and technology that they need to carry out their dangerous tasks is important to the British manufacturing base. Shipbuilding in the UK was on its knees before the Government came to power, but it has been turned around by a mixture of forward thinking by the defence companies and hard work by the employees. That would all be scuppered by the break-up of the UK.
The Parliamentary Under-Secretary of State for Scotland (David Cairns): My hon. Friend, like me, has many constituents who work in shipbuilding on the Clyde. Would he care to speculate about how many aircraft carriers an independent Scotland would need if the Union was broken up and about whether England, as a foreign country, would place its orders for aircraft carriers in an independent Scotland? How realistic does he think that either of those eventualities would be?
Jim Sheridan: I doubt whether there would be any aircraft orders in an independent Scotland. Any aircraft that were ordered would probably be made using Airfix glue, and that would most likely be the only thing that we could produce in an independent Scotland.
The important thing about shipbuilding is the valuable skills that would be lost. Apprenticeships would be sacrificed, simply because some people in Scotland want to create superficial borders that are unnecessary and unwanted. As someone who has spent a significant period of my working life in the shipyards, I feel confident that I reflect the genuine concerns of workers in that industry.
Ann McKechin (Glasgow, North) (Lab): Does my hon. Friend agree that the fact that we are members of NATO gives us great defence security? Small countries in Europe, such as Iceland, Estonia, Latvia and Norway, are all strong members of NATO. Does it not seem utter folly that we should consider leaving it?
Jim Sheridan:
My hon. Friend is absolutely right. It would be folly for us to even contemplate leaving NATO. We all need to remember that we are an island and that
we need to be protected as such. It would be folly if the scenario that she painted were to come to light.
As I said at the beginning, there is a school of thought within the nationalist ranks that North sea oil will be a panacea to all their whinges. If we scrape away the rhetoric and take a serious look at the economics, the figures do not add up. Well-respected financial experts, such as those at the Financial Times, warn that North sea oil revenues will dry up within the next 10 years, thereby placing a potential tax increase on Scottish people if they vote for independence and still aspire to retain the public service that they have now. That will not only impact on the Scots but could influence inward investment from other countries in the UK and beyond.
This coming Thursday, there will be a choice. Scotland faces an historic decision: the choice between two very different futures. We must recognise that there is a lot to lose. The onus is on those who want to trade education for separation and economic stability for economic risk to choose between building up Scotland and breaking up Britain. The nationalist plans for independence come at a cost, and the people and businesses of Scotland will be asked to pay the hefty price.
With economic policies helped along by “fiscal fairy dust”—not my words, but those of the SNP enterprise spokesperson, Jim Mather—the SNP is asking Scots to trade in hard-won economic stability for a risky wager on declining oil revenues and a corporation tax cut that Europe could cut back.
Sandra Osborne (Ayr, Carrick and Cumnock) (Lab): My hon. Friend makes powerful points about the benefits for Scotland of being in the Union in terms of its economy and the defence and security of our nation and jobs, but does he agree that there is also a school of thought among the nationalists that says that, if people think that it is better for Scotland to be part of the Union, they somehow love their country less or are less patriotic? Does he agree that that is a complete fallacy, and that those of us who see the benefits of being in the UK love Scotland just as much as any other Scot?
Jim Sheridan: My hon. Friend is absolutely right. Some in the SNP claim to speak for Scotland, but today’s performance shows that only one member of the Scottish National party is present. Indeed, the London leader of the SNP, who claims to stand up for Scotland, could not even find the time to attend this debate.
On the cost of the SNP, the United Kingdom is a Union that has served Scotland and its other nations well. By pooling our resources, we achieve much more together than we would apart.
Mr. Robert Goodwill (Scarborough and Whitby) (Con): I do not know whether the hon. Gentleman heard the actor Robert Carlyle on this morning’s “Today” programme. He said that, as a lifelong Labour man, he was going to vote SNP, but that he did not favour an independent Scotland. He said that he was voting SNP only because it was his last chance to give the Prime Minister a kicking before he goes next week.
Jim Sheridan:
The hon. Gentleman makes a valid point, but I think that Mr. Carlyle, like a number of my colleagues, might be somewhat confused about what
this Labour Government have done for Scotland in terms of jobs. If Mr. Carlyle wishes to give the Government a kicking, that is entirely up to him, but there are consequences—independence and the break-up of the UK. People need to understand that independence comes at a cost.
Scotland represents just over 8 per cent. of the UK population, one third of its land mass and one half of its coastline. Government officials, independent experts and informed commentators agree that the UK’s way of financing public services spending across Britain is based on equality of service provision. On that basis, Scotland benefits from a Union dividend that recognises the distinctive nature of service delivery to the Scottish people.
In each of the last eight years for which official figures are available, public expenditure in Scotland exceeded revenue. The SNP would give up the Union dividend, which benefits Scotland by more than £11 billion. Outside the UK, it would lose that dividend. Revenues from North sea oil and gas cannot fill the SNP’s financial gap. Even assuming the highest possible share of North sea revenues in Scotland when oil prices are high, those revenues cannot plug the SNP’s fiscal hole, and production is already in long-term decline.
The SNP’s plans to break up Britain, and its incoherent tax and spending plans, would leave the party with a net deficit of more than £12 billion, equivalent to well over £5,000 per household per year. Independence is not only a risky business, but an expensive one, too. I hope that the Mr. Carlyles of this world will understand that.
Pete Wishart (Perth and North Perthshire) (SNP): I do not know whether the hon. Gentleman saw the opinion poll this morning that showed that only 19 per cent. of the Scottish people believe that nonsensical £5,000 figure. Some 51 per cent. thought it was a load of rubbish. Is it not the case that nobody believes a word that the Government and the Prime Minister say anymore?
Jim Sheridan: Just because the SNP activists do not believe the figure does not mean that the rest of Scotland does not.
Pete Wishart: This was 2,000 people.
Jim Sheridan: If the SNP wishes to discuss the economics of its policy, it is free to do so, but it should come to the table with honesty and integrity.
The SNP proposes to raise income tax in Scotland initially by 3p in the pound. That would make Scotland the highest taxed part of the UK, place new cost burdens on businesses, fuel wage pressures and return Scotland to the bad old days of the brain drain. Despite what the nationalists claim, local income tax will not help the poorest pensioners, who currently qualify for council tax benefit. They will continue to have to pay sewerage and water rates. The SNP will tax only earned income, not shares, savings or property, so a very rich person in a £1 million home living off shares and savings will pay no local taxes to help fund local services.
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