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I want to raise again the point about officers grades being open to competition. I look forward to reading the proposals that the Minister will publish shortly. I understand his argument about the need for fairness to individuals and his view that the TUPE regulations should apply, but this is not unique territory. In the corporate world companies take over other companies of both similar and differing sizes, and TUPE applies in those cases, but in those cases the best person for the job gets it. In some cases none of the incumbents gets the job, and a replacement is recruited from outside. I see no reason why that should not apply to the most senior grades in this instance. The directors of each major service area, in particular, should undergo an open process, so that the population at large can feel
that it is not just a stitch-up by the county councilwhich, I am afraid, is the impression that they have had.
The council will continue to face challenges when it becomes unitary. It has been argued that this proposal is about financial resources and efficiency savings. Over the past 10 years, the Government have allocated funds to match their own priorities. As a result, the allocation of funds to areas such as education which are the responsibility of a unitary authority, and organisations such as the police which are funded through council tax, has been heavily skewed towards inner-city urban areas, which, by coincidence, happen by and large to be represented by Labour Members of Parliament. Such allocations have been justified by a plethora of data to do with deprivation, crime, social needs, health inequalities and so on. With much of that I have no argumentI think it appropriate to take such matters into accountbut a degree of balance is needed.
Operating services in rural areas costs money. In those areas, it costs more to deliver many of the services for which local authorities are responsible than it does in urban areas. Waste collection, for example, is relatively straightforward if populations live within a few miles of each other, while school transport is obviously more expensive when people are having to be bussed long distancesmany more of them, because fewer are able to walk.
The provision of elderly care is much more expensive in rural areas, particularly when efforts are being made to move care closer to the communitywhich I supportand to establish a network of district or other specialist nurses to provide services in peoples homes. That is much easier to do in an urban environment. Not only is it easier to recruit people to do the work, but they can use their time much more effectively if they can walk or drive short distances from one patient to the next. In some areas in my constituency, a district nurse can deal with only five appointments a day, because so much of her time is spent travelling from one person to the next. If the Government had taken those issues into account, much of the justification for the unitary proposal would not have been necessary.
Let me give the Minister a couple of examples of the splendid work done by councillors in my area who are fighting for their local communities. Many of them may well not wish to become councillors in a unitary authority, because of the time commitment that that would involve. I want to single out Joe Meredith, currently serving his third term as chairman of South Shropshire district council. He is fighting for the post office that is under threat in his village of Ashford Carbonnel, and for two schools that are under threat of amalgamation. His deputy leader, Councillor Jackie Williams of the Kemp Valley ward, is doing a valiant job while her chairman is indisposed, fighting for her post office and school at North Lydbury, which are threatened with closure.
Those stories could be repeated right across my constituency, and in other parts of Shropshire. Many of these valiant, public-spirited people might not continue their lives in public service because they do
not wish to do so within a unitary environment, which would be a great loss to the fabric of public life in this country.
The hon. Member for Bromley and Chislehurst (Robert Neill) made a speech in favour of the status quo that was worthy of a true Conservative. However, sometimes the potential gains oblige us to consider and take decisions that might be difficult and which change established arrangements. That is precisely the case with this order for Shropshire, but the measures it contains are based on proposals submitted from Shropshire by Shropshire county council, supported by one of the district councils and a number of other bodies and interests in the county; they are not a prescription produced or imposed by the centre.
John Healey: Well, let me move on to my second point. Purely in financial terms, after checking the figures, the quantifiable gains to the council tax payers of Shropshire will be about £9 million each year.
The hon. Gentleman confirmed at one point that he was talking about Professor Chisholm. Professor Chisholms modelling of the potential financial impact of this restructuring was based on the 1990s model of restructuring, which was entirely different as it was about breaking up large areas such as Humberside, Cleveland and Avon into smaller units. We are doing something different and the potential efficiency gainsfor the council tax payers and the services that support themare much greater and more significant.
