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Physical access to hospitals is never given sufficient attention by hospital planners. People need to get to hospitals without wasting time or paying too much. When I recently visited my local hospital, the Princess Royal University hospital in Farnborough, it took me half an hour to find somewhere to park my car and in the end, I had to park illegally—I hope that that admission will not be held against me—to get to the hospital on
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time. If that happens to me, it must also happen to many of my constituents, and something must be done. I have no answer to that problem, but it is a problem. It is said that people can use public transport, but in the real world, people use their cars to get to hospital, especially when public transport is not very good. It has improved a bit in the area, but it could be better.

Mr. Andrew Turner (Isle of Wight) (Con): Even when people use buses, they have to change frequently to get to hospital, and that is equally unsatisfactory.

Mr. Horam: It is, and the hospital in question is a long way from the areas of greatest need in my constituency. People from that area need to take three different buses to get to the hospital, and that is unacceptable for people on limited means and who are not very well.

The problem will be worsened by the expected reconfiguration, because the accident and emergency department at Queen Mary’s hospital in Sidcup is likely to close, and that is the one that serves the Cray Valley, the area with the least good health in my constituency. I recently went to a meeting about health problems in the Cray Valley area, convened by Mr. Harold Barker, a well respected local resident, and there was clear concern expressed about this issue. I ask the Minister to ensure that when the reconfiguration occurs, proper consideration is given to the need for people in that area to have good access to other accident and emergency departments. If their nearest accident and emergency centre is closed down, they will have to travel much further. There are other aspects to health issues in the Cray Valley, and I noted that at the meeting the primary care trust gave an undertaking that it will report back to the neighbourhood group by July on what is happening. The area certainly needs extra health care provision.

The third issue is cleanliness, and the situation is patchy. I get differing reports—some good, some very worrying—about attitudes to cleanliness in hospitals, some of which are reported to be casual, uninformed and poor. The hospital group does not have an especially good record on MRSA or clostridium difficile, and that is part of the problem.

Fourthly, the medical side of the matter—whether people will be properly treated—is a fundamental issue, but I do not want to comment on that in this debate. We will have to look at that after the reconfiguration and after the trust has done what it thinks necessary to improve the situation.

Finally, I want to say something about consultation with the local health community, by which I mean the relevant scrutiny committee of Bromley council, the Local Involvement Network—LINk—which is the public side of the trust’s board meetings, and the dissemination of information to the public either directly or through the local press. The new huge trust has three LINks to deal with, so it is becoming a more complicated issue. Public involvement went badly wrong under the previous management of the trust. In particular, the consultation on the future of Orpington hospital was badly handled, as was the issue of the future of Global house. It is an administrative building owned by the PCT, but the Bromley Hospitals NHS Trust paid a fee for its administration staff to use it. The poor handling of
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those issues created suspicions among those interested in health matters locally, but that could have been avoided by more openness.

In addition to the poor handling by old management, the new management have not got off to a good start in relation to statutory consultation. The LINk is a statutory body, and individuals who represent it have a right to be heard in the public section of board meetings. That did not appear to be properly understood at the recent board meeting of the trust. The LINk representatives were not treated with the respect that their position deserves. Not only that, but the board has failed to produce papers and agendas with sufficient time for them to be absorbed and understood by attendees. As we all know, the NHS is full of jargon and some of the papers are incomprehensible unless one has time to work them out. It is incumbent on management to give those who want to understand the time to work out what the reports say. In that respect, I draw the attention of the management to the NHS code of practice on openness and the code of conduct for NHS boards. I hope that the board will read, learn and inwardly digest—as we used to say at primary school—those documents, because I will hold it to account on its adherence to them. I hope that the Government will do the same.

Leaving those issues aside, the management of the huge new trust are also new. They may have stumbled in their consultations to begin with, but they should be given a chance. It is important not to hark back to the past, but to look to the future and how we can improve patient care in Bromley and adjoining boroughs. It is also important to look at the results of health care, rather than the process. We can spend too much time worrying about whether processes have been adhered to: it is important that people are treated properly and get well soon.

Last week I attended a seminar on NHS management. There is concern that, although many people want to become managers in the NHS, they are often put off by the stressful situation inherent in those jobs. NHS managers today have a plethora of targets compared with similar private sector jobs. They are subject to scrutiny by this House and other politicians. There is also often huge opposition to change—even necessary change—and that is not always responsibly conducted.

The South London Healthcare NHS Trust has an opportunity to plot a new way forward for the benefit of my constituents. I hope that the Secretary of State will monitor the situation closely: it is imperative that he does so.

1.9 pm

Mr. Graham Allen (Nottingham, North) (Lab): MPs have deluded themselves that they have power. We swallowed the mythology of parliamentary sovereignty. Real power actually exists in Government, who control Parliament lock, stock and barrel, even down to setting the minutiae of Parliament’s daily agenda. It is Government who are as responsible for Parliament’s current position just as much as weak MPs. Instead of Parliament being a strong, independent partner, Government’s steady attrition has made us a rubber stamp for decisions made in Whitehall. Our role, in the words of Gladstone, is

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That birthright has been sold for a little status and some chickenfeed allowances, and even they have been stripped away from us in recent days.

