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Royal Colleges Of Medicine

Volume 171: debated on Tuesday 1 May 1990

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To ask the Secretary of State for Health when he last met representatives of the royal colleges of medicine; and what matters were discussed.

On 4 April, I met representatives of the medical royal colleges along with representatives from the dental, midwifery and nursing royal colleges to discuss ways of safeguarding and securing improvements in clinical standards for National Health Service patients after the introduction of our NHS reforms in April next year.

Does my right hon. and learned Friend recall that he dug the first turf at the new general hospital in Bury a few years ago, thereby demonstrating his and the Government's commitment to high quality and good service in the NHS? When does he think that the royal colleges will finally realise that that same determination for quality and service runs through the health reforms that my right hon. and learned Friend is pursuing? When does he think that they will finally welcome some of the quality initiatives that we have taken instead of being so keen to criticise?

I well remember turning the first sod in my hon. Friend's constituency and I still have the spade in my study to remind me of that happy event. I am delighted that that new hospital is now operational.

With regard to quality, I accept that the royal colleges still have some concerns about the impact on clinical standards although I do not believe that those concerns are well founded. For that reason, I have been having a dialogue with all the royal colleges and I want them to make a positive contribution by helping to monitor clinical standards in the improved NHS in the 1990s. I detect a preparedness on the part of the royal colleges to contemplate that and a willingness to reach agreement if we can.

As the royal colleges have expressed some concern about opting out, should not they be told by the Secretary of State that a referendum was organised in my borough by the local council with questions that were approved by the local health authority and that more than 78 per cent. said that they were against opting out? If there were referendums in other parts of the country, is not it clear that the results would be the same? That is why the Secretary of State is so hostile to balloting and why he is so fearful of people being able to express their views. All the public relations advisors in the world will not be able to sell that idea to the British public.

The Labour party is quite bereft of any contribution to the debate on National Health Service reforms. Labour prefers to publicise ill-founded fears about what might occur and then carry out ballots afterwards like a lot of demented amateur Gallup pollsters. That is not a sensible approach to NHS reforms.

How does my right hon. and learned Friend equate his remarks in respect of the National Health Service and Community Care Bill with remarks made yesterday by my hon. Friend the Under-Secretary of State for Health to people from MIND when he said that hundreds of mentally ill patients have been dumped on the streets and that he is determined to give those people a new deal? Will my right hon. and learned Friend the Secretary of State tell us how the Government are going to give a new deal to those hundreds of mentally ill people who have been dumped on the streets because of a lack of places in appropriate hospitals?

My hon. Friend the Under-Secretary of State for Health used slightly different language and a slightly more analytical approach to a serious problem about which I know my hon. Friend the Member for Macclesfield (Mr. Winterton) feels strongly. As my hon. Friend the Under-Secretary said yesterday, he has put a great deal of work into preparing an initiative on that subject because we all know that mentally ill patients have fallen through the net and become homeless in London. When my hon. Friend the Under-Secretary is ready with the details, he will announce what I believe will be an extremely valuable new initiative to tackle that serious problem.

I congratulate the Secretary of State on having achieved unity among the royal colleges for the first time in the 40-year history of the NHS. Did he see their joint statement in the week he met them in which they concluded that there was no evidence that his changes will improve the standard of care, access to care, choice of care or even the cost-effectiveness of care? Why do Ministers persist in thinking that more than 20 colleges have got it wrong and that only they have got it right?

The hon. Gentleman should stop taking questions from my Parliamentary Private Secretary and answering them. The hon. Gentleman knows perfectly well that the royal colleges support the vast bulk of what we are doing, including the introduction of the resource management initiative and the introduction of clinical audit, in which the royal colleges are playing a leading role. I have already recognised that they still have some concerns about the consequences of the reforms, but at my meeting it was clear that the royal colleges wish to reach agreement with the Government on how standards can be monitored and supervised after we introduce the reforms next year.