The hon. Gentleman made an extraordinary argument, accusing me of running a dirigiste process, imposed from the centre. The hon. Member for Falmouth and Camborne (Julia Goldsworthy) was absolutely right: this is not being forced on councils. A minority of councils in England submitted proposals under this process, and the proposal we are discussing was submitted by a Conservative-led county council supported by a Conservative-led district council. A minority of councils submitted proposals as a result of the invitation we issued, and a minority of those that were submitted were accepted for implementation.
There was an interesting observation about the courtship of the county by the then Local Government Minister, my right hon. Friend the Member for South Shields (David Miliband), now the Foreign Secretary. Far from unitary solutions being forced on Shropshire, councils, business and some public service providers and users told him on his visit that the two-tier arrangement was not working and needed to be changed.
Mark Pritchard: To put it politely, the Ministers last remarks were at best disingenuous. The fact is that his Government have set their face against the current district council two-tier arrangement in Shropshireand in other counties throughout Englandand I hope that he will clarify his position.
John Healey: We are not setting our face against that arrangement, but we set out in the White Paper and in the context of the invitation why in many instances there were problems with the two-tier arrangements. My point is that we are not forcing solutions. In his former role, my right hon. Friend had similar discussions in Gloucestershire, East Sussex, Lincolnshire and Lancashire, and none of those authorities produced proposals for unitary status.
May I say to the hon. Member for Ludlow (Mr. Dunne) that he cannot argue that the arrangements will take decisions out of peoples reach and then criticise the detailed proposals for the area partnerships and the joint local committees, which are designed precisely to put decisions and budgets closer to the neighbourhoods and within reach of local people. I hope that he and his hon. Friends will work to strengthen those arrangements over the next year, because they are the basis for a sensible and important reform of the way in which local people can be involved in decisions.
Of course we will listen...the Secretary of State for Communities and Local Government or I will be pleased to meet him after that action
to discuss the next step forward.[ Official Report, 4 July 2007; Vol. 462, c. 950.]
Of course, the hon. Gentlemans local authority spent heavily in the courts and lost in the High Court. The appeal was heard at the end of January and we await that judgment. My right hon. Friend has not broken any of the commitments that he gave to the hon. Gentleman.
The Electoral Commission will examine the issue of large wards during the review before the May 2009 elections. I say to the hon. Member for Ludlow that if this were about simply reducing the number of Conservative councillors, why is this proposal being put forward by a Conservative-led council?
Conservative Members are right to press their arguments hard in debate, but if and when the order is passed, I hope that they will accept the decision that has been taken. I hope that they will accept that it has been properly approved by Parliament, and I hope that they will lend their weight to the efforts of those implementing it.
It being one and a half hours after the commencement of proceedings on the motion, Madam Deputy Speaker put the Question, pursuant to Standing Order No.16 (Proceedings under an Act or on European Documents).
That the draft Greater London Authority Elections (Election Addresses) (Amendment) Order 2008, which was laid before this House on 9th January, be approved.
That the draft FCO Services Trading Fund Order 2008, which was laid before this House on 14th January, be approved.
That the draft Defence Support Group Trading Fund Order 2008, which was laid before this House on 15th January, be approved.[ Mr. Michael Foster.]
Mr. Andy Slaughter (Ealing, Acton and Shepherd's Bush) (Lab): This petition was signed by 3,160 residents of the East Acton and Old Oak wards in my constituency who oppose the closure of the East Acton post office. It was presented to me outside the post office last week by Bill Davidson of The Acton Alliance, and John Keating, John Palmer and Paul Keegan of the Old Oak Tenants and Residents Association. They and a number of other signatories were so incensed by the proposal to destroy an essential part of their community that they wished to be here tonight to hear this, but I am glad that I persuaded them that they should not be.
May I finally say that this may be a rare example of a petition succeeding on the day that it is presentedor the day before it was presented, given the timebecause on Tuesday morning the Post Office Ltd published plans to close 169 sub-post offices in London and gave East Acton post office as the alternative post office to a number that were closing? We deduced from that that it is to stay open. I am grateful for that, but as seven of the 16 sub-post offices in my constituency are due for closure, I may be back with petitions in the near future.