So where do we go from here? Amazingly, we have been given one last chance to rescue our self-respect as Members of Parliament. MPs can elect a new person to speak for us and for our Parliament. Rather than having the preferred candidate of the Government, or alternative Government, as has happened in the past, we can for the first time make our own choice in a secret ballot about who we want to be the Speaker of this House. That is the most important decision that any of us will make in our political careers and about the future of Parliament. There will be no one else to blame, no excuses and no anxiety about being seen voting by the Whips in the wrong Lobby. It is a secret ballot, a private decision of conscience for all Members of this House, a vital choice and a tremendous responsibility.

It will also set a powerful precedent. The secret ballot is the enemy of undemocratic institutions abroad and at home. In this case, under threat is the tyranny of a leaden-footed and visionless system of government. The secret ballot is the longest established and most highly potent instrument that can be the salvation in the face of that tyranny and can lead us towards building a new Parliament under a new Speaker.

The secret ballot should be used not only in this forthcoming election for the Speaker, but should be extended by this House for use in Parliament to liberate two pivotal areas. First, it can be the means by which Parliament can take back control of its own affairs and be wholly responsible for its own actions, independent of Government, rather than being the victim of someone else’s decisions. MPs can take back control of our own agenda from Government by electing, in a secret ballot, our own Business Committee, so that Members of Parliament rather than the Government can agree the agenda. Of course, any sensible group of Members would seek to find time for appropriate Government business, but the responsibility would be ours. The selection of people on that Committee would be the responsibility of Members in all parties, and we would be taking back control of our destiny.

Secondly, we can take back responsibility for holding Government to account if we elect, by secret ballots, all our Departmental Select Committees. MPs can choose to elect to those Committees colleagues who command the respect of their fellow MPs, rather than those who are responsible to the very Government whom we are meant to be holding to account. Those MPs—some new, and many who would be returned to the Committees of which they are already members—would do so with added legitimacy and independence, completely free from the taint of Government or party patronage. The secret ballot could deliver that incredible prize to this House, returning the ability to hold to account the Government of the day and those who wish to be the Governments of future days.

Lynne Featherstone (Hornsey and Wood Green) (LD): I agree wholeheartedly with everything that the hon. Gentleman is saying. Is he aware that there are moves—from the right hon. Member for Holborn and St. Pancras (Frank Dobson), I believe—to try to get the secret ballot abolished? That would be an absolute tragedy, given that we have had this opportunity.

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Mr. Allen: If that is indeed the case, it is extremely misguided. Such opportunities for MPs do not even come once a Parliament; they come once a generation. We have the opportunity to remake the democracy in our country, and members of all parties should seize that opportunity.

Only a new Speaker can establish democratic decision making for MPs, and only then if it has been a clear part of the platform on which they have stood to seek our vote. The all-party group, Parliament First, is asking each of the candidates not only where they stand on this issue, but to demonstrate strong leadership over the next few weeks. That would lead to a debate about the need to strengthen the principle, which has now been broached, of getting a secret ballot into this place, because of all the benefits that would flow from that if it were extended in the two ways that I have suggested.

The leaders of the two main parties, and those of the minority parties, also have a chance by endorsing the secret ballot to be seen to be on the side of creating a genuinely independent Parliament. Instead of twisting in the wind and reacting to the latest crisis, they can be part of a new settlement for our Parliament and for our democracy. Have they the courage to do that? I certainly hope so.

Once the election of the Speaker is over, the pressure from Government to return to business as usual—the micro-management of Parliament—will be immense. So, hopefully with the consent of the party leaders—but without them if necessary—this issue must be moved forward by those who are centre-stage, through the debate and campaigning surrounding the election of a new Speaker. After the election, it must be moved forward without delay. The longer there is a delay, the less likely that it is that the precedent can be extended to democratise our politics in this House and in our country.

Government control of Members of Parliament has led this House and its Members to our lowest ebb in living memory. Now, Members have only one chance—only one—to put it right. We have one chance to cast aside our chains. We should do so by supporting a Speaker who will extend the secret ballot and give Parliament and parliamentarians a role in life and a fresh start.

1.18 pm

Mr. David Heath (Somerton and Frome) (LD): It is a great pleasure to follow the hon. Member for Nottingham, North (Mr. Allen). He expresses not only the desperation felt by so many right hon. and hon. Members at the state of our Parliament and our parliamentary democracy but our dismay at the extent to which this House has been trodden through the mud in recent weeks. People like me, who consider that it is an enormous privilege and honour to be a Member of Parliament and to be able to stand in this place and say what we want to say on behalf of our constituents, feel that our position—our vocation, if one wishes to call it that, and I think that it is a vocation—has been sullied by the actions of a few and by the almost irreparable damage to our reputation. That cannot be right.

