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Nhs Reform

Volume 171: debated on Tuesday 1 May 1990

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4.

To ask the Secretary of State for Health what are the total estimated costs of the opting-out submissions made for the National Health Service hospitals; and if he will make a statement.

Applications for NHS trust status will not be invited until Parliament has given approval to the necessary legislation. We have made no estimate of the cost of preparing such applications.

Does the Secretary of Health accept that people will regard it as an outrage if a single pound is spent on opting-out submissions, particularly in areas such as Bradford, which has the highest infant mortality rate in the Yorkshire region. If the Minister is so confident about the opting-out process as the first step to towards privatisation, why does he not hold a ballot in Bradford and other areas? Why does he collaborate with serville administrators who are the enemy within the National Health Service led by the Minister as chief saboteur?

I have no doubt that the hon. Gentleman will try to get the public to feel a sense of outrage about almost anything that happens in the Health Service in Bradford, but I do not recognise his description of current events. I am pleased that he has turned his mind to the possible deficiencies and weaknesses in the standard of care provided in Bradford at the moment. I hope that he will give his support to all those local people in Bradford who want to address them and that he will support anybody in Bradford who thinks that being given more local control over how they tackle the problems might improve things.

Does my right hon. and learned Friend agree that none of the real benefits of self-governing trust status will materialise without a clear commitment for regional health authorities to produce speedy and workable plans for weighted capitation? Will he give them a clear message that there must be no room for backsliding or fudging because money travelling with the patient is the essence of those reforms?

We are committed to ensuring that money is placed in the hands of the districts according to the number of their population adjusted for the age and propensity to sickness of that population. We will have to phase in progress to that end to make sure that there is no disruption of the system. However, I can assure my hon. Friend that as from next year, districts such as his own will receive funds on the basis of what they are now spending on their service—which, not surprisingly, is the basis of the present allocation. I am pleased to hear that in Hertfordshire people are now considering how they could use that money to improve the service further. I am sure that GPs, patients and others will be thinking about how to use the funds allocated to them on the new basis.

Is the Secretary of State aware that in Leeds, West, where the community health council balloted the staff at the Leeds General infirmary on proposals for opting out, nine out of 10 voted against the proposals? Now that the proposals have been widened to include other hospitals and institutions in Leeds, West, and detailed plans have been put forward, will he assure me and the House that there will be a full ballot of staff and people in the area before those proposals are taken a step further?

If the staff are given a description of NHS trust status which makes their blood run cold and their hair stand on end, one tends to find that in a subsequent ballot nine out of 10 say that they are against it. Ballots of that kind remind me of "Beyond the Fringe", many years ago, in which one of those who took part said that when they balloted people on whether they wanted their wives and kiddies fried to a frizzle in a nuclear holocaust 90 per cent. said no, 5 per cent. said yes, and 5 per cent. did not know. Such ballots do not add to public understanding of our Health Service reforms.

Would it not be a helpful if the first task of the newly recruited public relations adviser to my right hon. and learned Friend the Secretary of State were to take steps to persuade the general public and, apparently, some Members of Parliament that the term "opting out" is a misnomer and that in no circumstances will hospitals which choose to take part, be operating outside the National Health Service?

I do not have a public relations adviser and I do not intend to have one. [HON. MEMBERS: "Why not?"] I shall continue to tackle the problem of explaining the NHS reforms to the public myself. The difficulty, which is not encountered in the commercial world is that the public are constantly being given counter-explanations by those who make sensational statements about opting out and what it might mean. When we come to the reality and people can look at local plans put forward by local doctors, nurses and managers, we can have a sensible debate about what NHS trust status might do to improve the Health Service in many areas, including possilbly Bradford and Leeds.