The Petition of East Acton Residents,
Declares that the Post Office in Old Oak Common Lane is an essential part of our community.
The Petitioners therefore request that the House of Commons urge the Department for Business, Enterprise and Regulatory Reform to intervene in keeping our Post Office at 71 Old Oak Common Lane, W3, open.
And the Petitioners remain, etc.
David Tredinnick (Bosworth) (Con): It is unusual to start a debate at quarter to two in the morning these days, although a few years ago we were regularly here a lot later. I am pleased to have the opportunity to introduce this important debate about the threat to the homeopathic hospitals. Their very survival may be at stake and I look forward to hearing from the Minister.
This debate comes at a time when support for homeopathy is at an all-time high, including in the House, with one third of Members signing early-day motion 1240 in the last Session, in support of homeopathy. The Government claim to support choice in health care, but as far as homeopathy is concerned, they are reducing choice. It is not commonly known, but homeopathy has always been available on the health service because its founder, Nye Bevan, had a homeopathic doctor and insisted that that was the case.
In the UK we have four homeopathic hospitals, one in Scotland and three in England. I attended the opening of the beautiful new Glasgow homeopathic hospital before devolution, and it now of course comes under the purview of the Scottish Parliament. I understand that that hospital is protected since a successful campaign in 2004, but that is not the case for the three English hospitalsthe Royal London, Bristol and Tunbridge Wells homeopathic hospitals.
The three hospitals are fully integrated into the NHS. They all form part of their local NHS trusts and are staffed by statutorily regulated health professionals with additional training in complementary medicine. All receive patient referrals through normal NHS routes. They have some of the highest patient satisfaction ratings in the NHS and the majority of patients report improvements to their lives across a range of chronic conditions. The treatments employed are clinically safe and cost-effective. They often avert multiple referrals and treatments that many patients find ineffective and the cause of side effects. In addition to homeopathy, the hospitals now offer a full range of complementary therapies.
The flagship hospital is the world-renowned Royal London Homeopathic hospital. I have been the chair of the parliamentary integrated health care group and I used to be the treasurer of the all-party parliamentary group for alternative and complementary medicine. For almost all of my 20 years in this place, I have been an officer of one or other group, so I have had a long association with the Royal London and I believe it to be a very valuable asset. It is the largest and best integrated public sector provider of complementary medicine in Europe. It is also part of the University College London Hospitals NHS Foundation Trust.
The Royal London provides some 25,000 new and follow-up out-patient appointments a year. Until recently, the number of referrals had been steadily increasing. What has gone wrong? Well, eight primary care trusts have withdrawn their contracts from the Royal London in the last 18 months and patient referrals are down by 20 per cent. on the same period last year. There is great uncertainty about the
intentions of the host PCT Camden and its neighbour Islington. If they were to withdraw their support or substantially reduce it, the consequences for the hospital would be very serious. The reduction in referrals has meant that parts of the newly developed buildingI attended its openingare now being used for other services. Despite those problems, the hospital is in discussion with the trust about the proposed polyclinic; it is developing integrated care pathways, integrating complementary and conventional approaches; and, as always, it is pioneering this field of health care.
As for the other two hospitals, West Kent PCT is responsible for the Tunbridge Wells hospital and, sadly, it will withdraw its support from April 2008. That decision has been temporarily rescinded pending a legal challenge by patients. I urge the Minister to look closely at what happened at Tunbridge Wells, where the decision was very unwelcome. Bristol homeopathic hospital has also suffered considerable cuts.
So, why is there a problem? The Government claim that they are increasing choice, but the impact from the perspective of a homeopathic hospital is quite different. If the Minister reflects on the White Papers that have been published in recent years, he will see that they all suggest that choice will increase. The NHS Improvement Plan, published in 2004, states:
By 2008, patients referred by their GP will be able to choose any provider able to meet NHS standards and to deliver care at tariff.
That appears to guarantee the right to choose treatment at the homeopathic hospitals. The December 2003 document, Building on the Best: Choice, Responsiveness and Equity in the NHS stated that NHS services should be more responsive to patients. The January 2006 document, Our health, our care, our say states:
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