We should be proud to be in this place and to do the job that we do. We are not entitled to the respect of our fellow citizens, but we need to be able to earn it. As I said earlier today, we can do that by dealing with the sordid issue of our expenses and the way that some
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Members—although not all—have chosen to interpret the rules. However, the issue goes much wider, because we also have to look at the whole system of democratic accountability.

From what she said earlier, I think that the Leader of the House has got it, as I think has the shadow Leader of the House. There is a realisation among those who think about these matters that we cannot go on like this; equally, however, I know perfectly well that there is a ballast of Members who, sadly, do not share that interest. They will obstruct proper reforms of the sort set out by the hon. Member for Nottingham, North, and they will be bullied and coerced by the Whips.

The Whips have no business in this area of our work. They can butt out of our election of a Speaker—it is not their issue. They need to understand that, because too often the influence of the Whips of all parties has got in the way of realistic reform. When Robin Cook was proposing his far-reaching reforms, he was defeated by a coalition of Whips. The then Leader of the House defeated by other elements in the Government—that cannot be the right way to deal with the problems that face us.

Mr. Allen: We need to be a little careful about blaming the Whips. On the Government side, they are the paid servants of the party leadership. The Whips of the Opposition parties are also very close to their party leaderships. They are surrogates for the decisions of the Government and the alternative Governments, and special views are not conjured up in the respective Whips’ offices. The Government Whips’ Office is the largest department of state, and we should not disown what goes on by saying, “This is just the Whips.” We should be clear that they express the Government’s view, and that needs to be smoked out as such.

Mr. Heath: I accept that entirely. I am simply identifying the agents of reaction—the ones we sometimes see glaring at Members at the entrance to the Aye or No Lobby when they feel that those Members are not doing what they have been told to do.

We need to address exactly the issues that the hon. Member for Nottingham, North has set out. For instance, he mentioned a business committee: how long have we been saying that it is for this House to decide the business, and not the Executive? The Executive put Bills before the House for approval, and it is our job to scrutinise them. It is not the House’s job to help and assist the Government to whisk a Bill through the House before it can be properly scrutinised. Proper scrutiny can take place only when the responsibility for setting the business of the House has been taken from the Executive. That is not their business: it is ours, and we should take back responsibility for it.

There are many things that we can do to make the House better able to hold the Government of the day to account, but I would go further and say that the problem is not confined to Parliament. There is a real crisis throughout this country’s democratic structures. People increasingly feel disaffected and disconnected from the political process, and that is getting more pronounced every year. They feel powerless, and believe that their MPs either do not represent them properly or are incapable of changing decisions taken by unseen bureaucrats
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and agencies. They feel that local councils do not have the powers to make local decisions on their behalf that they believed were invested in them because—again—such decisions are so often matters for an agency or a Government Department, at either regional or national level. As a result, councils find that they are being second guessed when it comes to their administrative responsibilities.

Very often, things happen that are entirely contrary to the wishes and needs of local communities simply because someone who is unaccountable says so. Nobody appears able to change such decisions.

Bob Russell (Colchester) (LD): Both my hon. Friend and I were leaders of local councils before we came to this place. Does he agree that, after 12 years of a new Labour Government, local communities have less say over what goes on in their area than they did before 1997?

Mr. Heath: I am absolutely sure that that is true. I used to be the leader of a county council, and I can point to things in Somerset that are there because I agreed with council committees that they should be. Increasingly, however, the restrictions placed on local government mean that councils are no longer able to take such decisions. As I say, more and more decisions are being taken at a level that is not accountable to the man or woman in the street, and people have no way of connecting with those who make the decisions.

For example, my son is taking his driving test this afternoon. Whether he passes or fails remains to be seen, but just to take the test he is having to go to a town that is 30 miles and more than an hour distant from our home. That is because someone who is not accountable to local people or this House has decided to close the test centre nearer to our community in the interests of service efficiency. That is what suits the bureaucrats, and so local people have to make the longer journey that I have described.

The problem is not confined to the day of the test. Everyone who has taken a driving test will know that driving lessons have to be conducted in the streets where the test is to be held. Over recent weeks, my son has had to have three-or four-hour sessions with his driving instructor—at great expense, I might say, with some passion—of which two hours is spent getting to and from the town where the test is to be held. That is not what local people want, and it is not serving the local public.

The same problem arises with tax offices, which are being closed all across the country. The Bristol tax office is well over an hour’s travel from where I and my constituents live but we have to go there because the one in Frome, which used to be on the doorstep, is no longer open. What sort of service is that for local people with an inquiry about which they need to consult the tax man? Never mind about the inconvenience of travelling to the centre of a city, what about the environmental consequences? That cannot be in the interests of local people.

Mr. Horam: Will the hon. Gentleman give way?

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